Representing nearly 70% of the 325,000 certified nurse practitioners in the United States, according to the American Association of Nurse Practitioners (AANP), family nurse practitioners (FNPs) are helping to address the twin problems of a physician shortage in primary care and aging baby boomers with growing health care needs. While operating at the forefront of health care, FNPs work with patients in areas ranging from preventive care to the treatment of serious illnesses.
Working as an FNP is a rewarding profession with the opportunity to offer a broad spectrum of health care services or specialize in a particular area, such as the treatment of diabetes, obesity or another chronic health condition. And while the types of health care that FNPs can provide are extensive, so are their work environments.
The diversity of where family nurse practitioners can work makes the profession appealing to individuals with various preferences and ambitions. BSN-prepared RNs who pursue an online Master of Science in Nursing position themselves to deliver care as FNPs in settings where they feel most comfortable and can do their best work.
Family Nurse Practitioners Work in Many Health Care Settings
So exactly where can a family nurse practitioner work? The AANP lists the top three practice settings as hospital outpatient clinics, private group practices and private physician practices.
Hospital Outpatient Clinics
Driven by factors such as advances in technology, Medicare payment practices, incentives to cut costs and a desire to improve patients’ experience, hospitals are increasing their expansion into outpatient services. Hospital outpatient clinics are located primarily in large urban areas, and nurse practitioners who work in hospital outpatient clinics treat patients with a wide variety of health issues such as diseases of the digestive system; ear, nose, throat and mouth; and circulatory system.
According to the AANP’s 2020 survey:
- When nurse practitioners who worked in hospital outpatient clinics made referrals, they most often referred their patients to physician specialists.
- Almost 98% of nurse practitioners working in hospital outpatient clinics prescribed medication, writing an average of 18 prescriptions per day.
Private Group Practices
Private group practices can focus on a single specialty or operate as multispecialty practices, so the range of care that nurse practitioners can provide in those settings depends on the particular group practice. The Medical Group Management Association forecasts that group practices that offer primary care will benefit from a growing emphasis on disease prevention; it also expects group practices to increase their delivery of services focused on chronic care management.
The AANP’s 2020 survey found:
- While working in private group practices, nurse practitioners saw about 18 patients daily.
- Roughly 98% of nurse practitioners working in private group practices prescribed medication, and they wrote an average of 23 prescriptions per day.
Private Physician Practices
By hiring nurse practitioners, private physician practices can increase the number of patients they treat and free physicians’ time to work on patients’ more complex health issues. For example, nurse practitioners who work in private physician practices can conduct examinations and screenings, educate patients about their medications and how to administer them and see patients for follow-up visits.
According to the AANP’s 2020 survey:
- While working in private physician practices, nurse practitioners treated an average of 19 patients daily.
- About 99% of nurse practitioners working in private physician practices prescribed medication, writing an average of 27 prescriptions per day.
But the locations where family nurse practitioners can work are not limited to those three settings. For example, FNPs also work in:
- Emergency rooms
- Urgent care centers
- Community health centers
- Schools
- Nursing homes
FNPs Can Establish Their Own Private Practices
Individuals who are exploring where family nurse practitioners can work can also establish their own private practices. The services FNPs can provide, as well as the degree of required supervision, are determined by the states in which they practice. The AANP categorizes states as follows:
- Full-practice states. These states permit nurse practitioners to offer services such as evaluating and diagnosing patients, ordering tests, managing treatment and prescribing medicine.
- Reduced-practice states. These states reduce nurse practitioners’ ability to provide at least one element of practice and require nurse practitioners to have agreements with other health providers to offer health care, or they place restrictions on the setting of at least one element of practice.
- Restricted-practice states. These states’ licensure and practice laws restrict nurse practitioners from offering at least one element of practice, and they require supervision, delegation or team management by another health provider to provide health care.
FNPs who want to open private practices also need to consider other challenges they may face, such as:
- Choosing a business structure for the practice (e.g., sole proprietorship or limited liability company)
- Developing a business plan
- Gaining expertise in the aspects of operating a business (e.g., accounting, billing, information technology and human resources)
- Marketing the practice
- Obtaining professional liability insurance for the practice
FNPs Are Needed in Rural Areas, Internationally and in Telehealth
In terms of geographic location, the settings where family nurse practitioners can work are almost unlimited. For example:
- FNPs are particularly well suited to offer health care in rural areas, where a scarcity of providers is especially severe and patients frequently have to travel long distances to obtain health care.
- Working internationally is an option available to FNPs. For example, the U.S. Department of State’s Bureau of Medical Services hires nurse practitioners for overseas assignments providing health care to diplomats and their families. FNPs also can work for Doctors Without Borders, often training local nurses and health providers.
- FNPs have been part of the increasing use of telehealth, providing services remotely from any location. Their role in telehealth continued to expand during the COVID-19 pandemic.
FNPs Have Choice in Their Work Environments
Because of the numerous settings where family nurse practitioners can work, individuals can choose the type of environment that best aligns with their preferences. Registered nurses who may be interested in becoming an FNP can explore the University of North Dakota’s online Master of Science in Nursing program and learn how it can help them pursue their professional ambitions. Discover a career in health care that offers a wide variety of workplace options today.
Recommended Readings
FNP vs. PNP: Comparing Nursing Career Paths
How to Become a Family Nurse Practitioner
What Is the Role of a Family Nurse Practitioner?
Sources:
American Association of Nurse Practitioners, NP Fact Sheet
American Association of Nurse Practitioners, Practice Management
American Association of Nurse Practitioners, “The State of the Nurse Practitioner Profession 2020”
American Association of Nurse Practitioners, State Practice Environment
American College of Physicians, Group Practices
American Nurse, “Starting a Nurse Practitioner Clinic: Legal Considerations”
Berxi, “How to Open Your Own Private Practice as a Nurse Practitioner”
Deloitte Insights, “Growth in Outpatient Care”
Doctors Without Borders, Registered Nurses/Nurse Practitioners
Fast Company, “As Thousands of Doctors’ Offices Shutter, Telehealth Becomes a Way of Life”
Johnson & Johnson, Family Nurse Practitioner (FNP) at a Glance
Medical Economics, “The Value of Nurse Practitioners to Medical Practices”
Modern Healthcare, “Rural Women Must Often Travel Great Distances for Care”
The Nurse Practitioner, “How NPs Can Help Expand Telehealth Services”
U.S. Department of State, About the Bureau of Medical Services