Nurse practitioners work in a variety of settings, including:
Some nurse practitioners work in clinics without doctor supervision. Others work together with doctors as a joint health care team. Their scope of practice and authority depends on state laws.
Like many other professions, nurse practitioners are regulated at two different levels. They are licensed through a process that takes place at the state level under state laws. They are also certified through national organizations, with consistent professional practice standards across all states.
The laws on NP licensure vary greatly from state to state. Today, more states are requiring NPs to have a master's degree and national certification.
In some states, NP practice is completely independent. Other states require that NPs work with an MD for prescriptive practice privileges or to get licensed.
National certification is offered through various nursing organizations (such as the American Nurses' Association, Pediatric Nursing Certification Board, and others). Most of these organizations require that NPs complete an approved master's-level NP program before taking the certification exam. The exams tend to be offered in specialty areas, such as:
To be recertified, NPs need to show proof of continuing education. Only certified nurse practitioners may use a "C" either in front of or behind their other credentials (e.g., Certified Pediatric Nurse Practitioner, FNP-C, Certified Family Nurse Practitioner). Some nurse practitioners may use the credential ARNP, which means advanced registered nurse practitioner. This is a broader category that includes clinical nurse specialists, certified nurse midwives, and nurse anesthetists.
Linda J. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.