How to Become a Family Nurse Practitioner: The Complete Guide

Two FNP students examining a female patient
Two FNP students examining a female patient

Learn more about Marymount's online family nurse practitioner program.

Few career paths have grown as exponentially in recent decades as family nurse practitioners (FNPs). This rapidly increasing health care field provides nurses with high salaries and strong job security with only 1.2% unemployment. With our aging population, the Bureau of Labor Statistics predicts a steep 26% employment rise for FNPs in the coming years.

Many nurses and nursing students may have questions about how to become a family nurse practitioner. In this overview, you’ll discover everything from what a family nurse practitioner does to what an FNP earns. You’ll also find a summary of relevant state laws and discover the exact steps you need to follow in order to become an FNP.


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What Is a Family Nurse Practitioner?

A nurse practitioner is a registered nurse who has gotten a master’s of science in nursing, followed by an FNP certification. This extra preparation gives nurse practitioners broad knowledge to perform exams, order lab work and prescriptions,diagnose common primary care and medical problems, and authorize treatments. A nurse practitioner is a licensed nursing professional with responsibilities for treatment and diagnosis beyond the level of a registered nurse. 

A family nurse practitioner (FNP) is a nurse practitioner who delivers health care across a wide range of age demographics. FNP practice covers infants to adolescents, young adults to seniors—similar to family physicians. There are many specialty certifications for nurse practitioners, but FNPs are the largest group accounting for 65.4% of nurse practitioner certifications.

History of the Family Nurse Practitioner Role

In 1965, the Medicare Act created a new surge of older and low-income patients seeking health care. This greater patient demand resulted in lower physician availability, and nurses stepped in to fill the gap. That same year the nurse practitioner role was born.

The first nurse practitioner curriculum launched at the University of Colorado as a certificate program to bring primary care to children. Though it began as a certificate program, it would become a master’s program by the 1970s. The focus expanded from pediatrics to families, adults, gerontology, women’s health, and other specialties.

By 1973, more than 65 nurse practitioner programs were available in the United States; by 1980, that number had swelled to 200. That same year, the Nurse Practitioner Association for Continuing Education (NPACE) was established. In 1985, the American Association of Nurse Practitioners (AANP) formed.

The nurse practitioner profession has escalated steadily both in available programs and in numbers of nurse practitioners. Today, more than five decades later, 290,000 nurse practitioners practice in the U.S.

As one scholarly journal noted, “the rapid growth of NPs since the initial certificate program has been astounding.” The AANP predicts that the aging population and the number of people living with chronic disease will continue to drive the demand for nurse practitioners.

What Does a Family Nurse Practitioner Do?

For those wondering how to become a family nurse practitioner, a natural question is what an FNP does. A family nurse practitioner provides care for patients of all ages, from babies and adolescents to young adults and seniors. An FNP is equipped to serve patients across their lifespan.

FNP care may include performing exams, diagnosing and treating illness, ordering lab work and tests, and prescribing medication. A family nurse practitioner also delivers health education to patients.

An FNP may work in independent practice if their state permits. Or FNPs frequently work with a team of specialists to provide preventive and diagnostic care.

The FNP Role: Duties & Responsibilities

Family nurse practitioner duties and responsibilities go beyond monitoring patients to managing patient care. A nurse practitioner’s responsibilities may comprise developing treatment plans that include:

  • Creating or contributing to patient care plans
  • Offering health education
  • Recommending lifestyle changes to promote health
  • Performing physical exams
  • Evaluating and interpreting findings
  • Prescribing medication
  • Ordering lab and diagnostic tests
  • Writing admission, transfer, and discharge orders
  • Referring for consultation

With appropriate training, an FNP may perform such complex procedures as bone marrow biopsies, lumbar puncture, fine needle aspiration, and suturing. FNPs must also be able to interpret and communicate clinical data effectively.

Depending on their role, FNPs may also serve as preceptors in postgraduate programs or conduct research and counsel patients.

