HealthEd: How to Become a Nurse Practitioner: The Osmosis Ultimate Guide, Part Two

How to Become a Nurse Practitioner: The Osmosis Ultimate Guide, Part Two

Osmosis Team
Published on Nov 20, 2023. Updated on Nov 21, 2023.

Well, hello! Thanks for joining us for Part Two of "How to Become a Nurse Practitioner: The Osmosis Ultimate Guide." Here's where you'll get all of the advice and guidance you'll ever need to succeed as an NP from experienced clinicians and nurse practitioners. (Curious about Part One? Here you go!)

You Have a Site and a Preceptor, Now What?

Skills Checklist

In clinicals, you’ll want to focus on the skills you need to advance your practice and align with the board certification exam for your population foci. If you can’t find a checklist, go to the board certification body and look for the skills covered on the boards, or ask your faculty or preceptor. 

Presenting to a Preceptor

Presenting patient cases effectively to an attending or preceptor is crucial for students in clinical settings. It demonstrates your clinical reasoning, knowledge base, and communication skills. Several formats can be used, and the choice often depends on the preference of the institution, preceptor, or the specific situation. Here’s one of the most widely used frameworks, along with tips for utilizing it:

SBAR (Situation, Background, Assessment, Recommendation)

  • Situation: Clearly state the current situation or problem.

  • Background: Offer relevant contextual patient information.

  • Assessment: Present your clinical findings and your analysis.

  • Recommendation: Suggest next steps or interventions.

Tip: SBAR is especially useful for urgent or emergent situations due to its concise nature.

Additional Tips for Presenting to Preceptors

  • Preparation: Familiarize yourself with the patient’s history and current condition. Understand the context, reason for their visit, and have a clear idea of what you want to communicate.

  • Conciseness: While you want to be thorough, it's also essential to be succinct. Highlight the most critical points.

  • Clinical Reasoning: Clearly explain your thought process to demonstrate your understanding and allow the preceptor to provide more focused feedback.

  • Engage with the Preceptor: Ask questions and seek clarification about areas you're uncertain of to showcase your eagerness to learn.

  • Stay Open to Feedback: Constructive feedback is a cornerstone of clinical education. Embrace it to refine your skills.

  • Follow a Logical Flow: Regardless of the format you use, ensure your presentation has a logical flow, moving from the patient's presenting problem to your proposed intervention.

  • Anticipate Questions: Think about potential questions the preceptor might ask and be prepared with answers. This proactive approach can be impressive.

  • Use Visual Aids When Necessary: If you've sketched a diagram or have lab results, use them to aid your presentation.

By mastering the art of patient case presentations, NP students can foster trust with their preceptors, ensuring a more enriching clinical experience. As you progress, you'll adapt these frameworks based on personal preferences and specific clinical scenarios.


Documentation is an essential skill for an NP to master. Thorough and accurate documentation helps with communication with the other healthcare team members, serves as a way to ensure the patient’s health plan is being followed, and measures patient progress towards goals. A subjective, objective, assessment, plan (SOAP) note is one of the most common documentation methods. If you use an electronic medical record (EMR), your preceptor will sign off on your note. You’ll want to have the note in draft mode and use the following format:

  • Subjective: Patient's symptoms or self-report of symptoms in their own words.

  • Objective: Your clinical observations, examination findings, and test results.

  • Assessment: Your clinical impression or differential diagnoses.

  • Plan: Interventions, further tests, or treatments you propose.

Tip: SOAP notes are often used for routine patient encounters. Remember to be thorough but concise.

School-Required Documentation 

Your program may require you to use an electronic system to document your patient encounters. Maintain patient confidentiality when doing so but include all items in the SOAP note and follow your school’s documentation policy. Many programs also give the preceptor access to the school documentation, and they may sign off on the note in the school’s chosen system. 

Resources to Facilitate Learning

With so much to learn in your program, it can feel overwhelming. Let’s review resources and tips to help you be successful in the classroom, clinical, and beyond!

