Family nurse practitioners (FNP) are advanced practice registered nurses who work autonomously or in collaboration with other healthcare professionals to deliver family-focused care. Given the rather broad nature of the “family” patient population focus, FNPs offer a wide range of healthcare services that revolve around the family unit; from health promotion and disease prevention to direct care and counseling across the lifespan.
Because FNPs possess a graduate-level education, as well as clinical training in family medicine, they are qualified to diagnosis and treat complex health conditions of the body and mind. Their advanced training and education also often qualifies FNPs to serve as hospital and clinic administrators and policy makers.
FNPs may work in a variety of settings, including conventional doctor’s offices, clinics, private homes, schools, or hospitals. Family nurse practitioners place a strong emphasis on wellness and prevention, but also provide treatment for everything from mild ailments to serious conditions affecting any member of the family, from children to grandparents. An FNP can be expected to perform duties that include:
- Developing treatment plans for acute and chronic diseases
- Educating and guiding patients on disease prevention and healthy lifestyle habits
- Understanding the changes in health promotion throughout the aging process
- Conducting exams
- Performing diagnostic tests and screening evaluations
- Managing overall patient care regarding lifestyle and development issues
- Emphasizing preventative care and disease management
- Prescribing medications
Education and Degree Program Options
Becoming an FNP involves first passing the NCLEX-RN exam and becoming a licensed RN. Crucial experience is gained in the years spent working as a registered nurse. From there, most FNP aspirants work toward a Master’s Degree in Nursing (MSN) with a concentration in family practice, a post graduate degree specific to FNP preparation, or a Doctor of Nursing Practice (DNP).
Often, registered nurses complete a general graduate degree in nursing and then go on to complete a post-graduate certificate program for family nurse practitioners. Many would-be FNPs choose to center their master’s education on an FNP specialization. Subspecialties available to FNPs include:
- Long-Term Care
- Critical Care
Family nurse practitioner graduate and post-graduate programs combine didactic learning with clinical experience that places a heavy emphasis on mastering advanced clinical skills. In addition to foundational courses in advanced health assessment, pathophysiology, and pharmacology, would-be FNPs can also expect to take courses that cover:
- Nursing research methods
- Adult and geriatric care
- Family/lifespan nursing theory
- Family/lifespan nursing care
- Management of acute and chronic illnesses
- Socio-cultural issues
- Dynamics of family health care
- Family counseling
National FNP Certification
Upon completion of a graduate or post-graduate program, graduates are eligible for national certification. Most FNP programs are developed to meet current national standards for FNP certification. Most states require a national certification for FNP licensure, although not all states recognize the same national certifying bodies. It is important that licensure candidates verify with their state’s Board of Nursing beforehand which national certifying bodies are recognized.
The American Nurses Credentialing Center (ANCC), a subsidiary of the American Nurses Association, offers the FNP-BC primary care certification. To qualify for this certification, applicants must hold a current and active RN license and a master’s, post-graduate, or doctorate degree from an FNP program accredited by the Commission on Collegiate Nursing Education (CCNE) or the National League for Nursing Accrediting Commission (NLNAC). Applicants must complete a minimum of 500 faculty-supervised clinical hours within their FNP program to be eligible for certification. In addition, the FNP program must include content in health promotion and disease prevention, and differential diagnosis and disease management, as well as coursework across the lifespan in three, separate courses:
- Advanced physical/health assessment
- Advanced pharmacology
- Advanced pathophysiology
After applying for certification, all applicants have up to 90 days to take the exam through a local Prometric Testing Center. Recertification takes place every 5 years and requires meeting specific clinical practice and continuing education requirements.
Other specialty certifications offered by the ANCC that family nurse practitioners may elect to earn include:
- Acute Care Nurse Practitioner
- Adult Nurse Practitioner
- Adult Psychiatric and Mental Health Nurse Practitioner
- Diabetes Management – Advanced
- Family Psych and Mental Health Nurse Practitioner
- Pediatric Nurse Practitioner
- School Nurse Practitioner
- Gerontological Nurse Practitioner
The American Academy of Nurse Practitioners (AANP) also offers a national certification in family practice. To qualify for this certification, applicants must hold a current and active RN license and a master’s, post-master’s, or doctoral degree from an adult, gerontologic or family nurse practitioner program.
Applicants must provide documentation showing they’ve completed:
- A minimum of 500 clinical clock hours of faculty-supervised practice
- Courses in advanced physical assessment, advanced pharmacology, and advanced pathophysiology
Once an applicant applies to take the certification examination (applicants can request an application or apply online), they have 120 days to complete the test after they have received an Approval to Test date from Professional Examination Services. All appointments for testing must be made through Prometric Testing Center. Recertification is required every 5 years, and specific clinical practice and continuing education requirements must be met during each renewal cycle.
FNP Professional Organizations
Professional organizations often represent constituent and state nurses associations to raise standards of nursing, to promote the rights of nurses in the workplace, and to lobby Congress and other regulatory agencies on issues that affect both nursing professionals and the public. There are a number of professional organizations of which FNPs are often members:
- American College of Nurse Practitioners (ACNP)
- American Nurses Association (ANA)
- American Society for Pain Management Nursing (ASPMN)
- International Society of Psychiatric-Mental Health Nurses (ISPN)
- National Gerontological Nursing Association
According to the National Salary Report 2011 published by Advance for NPs and PAs, family nurse practitioners earned average salaries that differed based on subspecialty and setting:
- Gerontology $94,485
- Mental Health $92,396
- HIV Clinic $89,506
- Family Practice $89,317
- Diabetes/ Endocrinology $88,397
- Retail Clinic $96,800
The average hourly rate for FNPs in the above categories was between $40 and $62 an hour.
A 2011 survey of 3,812 NPs conducted by the American Academy of Nurse Practitioners showed that the average, full-time base salary for a nurse practitioner was $91,310, while the average, full-time base salary for an FNP was $96,910.
Average, full-time base salaries for NPs were further broken down in the survey by practice setting:
- Private NP $111,750
- Private Physician $95,680
- Community Health Center $92,110
- Rural Health Clinic $92,560
- Hospital Outpatient Clinic $98,720
- Occupational/Employee Health $99,030
- Emergency Room/Urgent Care $115,070
- In-Patient Hospital Unit $103,650
- Veterans Admin Facility $111,110