Family nurse practitioners and opportunities for specialization

Family nurse practitioners, known as FNPs, are advanced practice registered nurses (APRNs) who have pursued specialized graduate education and provide primary health care services to people across the age spectrum. They fulfill a crucial role in the health care system and have a focus on health promotion and health education.

FNPs can perform many of the same duties as a medical doctor and often provide primary care for patients, especially in rural or underserved areas. Depending on the state they live in, they can have varying levels of practice authority, which refers to the level of physician oversight they require. 

The services provided by FNPs are varied, are always patient-facing, and as well as their responsibilities in treating illnesses and injuries, they are also expected to teach people about disease prevention and healthy lifestyle habits.

Duties range from the assessment and diagnosis of health conditions, conducting routine physical exams, prescribing medications and other therapies, to developing and carrying out treatment plans for acute and chronic illnesses. Additionally, FNPs will order and interpret lab and other diagnostic tests, assist in minor surgeries, make appropriate referrals when needed, and provide primary health care with an emphasis on preventative care.

FNPs are often employed in hospitals and private medical offices, but they can also work in a wide variety of settings, such as clinics, community health centers, colleges and universities, and outpatient medical facilities. They can also work using telemedicine and assist patients in their homes, within home health care and in telemedicine.

Throughout their studies and clinical residencies, FNPs will often have the opportunity to enter into a subspecialty. This means they will go through a standard family nurse practitioner degree program and may be able to take specialty elective courses or complete their clinical requirements in a specific area in order to get the experience required to pass additional, optional certification exams. These certifications can be obtained at any time during their careers.

It is not a requirement for an FNP to subspecialize, but many students find that adding a certification will expand their opportunities for employment and allow them to practice in the focused area of care that interests them most.

The broad scope of responsibilities within the role of the FNP allows for focus on a range of sub-specialties that deal with specific patient populations, offering an opportunity to refine skills and knowledge within the wide sphere of family healthcare. Popular subspecialties include acute care, pediatrics, gerontology, women’s health, nurse midwifery, emergency room, oncology, dermatology, and occupational health, and there are some similarities in certain areas with regard to a focus on health education and outreach.

Subspecialties for nurse practitioners

In order to make decisions as to what subspeciality a family nurse practitioner wants to follow, it’s important to understand the remit of those other nurse practitioner roles, too, and how they can overlap with some of the job requirements of FNPs.

Acute care nurse practitioners

These are advanced practice registered nurses who specialize in providing care to patients with acute and/or critical medical conditions, and they mainly work in hospital settings, emergency departments, intensive care units, and in cardiology or neurology. They are trained to manage complex and rapidly changing medical conditions and work as part of a healthcare team with other healthcare professionals.

Pediatric nurse practitioners

This specialty provides regular health care for children. Pediatric nurse practitioners have advanced education and training in looking after infants, children, and teens. They can deliver much of the healthcare needed by children, consulting doctors and specialists where necessary. Similarly to family nurse practitioners, much of their role involves education—in this case, for children and their families about growth and childhood development—and they can also treat acute illnesses such as ear infections and rashes as well as manage chronic illnesses such as asthma. 

Gerontology nurse practitioners

These provide care to older adults by performing examinations, diagnosing conditions, and giving out prescriptions. They work in settings such as hospitals, long-term care facilities, and private homes.

Women’s health nurse practitioners

Women’s health nurse practitioners provide biological, intersex, and transgender women with healthcare throughout their lives, with a focus on general women’s health, including gynecological and obstetric health. They work in a variety of settings, including private practice offices, clinics, universities, and hospitals, and provide well-visited care, disease prevention and education, contraceptive counseling, and prenatal support, amongst other duties. 

Nurse midwives 

The role of a nurse midwife includes educating women on birth options and helping them in planning their birth, monitoring maternal health and fetal growth, attending births in hospitals and birthing centers, and assisting mothers with breastfeeding, self-care, and postpartum healthcare.

Emergency room nurse practitioners

This specialty works in acute care settings such as emergency departments and urgent care facilities. They diagnose and treat children, adults, and seniors for illnesses, primary care needs, trauma, or injuries. FNPs who want to specialize in emergency care can do so in three ways—either via continuing education and clinical practice, the completion of an emergency care or postgraduate program, or via an emergency fellowship program.

Oncology nurse practitioners

These are caregivers to patients with cancer and specialize in cancer screening and prevention, giving direct care to oncology patients in active treatments and remission and working in cancer research. NPs with general degrees are able to practice within this field, and they can specialize by gaining a nurse practitioner degree with oncology as a subspeciality or a post-master’s certification from an accredited program. 