Since NPs are charged with learning the skills of diagnosis and treatment, you’ll want to check out some medical student resources such as the Elsevier Medical Education hub, or the Osmosis Suite, which includes both our Basic Sciences content and content from our new Clinical Sciences library.

Find resources that are helpful in developing differential diagnoses, diagnoses, and treatment, including:

  • Clinical Pathways in your EMR: Clinical Pathways within the EMR system are evidence-based frameworks that guide the NP through the most effective care processes for specific medical conditions. A few advantages to using Clinical Pathways include:

    • They serve to standardize treatment thereby reducing variability and improving patient outcomes. 

    • They can streamline the documentation process, ensuring all necessary data is captured efficiently and systematically.

    • They provide integrated decision support tools with real-time alerts and evidence-based recommendations which are instrumental in making informed clinical decisions. 

  • Clinical Sciences for NPsOsmosis by Elsevier has a new library of videos to support our NP learners as they translate knowledge into practice. Available both online and in the Osmosis app, the Clinical Sciences library includes helpful decision-making trees (DMTs) paired with clinically-focused videos to outline the next steps in diagnosis and patient management. 

  • PracticeUpdate: PracticeUpdate is a free platform for healthcare professionals that offers curated content such as articles, guidelines, and research tailored to specific clinical specialties, helping providers stay abreast of the latest developments in their fields.

  • ClinicalKeyClinicalKey (CK) is a comprehensive resource for healthcare professionals seeking quick answers to clinical questions. Due to its wide range of content — from journals and books to practice guidelines — it's commonly used in both educational settings for NP students and clinical practice within hospitals.

Study Habits

If you’re accustomed to skimming through textbooks or doing last-minute cramming with exams around the corner, brace yourself for a shift in study habits! You'll be expected to read and understand an extensive body of knowledge that requires daily immersion in your study materials. Ultimately, you'll need to have your books and other resources nearby. It may be challenging during the first term, but you'll learn to embrace studying as you go.

Beyond Textbooks

Your courses will provide lectures, notes, textbooks, and other coursework content, but nursing programs aren’t all about theoretical knowledge. You’ll be expected to apply what you’ve learned in a clinical setting. Getting out into the clinical setting will help you get a better understanding of how to use the skills you read and learn about in your classes.


You will, of course, regularly take exams to assess your knowledge. However, it’s important to note that nursing isn’t always about what’s right and wrong; sometimes, there’s more than one correct answer! Many nursing exams ask you questions about which actions are “best” or “most appropriate,” so it’s up to you to learn to prioritize patient care.

To excel on your exams, take the time to understand the question thoroughly. By closely examining what's being asked, you'll be better prepared to provide the correct answers. 

It’s also important to remember that exams aren’t created to set you up for failure. They’re designed to help you think critically, assess your knowledge, skills, and determine your ability to adapt so you're prepared for the real world of nursing. The ability to think critically and navigate through uncertainty will translate into your nursing practice and become one of your most valued traits as a health professional.

Last but not least, before you take your exams, take the time to study for it properly. Many textbook publishers offer additional resources such as practice questions, case studies, and outlines for the content covered in the textbook. And if your school has access to an interactive learning platform (such as Osmosis by Elsevier), make sure to USE IT! They’re an excellent resource for preparing for exams and determining areas where you need to redirect your learning focus.

What to Buy

In addition to your textbooks, there are items that are pivotal to your nursing journey. Alongside a stethoscope and your program’s approved dress code, you may also need to purchase other items required by your program, such as interactive learning platforms like Osmosis by Elsevier, electronic simulation programs like Shadow Health, which is used in online and in-person programs to provide a simulated learning experience before labs or clinicals.

So you’ve successfully completed your NP program. Congratulations! It’s a huge accomplishment, and you should take some time to celebrate. But before you can begin working as a nurse practitioner, there are a few more steps you have to take, like obtaining your RN license and being certified as an NP. Certification requires an exam, and this one’s specific to your chosen population foci. Board certification confirms that you’ve completed the education requirements and acquired the experience and skills to provide advanced care to specific patient populations. The fees associated with your nursing certification are added to the educational expenses you may incur. The fees range from $300 to $500, and renewal periods range from three to five years. Let’s look at the most common specializations and what you will likely need to apply. 

