How to Become a Family Nurse Practitioner: The Complete Guide

Two FNPs examine a patient’s ear using an otoscope.
Two FNPs examine a patient’s ear using an otoscope.

Updated on March 29, 2023.

Few career paths have grown as exponentially in recent decades as family nurse practitioners (FNPs). This rapidly increasing health care field provides advanced practice registered nurses (APRNs) with high salaries and strong job security. With our aging population, the U.S. Bureau of Labor Statistics (BLS) predicts a steep 40% employment rise for nurse anesthetists, nurse midwives and nurse practitioners within the ten-year period between 2021 and 2031. Family nurse practitioners make up 70.3% of nurse practitioners in the U.S., which means they should experience significant growth during this period. 

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 to become an FNP, including earning an advanced degree.

 

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Few career paths have grown as exponentially in recent decades as family nurse practitioners (FNPs). This rapidly increasing health care field provides advanced practice registered nurses (APRNs) with high salaries and strong job security. With our aging population, the U.S. Bureau of Labor Statistics (BLS) predicts a steep 40% employment rise for nurse anesthetists, nurse midwives and nurse practitioners within the ten-year period between 2021 and 2031. Family nurse practitioners make up 70.3% of nurse practitioners in the U.S., which means they should experience significant growth during this period. 

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 to become an FNP, including earning an advanced degree.

 

What Is a Family Nurse Practitioner?

A family nurse practitioner is an advanced practice registered nurse who has a Master of Science in Nursing (MSN) or a Doctor of Nursing Practice (DNP) and FNP certification. Family nurse practitioners deliver health care across a wide range of age demographics. FNP practice covers patients of all ages, including infants, adolescents, young adults, adults and seniors — similar to family physicians. There are many specialty certifications for nurse practitioners, but the FNP certification is among the most popular.

 

How to Become a Family Nurse Practitioner: 5 Steps

The process of how to become a family nurse practitioner involves several simple but essential steps. Someone wishing to become a nurse practitioner must:

 

Step 1: Become a Licensed RN

Aspiring FNPs must start by obtaining a license as an RN in their state. Candidates must earn at minimum an Associate Degree in Nursing and apply to their state licensing agency to take their licensing exam. 

 

Step 2: Complete a BSN Degree

The second step toward becoming an FNP is to earn a Bachelor of Science in Nursing (BSN) degree. Completing a registered nursing program can take two to four years. During this time, students learn about disease prevention and physical examination.

 

Step 3: Complete an Advanced Nursing Degree

The next step toward becoming an FNP is to complete an advanced nursing degree, such as a Master of Science in Nursing (MSN) or Doctor of Nursing Practice (DNP) with a focus on preparing graduates for national certification as family nurse practitioners. 

 

BSN-Prepared Nurses Can Earn an MSN and FNP Certification in Tandem

Coursework in an accredited MSN-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 University’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 Essentials of Master’s Education in Nursing and the National Organization of Nurse Practitioner Faculties' Criteria for Evaluation of Nurse Practitioner Programs.

An alternative path for RNs with a BSN wishing to become an FNP involves completing a doctor of nursing practice (DNP) degree. Programs designed for this group incorporate master’s-level work in the doctoral program, streamlining the educational experience.

 

BSN-Prepared Nurses May Also Consider a DNP Degree

If you are a licensed RN with a BSN degree, you may consider becoming a family nurse practitioner with a doctor of nursing practice (DNP) degree. The DNP is one of two terminal degrees in nursing, the other being a PhD in nursing. The PhD programs tend to focus on advanced research in nursing, as well as academics. The DNP was established as a practice-oriented doctorate, building on the master’s-level education in evidence-based practice, quality measures and systems leadership.

At Marymount University, you can enroll in a DNP-FNP program that incorporates master’s-level and doctoral coursework in a single educational experience.

Another consideration is the continued push for advancing the education of nurses in every role. The National Organization of Nurse Practitioner Faculties (NONPF) is advocating for the DNP to be the minimum degree requirement for nurse practitioners by 2025. 

 

Nurses With an MSN Can Opt for a Post-Master’s Certificate

If you have completed an MSN with a specialty other than family care and you would like to expand your practice population, you can enroll in a post-master’s FNP certificate program that will give you the education you need to be certified as an FNP. Coursework and clinical hours will prepare you to deliver primary care to patients across the lifespan, with the knowledge to treat acute and chronic illnesses. 

