Family Nurse Practitioner Salary, Role, and Scope of Practice

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An FNP meets with patients.
The American health care system has a growing need for advanced practice nurses, including nurse practitioners. Many experts project that in the coming decade, the U.S. will see a significant shortage of trained physicians, leading to large gaps in overall health care availability. This shortage stems from the aging of baby boomers, which has led to a rise in patients with chronic conditions. Many medical schools and colleges are struggling to keep pace with this demand.

When doctors are in short supply, advanced practice nurses may be able to pick up some of the slack. These nurses can diagnose patients, develop and implement treatment plans, and provide ongoing case management. Indeed, advanced practice nurses already provide primary care for many Americans, and many of these nurses are family nurse practitioners (FNPs). In fact, according to the American Association of Nurse Practitioners, 49.2% of all nurse practitioners hold the FNP designation.

FNPs can play a significant role in providing cost-effective, high-quality care for patients and in offering support and stability to a health system in flux. As such, opportunities abound for advanced nursing professionals who wish to make positive contributions to patient outcomes. One way to take advantage of such opportunities is by pursuing an advanced education, such as a Bachelor of Science (BSN) to Doctor of Nursing Practice (DNP) degree.

What Does a Family Nurse Practitioner Do?

To better understand the role family nurse practitioners play in patient treatment and care, it’s important to understand what this job entails.

Family Nurse Practitioner Job Description

A family nurse practitioner is a registered nurse with advanced training, specialization, and certification. While achieving status as an RN is one prerequisite, FNPs also have additional clinical practice and formal education requirements.

Family nurse practitioners are trained to provide treatment and care to children as well as adults. They generally work in the field of family practice, and may work with the same patients from childhood through adulthood. An FNP’s role may include comprehensive care to help patients maintain a safe and healthy lifestyle.

Responsibilities of a Family Nurse Practitioner

As they provide care for their patients, FNPs have a number of vital responsibilities, including:

  • Evaluating and diagnosing patients. FNPs perform physical examinations, collect medical histories, and diagnose their patients.
  • Screening and disease prevention. Success as a family nurse practitioner requires the use of health screenings and evaluations, helping with early detection of chronic or acute conditions such as cancer, diabetes, or cardiovascular disease.
  • Developing and implementing treatment plans. Once a diagnosis has been made, the family nurse practitioner formulates an effective treatment, which may include lifestyle changes, pharmaceutical intervention, physical therapy, or a referral to a specialist.
  • Management of chronic conditions. In the course of their practice, family nurse practitioners will likely have patients who struggle with chronic conditions, such as diabetes, arthritis, or inflammation. Part of their job is helping patients learn to cope with and manage these conditions.
  • Patient education. FNPs also advise patients on how to live healthy lifestyles and minimize their risk of illness. This might include nutritional coaching or tips on effective stress management. When treating children or adolescents, family nurse practitioners must also communicate care plans to parents or guardians.
  • Conducting research. The family nurse practitioner’s clinical practice may be augmented with experimental work or other forms of research, helping to deepen their understanding of effective patient care.
  • Public health advocacy. Family nurse practitioners who work in community clinics or urgent care facilities may be responsible for promoting healthy living within the community.
  • Collaboration with other professionals. In some care contexts, advanced practice nurses may work in collaboration with physicians, partnering to provide high standards of care. Family nurse practitioners must also be prepared to refer their patients to relevant specialists, such as substance abuse coaches, mental health care providers, oncologists, etc.

What does a family nurse practitioner do? The basic job description is wide-ranging and complex, depending on the specific needs of the patient, community, and health facility.

Essential Skills of a Family Nurse Practitioner

In order for family nurse practitioners to provide optimal patient outcomes, several essential skills are required.

  • Clinical judgment. FNPs must be adept at evaluating patients, conducting exams, and implementing the right treatments. Extensive clinical experience is a major asset to effective family nurse practitioners.
  • Critical thinking and decision-making. Successful FNPs also must be prepared to analyze a patient’s needs, think through possible diagnoses, and reach sound conclusions about how best to treat a condition.
  • Compassion. In working as an advanced practice nurse, it’s not uncommon to meet with patients who have serious, chronic, or even terminal conditions. The ability to provide understanding, empathetic care is crucial.
  • Communication. Family nurse practitioners must be equipped to communicate diagnoses and care plans to patients and, if the patient is a minor, to parents or guardians. Additionally, being able to educate patients about nutrition, wellness, and disease prevention is an important aspect of the job.
  • Collaboration. While some family nurse practitioners practice solo, others work in conjunction with physicians and other advanced practice nurses. Cooperation with other medical providers is an essential skill for success in this role.

These skills can be honed through clinical practice, as well as through degree or certificate programs.

Family Nurse Practitioner Salary and Job Outlook

Those interested in working as family nurse practitioners will want to consider both the expected salary range and the current job forecast.

Family Nurse Practitioner Salary

According to data from the U.S. Bureau of Labor Statistics (BLS), the median salary for a family nurse practitioner is $115,800.

However, a number of factors can determine a specific FNP’s salary. One of the most significant factors is experience. Those with longer tenure and more experience in advanced practice nursing will generally command higher salaries.

In some cases, education might also be a factor in determining salary. This is mostly true in academic medical settings, where having a DNP can provide a salary advantage over those with a Master of Science in Nursing (MSN).

Geography is another major factor in salary range. Some markets have a higher demand for family nurse practitioners than others and thus may offer more generous salaries. As a rule of thumb, larger metropolitan areas tend to offer higher salaries.

Finally, area of clinical practice is an important consideration. Nurse practitioners certified in specialty practices such as geriatric care or substance abuse counseling may command higher salaries.