Nursing Practitioner Certifications

Adult/Gero Acute Care NP (AGACNP)

AGACNPs typically seek certification through the American Nurses Credentialing Center (ANCC) or AACN Certification Corporation. To become an AGACNP, candidates must earn a master or doctoral degree in the specialty and complete roughly 500 supervised clinical hours. Recertification is mandated every five years and necessitates 75 continuing education (CE) hours combined with at least 100 practice hours over the recertification cycle.

Adult/Gero Primary Care NP (AGPCNP)

AGPCNPs typically seek certification through ANCC. To be eligible, candidates should possess a master’s or doctoral degree in the AGPCNP specialty and typically undergo 500 supervised clinical hours. Every five years, recertification is essential, demanding 75 CE hours and 100 practice hours over this duration.

Emergency NP (ENP)

ENPs seek certification from the American Academy of Nurse Practitioners Certification Board (AANPCB) or the American Association of Critical-Care Nurses (AACN). To be an ENP, you must have a master's or doctoral degree emphasizing emergency care and complete around 500 clinical hours. Every five years, recertification becomes due, which entails 100 CE hours and an equivalent number of practice hours.

Family NP (FNP)

FNPs are generally certified by the ANCC or AANPCB. A master's or doctoral degree in the FNP specialty is a prerequisite, coupled with 500-700 supervised clinical hours. Recertification is every five years and requires 100 CE hours and 1,000 practice hours.

Neonatal Intensive Care NP (NNP)

These specialized NPs focus on newborns experiencing health complications, frequently operating in NICUs. Certification is handled by the National Certification Corporation (NCC). They need a master's or doctoral degree in neonatal care and roughly 500 clinical hours. Recertification is every three years, involving 45 CE hours specific to the specialty.

Pediatric NP (PNP)

PNPyou certification is managed by the Pediatric Nursing Certification Board (PNCB). Educational prerequisites include a master's or doctoral degree in pediatrics and around 500 supervised clinical hours. For recertification every five years, PNCB requires 15 CE hours annually.

Psychiatric Mental Health NP (PMHNP)

PMHNPs are certified through ANCC. An aspiring psychiatric mental health NP should have a master's or doctoral degree in the domain, along with 500 clinical hours. Every five years, recertification is due, needing 75 CE hours and 100 practice hours.

Women’s Health NP (WHNP)

The NCC oversees the WHNP certification. To become a WHNP, you must attain a master's or doctoral degree in women's health and complete about 500 clinical hours. Recertification occurs every three years and requires 45 CE hours centered on the specialty.

For those pursuing any of these specialties, it's wise to consult the appropriate certification body and state board of nursing for the most recent and specific details.

The Pathway to NP Licensure

There are several steps that need to be completed to ensure you meet the necessary criteria to qualify for NP board exams. Here's a breakdown of the typical requirements:

Complete an Accredited Program (or Portfolio Assessment) 

First and foremost, you'll need to graduate from an accredited NP program in most cases or meet the requirements for portfolio assessment. It’s important to note that some NP board exams, like the ENP exam, may offer an alternative pathway through portfolio assessment. Be sure to check with the specific certifying body for the certification you're interested in to determine if portfolio assessment is an option and what the requirements are. Always verify that your chosen program or assessment method aligns with the certification you intend to pursue.

Meet Educational Prerequisites 

Depending on the certification body and specialty, you may need to fulfill specific educational prerequisites, such as coursework in advanced health assessment, pharmacology, and pathophysiology.

Maintain/Obtain Your RN License 

Before pursuing Nurse Practitioner certification, you must be a licensed Registered Nurse (RN). Ensure that you hold an active, unencumbered RN license in your state.

Gain Clinical Experience

All nurse practitioner certification organizations require a certain number of clinical practice hours as part of your education. Typically there’s a minimum of 500 clinical hours with the trend towards 750 hours to meet with current initiatives or 1,000 if you’re graduating from a DNP Program. Be prepared to complete the required clinical hours in your chosen specialty prior to graduation. 

