At a basic level, family nurse practitioners (FNPs) are nurse practitioners (NPs) who specialize in providing primary care to families.
If you're interested in becoming an FNP, you could play an integral role in health care. As the name indicates, FNPs see patients of all ages and backgrounds. You’ll treat a range of chronic and acute conditions seen in infants, children, adults, and seniors.
Not only does the work promise to be varied, but also deeply meaningful, as you may forge relationships with patients throughout their lives.
Because of their diverse skills and clinical experience, FNPs (and NPs in general) are in high demand. There were more than 290,000 licensed NPs working in the U.S. at the end of 2019.
While jobs are forecasted to grow, it takes extensive study and preparation to become an FNP. Fundamental to this process is earning a graduate degree. A Master of Science in Nursing (MSN) is required for licensure as an advanced practice registered nurse (APRN), while a Doctor of Nursing Practice (DNP) could help you further advance your career and earning potential.
There are three main reasons to become a family nurse practitioner:
An increasing number of job opportunities: According to the U.S. Bureau of Labor Statistics (BLS), NP employment is projected to grow 52% between 2019 and 2029. Nearly three-quarters of NPs are certified in family practice, so FNPs should benefit from plentiful job opportunities.
A competitive salary: Nurse practitioners earned a median salary of $115,800 in May 2019. This level of compensation tracks closely with 2019 AANP research, which found the median base salary for a full-time NP was $110,000. Median total income, which is inclusive of bonuses, was $115,000.
A high degree of job satisfaction: As mentioned, FNPs get the chance to make deep connections with their patients, some of whom an FNP may see for decades.
Some other benefits of becoming an FNP include:
Diverse daily responsibilities
As an FNP, not only will the ages of your patients range, but so will your job responsibilities. On any given day, an FNP may:
- Conduct regular physical examinations
- Diagnose various acute and chronic conditions, including illness, disease, and injury
- Develop and implement patient-specific treatment plans
- Order, perform, and interpret diagnostic tests
- Prescribe medication and monitor patient responses to treatments
- Educate patients and families on wellness and disease prevention
- Collaborate with physicians and other health care professionals
Varied work settings
FNPs are employed in a wide number of settings. If you study to become an FNP, you'll be able to find jobs in:
- State, local, and private hospitals
- Regional health systems
- Offices of physicians and other health practitioners
- Educational services, including colleges and universities
- Outpatient centers and community clinics
- Independent practice
- On-the-job autonomy
Registered nurses need instructions from attending physicians before they can perform job duties. FNPs — because they are APRNs — can enjoy much greater on-the-job autonomy. You may benefit from full-practice authority depending on the state where you work.
As of 2020, these states and U.S. territories extend full-practice authority to FNPs: Alaska, Arizona, Colorado, Connecticut, District of Columbia, Guam, Hawaii, Idaho, Iowa, Maine, Maryland, Minnesota, Montana, Nebraska, Nevada, New Hampshire, New Mexico, North Dakota, Northern Mariana Islands, Oregon, Rhode Island, Vermont, Washington, and Wyoming.
Nursing shortage
America is experiencing a shortage of nurses as the population ages and health care demand increases. FNPs can help mitigate the impacts of this shortage by providing care to historically underserved areas like rural populations. If they have full-practice authority, FNPs can better connect rural patients with high-quality and accessible care.
Scope of practice
A related trend to the shortage is the continued push for modernization of APRN scope of practice laws. While some states and territories extend full practice to FNPs, the rest either reduce or restrict the scope of independent practice. However, there is an advocacy growing for empowering nurses. A report from UnitedHealth Group said that if all states extended full-practice authority to NPs:
- The number of U.S. residents living in a county with a primary care shortage would fall from more than 70%
- The number of rural residents living in a county with a primary care shortage would decline from 23 million to 8 million
Workplaces with the highest levels of employment for nurse practitioners are:
- Offices of physicians
- General medical and surgical hospitals
- Outpatient care centers
- Colleges, universities, and professional schools
- Offices of other health practitioners
You can find job postings for FNPs across the country. The metropolitan areas with the highest total level of NP employment in 2019 include:
- New York-Newark-Jersey City, (New York, New Jersey)
- Boston-Cambridge-Nashua, (Massachusetts, New Hampshire)
- Chicago-Naperville-Elgin, (Illinois)
- Philadelphia-Camden-Wilmington, (Pennsylvania, Maryland, Delaware)
- Atlanta-Sandy Springs-Roswell, (Georgia)
- Dallas-Fort Worth-Arlington, (Texas)
- Los Angeles-Long Beach-Anaheim, (California)
- Miami-Fort Lauderdale-West Palm Beach, (Florida)
- Houston-The Woodlands-Sugar Land, (Texas)
- Phoenix-Mesa-Scottsdale, (Arizona)
Remember, many job opportunities may exist in more rural areas. The nonmetropolitan areas with the highest level of NP employment include:
- Northeastern Ohio
- Northeastern Mississippi
- Kansas (excluding metro areas)
- South Georgia
- Central Kentucky
Entry-level opportunities
As mentioned previously, the median annual salary for an NP is just under $110,000. However, PayScale pegged the average 2020 entry-level salary for FNPs much lower at $90,641. Level of experience factors heavily into salary, and it can take years to become an FNP. Essentially, the steps include:
- Earning a Bachelor of Science in Nursing (BSN)
- Passing a national certification exam to become a registered nurse
- Earning an MSN
- Obtaining FNP certification from a national board of nursing
- Registering and becoming licensed in the state where you intend to work
Advanced job options
Once you have completed those steps, you may wish to earn a DNP. This is the terminal degree for practicing nurses — meaning there are no advanced degrees above it. Such distinction can help you earn a higher salary or move into adjacent roles with higher salaries. Nurses with FNP credentials can also work in administration or as directors of nursing.