Family Nurse Practitioner Job Outlook

According to BLS data, the field is expected to grow by 26% between 2018 and 2028. This is much faster than the projected average growth for all jobs, and suggests that advanced practice nursing is a field rich in opportunity. It is important to note that the specific job outlook for nurse practitioners varies according to location.

While there are a number of potential factors to consider here, surely one of them is the expected shortfall of physicians. With an anticipated deficit of primary care providers, many health care organizations are looking for qualified advanced practice nurses who can fill this crucial role.

Family Nurse Practitioner Role in Health Care

Where does the FNP role fall within the broader context of the American health care system? There are a number of clinical contexts in which a family nurse practitioner can practice, though they often provide primary care.

According to the American Association of Nurse Practitioners, about 89% of all nurse practitioners are prepared for primary care and about 75% work in a family practice role.

The organization notes that nurse practitioners comprise “the most rapidly growing component of the primary care workforce,” and that their combination of medical expertise and nurse training makes them uniquely suited to care for patients in an ever-changing health care landscape.

Care Settings for a Family Nurse Practitioner

The family nurse practitioner role can be fulfilled in any of the following settings.

  • Hospitals. Many FNPs work in hospital settings, where they provide acute care to patients in need and in some cases may offer a medical specialty, such as women’s health. Family nurse practitioners can also develop specialized practice areas focused on oncology, neonatal care, and more.
  • Outpatient care facilities. Many patients choose outpatient care facilities as a way to receive quick and cost-effective care, particularly for acute injuries or illnesses. FNPs are well-equipped to fill this need.
  • Educational institutions. FNPs may also find opportunities to practice in educational institutions, including teaching hospitals. In these settings, research and clinical trials may be a significant part of the job. For family nurse practitioners who wish to work in an academic setting, pursuing a DNP can be especially fruitful, helping FNPs command a higher salary level.
  • Rural care. Many rural areas face a significant dearth of primary care providers, and FNPs can fill the gap. In this role, an FNP might diagnose and treat patients, help prevent the spread of disease, and offer wellness promotion. “Compared to other primary care disciplines, NPs are most likely to practice in rural communities,” says the American Association of Nurse Practitioners. “Indeed, 18% of NPs practice in communities of fewer than 25,000 residents.”

Family Nurse Practitioner Scope of Practice

Generally speaking, the family nurse practitioner scope of practice is fairly wide, as FNPs treat patients of all ages and often operate in primary care rather than specializing. As such, the scope of responsibility for a family nurse practitioner may range from pediatric to geriatric care.

About the Family Nurse Practitioner Scope of Practice

The American Association of Nurse Practitioners provides a helpful summary of how nurse practitioners work. “As licensed, independent practitioners, NPs practice autonomously and in coordination with health care professionals and other individuals,” the organization states. What this means is that nurse practitioners do everything from diagnosing and managing health problems to promoting healthy lifestyles, implementing disease prevention measures, and counseling patients on an individual, family, or community level.

However, there are limits to what a nurse practitioner may do, which can vary by state. One key example is the prescriptive authority. FNPs may prescribe medications and controlled substances in all 50 states, but some states allow nurse practitioners to prescribe medications with complete autonomy, while others require that they do so in collaboration with a supervising physician. A few states also impose probationary periods before nurse practitioners are allowed to prescribe medications.

Similarly, some states allow nurses full practice authority (FPA), which means they can diagnose and treat patients without the need for any kind of contract, relationship, or supervision from a physician. However, in some states, nurse practitioners must work in collaborative practice, meaning they must have support or oversight from a qualified doctor.

Specialized Practice Areas

Some family nurse practitioners pursue advanced training and credentialing in specialized practice areas. Some examples of these niche areas of practice include women’s health, neonatal care, and pediatrics. Pursuit of a specialized practice area can sometimes lead to higher salaries or additional opportunities for career advancement, particularly in markets where these specialties are in high demand.

The family nurse practitioner (FNP) designation stands separate from the adult gerontology nurse practitioner role (AGNP). The former focuses on care for all ages, from pediatrics through adulthood. AGNPs generally focus on care for adults only, and may sometimes have a particular emphasis on geriatric care, such as treatment management for those with dementia and other age-related health conditions. Both the FNP and AGNP distinctions offer ample opportunity to treat diverse patient groups, fulfill a primary care role, and pursue career advancement.

Pursuing an Advanced Nursing Career

As the American population ages and the health care industry becomes increasingly fragmented, primary care providers are both more important and in shorter supply than ever. Nurse practitioners can fill this role, seek optimal patient outcomes, and provide a sense of stability to a health care environment that’s evolving and uncertain.

One of the best ways to advance your career as a nurse practitioner is to enroll in an online degree program, such as Regis College’s online BSN to DNP program. The curriculum provides the skills and clinical experience needed to advance your understanding of nursing, and to diagnose and treat patients with greater autonomy. Learn more about Regis College and assuming new levels of responsibility for patient outcomes.

Recommended Readings
What Is a Doctor of Nursing Practice? Examining an Advanced Degree
How Nurses Can Help Heal Childhood Trauma in Adults
Nurse Safety and Prescribing Medications: A Delicate Balance

ACOG, “What Is the Job Outlook for Primary Care Nurse Practitioners?” 
American Association of Nurse Practitioners, “Nurse Practitioner Role Grows to More Than 270,000”
American Association of Nurse Practitioners, Scope of Practice for Nurse Practitioners
American Journal of Managed Care, “Nurse Practitioners Play an Increasing Role in Primary Care”
The Balance, “What Does a Nurse Practitioner (NP) Do?”
Health Affairs, “Primary Care Workforce Data and the Need for Nurse Practitioner Full Practice Authority” 
U.S. Bureau of Labor Statistics, Nurse Anesthetists, Nurse Midwives, and Nurse Practitioners