Apply for Certification 

After completing your program, you can apply for certification through the appropriate certifying body, such as the American Nurses Credentialing Center (ANCC), the American Academy of Nurse Practitioners Certification Board (AANPCB), or another relevant certifying organization.

Pass a Certification Exam 

Once your application is approved, you'll need to pass the board exam specific to your chosen specialty. These exams assesses your knowledge and competence in your area of practice.

Meet State Requirements 

In addition to national certification, you must meet your state's specific requirements for NP licensure. These requirements can vary but often include submitting an application, passing a criminal background check, and paying licensing fees.

Certifying Organizations

You need to renew your certification according to the changing needs of the healthcare industry and each certifying board.

What Are the Board Exam Fees?

Board exam fees can vary based on the certifying body and specialty. Expect to pay anywhere from $200 to $400. Discounts are generally offered to members of professional organizations. Be sure to check the specific fees for your chosen certification organization and budget accordingly to cover these expenses. 

How Do You Prepare for the NP Boards?

Remember that success on the NP boards isn’t just about cramming information but also about understanding the material and having the confidence to apply your knowledge. By following a well-planned study schedule and taking care of yourself along the way, you'll be well-prepared to excel on exam day.

After completing your program, it's crucial to take some time for self-care and relaxation. Your NP journey has likely been demanding, both physically and emotionally.

A Quick Guide to Preparing for Your NP Board Exams

Rest and Recuperation (R&R)

Graduating from an NP program is a significant achievement, and you deserve a break. Take a week or two to prioritize self-care. Catch up on sleep, nourish your body with good food, engage in regular exercise, and savor fresh air. Reconnect with friends and family who may not have seen much of you during your intense academic journey.

Mental R&R

Don't forget to provide your brain with some well-deserved relaxation. The NP board exams require focused preparation, so managing anxiety and maintaining a positive mindset is crucial. When you're well-rested and mentally prepared, you'll approach your studies and the exam with greater confidence.

Utilize Predictor Exams

If your NP program offers a predictor exam, this is an invaluable resource. Use it as a starting point to identify areas you need to study. The predictor exam can help pinpoint your strengths and weaknesses, allowing you to tailor your preparation accordingly. Use the predictor exam scores and content areas as the basis for your student schedule. 

Set a Study Schedule

After your mini-break, it's time to create a well-structured study plan. Set a target date for your NP board exam, typically in about a month or two, giving yourself adequate preparation time. Remember that everyone's study needs differ, but a general guideline is to dedicate around three hours per day to review your study materials.

Organize Your Study Materials

Gather all the necessary study resources, including textbooks, practice exams, and study guides, well in advance. Having everything ready will make your study sessions more efficient.

Create a Study Calendar

Develop a study calendar or schedule that outlines what topics you'll cover each day or week. Breaking down your study plan into manageable chunks can prevent overwhelm and help you stay on track.

Simulate Taking the NP Boards 

Practice, practice, practice! Incorporate practice exams into your study routine. Make sure the practice exams are the same length as the boards you’ll be sitting for, along with the same time limits. You’ll also want to avoid distractions while you become familiar with the format of the NP board exams and assess your test-taking skills and stamina. 

Seek Support

Consider attending an online or live review course, joining a study group, or finding a study partner. Discussing complex concepts with peers can enhance your understanding and provide motivation. Attending a live, online review session can help refresh your memory on content that you had in past terms. 

Self-Assessment Exams

Most of the boards have a self-assessment exam that you can take to help you prepare for the boards. It’s a good idea to assess your progress and adjust your study plan as needed based on your self-assessment results. Focus more on challenging areas while maintaining your mastery of previously learned material.

Do Your Best to Stay Healthy

Continue prioritizing your physical and mental health throughout your preparation. Maintain a balanced diet, exercise regularly, and practice stress-relief techniques like mindfulness or meditation.