Family Nurse Practitioner Skills

The family nurse practitioner role is significant in health care and requires robust skills. The AANP, AACN, and the National Organization of Nurse Practitioner Faculties have identified core skills necessary for all FNPs. Some essential non-clinical FNP skills include:

  • Critical thinking
  • Compassion
  • Leadership
  • Technological literacy
  • Policy understanding
  • A strong scientific foundation
  • Collaborative skills for working in teams
  • Communication skills
  • Proficiency in managing health care delivery systems
  • Expertise in health care practices
  • Aptitude in the practitioner-patient relationships
  • Competence in clinical and independent practices
  • Strong core ethics

Nurse practitioners should also be detail-oriented and cope well with occasional stress.

Becoming a Family Nurse Practitioner: Step-By-Step

The process of how to become a family nurse practitioner may seem obscure, but it entails several simple but essential steps. Someone wishing to become a nurse practitioner must:

  1. Obtain a license as an RN in their state. Candidates must apply to their state licensing agency to take their licensing exam. All 50 states have the same standard for passing the licensing exam.
  2. Achieve their Bachelor of Science in Nursing (BSN) degree. Completing a registered nursing program can take two to four years. During this time, a student will learn about disease prevention and physical examination.
  3. Achieve a Master of Science in Nursing (MSN) in an accredited program with a focus preparing graduates for national certification as family nurse practitioners. Gaining an MSN will involve both classroom education and clinical hours working with patients.
  4. Pass a national certification exam. Common certifications for nurse practitioners include the American Nurses Credentialing Center (ANCC) certification and the American Academy of Nurse Practitioners (AANP) certification.
  5. Finally, when certification is achieved, candidates must apply for their FNP license in their state, the final step in how to become a family nurse practitioner.

Many, but not all, graduate programs require experience as a registered nurse for one or two years prior to enrollment.

How Long Does It Take to Become a Family Nurse Practitioner?

The length of time it takes to become an FNP depends on whether or not you already have your RN license or BSN degree. Here is the time involved in each step:

  • Completing a Bachelor of Science in Nursing degree and getting your RN license can take 2 to 4 years.
  • Once you have your BSN and RN, obtaining your master’s degree (MSN) through an MSN-FNP program can take 2 to 3 years.
  • FNP exams are given on a rolling basis.

The general time range is six to eight years to complete all degrees and certifications.

Coursework for FNP Programs

Coursework in an accredited FNP program will equip you to provide sound family health care. It will also prepare you for the national certification exam you must take. A combination of classroom experience, laboratory experience, and clinical experience are all part of becoming a family nurse practitioner.

Coursework commonly covers:

  • Pathophysiology
  • Pharmacology
  • Health care analysis
  • Leadership and ethics
  • Population health
  •  Primary health care
  • Models of delivering care
  • Physical health assessment and diagnostics
  • Health care policy

Marymount’s Master of Science in Nursing Family Nurse Practitioner coursework covers each of these areas in-depth. The coursework, which focuses on the intellectual, ethical and spiritual development of the student, is framed within the American Association of Colleges of Nursing’s Essential of Master’s Education in Nursing and the National Organization of Nurse Practitioner Faculties' Criteria for Evaluation of Nurse Practitioner Programs.

Family Nurse Practitioner Clinicals

Clinicals are indispensable, real-time training in how to become a family nurse practitioner. They enable you to use your classroom knowledge in a clinical setting by working directly with patients at a health care site. Generally, students will experience about 500-700 clinical hours on the path to their FNP, equipping them for real-life, advanced practice nursing.

FNP Preceptors

As you transition into your FNP role, an experienced clinical preceptor will serve as a mentor to help you during your clinicals. Your preceptor may be a nurse practitioner, a physician’s assistant, or a physician.

At Marymount, the FNP program team works with students to ensure robust clinical placement and a strong preceptor.

Family Nurse Practitioner Certification & Licensure

Before you can become licensed as an FNP, most states require you first get your FNP certification. Certification follows your master’s degree and culminates your rigorous preparation and training. As AANP notes, “Certification formally recognizes all you’ve learned along your journey to become an NP.”

Two nationally recognized certifications are AANP certification and ANCC certification.

AANP Certification

The American Association of Nurse Practitioners Certification Board awards this AANP certification. The AANP is multiple-choice, competency-based, and has 150 exam questions over 3 hours.

