What Is the Day-to-Day of a Nurse Practitioner?

Students in the Master of Science in Nursing - Nurse Practitioner (NP) program at Spring Arbor University are poised to enter rewarding careers.
Nurse practitioner jobs were listed by U.S. News and World Report among the top five Best Healthcare Jobs in 2019.
Reasons why nurse practitioner jobs earned this rank include a healthy median salary of $113,930, career satisfaction, flexibility, opportunity for growth, low stress levels, and work-life balance.
Although the nurse practitioner job description varies, and daily routine primarily depends on specialty and work setting, this article will take a look at the nature of an NP’s day-to-day.
Areas of Specialty
Nurse practitioners are advanced practice nurses who have earned their Master of Science in Nursing (MSN) and passed a licensure exam. This exam allows them to practice as an NP.
There are various areas of speciality an NP can take on. The Family Nurse Practitioner (FNP) and Adult-Gerontology Nurse Practitioner (AGNP) roles are fairly common.
Two organizations offer NP certifications in family and adult-gerontology roles: the American Association of Nurse Practitioners (AANP) and the American Nurses Credentialing Center (ANCC). The difference between these two roles involves the patient population NPs serve.
FNPs can treat patients of any age. AGNPs are focused on providing specialized care for elderly patients. Both focus areas are offered through Spring Arbor’s online MSN-NP program.
NPs can take on more than one specialization by completing a post graduate certificate program and earning additional licensing. Aside from the Family Nurse Practitioner and Adult Gerontology Nurse Practitioner roles, NPs can become:
- Acute Care Nurse Practitioners
- Emergency Nurse Practitioners
- Neonatal Nurse Practitioners
- Pediatric Nurse Practitioners
- Women’s Health Nurse Practitioners
- Psychiatric Nurse Practitioners
Other advanced practice nursing fields NPs can pursue include becoming a certified nurse midwife, clinical nurse specialist, and certified registered nurse anesthetist.
There are even subspecialities NPs can choose from including dermatology, cardiology, endocrinology, and emergency care. Depending on subspecialty, additional education and certifications may be required.
What Does a Nurse Practitioner Do?
NPs often have many of the same duties as physicians. This includes assessing, diagnosing, and treating patients. They can order tests, further exams, and communicate with other healthcare providers to ensure their patients receive comprehensive, holistic care. In all 50 states and Washington D.C., NPs can prescribe medication.
Nurse practitioners have full practice autonomy in 22 states.
Depending on which state a given nurse practitioner works in, a supervising physician may be required to be present. However, 22 states currently offer nurse practitioners full practice autonomy. This means NPs can practice on their own without being supervised by a doctor. (Source).
A growing number of states have begun leaning towards less restrictive NP practice autonomy because of the nationwide physician shortage. In some states, NPs can even run their own practices.
Where Do Nurse Practitioners Work?
Becoming a nurse practitioner is a practical option for those who want the opportunity to work in a wide range of settings. NPs may treat patients in nursing homes, schools, and speciality or mobile clinics.
The majority of NPs work in:
- Private practice: 24.2 percent
- Hospital outpatient: 14.5 percent
- Inpatient hospital units: 12.1 percent
- Federal community health centers: 8.1 percent
- Urgent care: 4.3 percent
- Emergency rooms: 3.1 percent
NPs have access to upward mobility and higher-level responsibilities as compared to registered nurses (RNs).
According to recent data from the AANP, “14.3 percent of NPs had administrative roles at their main NP practice sites, described as 'professional-level' (director, manager, or supervisor). One in five held 'executive-level' positions (CEO, CNO, or owner).”
The Daily Routine
Nurse practitioners’ daily routines tend to vary. However, some similarities exist with regard to how NPs see their patients. Many nurse practitioners work in an outpatient setting including in clinics, urgent care facilities, and primary care offices.
Those in clinic settings have scheduled appointments with patients, whereas urgent care and retail clinics accept drop-in patients. According to the AANP, over 50 percent of NPs see three or more patients per hour.