Your work setting can also impact your salary. According to the BLS, NPs in residential intellectual and developmental disability, mental health, and substance abuse facilities earned a median annual salary of $123,900 in 2019.
As health care practitioners, FNPs must have mastery of various nursing competencies, including health assessment, pharmacology, population health, and disease prevention. Increasingly, employers are looking for nurses who also possess a hybrid of technical and soft skills.
A master's is a must for FNPs. This degree is required for licensure as an APRN. If you're interested in gaining even further education, consider working toward a doctorate. The Doctor of Nursing Practice (DNP) is the terminal degree for clinically focused nurses (as opposed to research-focused nurses). Completing a DNP program will grant you with the most extensive training and experience. Also, a doctorate could be required for APRN licensure in the future. In 2004, the AACN recommended that the DNP replace the MSN as the requirement for becoming an APRN. Though the change has not yet happened as of 2020, earning a DNP may help you get ahead of the curve.
The fastest-growing skills sought by employers
While a hybrid skill set is important to contend as a modern job candidate — as we'll show in a bit — FNPs must still be proficient in medical areas of knowledge. The fastest-growing skills in demand by nursing employers (measured by the growth in job postings requesting the skill) include:
Top Skill |
Projected Posting Growth (2018-2023) |
|---|---|
| Clinical care nursing | 146% |
| Ensuring patient comfort | 95% |
| Medication management | 55% |
| Telemetry | 50% |
| Patient monitoring | 46% |
| Spreadsheets | 46% |
| Urgent care | 46% |
| Management of crisis or emergency situations | 45% |
| Interactions with patients and other medical personnel | 42% |
| Artificial intelligence | 19.5% |
Source: Burning Glass Technologies
Technical skills
Health care is increasingly digital, much like other industries. FNPs today must know how to use electronic health records (EHRs) in addition to safely prescribing medications. The top technical skills sought in nurses (as measured by percentage of job postings requesting the skill) include:
- Search Query Language (SQL): 38.9%
- Data science: 38.2%
- Data analytics: 37.6%
- SAS (software suite): 37.2%
- R (programming language): 29.4%
- Project management: 27.1%
- Python (programming language): 23%
- Tableau: 21.4%
- Machine learning: 20.1%
Soft skills in family nurse practice
FNPs are notable for taking a patient-centric approach to medicine. That entails close communication with patients and their families about medication, treatments, disease prevention, and other issues. FNPs also frequently coordinate with other health care stakeholders. All this goes to show how important soft skills are to nursing success. Top skills identified (as measured by share of job-posting requirements) include:
- Communication: 42.7%
- Teamwork/collaboration: 38.1%
- Research: 34.8%
- Planning: 26.1%
- Problem solving: 24.3%
- Professional writing: 18.4%
- Detail-oriented perspective: 15.7%
- Written communications: 15.2%
Top emerging skills
Over the coming years, you can expect to increasingly see the following skills in future job posts:
Emerging Skill |
Projected Posting Growth (2018–2023) |
|---|---|
| Data documentation | 190% |
| Medical history review | 126% |
| Neurological disorders | 109% |
| Maternal-fetal medicine | 100% |
| Smoking cessation | 81% |
| Incision | 75% |
| Patient issue resolution | 50% |
| Sepsis | 46% |
| Biotherapy | 44% |
Source: Burning Glass Technologies
Joining a professional organization in your field can help you stay up to date on nursing trends and connect with peers. You can also gain access to exclusive resources and continuing education. Some of the most popular organizations for FNPs include:
Become an FNP and help patients over their lifetimes
There are many attractive aspects to the FNP role, including plentiful job opportunities, competitive salaries, and wide potential to find exciting, meaningful work. If you're interested in this career path, you’ll need to earn a Master of Science in Nursing. But if you really want to stand out from the crowd and develop in-demand skills, a Doctor of Nursing Practice (DNP) can help you reach the highest levels of clinical expertise and preparation.
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Sources
- AANP - More Than 290,000 Nurse Practitioners Licensed in the United States
- BLS - Job Outlook for Nurse Anesthetists, Nurse Midwives, and Nurse Practitioners
- AANP - NP Fact Sheet
- BLS - Pay for Nurse Anesthetists, Nurse Midwives, and Nurse Practitioners
- AANP - State Practice Environment
- AACN - Fact Sheet: Nursing Shortage
- AANP - National Nurse Practitioner Week: NPs Are Key to Providing Better Rural Care
- UHG - Addressing the Nation’s Primary Care Shortage: Advanced Practice Clinicians and Innovative Care Delivery Models
- BLS - Occupational Employment and Wages, May 2019, Nurse Practitioners
- PayScale - Average Entry-Level FNP Salary
- AACN - Position Statement on the Practice Doctorate in Nursing
- Burning Glass Technologies
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