They offer a range of nurse practitioner certifications, including the Family Nurse Practitioner Certification (FNP). The FNP certification tests clinical knowledge in family and individual care and is valid for 5 years before renewal

ANCC Certification

The American Nurses Credential Center offers numerous nurse practitioner certifications, including the Family Nurse Practitioner Certification (FNP-BC). The ANCC exam offers 175 questions over 3.5 hours and includes healthcare policy and theory questions. The FNP-BC also tests clinical knowledge in family and individual care and is valid for 5 years before renewal.

At Marymount, 100% of 2019 graduates passed their certification exam on their first attempt.

Once you have your certification, you may apply for your license—the final step in how to become a family nurse practitioner. Each state has individual licensing requirements.

Where Do Family Nurse Practitioners Work?

Nurse practitioners have a range of possible work environments, depending on their focus of practice. About 73% of nurse practitioners deliver primary care, and approximately 24% work in private practice. But they also practice in:

  • Private and public general medical and surgical hospitals
  • Specialty hospitals
  • Outpatient care centers
  • Private and public colleges, universities, and public schools
  • Offices of other health practitioners
  • Community housing and emergency relief services

Family Nurse Practitioner Work Hours

FNP hours vary with their work environment. When working in a family practice office, FNPs usually work normal business hours with the office. Hospitals and 24-hour clinics may require shifts, including working nights, holidays, or weekends.

FNPs average seeing 18 patients a day.

Family Nurse Practitioner Salary: How Much Do FNPs Earn?

According to the U.S. Bureau of Labor Statistics (BLS), FNPs’ median pay in 2019 was $109,820 per year. Contrast that with the median salary for registered nurses, which was $73,300.

FNP salaries tend to vary based on the region and practice setting. The range varies from $81,410 in the lowest 10th percentile to $152,160 in the 90th percentile.

Family Nurse Practitioner Job Outlook

As the demand for primary and family practice care increases, so will the need for nurse practitioners. The Association of American Medical Colleges predicts a shortage of nearly 122,000 physicians in the next 12 years. Further, BLS notes that nurse practitioners can do many of the duties of physicians and thus may help reduce healthcare costs.

BLS predicts the demand for nurse practitioners will grow 26% over a decade. “About 16,900 job openings for nurse practitioners  . . . are projected each year, on average.” In concrete numbers, that translates to 189,100 nurse practitioners who were employed in the U.S. in 2018 and 242,400 needed by 2028.

In 1996, seven nurse practitioners worked at the National Institutes of Health, the largest biomedical research agency in the world. Currently, over 100 do.

Family Nurse Practitioner Job Satisfaction

Few jobs promise greater opportunities and satisfaction than that of a nurse practitioner. U.S. News & World Report places nurse practitioners in the top five jobs in the U.S., ranked on such elements as 10-year growth and salary. The profession earned this ranking thanks to:

  • A high median salary
  • A low unemployment rate (1.2%)
  • The high 10-year growth volume

It also ranked #4 among best healthcare jobs and #5 among best STEM jobs. Due to family care’s popularity, 65.4% of nurse practitioners train in the area of family care.

Family Nurse Practitioner Scope of Practice

The scope of practice indicates the services that a health professional is allowed to perform based on their certification. Family nurse practitioners provide an expansive scope of practice to families across the span of their lives.

State Practice Environment for FNPs

Each state has individual laws regarding their scope of practice for family nurse practitioners. These laws are divided roughly into three groups:

  • Full practice authority – These states allow all FNPs to evaluate patients, prescribe medication, and manage treatment.
  • Reduced practice authority – These states limit at least one element of FNP practice. This means the state requires a transition time to independent practice or prescribing authority.
  • Restricted practice authority – These states restrict at least one element of FNP practice. This means the state requires the FNP to maintain a working physician relationship.