Beginning an Appointment
In clinics, nurse practitioners often have assistive personnel to help them manage patient care. For patient appointments, a medical assistant or nurse may call the patient back, review their medications and medical history, and take their vital signs to chart and report to the nurse practitioner. Depending on the job and setting, nurse practitioners may also perform these tasks.
Assessment
During assessment, nurse practitioners review chief complaints from patients, collect subjective data such as descriptions of the symptoms patients have, and then perform head-to-toe assessments to gather objective data about the patient condition.
To assist with diagnosis, nurse practitioners may order labs or other tests according to their patient assessment findings.
Labs or tests may include:
- X-rays exams
- Blood work
- Cultures
- Flu or strep swabs
- Miscellaneous tests
Diagnosis and Treatment
Once a diagnosis has been made, nurse practitioners propose treatment. Treatment can range from prescriptions for medication, different therapies, suggestions concerning lifestyle changes, and education as to how to treat illnesses at home.
As a part of holistic care, NPs often provide guidance and counseling. Nurse practitioners may also refer patients in need of higher levels of care to another provider, such as a specialist. When signs and symptoms that may indicate a serious medical emergency, nurse practitioners will send patients to the emergency department.
The Hospital Setting
Nurse practitioners working in an inpatient hospital setting often perform “rounds” with the treatment team in the morning.
NPs visiting each of their patients do the following:
- Discuss how patient’s condition is progressing
- Review data including labs and imaging studies
- Perform a comprehensive health assessment
- Make adjustments to the patient’s plan of care according to findings
NPs work with an extensive team including physicians, social workers, physical therapists, and pharmacists.
Rounds are typically completed with physicians, and may also include providers from other disciplines, such as social work, physical therapy, or pharmacology.
After rounds, what does a nurse practitioner do? This varies by job, but nurse practitioners often have an office in the hospital where they may complete documentation and review patient charts.
This includes writing notes documenting assessment findings, care plans, and changes to be made. NPs are often available for nurses to contact should they notice any changes in patient status.
Benefits of Being a Nurse Practitioner
The career of a nurse practitioner is a rewarding one, with many benefits. Ranked as a top job nationwide for several consecutive years, the growing and consistent need for professionals in this role is not likely to end soon. If you are currently a registered nurse considering the path of nurse practitioner, taking a RN to NP degree program could potentially advance your career.
NPs enjoy many benefits including:
- Workplace independence
- Flexibility
- Bright career outlook
- Work-life balance
- Substantial job satisfaction
With a predicted growth rate of 31% for NPs between 2016 and 2026, high demand reflects the wealth of opportunities available to those active and in pursuit of this role.
As the healthcare field grows, the need for nurse practitioners can only increase.
Start Your Journey as a Nurse Practitioner
Spring Arbor University’s Master of Science in Nursing- Nurse Practitioner program offers a convenient online format aiming to instill a foundation of ethical nursing practice.
Designed for working nurses, the program’s flexible structure allows for manageable pacing and multiple entry points per year, so you can start at a time that works best for you. Graduate ready to pursue licensure and advance your nursing career.
Read our blog on what you should know about the AANP vs. ANCC exam.
Click here to learn more about Spring Arbor's online MSN-NP program.
Sources:
American Association of Nurse Practitioners. (2019). NP Fact Sheet https://www.aanp.org/about/all-about-nps/np-fact-sheet
Bureau of Labor Statistics. (2019). Nurse anesthetists, nurse midwives, and nurse practitioners. https://www.bls.gov/ooh/healthcare/nurse-anesthetists-nurse-midwives-and-nurse-practitioners.htm
NP Now. (2019). Nurse Practitioner Autonomy: A Shift to More Independent Practice
U.S. News and World Report. (N.d). The 100 best jobs in America. https://money.usnews.com/careers/best-jobs/rankings/the-100-best-jobs