Exam Day Preparation

In the days leading up to your NP board exam, make sure you're well-rested, have all necessary identification and documents ready, and know the location and schedule of your exam. Schedule the exam for your best time of the day and ensure you have eaten a nutritious meal as well as had a good night’s sleep. If you’re not ready, reschedule the exam! 

Planning for Nurse Practitioner Board Success 

The key to passing NP boards is to vary the review and study materials along with including time for self-care. Make sure to keep things balanced and include fun activities as well as various study modalities for NP board review.

Use the REHEARSE Method

Use the acronym "REHEARSE," as a comprehensive approach to preparing for the NP board exam. 

- Review core material systematically.

- Evaluate progress with practice exams.

- Harness multiple study methods (videos, flashcards, group study).

- Engage with faculty, academic coaches, and peers for discussion and clarification.

- Assess strengths and weaknesses regularly.

- Revisit difficult topics for additional review.

- Simulate test conditions with timed question bank sessions.

- Ensure relaxation, self-care, and mental preparation techniques are utilized. 

The following schedule includes 32 days and integrates a variety of learning techniques, from in-depth review sessions and evaluative practice exams to harnessing educational resources and engaging with academic support. 

State Practice 

The world of NPs is ever-evolving, particularly when it comes to state practice requirements. Here’s a breakdown of the current NP practice environment and resources to keep abreast of the changing landscape in NP practice initiatives. 

State Practice Types

Understanding the scope of NP practice by state is crucial to following your state requirements. You’ll want to know if your state is a full practice, reduced practice, or restricted practice state.

Full Practice 

Full practice allows NPs to evaluate patients, diagnose, order and interpret diagnostic tests, and initiate treatment plans. This autonomy fosters a seamless patient experience, especially in areas underserved by physicians. Note that some full-practice states may require the NP to practice for a minimum amount of time prior to granting full practice authority. 

Reduced Practice

One of the key practice elements is reduced, necessitating a collaborative agreement with a physician. This model bridges the gap between full autonomy and restrictive practices, ensuring patients receive comprehensive care.

Restricted Practice 

This model has more significant limitations, such as mandating supervision, delegation, or team management by another health provider. It's essential for NPs in these states to establish strong collaborative relationships for optimal patient care.

Resources for NPs By State

Take a look at this handy map of the US that provides the practice guidelines by state. 

Maintaining Your License

Once you get your advanced practice nursing license, you’ll need to maintain it. It’s important to know that the requirements for an NP will likely include keeping up with your RN licensure, depending on your state requirements. Also, you’ll need to keep up with your board certification. Each state and board may have different requirements; however, there are some general guidelines to get you started. It’s important to note that continuing education and practice requirements can vary significantly from state to state in the US (and country to country outside of the US). Make sure to refer to this comprehensive list of every US state and its requirements for nursing licensure and continuing education to stay current.

Transitioning from Registered Nurse to Nurse Practitioner

Transitioning from an RN to an NP is a significant and life-changing journey in your career. While both roles are entrenched in patient care, the leap to nurse practitioner embodies a shift to a more autonomous and decision-making role within the healthcare landscape. It's a move that promises broader clinical responsibilities, deeper patient interactions, and an opportunity to make a more profound impact on patient outcomes. However, with these expanded horizons come new challenges, responsibilities, and expectations. For many, this transition isn’t just about professional growth but also a personal metamorphosis, deepening your commitment to healthcare and patient advocacy.

Staying With Your Current Employer

Transitioning to an NP role within a familiar environment has several benefits. Firstly, you’ll have an understanding of the organizational culture, protocols, and systems, significantly reducing the initial learning curve. An established rapport with colleagues streamlines collaboration, while internal growth opportunities might be more accessible due to a proven track record and loyalty. Onboarding as an NP could be more straightforward, with fewer administrative obstacles such as credentialing. Moreover, this established relationship may lend an edge in contract negotiations, ensuring favorable terms in areas like salary and benefits. Lastly, emotional and professional support within a known setting can provide comfort during the transition phase.

