The state of California is in the midst of a primary care crisis. According to a 2016 survey by the California Primary Care Association, by 2030, the state will need an estimated 8,243 additional primary care physicians to meet the needs of patients in need of these important services. The number is a 32% increase compared to the 25,153 doctors employed in this area of practice in 2010.
To meet the rising demand for primary care, a growing number of healthcare organizations are supplementing their physician staff with other forms of providers, such as physician assistants and nurse practitioners. A nurse practitioner — or NP — is an advanced practice nurse who is qualified to provide many of the same services as a doctor, including assessing and diagnosing patients. For many registered nurses, NP roles are exciting opportunities to further their skill set and play a more independent role in healthcare delivery.
Interested in pursuing a career as an NP? With growing demand and numerous nurse practitioner programs California and out-of-state residents alike can choose from, the state is a great place to launch your career. To get started, you will need to find a program that offers your chosen specialty, meets the academic requirements and equips you to complete state licensure.
What is a Nurse Practitioner?
Classified as mid-level providers, nurse practitioners are an integral component of the comprehensive care delivery system. The American Association of Nurse Practitioners describes the responsibilities of professionals in these roles as the blend of “clinical expertise in diagnosing and treating health conditions with an added emphasis on disease prevention and health management.”
As opposed to the typical responsibilities of registered nurses, NPs are able to provide a number of services traditionally assigned to a physician, including:
- Ordering and analyzing diagnostic and laboratory tests, such as x-rays and EKGs.
- Diagnosing illnesses and injuries.
- Prescribing pharmaceuticals.
- Prescribing rehabilitation services, such as physical therapy.
- Creating treatment plans.
- Assisting in or performing minor procedures and surgeries, such as suturing and casting.
While registered nurses traditionally provide patient care as a component of a healthcare team, an NP has a higher level of independence. In some states, they can even provide primary care in an independent capacity, though current California laws require most of these professionals in the state to have some level of oversight from a physician supervisor.
As growing numbers of patients seek primary care, NPs are helping clinics, hospitals, and other healthcare organizations meet this important need. In fact, according to the American Association of Nurse Practitioners, each year Americans make more than 1.02 billion visits to NPs.
“The demand for nurse practitioners has never been higher,” AANP President Cindy Cooke told Forbes. “With the rise of full practice authority in 22 states and the District of Columbia, more patients than ever have direct access to high-quality nurse practitioner care in every setting — including the veterans’ health system.”
Becoming a Nurse Practitioner in California
According to the California Board of Registered Nursing’s 2017 Survey of Nurse Practitioners and Certified Nurse Midwives, there were 20,337 NPs in California as of November 2016. Between 2010 and 2017, employment rates were at 74 percent in urban environments and 75 percent in rural areas, with each NP working an average of 35 hours a week. The majority of NPs (61.1 percent) worked in an ambulatory setting, with the hospital reported as the second most common setting (25.7 percent).
In California — as in every state in the U.S. — NP roles require additional training and education beyond the basic nursing qualifications. According to the California Board of Registered Nursing, to apply for one of these roles in the Golden State, you must meet the following requirements:
- Hold RN certification in California.
- Complete a graduate degree.
- Earn national Nurse Practitioner Certification.
- Complete the certification application from the California Board of Registered Nursing.
If you already hold RN certification, your first step is to choose an appropriate nurse practitioner program, California-based if possible. You will be joining a large number of your nursing colleagues in this pursuit — according to the California Association for Nurse Practitioners, almost 20,000 new NPs are educated each year through programs at more than 350 colleges and universities across the country.
When it comes to meeting the academic qualifications for NP practice, the Master of Science in Nursing is the most common option. While some nurses do pursue a Doctor of Nursing Practice or Ph.D. in Nursing, a doctoral-level degree is not required to practice in California. Consequently, if you are considering a career as an NP, you will most likely want to start by looking at MSN programs.
Earning an MSN Degree
Educational requirements for professionals in the nursing field are on the rise. In 2010, the Institute of Medicine released its report, “The Future of Nursing: Leading Change, Advancing Health,” in which the organization recommended increasing the number of nurses with a Bachelor of Science in Nursing degree to 80 percent by 2020. In the past, nurses who wished to advance in the workplace earned a BSN to set themselves apart. But as the degree becomes increasingly common, the Master of Science in Nursing has increasingly taken its place as the standard for nurse leaders — which includes aspiring nurse practitioners.