An online FNP certificate program from Marymount University is flexible enough that you can continue to work and study part time and finish in 20 months.

 

Step 4: Get Certified

Upon completion of an advanced nursing degree from an accredited program, future FNPs must also 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.

 

Step 5: Apply for Licensure

Last, when certification is achieved, candidates must apply for their FNP license in their state, the final step to becoming a family nurse practitioner. Upon completing this step, professionals are eligible to work as an FNP and earn a family nurse practitioner salary.

 

History of the Family Nurse Practitioner Role

In 1965, the Medicare Act created a 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 was 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, neonatology and other specialties.

By 1973, more than 65 nurse practitioner programs were operating 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) was formed.

The nurse practitioner profession has escalated steadily both in available programs and in the number of nurse practitioners. Today, more than five decades later, 355,000 nurse practitioners practice in the U.S. 

 

What Does a Family Nurse Practitioner Do?

For those wondering how to become a family nurse practitioner, it makes sense to also wonder 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 lifespans.

FNP care may include performing exams, diagnosing and treating illness, ordering lab work and tests and prescribing medication, depending on their state’s practice environment. They also deliver health education to patients.

 

The FNP Role: Duties and 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 and patient counseling
  • 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 the appropriate educational background, 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.

FNPs may serve as preceptors in postgraduate programs, helping to guide the education of nurse practitioner candidates, or they may conduct research on topics of particular interest, such as working conditions for nurses or the implementation of health policies that affect whole communities.

 

Family Nurse Practitioner Skills

The family nurse practitioner role is significant in health care and requires robust skills. The AANP, the AACN and the National Organization of Nurse Practitioner Faculties have identified core skills necessary for all FNPs. Some essential nonclinical 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 relationship
  • Competence in clinical and independent practices
  • Strong core ethics

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

7 Reasons to Become an FNP Infographic

 

Why Become a Family Nurse Practitioner?

Every nurse has a different reason for considering how to become a family nurse practitioner. There are many benefits of being a family nurse practitioner — the field offers rapid job growth, with almost 32,000 jobs including telehealth roles expected to be added each year between 2021 and 2031. It also offers strong monetary compensation, as family nurse practitioner salary ranges are often in the six figures.

According to the AANP, 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 and improving patient outcomes.

 

How Long Does It Take to Become an FNP?

The length of time it takes to become an FNP depends on whether 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 two to four years.
  • Once you have your BSN and RN, obtaining your master’s degree (MSN) through an MSN-FNP program can take two to three years.
  • If you have a BSN and RN license and decide to pursue a DNP, the program will take a little over three years. 
  • If you have an MSN that is not focused on family practice, you can earn a post-master’s FNP certificate in 20 months.
  • FNP exams are given on a rolling basis.

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

 

Family Nurse Practitioner Clinicals

Clinicals are an indispensable part of the education of a family nurse practitioner. They enable you to apply 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 part of your clinical experience, you will be mentored and evaluated by an experienced clinical preceptor. 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 and Licensure

Before you can become licensed as an FNP, most states require you first to 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 becoming 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 and 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 is required.

 

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 health care policy and theory questions. The FNP-BC also tests clinical knowledge in family and individual care and is valid for five years before renewal.

Once you have your certification, you may apply to your state board of nursing for your license — the final step in becoming 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. An FNP may work in independent practice if their state permits. FNPs frequently work with a team of specialists to provide preventive and diagnostic care. The most common work environments for nurse practitioners include:

  • 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. Hospitals and 24-hour clinics may require shifts, including working nights, holidays or weekends.

 

Family Nurse Practitioner Salary: How Much Do FNPs Earn?

According to the U.S. Bureau of Labor Statistics (BLS), the median annual family nurse practitioner salary in 2021 was $120,680 per year. Contrast that with the median salary for registered nurses, which was $77,600.

FNP salaries tend to vary based on the region and practice setting. According to 2021 data from the BLS, the range spans from a mean of $95,120 in Tennessee to $151,830 in California. 

 

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 the nationwide physician shortage is expected to last through at least 2034, if not longer.

Consequently, demand for nurse practitioners is expected to remain strong for the foreseeable future. Nurse practitioners are expected to see a 46% job growth between 2021 and 2031, according to the BLS.

