Family Nurse Practitioner

What is a Family Nurse Practitioner (FNP)?

A Family Nurse Practitioner is an essential member of the healthcare team. The FNP is a highly educated Registered Nurse (RN) who, in most cases, has received a graduate degree (Master of Science in Nursing) or higher (Doctorate of Nursing Practice or Doctor of Philosophy).  FNPs of the past were grandfathered in with a Bachelor of Science in Nursing.  

The FNP conduct health assessments, educate clients, diagnose illnesses, order diagnostic tests, and prescribe medications and durable medical equipment. However, the Family Nurse Practitioner focuses on more than just the clinical illness. FNPs have a unique perspective in which they focus on preventative care in addition to diagnosing and treating disease.  They focus on maintaining health and well-being in their patient population.  

The Family Nurse Practitioner functions as an integral member of a busy health system.  FNPs collaborate closely with a team of physicians, specialists, nurses, and ancillary staff. Depending on the rules and regulations of the state, the FNP may work under the supervision of a physician, collaborate closely with their overseeing doctor, or have complete independence. 

Why do we need a Family Nurse Practitioner?

There is an existing shortage of primary care physicians and it is continuing to grow. By 2025, there will be an anticipated deficit of between 15,000 and 35,600 primary care doctors.  This shortage will continue to grow.  As the average age of the US population increases, so does the need for medical care. However, the average age of the physician workforce is also rising.  This means that more than one-third of physicians are over 55 years old.  Many primary care physicians have also closed up shop due to retirement. 

Since Family Nurse Practitioners can provide primary care to all ages across the lifespan, they are an excellent choice to fill the gap for primary care physicians.  Many FNPs focus on primary care, but they also have the option to specialize in a multitude of health care fields.  These subspecialties include women's health and cardiology Nurse Practitioner. With FNPs growing in ranks, more Americans than ever can now access quality health care.

What does a family nurse practitioner do? 

The job description differs based on the position that the FNP has chosen and on the state in which the FNP is licensed.  In general, Family Nurse Practitioners provide healthcare to patients of all ages and for a variety of medical conditions ranging from mild ailments to serious illnesses.  A Family Nurse Practitioner must be skilled in the essential diagnostic for varied populations, as well as able to educate and empower patients.  

Job Description

FNPs focus on minimizing stress, maximizing wellness, and encouraging healthy lifestyle changes.  However, they have the clinical expertise to diagnose medical conditions and prescribe medications.  FNPs are trusted to collaborate with other members of the healthcare team, communicate clearly, use critical clinical judgment, and provide precise, compassionate care.

FNPs perform complete medical histories and examinations, develop care plans, diagnose medical conditions, order appropriate diagnostic tests, prescribe medications, and make referrals to specialists and physicians as appropriate.  Along with their traditional path in acute and long-term care facilities, FNPs also work in education with both medical and nursing students.

As a primary care provider, FNPs act as the primary point of contact for patients, maintain patient records and oversee total patient care.  In some cases, they perform or assist with minor procedures and occasionally can first assist in surgery.  FNPs can also act as a medical home, which means that they act as the comprehensive "home" for primary care for patients.

Family Nurse Practitioners are licensed, independent practitioners who are graduate-educated and nationally certified.  They are Advanced Practice Registered Nurses (APRNs) who care for patients of all ages throughout the lifespan (from infants to the geriatric population). FNPs assess, diagnose, treat, prescribe, and manage health conditions.  They practice in institutions of higher learning, ambulatory care, acute care, and long-term care settings.  

The role of all Nurse Practitioners is based upon caring for their population specialty of choice.  In the case of Family Nurse Practitioners, "family" is their chosen population.  Family Nurse Practitioners provide health care services to individuals, families, groups, and communities.  They can care for all ages from infancy to teenagers to adults to the elderly.

FNPs take a national certification exam that is specific to their broad scope of practice. If the Family Nurse Practitioner is able to pass this exam, it signifies that the FNP has achieved the specialized skills and education needed to clinically practice. Two certifying bodies that provide the exam: the American Nurses Credentialing Center (AACN) and the American Academy of Nurse Practitioners National Certification Board (AANPCB).

Scope of Practice

The Scope of Practice for a Family Nurse Practitioner is tremendously dependent on the state that you are licensed.  NPs can practice both autonomously and in conjunction with physicians and other healthcare professionals.  Some states allow FNPs to practice completely independent and some require complete physician oversight.

How much does a Family Nurse Practitioner Make?

A Family Nurse Practitioner must possess growth in clinical development and increased risk for liability.  This surge in skills and responsibility involves fair compensation. Thankfully, the outlook is perfect for future FNPs.  

According to the Bureau of Labor Statistics (2017), the market for Nurse Practitioners will grow by 36%, surpassing average job growth for many other professions.  The need for FNPs will continue to rise as the population ages.  Choosing a career as an FNP will provide job security with a positive job outlook and attractive pay.

The average national salary for a Family Nurse Practitioner is $120,955 annually according to Glassdoor.  The average pay range for FNPs across the United States is between $117,000 to $137,000.  

The Bureau of Labor Statistics (2017) estimates that 166,280 Nurse Practitioners are employed.  FNPs are employed in offices of physicians or other healthcare practitioners, hospitals, outpatient care centers, and colleges, universities, and professional schools.

Family Nurse Practitioner Certification

In order to become a Family Nurse Practitioner, you must first earn a Bachelor's of Science Degree in Nursing (BSN) from an accredited college or university.  Next, you must take and pass the NCLEX-RN and become a licensed RN.  You will enter into a Master of Science of Nursing(MSN) program specifically for Family Nurse Practitioners.  Most programs require RN experience prior to admission.  

The certification program is a way to ensure that the board-certified FNPs uphold the minimal professional standards that the certifying board requires. National certification is given by one of two certifying bodies.

The first is the American Academy of Nurse Practitioners National Certification Board (AANPCB).  The AANPCB is separate from the American Academy of Nurse Practitioners (AANP) and was established in the 1990s to trademark the credential of Nurse Practitioner- Certified (NP-C).  The Accreditation Board of Specialty Nursing Certification (ABSNC) accredits the AANPCB’s FNP certification.

The second agency is the American Nurses Credentialing Center (ANCC).  The ANCC provides the Family Nurse Practitioner Certification (FNP-BC).

The National Certification Exam

Certification occurs from one of two national certification exams that signify that the Family Nurse Practitioner attained the specialized skills and education necessary for professional clinical practice. Passing this exam signifies that the FNP has achieved the specialized skills and education needed to clinically practice.  After you take the FNP exam, you will find out immediately if you have passed or failed.

According to 2015 passing rates, the average pass rate was 75% for the ANCC FNP exam and 81.4% for the AANP FNP exam. If you fail the ANCC FNP exam, you can attempt to retake after 60 days of the last testing date.  However, you can only take the ANCC exam three times in a 12-month period.  If you fail the AANPCB FNP exam, you must complete 15 hours of continuing education in the areas of weakness identified in the score report.  

After passing the certification exam, you will have to apply to the applicable medical or nursing board to be licensed in your state.  If you plan to practice in more than one state, you must apply for licensure separately.  FNPs scope of practice and autonomy is based on each state's rules and regulations.