The general MSN is a graduate-level degree that typically takes about two years to complete, though the exact length of the program will depend on your course load. The classes in these nurse practitioner programs (California and out-of-state alike) are designed to provide you with the advanced practice skills required to assume leadership positions, generally in a chosen specialty within the scope of nurse practitioner practice. If you are interested in a career as an NP, you will typically look for a program that offers an MSN program with a nurse practitioner concentration or specialty.
When it comes to obtaining acceptance in a nurse practitioner program, California residents and out-of-state applicants alike are generally expected to hold a Bachelor of Science in Nursing degree, possess current registered nurse certification, and already have some experience working in the nursing field.
At National University, as with the majority of master’s in nursing, California-based programs, the specific admission requirements for the MSN program include the following:
- Hold a BSN from a State Board of Nursing approved, nationally accredited School of Nursing at a regionally accredited university.
- Hold current, active and unencumbered RN licensure in the state in which you reside.
- Have earned a cumulative GPA of at least 3.0 on a 4.0 scale in your previous degree program. Any applicants with a GPA between 2.5 and 2.99 will be considered on a case-by-case basis.
Keep in mind that meeting these requirements does not guarantee you will be accepted. Your application will be reviewed on a holistic basis by a National admissions committee, but fulfilling these standards is a good start.
Don’t have a bachelor’s? Some institutions offer RN to MSN fast-track options which combine the BSN and MSN degrees into one seamless program.
Choosing Your MSN Specialty
When it comes to choosing nurse practitioner programs, California and other states will often offer the option of choosing a specialty within the NP degree. Consequently, the area of practice that you wish to go into after graduation will play a significant role in what specific program you choose to attend.
Common nurse practitioner areas of specialization include family practice, acute care, pediatrics, adult gerontology, and emergency medicine.
The state of California recognizes a number of NP specialties, but family nurse practitioners are by far the most common option, according to the California Board of Registered Nursing’s 2017 survey. The report revealed that the field of educational specialty among nurse practitioners in California breaks down as follows:
- Family/individual (62.8 percent).
- Adult primary care (24.6 percent).
- Pediatric primary care (16.2 percent).
- Women’s health/gender-related (15.8 percent).
- Geriatric primary care (13.6 percent).
- Acute care – adult/geriatric (9.7 percent).
- Psychiatric/mental health (7.8 percent).
- Occupational health (3 percent).
- Acute care – pediatric (2.9 percent).
- Palliative care/hospice (2.2 percent).
- Oncology (2.1 percent).
- Perinatal (1.8 percent).
- Neonatology (1 percent).
- Midwifery (0.3 percent).
- Other (5.1 percent).
Not sure which specialty is right for you? Spending time working in the clinical setting as a registered nurse is a great opportunity to experience different areas of care and gain a better idea of what option might be the best fit. If you don’t actively work with nurse practitioners in your organization, consider reaching out to local NPs who practice in areas that you find interesting to learn more about what the day-to-day looks like in their role.
Considering a Doctoral-Level Degree in Nursing
While the MSN is the more common path for aspiring nursing practitioners, some NPs do hold doctoral degrees. There are two options at this level: the Doctor of Nursing Practice — or DNP — and the Ph.D. in Nursing.
At the most basic level, the main difference between the two paths is that the DNP is a clinical-based degree, while Ph.D. programs are typically built with a research focus. If you wish to go into research in addition to — or in place of — clinical practice, a Ph.D. is likely the more appropriate choice. However, if you wish to remain primarily focused on delivering clinical care, a DNP is typically the better option.
Unsure if a doctoral-level degree is right for you? Some nurses choose to complete an MSN before deciding whether to complete a DNP or Ph.D. With an MSN on your resume, you will typically be able to complete the higher degree in a shorter period of time.
If you have previously completed a graduate-level degree, but want to advance your knowledge and skill to pursue an NP career, consider enrolling in the National University Post-Graduate Family Nurse Practitioner Certificate program, a non-degree option approved by the Commission on Collegiate Nursing Education.