The following states grant full practice authority to FNPs:

  • Alaska
  • Arizona
  • Colorado
  • Connecticut
  • Hawaii
  • Idaho
  • Iowa
  • Maine
  • Maryland
  • Minnesota
  • Montana
  • Nebraska
  • Nevada
  • New Hampshire
  • New Mexico
  • North Dakota
  • Oregon
  • Rhode Island
  • South Dakota
  • Vermont
  • Washington (state)
  • Washington, D.C.
  • Wyoming

The following states grant reduced practice authority to FNPs:

  • Alabama
  • Arkansas
  • Delaware
  • Illinois
  • Indiana
  • Kansas
  • Kentucky
  • Louisiana
  • Mississippi
  • New Jersey
  • New York
  • Ohio
  • Pennsylvania
  • Utah
  • West Virginia
  • Wisconsin

The following states grant restricted practice authority to FNPs:

  • California
  • Florida
  • Georgia
  • Massachusetts
  • Michigan
  • Missouri
  • North Carolina
  • Oklahoma
  • South Carolina
  • Tennessee
  • Texas
  • Virginia

Organizations such as the Institute of Medicine advocate for FNPs to practice “to the full extent of their education and training” to meet the demand for care. Learn more about the specific laws in your state.

Can Family Nurse Practitioners Prescribe Medication?

Yes, nurse practitioners “hold prescriptive privileges, including controlled substances, in all 50 states and D.C.” Additionally “95.7% of NPs prescribe medications, and those in full-time practice write an average of 20 prescriptions per day.” The scope of their prescriptive authority varies, however, depending on the state.

  • Some states imbue FNPs with full prescriptive authority, able to prescribe without physician oversight.
  • Others require that an FNP complete a certain number of hours with a physician before they transition to prescribing medication independently.
  • Finally, some states require the FNP to maintain a relationship with a physician to prescribe medicine.

Family Nurse Practitioner vs Registered Nurse: What’s the Difference?

While family nurse practitioners and registered nurses both provide dedicated care for patients, there are several key differences:

Family Nurse Practitioner vs Physician: What’s the Difference?

Nurse practitioners and doctors’ roles overlap in several areas—they each diagnose illness, prescribe medicine, and make patient treatment plans. But key differences exist:

  • An FNP holds a master’s at a minimum, while a doctor must complete medical school and a residency.
  • An FNP has 6 to 8 years of postsecondary education, while a doctor has an average of 11.
  • An FNP’s ability to prescribe medicine and diagnose illness independently varies by state. Doctors can prescribe independently in all 50 states.
  • An FNP’s median salary is $109,820, while a doctor’s mean annual wage is $203,880.
  • Both professions’ growth outpaces the national average for all jobs. But the 26% projected rate of growth for FNPs overtakes the 7% growth rate for doctors.

Family Nurse Practitioner vs Physician’s Assistant: What’s the Difference?

Family nurse practitioners and physician’s assistants are both non-physician roles that are growing quickly in medicine. Here are some basic similarities and differences:

Family Nurse Practitioner Organizations

Many national and regional organizations support nurse practitioners in their work. Some keep their members informed of upcoming changes or potential changes in the field while others advocate for reform. You may be able to attend meetings or conferences they sponsor for networking and career growth. Among these are:

See here for a list of regional nurse practitioner associations around the U.S.

Why Become a Family Nurse Practitioner?

Every nurse has a different reason for considering why and how to become a family nurse practitioner. The field of family nurse practitioners offers rapid job growth with almost 17,000 jobs added each year. It also offers strong monetary compensation, with average six-figure salaries.

Beyond financial security, FNPs can know they are filling a critical need for patients in health care. They want to serve others to improve the health of diverse populations globally. In 2019, more than 89% of NPs went into primary care programs, while only 7% of physicians entered a primary care residency.

NPs provide more than “290,000 solutions to the primary care shortage facing Americans today.” As AANP notes, nurse practitioners are “more than just health care providers; they are mentors and educators.” FNP students can know they are not only investing in their careers but providing care where it may otherwise be limited.

FNP students in a clinical setting learning how to become a family nurse practitioner

Your Next Step in Becoming a Family Nurse Practitioner

Are you ready for the next step in learning how to become a family nurse practitioner? There has never been a better time.

Marymount’s FNP programs are CCNE accredited, and 100% of 2019 Marymount graduates passed their certification exam on their first attempt. The program also takes the stress out of finding clinical placement, matching candidates with high-quality experiences.

Marymount students are guided by Catholic traditions, focused on intellectual curiosity, service to others and a global perspective.

Join the growing body of professional nurses making a difference with an online MSN-FNP degree from Marymount University.


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