However, there are potential drawbacks to consider. One of the most prevalent challenges is the perception barrier, where colleagues might still view you predominantly as an RN, affecting dynamics and autonomy in clinical decisions. Staying within the same environment might limit exposure to diverse clinical experiences, potentially inhibiting broader professional growth. Financially, there's a possibility that employers might reserve more competitive salaries or benefits for external hires. Role boundaries could blur, especially in institutions with limited staffing, leading to confusion between RN and NP responsibilities. Finally, the comfort of a known setting might inadvertently discourage the pursuit of new challenges or branching out into different clinical settings and specialties.


How Fellowships Help New NPs

For new NPs, fellowships provide a bridge between the theoretical knowledge garnered during their academic journey and the practical application in real-world settings. These programs offer structured learning, enabling NPs to deepen their understanding and hone their skills under the guidance of seasoned professionals. Fellowships also facilitate valuable mentorship opportunities, connecting fresh graduates with experts in their chosen field. This not only paves the way for robust professional growth but also creates networking avenues that can be instrumental in future career moves. Additionally, having a fellowship under one's belt can significantly enhance employability, making NPs more competitive in the job market.

Duration and Typical Pay Rate of Fellowships

Fellowships for NPs predominantly span 12 months. However, depending on the specialty and depth of training, some may be shorter (around six months) or extend up to 24 months. As for compensation, fellowships are generally paid. Think of them as postgraduate training, akin to medical residencies. While the stipend or salary offered to fellows is typically less than what a fully credentialed NP might earn, it's usually higher than the earnings of a new graduate RN. Compensation nuances can vary based on the institution, geographical location, and the fellowship's specialty.

Common Types of Fellowships

Several fellowships cater to the diverse interests of NPs. Hospital fellowships, for instance, provide a broad spectrum of exposure across various hospital departments, helping NPs acclimatize to in-patient care dynamics. More specialized fellowships, such as emergency medicine, equip NPs to handle high-acuity settings, teaching them critical decision-making and procedural skills. Cardiology fellowships delve into the intricacies of heart-related ailments, from outpatient management to in-hospital monitoring. Oncology fellowships, on the other hand, focus on providing in-depth knowledge about cancer care, covering aspects from chemotherapy administration to survivorship.

Applying for Fellowships and Considerations

For those interested in pursuing a fellowship, the initial step is to research institutions and organizations offering these programs. It's imperative to prioritize accredited fellowships, ensuring that the training aligns with industry standards and is recognized universally. Some fellowships may also lead to certification eligibility, especially in specialized areas like psychiatry or cardiology.  It's advisable to verify this aspect during the application process, as such certifications can further boost an NP's professional credentials. The combination of robust training and certification can be a game-changer in an NP's career trajectory.

The Value of Mentorships

Mentorships in the healthcare landscape are invaluable, nurturing professional growth, facilitating knowledge transfer, and fostering collaboration. In modern healthcare settings, this symbiotic relationship highlights that while traditional experience is a cornerstone, the fresh perspectives and skills of newer practitioners are of paramount importance as the mentor/mentee relationship can, at times, be interchangeable. New NPs are also mentors to their RN peers and often will mentor RNs moving into the NP role. It’s important to emphasize that learning is continuous, and expertise can come from any direction.

Seasoned mentors offer:

  • Real-world context not found in textbooks.

  • Experience with sharing and providing insights into patient care intricacies.

  • Guidance in navigating the complex healthcare environment

  • A multidimensional mentorship dynamic where new NPs can mentor RN peers, sharing recent academic learnings and current methodologies, ensuring that all healthcare professionals remain updated with the latest in clinical care.

The fluidity of the mentor-mentee relationship:

  • Seasoned mentors, rich in experience, might sometimes need guidance in emerging technological trends.

  • Tech-savvy mentees can reverse roles by guiding their mentors in mastering new technology, tools, or learning platforms (like the Osmosis Suite).

Resources for New NPs

  • Use social media groups to connect to other NP professionals and learn from their experiences (Facebook, Reddit, Quora, Discord).

  • Use LinkedIn to create a professional profile (similar to a resume or CV), develop professional connections, and read about industry trends.

