You don’t choose a career in medicine lightly.
You choose it because you want real responsibility, meaningful patient relationships, and a path that continues to expand as healthcare evolves. The challenge is figuring out which role gives you all of that without boxing you in.
That’s why the nurse practitioner (NP) path gets so much attention. NPs continue to take on broader clinical responsibilities, lead patient care in primary and specialty settings, and step into roles that offer both autonomy and stability. With nurse practitioner recognized as the top job in America in 2024 by US News and World Report, more clinicians are asking what it actually takes to get there.
If you are early in your training or already working at the bedside, understanding the complete NP journey helps you make a confident career decision. From education and certification to specialties and long-term outlook, here is what the NP pathway looks like.
This guide walks through each stage so you can evaluate whether becoming a nurse practitioner aligns with the future you want to build.
Table of Contents
Why Become a Nurse Practitioner?
The NP role continues to grow quickly. According to the Bureau of Labor Statistics, nurse practitioner roles are projected to increase by 45% by 2032, making them one of the fastest-growing jobs in the US.
Many clinicians pursue NP training because it offers:
- Increased autonomy in patient care
- Opportunities to specialize in areas you enjoy
- Strong demand in primary care and specialty settings
- Flexible roles across hospitals, clinics, telemedicine, urgent care, and rural programs
NPs also have opportunities to work temporary assignments, which can offer flexible scheduling, strong hourly rates, and exposure to a variety of clinical settings. For clinicians who want advanced training while staying closely involved in patient care, the NP path is worth considering.
What Does The Nurse Practitioner Role Entail?
Nurse practitioners are advanced practice clinicians who assess patients, diagnose conditions, prescribe medications, and manage treatment plans across a variety of care settings. In contrast to RNs, NPs often serve as primary care clinicians and may practice independently depending on state regulations.
NPs care for patients across the lifespan, assist with chronic disease management, conduct physical exams, and collaborate with multidisciplinary teams. They practice in specialties that include family medicine, pediatrics, psychiatry, women’s health, and adult gerontology.
Some NPs blend permanent roles with short-term locum tenens assignments to support clinical coverage needs or explore different practice environments before settling into a long-term position.
How Do NPs Compare to RNs and PAs?
Registered nurses (RNs) primarily deliver bedside care and support the clinical team. Nurse practitioners complete graduate-level education that prepares them to diagnose and manage conditions, which generally brings greater autonomy and higher earning potential.
Physician assistants (PAs) are also advanced practice providers. They complete a medical-based graduate program, rather than a nursing-based one. PA training is generalist, while NP programs focus on a specific population. In many states, NPs hold broader practice authority, while PAs typically work under closer physician collaboration.
Choosing between a PA or NP role often comes down to:
- Whether you prefer the medical model or the nursing model
- How much autonomy you want
- Whether you want to specialize or remain a generalist
NPs may also have an advantage if they plan to incorporate flexible locum work, since many temporary and travel assignments specifically seek NP coverage in primary care, urgent care, and behavioral health.
Educational Requirements to Transfer from RN to NP
Most clinicians complete the full NP pathway in about six to eight years. Your timeline depends on whether you study full-time or part-time and how much experience you bring from previous roles.
Step 1: Become a Registered Nurse
Most clinicians start with a Bachelor of Science in Nursing, although some begin with an associate degree and complete a bridge program. After nursing school, you’ll take the NCLEX-RN and start practicing as an RN.
Aspiring NPs generally gain one to two years of bedside experience before applying to graduate programs. This experience builds clinical judgment and helps you understand patient flow, teamwork, and communication.
Step 2: Complete a Graduate NP Program
NP education requires one of the following degree paths:
- Master of Science in Nursing
- Doctor of Nursing Practice
These programs include advanced coursework, clinical rotations, and specialty-specific training. NP schooling typically takes two to four years, depending on your schedule and degree type.
You will also choose a specialty such as family medicine, pediatrics, psychiatric mental health, women’s health, or adult gerontology. Each specialty integrates classroom learning with supervised clinical hours that prepare you for certification.
Step 3: Pass The National Certification Exam
After completing your degree, you will take a national certification exam through either the American Association of Nurse Practitioners (AANP) or the American Nurses Credentialing Center (ANCC). Your specialty determines which exam you qualify for.
Both exams are widely accepted. The AANP exam focuses more on clinical application, while the ANCC exam adds questions on professional practice, policy, and research. Your decision usually comes down to test style and which emphasis you prefer.
Step 4: Obtain State Licensure
NPs must hold state licensure. Requirements vary based on where you practice:
- Some states grant full independent practice authority
- Some require a supervisory or collaborative agreement
- A few maintain restricted practice rules
Licensure must be renewed regularly and requires continuing education that aligns with state and national standards.
Choosing an NP Specialty and Practice Setting
Your NP specialty shapes your coursework, clinical experiences, certification exam, and job opportunities. While all programs require advanced pharmacology, pathophysiology, and assessment, your specialty determines the patient populations you work with.
According to the AANP, common specialties include family medicine, adult gerontology, pediatrics, psychiatric mental health, women’s health, and acute care.
Full-time and locum tenens NPs work in a variety of settings, including:
- Primary care clinics
- Hospital inpatient teams
- Behavioral health settings
- Urgent care centers
- Telemedicine roles
- Community and rural health organizations
- Independent practices (depending on state regulations)
Your specialty will influence your certification path, job outlook, and earning potential.
Career Outlook and NP Earning Potential
Nurse practitioner roles continue to grow quickly, especially in primary care, behavioral health, and rural settings. As communities seek more access to care and physician shortages widen, NPs are stepping into roles with expanded responsibility.
The Bureau of Labor Statistics reports median NP pay at $132,060 per year, or about $63 per hour. Compensation varies by state, specialty, experience, and schedule.
Clinicians working locum tenens roles through staffing firms can earn competitive hourly rates. For example, OnCall’s NP rates may reach up to $125 per hour based on location and clinical need.
For a deeper breakdown of NP earnings, see the 2026 NP Salary Guide.
Planning Your Next Steps
If you are ready to pursue an NP role, start by mapping your timeline, comparing accredited programs, and reviewing clinical hour requirements. Talking with practicing NPs or researching your state’s licensing rules can also help you plan a realistic path.
When you are ready to explore opportunities, OnCall Solutions can support your next move as your medical staffing and hospital practice partner. We help clinicians find full-time and locum tenens NP roles with flexible scheduling and meaningful clinical environments.
Explore current NP roles on our jobs board or connect with us to discuss your career plans.