 

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 as the No. 1 job in health care and No. 2 in the Top 100 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 (0.4%)
  • The high 10-year growth volume

Nurse practitioner is also ranked #2 among the best STEM jobs.

 

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. This is one of the benefits of becoming a family nurse practitioner, and many NPs enjoy the role and the independence and autonomy they have to make care decisions for their patients.

 

Can Family Nurse Practitioners Prescribe Medication?

Yes, the AANP reports that nurse practitioners hold prescriptive privileges in all 50 states and the District of Columbia. However, the scope of their prescriptive authority varies depending on the state.

  • 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 have physician supervision when they prescribe medication over the entire course of their career.

 

State Practice Environment for FNPs

Each state has individual laws regarding the scope of practice for family nurse practitioners. The following states, territories and the federal district grant full practice authority to FNPs:

  • Alaska
  • Arizona
  • Arkansas
  • California
  • Colorado
  • Connecticut
  • Delaware
  • Florida
  • Guam
  • Hawaii
  • Idaho
  • Illinois
  • Iowa
  • Kansas
  • Maine
  • Maryland
  • Massachusetts
  • Minnesota
  • Montana
  • Nebraska
  • Nevada
  • New Hampshire
  • New Mexico
  • New York
  • North Dakota
  • Northern Mariana Islands
  • Oregon
  • Rhode Island
  • South Dakota
  • Utah
  • Vermont
  • Virginia
  • Washington State
  • Wyoming

The following states and territories grant reduced practice authority to FNPs:

  • Alabama
  • American Samoa
  • Indiana
  • Kentucky
  • Louisiana
  • Mississippi
  • New Jersey
  • Ohio
  • Pennsylvania
  • Puerto Rico
  • U.S. Virgin Islands
  • West Virginia
  • Wisconsin

The following states grant restricted practice authority to FNPs:

  • Georgia
  • Michigan
  • Missouri
  • North Carolina
  • Oklahoma
  • South Carolina
  • Tennessee
  • Texas

Learn more about the specific laws in your state.

 

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:

  • A nurse practitioner has at least a master’s degree, while a registered nurse may hold an associate's or bachelor’s degree.
  • The benefits of becoming an FNP are numerous. For example, family nurse practitioners can prescribe medicine, create patient care plans and diagnose illness, depending on their state’s practice environment. FNPs also have far more autonomy than registered nurses.
  • FNPs are more likely to work in a university, community clinic or government agency.
  • Nurse practitioners enjoy a greater median salary at $120,680 than nurses do at $77,600.
  • Though both professions have a strong job outlook, the projected job growth for NPs (40%) outpaces that for registered nurses (6%).

 

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

The term nurse practitioner applies to one segment of advanced practice registered nurses, the other two being nurse-midwives and nurse anesthetists. Before completing their master’s program, nurse practitioners must select a patient population group and modality (primary care or acute care) for which they focus their education and certification. Here are the specialty areas for nurse practitioners:

  • Family 
  • Adult
  • Adult-Gerontology Acute Care
  • Adult-Gerontology Primary Care
  • Psychiatric/Mental Health
  • Acute Care
  • Pediatrics Acute Care
  • Pediatrics Primary Care
  • Women’s Health
  • Gerontology
  • Neonatal

The majority of nurse practitioners are certified as family nurse practitioners. That being said, nurse practitioners can seek certification in another specialty group once they have completed the required education and examination.

 

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.
  • Becoming a family nurse practitioner takes less time: an FNP has six to eight 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 states and territories.
  • An FNP’s median salary was $120,680 in 2021 according to the BLS, while a doctor’s mean annual wage was $208,000.
  • Both professions have a positive job growth rate, according to the BLS. But the 40% projected rate of growth for NPs far outpaces the 3% growth rate for doctors, which is slower than the average for all jobs.

 

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:

  • Both an FNP and a physician’s assistant (PA) require master’s level education.
  • PAs are required to work under the supervision of a physician. NPs may operate an independent practice in states that allow full practice authority.
  • The median pay is quite similar, at $120,680 for an FNP in 2021 according to the BLS, and $121,530 for a PA.

 

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.

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 University’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 a clinical placement by matching candidates with high-quality experiences.

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

Join the growing body of professional nurses making a difference with an online FNP degree from Marymount University. If you’re interested in becoming an FNP at Marymount, contact one of our admissions advisors to discuss which pathway is right for you.

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