Dermatology nurses

Dermatology nurses provide a crucial element in the diagnosis and treatment of skin conditions and diseases, handling patient cases that range from eczema to skin cancer. Duties will include conducting treatment plans, developing treatment plans, and performing procedures such as skin biopsies. They also play a vital role in promoting skin health and educating patients about sun protection and good skincare habits.

Occupational health nurse practitioners

These nurses are able to work in a range of settings, such as industrial organizations and educational workplaces, and are responsible for the health and safety of the people who work in them. Responsibilities will include monitoring employee health, encouraging better choices, and educating the workforce about effective health and safety in order to reduce work-related injuries.

What makes a good nurse practitioner?

Acquiring the skills and knowledge required to be an effective nurse comes from studying the right course and learning through practical experience, as well as improving and nurturing personal characteristics that draw candidates to the profession in the first instance. 

For example, when dealing with someone’s health, it is important to be attentive to what they tell you so it’s easier to pick up on clues as to what may be the cause of their complaint or what lies behind their symptoms. Good communication skills are crucial, whether it be with patients, colleagues, or management, and this encompasses not only good speaking skills but also actively listening to others. 

Empathy is an important quality for effective nurse practitioners and enables them to put themselves in their patient’s shoes and identify with their feelings. Empathy is regarded as an integral element in building a trusting patient-provider relationship. Tenacity is also a useful characteristic, as nurse practitioners have to persevere and sometimes develop alternative plans to help patients, using out-of-the-box thinking when necessary. 

Effective time management is vital in order to deal with the patient and workload demands of the role. Taught in school and clinical rotations, it is something that develops with experience. It’s important to make the most of what could be limited time spent with patients, for example, and learn how to succinctly communicate with them by asking the right type of questions and politely controlling conversations to ensure they remain on topic.

Steps to becoming a family nurse practitioner

Although gaining the qualifications and experience required to become an FNP can vary depending on how students decide to pursue their degree—whether it be full-time, part-time, in-person, or online, the steps will be:

Earning a bachelor of science in nursing

This is a four-year bachelor’s degree program accredited by the American Association of Colleges of Nursing (AACN) or the Commission on Collegiate Nursing Education (CCNE). It is also possible to become a nurse by earning a two-year associate degree in nursing (AND), although the AACN recognizes a bachelor’s as the minimum educational requirement for professional nursing practice. 

Getting licensed as a registered nurse

In order to get an RN license, nurses have to pass the NCLEX (National Council Licensure Examination), which is a nationwide examination for the licensing of nurses in both the United States and Canada.

Gaining experience working as a registered nurse

Most nurses will work for a few years to gain experience in providing patient care.

Obtaining further education through an accredited family nurse practitioner program

Further education courses can be completed either via full-time or part-time programs and offer the option of taking classes online or in a traditional campus setting. 

Considering which family nurse practitioner specialties to pursue is a very important element of career planning for FNPs, whether they are at the beginning of their studies or already within the workplace and seek to specialise. Choosing a reputable program is vital, so a candidate can get the best out of their course and feel confident they are moving forward in their chosen career. The University of Indianapolis’ School of Nursing’s online programs are designed to prepare students for careers in nursing, including advanced practice, education, and health systems leadership, providing a top-tier education and support throughout their academic journey.

Applicants can get assistance and guidance from dedicated enrolment advisors who can answer questions about tuition, admission requirements, clinical placement, and more. They can be reached by email, or students can fill out a form in order to arrange an appointment time that is convenient for them.

Students become certified as FNPs either by passing the certification exam from the American Nurses Credentialing Center (ANCC) or the American Academy of Nurse Practitioners (AANP). Before taking the certification exams, candidates must have a current, active RN license in a state or territory of the US or the equivalent in another country, a master’s postgraduate or doctoral degree from an FNP program accredited by the CCNE or the ACEN, a minimum of 500 faculty-supervised clinical hours, and a completed graduate-level course in advanced physiology/pathophysiology, advanced health assessment, or advanced pharmacology.

As well as gaining specific examinations in order to pursue their career, it’s important for FNPs to commit to lifelong learning as they progress. According to an article published in The National Library of Medicine, continuing professional development is central to nurses’ lifelong learning and is part of the way nurses are able to keep their knowledge and skills up to date. This can be done through the workplace, via courses, webinars, or seminars, through undertaking extra studies and pursuing professional certifications, or by the nurses themselves taking responsibility for reading relevant research papers or more general articles related to health and medicine. 

The future outlook

The job outlook is excellent for family nurse practitioners. According to the Bureau of Labor Statistics, overall employment of nurse anesthetists, nurse midwives, and nurse practitioners is expected to grow 38% between 2022 and 2032, which is much faster than the average for all occupations, and there are expected to be around 29,000 openings for these roles each year, on average, over those ten years.