Earning NP Certification
Once you have completed your degree, you will need to earn your national Nurse Practitioner Certification in order to practice in the state of California.
The California Board of Registered Nursing recognizes six classifications of advanced practice nursing:
- Nurse practitioner (NP).
- Clinical nurse specialist (CNS).
- Nurse anesthetist (NA).
- Nurse-midwife (NMW).
- Public health nurse (PHN).
- Psychiatric/mental health nurse (PMH).
The organization will accept NP licensure from a number of professional groups, including the American Nurses Credentialing Center and the American Academy of Nurse Practitioners. To sit for one of these national nurse practitioner certification examinations, you must first complete a graduate nurse practitioner program (California location is not a requirement) that has been accredited by either the Commission on Collegiate Nursing Education or the Accreditation Commission for Education in Nursing.
Once you pass your certification exam, your final step is to fill out the California APN certification application. You must already hold a California registered nurse licensure before applying. If you do not have your permanent California RN license when you apply, you will have to apply for the Temporary Nurse Practitioner Certificate.
The Job Outlook for Your NP Career
Think an NP role could be the right career for you? Based on demand in both California and across the nation, the time may be right to consider entering the field, regardless of where you wish to practice.
According to the Bureau of Labor Statistics (BLS), demand for advanced practice nurses — a category which includes nurse practitioners, nurse anesthetists, and nurse midwives — is expected to increase by 31 percent between 2016 and 2026 nationwide, a rate which is significantly higher than the average across industries. The BLS predicts this increase will add approximately 64,200 new positions to the job market from coast to coast.
California is the largest employer of NPs among states in the U.S., with 13,570 employed as of May 2017, according to the BLS. Among these practitioners, the average salary is $126,770 a year, the highest annual mean wage of any state. While that salary may make California an appealing choice, keep in mind that the state’s cost of living is also high.
When it comes to working as an NP in California, you will typically work in a role where you practice under some level of oversight from a physician. The exception is in the Veteran Affairs hospital setting. In 2016, the VA announced that it was changing provider regulations within the organization in order to give VA advanced practice registered nurses the authority to practice “to the full extent of their education, training, and certification.” This included states — like California — that would otherwise limit such full practice authority. The exception to this rule, according to the VA, is any state restriction related to the ability to prescribe and administer controlled substances.
“Advanced practice registered nurses are valuable members of VA’s health care system,” said VA Under Secretary for Health Dr. David J. Shulkin. “Amending this regulation increases our capacity to provide timely, efficient, effective and safe primary care, aids VA in making the most efficient use of APRN staff capabilities and provides a degree of much-needed experience to alleviate the current access challenges that are affecting the VA.”
Consequently, if your goal is to work as independently as possible as an NP in California, you may want to consider applying at a VA hospital. Otherwise, there is a wide variety of environments where you may want to seek employment, including private practices, clinics, long-term care facilities, and other hospitals outside the VA system. In these settings, you will still maintain a great degree of freedom in providing primary care, despite state regulations.
Your Nursing Degree With National University
When it comes to earning your nurse practitioner degree in California, National University offers four master’s degree specialization options, including the Specialization in Family Nurse Practitioner.
This program is designed to give you the skills and knowledge you need to manage the care of individuals and families across the lifespan. The program will specifically emphasize your abilities to think critically; create differential diagnoses; improve healthcare outcomes through evidence-based findings; and lead healthcare efforts in the areas of health promotion, disease prevention, acute and chronic health condition management and primary care for diverse individuals and their families. You will further be prepared to provide these primary care services in a variety of clinics and community-based settings.
With a curriculum specifically designed to prepare you for NP certification, you will be eligible to sit for the American Nurses Credentialing Center or American Academy of Nurse Practitioners national certification examinations upon graduation from the National University MSN FNP program.
To meet the unique needs of busy nursing professionals, the National program offers you the option to pursue your master’s degree through a physical classroom environment, online courses, or a combination of both. If you are currently working in the healthcare field, the online degree option can provide the flexibility you need to advance your education, while simultaneously gaining experience in the workplace.
Wondering if the MSN FNP program through National University is the right fit for your career goals? Just fill out this information form and an admissions advisor will contact you soon to discuss your options. In the meantime, consider exploring the National University MSN application instructions online on our website.