Landing Your First Job as a Nurse Practitioner

Earning your NP degree is a monumental milestone! You've transitioned from being an RN to an NP student, then on to a fully-fledged healthcare professional with greater autonomy! While stepping into this advanced role may feel daunting initially, fear not! These invaluable tips will guide you in securing your first position as a Nurse Practitioner:

Updating Your Resume/CV

  • Highlight Advanced Clinical Skills: Make sure you emphasize your advanced training, clinical rotations, and specific NP skills.

  • Tailored Objectives: Adapt your objective statement to clearly reflect your desire for an NP position and why you’re the best fit.

  • Include Relevant Certifications: If you’ve achieved any NP-specific certifications, be sure to list them prominently.

Clinical Partnerships

  • Leverage Relationships: Remember the clinical sites you trained at? Reach out! They already know your work ethic and clinical abilities.

  • Letters of Recommendation: Secure strong recommendations from clinicians or physicians you’ve partnered with during your rotations.

Market Yourself

  • Elevator Pitch: Prepare a concise, impactful statement about who you are, your NP training, and your aspirations.

  • Networking: Attend healthcare conferences, seminars, and workshops to meet potential employers or get leads.

LinkedIn Profile Suggestions

  • Professional Photo: Ensure your photo is clear, professional, and current.

  • Detailed Summary: Describe your NP qualifications, specialties, and aspirations.

  • Recommendations: Get colleagues or supervisors to write LinkedIn recommendations attesting to your skills and performance.

  • Engage: Share and comment on relevant articles, showing your continuous involvement and learning in the field.

Popular Online Job Boards

  • Regular Checks: Platforms like Indeed, Glassdoor, and NP job-specific boards update frequently. Check regularly and set up job alerts.

  • Customize Applications: Instead of a generic application, tailor your cover letter and resume for each position.

Follow Up With Prospective Employers

  • Timely Follow-Ups: A week after applying or post-interview, send a polite email reiterating your interest in the position.

  • Thank You Notes: After an interview, it's a kind gesture (and a good reminder of your dedication) to send a 'thank you' note, whether it's an email or handwritten.

Embarking on your NP journey is exciting! With a blend of networking, showcasing your skills, and proactive searching, your first NP position will be just around the corner. By balancing between persistence and respect for the hiring process, you maximize your chances of securing the NP position that aligns with your career aspirations and the population foci in which you specialize.

Advancing Your Career

Dual Certification 

Specializing in more than one area offers NPs a competitive edge in the healthcare market. For instance, an FNP with an additional psychiatric mental health certification can cater to a broader patient demographic, enhancing their utility in diverse clinical settings. This expanded scope can lead to increased salary prospects, varied job opportunities, and the satisfaction of serving patients with complex, multifaceted needs.

Doctorate Degree

Pursuing a DNP degree equips NPs with profound clinical expertise, opening doors to leadership roles, policy-making, and advanced practice areas. Alternatively, an NP with a PhD or EdD gears NPs towards academia and research, carving a niche in molding future healthcare professionals and groundbreaking studies. All avenues promise elevated salaries, a broader career trajectory, and the prestige of holding the highest nursing degrees.


As mentioned above, fellowships are specialized training in specific areas such as cardiology, oncology, or emergency medicine. This intense, focused training ensures NPs are well-prepared to handle intricate cases, making them sought-after professionals in their specialty, which can reflect in both job opportunities and remuneration.

Volunteer for Leadership Roles

Taking up leadership roles within clinical settings or in professional bodies showcases an NP's commitment to the profession's growth. These roles often come with responsibilities that can amplify an NP's influence, expand their network, and pave the way for other prestigious opportunities, potentially with increased compensation and benefits.

Precepting and Teaching

Share knowledge by mentoring NP students or conducting workshops as an expert in your field. It not only garners respect from peers and students but can also lead to opportunities in academic settings, curriculum development, or even consulting roles.

Serving On Boards

Being a board member allows NPs to be at the forefront of decision-making processes in healthcare institutions or associations. This influence can lead to systemic improvements in patient care, policy modifications, and can elevate the NP's profile within the professional community.

Join Professional Organizations

Memberships in professional bodies offer more than just networking opportunities. They provide NPs access to resources, advanced training, and platforms for advocacy – all vital tools for professional growth, keeping abreast of industry changes, and positioning oneself as an active, engaged professional.

Networking, Conferences, and Workshops

Dedication to continuous learning and fostering connections can significantly propel an NP's career. Conferences and workshops are hotspots for the latest industry trends, research findings, and innovative practices. Networking at such events can lead to collaborative projects, job offers, or even partnerships, ensuring an NP's skills and knowledge remain at the pinnacle of the profession.

Embracing Your NP Career

NPs stand at the forefront of patient care, offering a blend of both nursing and healthcare services. As they navigate this challenging and rewarding role, new NPs, in particular, may be exposed to the stresses and demands of heightened responsibilities. The shift from a registered nurse to an advanced practice role can be invigorating, but it's essential to recognize the importance of personal well-being in this journey. Balancing the demands of the job with self-care, being vigilant about the signs of burnout, and seeking mental health support when needed are not just strategies for success but vital for the longevity of your career. Here's some advice tailored for new NPs to help them flourish personally and professionally:

Don’t Forget to Practice Self-Care!

  • Prioritize Sleep: Fatigue can impair clinical judgment. Aim for 7-9 hours of sleep daily to ensure you're well-rested.

  • Healthy Nutrition: Eating a balanced diet fuels your body and mind. Carry healthy snacks for energy during long shifts.

  • Stay Active: Regular physical activity can reduce stress. Find an exercise routine that fits your schedule, even if it's just a 10-minute walk.

  • Set Boundaries: Learn to say "no" when necessary and ensure you take breaks during your shifts.

  • Engage in a Hobby: Enjoy activities you love outside of work. It helps to have an outlet unrelated to your profession.

How to Prevent Burnout

  • Know the Signs: Recognize early signs of burnout like exhaustion, cynicism about work, or feeling ineffective.

  • Seek Out Regular Supervision or Mentorship: Regular check-ins can offer support, guidance, and a space to debrief challenging cases.

  • Establish a Good Work-Life Balance: Ensure you're not over-scheduling yourself and have time for personal and family life.

  • Continuous Learning: Engage in professional development. Feeling competent can combat feelings of inadequacy.

  • Delegate When Possible: Utilize your team. Remember, you don't have to do everything alone.

Mental Health Support

  • Peer Support: Conversations with colleagues can offer insight and understanding since they're in the same field.

  • Professional Counseling: Consider therapy or counseling as a proactive approach to managing stress and emotional challenges.

  • Mindfulness and Meditation: Techniques like deep breathing, meditation, and progressive muscle relaxation can manage anxiety and stress.

  • Avoid Isolation: Connect with friends and loved ones regularly. Social connections can act as a buffer against stress.

  • Seek Resources: Familiarize yourself with resources available through your workplace or professional organizations designed to support NP mental health.

Remember, as a new nurse practitioner, you're transitioning into a role with increased responsibilities. It's normal to feel a mix of excitement and apprehension. Prioritizing self-care, being proactive about burnout, and seeking mental health support are essential to ensuring you have a long, healthy, and fulfilling career.

References & Resources

*State-specific nursing boards or regulatory bodies (e.g., California Board of Registered Nursing, New York State Education Department - Office of the Professions)

**Please note that specific salary ranges, licensing requirements, and resources may vary by state or country. It's essential to consult your jurisdiction's relevant nursing organizations and regulatory bodies for accurate and up-to-date information.

Contributors & Reviewers 

Maria Pfrommer, DNP, Ph.D., FNP-BC, RN, Director of Nursing Education 

Elizabeth Lucas, EdD, RN, CNE, Senior Content Manager

Kelsey LaFayette, DNP, ARNP, FNP-C, Nursing Content Manager 

Lisa Miklush, PhD, RN, CNS, Senior Content Editor 

We hope you love this guide as much as we enjoyed making it.

Happy learning, everyone!