The healthcare sector needs advanced practice professionals who can deliver comprehensive patient care. Many healthcare professionals have shifted to remote work. It means the healthcare system needs more hands-on experience, especially with the increasing aging population and diverse medical issues.

Family nurse practitioners (FNPs) are one of the vital professionals that hold important roles in healthcare organizations. An FNP’s scope of practice goes beyond being a registered nurse. These professionals arm themselves with advanced skills and knowledge through progressive learning and experience to provide optimal health services to patients.

If you’re an aspiring nurse or an RN wondering how to become a nurse practitioner in North Carolina, Texas Woman’s University can show you the steps and path to becoming one. TWU has programs for aspiring FNPs in NC, and all over the country, to improve their skills and expand their knowledge. It discusses the courses you need to take, exams you need to pass, and opportunities you can access in North Carolina. This article will also discuss the factors to expect in a career as an FNP, including the regulations and opportunities that come with the role.

Who are family nurse practitioners?

Family nurse practitioners (FNPs) are advanced practice registered nurses (APRNs) who can care for patients of all ages, from infants to seniors. Here’s what this means: Imagine a healthcare professional with the clinical expertise necessary to diagnose and treat a four-year-old child with sinus issues who can also treat a 64-year-old elder with diabetes. That’s who family nurse practitioners are.

They have several responsibilities, including conducting physical examinations, interpreting tests, and observing medical histories. FNPs’ clinical duties are almost identical to a physician’s, but they have a distinctive nursing perspective to support their skills. They also add broader areas of nursing, such as leadership, education, and counseling, to their roles.

Family nurse practitioners can specialize in different fields. Their ability to specialize in any field of their choice is one of their strong suits. Pediatric FNPs, for instance, focus on children’s health through wellness checks, immunizations, etc. On the other hand, geriatric FNPs care for elderly patients and tackle their age-related health challenges.

FNPs are healthcare chameleons who can adapt their skills to give the best patient care, regardless of their healthcare setting. However, like most professions, specific regulations guide FNPs, and it’s essential to know and understand these regulations.

Key regulations guiding the profession of family nurse practitioners

While these regulations may vary state by state, these are the common rules nurses follow when guiding family nurse practitioners:


Like every profession, FNPs must have an adequate and quality educational portfolio. To become a family nursing practitioner, nurses must first become registered nurses (RNs). You’ll need to earn an associate’s or bachelor’s degree in nursing and pass the National Council Licensure Examination (NCLEX-RN) to become an RN. This education and training phase focuses on general nursing practice and is the foundation for all advanced knowledge.

Once you have clinical experience as an RN, you can enroll for a doctor of nursing practice (DNP) or a master’s degree in nursing (MSN). Texas Woman’s University’s online master of science in nursing (FNP) program teaches nurses an advanced approach to leadership skills and critical thinking.

The curriculum in this stage dives deeper into advanced nursing practices, such as advanced pharmacology and pathophysiology. They also learn about health promotion, disease prevention, research methods, health policy, and leadership. Advanced education also teaches students through clinical practices, where they get hands-on training that lets them apply their knowledge in real-world contexts.


All FNPs must have an active RN license. You get an RN license when you complete a nursing degree and pass the NCLEX-RN. They must also obtain advanced practice registered nurse (APRN) licensure when they complete their advanced degree.

The requirements for APRN licensure vary by state but generally include:

  • Having an active RN license
  • Earning a graduate degree from an accredited nursing program
  • Passing a national certification exam

Medical bodies, such as the American Nurses Credentialing Center (ANCC), offer this examination. For instance, in North Carolina, both the RN and APRN licenses are issued by the North Carolina Board of Nursing. FNPs must renew their licenses periodically, and renewal often requires that nurses enroll in continuing education to ensure they remain current with constantly evolving healthcare practices.

Prescriptive authority

Prescriptive authority is an FNP’s legal ability to prescribe medications, including controlled substances, to their patients. Being able to prescribe drugs means that FNPs can provide comprehensive care to patients in the absence of a physician. This authority shows that these professionals can hold independent practices.

However, the level of prescriptive authority varies across states. Some states allow “full practice,” where FNPs can prescribe drugs to patients independently. Other states have “restricted practice” or “reduced practice,” where physicians must collaborate, supervise, or agree with the FNP before they can prescribe.

In “full practice” states, FNPs can observe and diagnose patients, order a lab test and interpret the results, and also commence treatment without the supervision of a physician. States like this believe that FNPs are skilled enough to treat patients, and it is especially beneficial for rural areas where doctors are in short supply.

Many states, including North Carolina, grant FNPs the authority to prescribe a full range of medications, including Schedule II-V controlled substances. This permission helps them manage and modify their patients’ medication regimens effectively.

States that offer “reduced practices” make it compulsory for the FNP to have a collaborative agreement with the physician. It means that while FNPs have a certain level of independence, they must consult a physician before they can make certain medical decisions for patients.

Of course, reduced practices still give nurses a level of autonomy. “Restricted practice” states don’t allow it. In regions like this, FNPs have little to no authority over diagnosing and treating patients independently.

Family nurse practitioners must meet specific criteria to have this authority. First, they must have completed advanced pharmacology coursework and maintain a valid RN license and advanced practice certification. Secondly, depending on their location, they may need to obtain a separate prescribing license. They may also need to apply for a Drug Enforcement Administration (DEA) number, which allows healthcare providers to write prescriptions for controlled substances.

Continuing education

As mentioned earlier, continuing education is essential to maintaining your licensure and certification. What’s continuing education? They’re the courses, seminars, and webinars you take to brush up on your knowledge of a particular area or practice. In the case of nursing, it’s a crucial way for FNPs to stay updated with the ever-evolving medical field.

State licensure boards and certification bodies usually require FNPs to complete a certain number of continuing education units (CEUs) every one to two years for licensure and every five years for certification. Although the exact number can vary by state and certifying organization, this training sharpens their competence and helps them hone their expertise.

FNPs primarily pursue continuing education to enhance their practice. They may attend workshops, seminars, and conferences to learn from industry experts. They may also participate in webinars and online courses. These programs teach FNPs various topics in nursing, including new treatment protocols, emerging technologies, recent research findings, and healthcare policy and ethics updates.

FNPs may also choose to pursue continuing education to grow in their area of practice. Family nurse practitioners can treat patients of varying ages, but they can also choose to focus on one specific area. For example, an FNP might explore updates in chronic disease management or pediatric care. Continuous learning can help them discover better ways and knowledge to treat their patients.


FNPs must maintain detailed and accurate patient records at all times. These records usually contain the patient’s history, such as their medical and family history. It may also contain their examination and test results, medications prescribed to them, their last appointment, a new diagnosis, and treatment plans. What record-keeping does is help any other professionals treating this patient understand their health status and treat them according to existing plans.

Record-keeping can also help in making informed clinical decisions. How? A physician can decide whether to stop an existing treatment for a diabetic patient by studying the records of how the patient reacted to the medications.

Besides these, FNPs must also keep a good record for legal purposes. Medical records can serve as legal records of the care provided and can protect nurses in cases of malpractice claims. Hence, family nurse practitioners must have excellent documentation skills and stay updated on legal requirements for medical documentation.

Job opportunities in the family nurse practitioner career

Family nurse practitioners’ (FNPs) knowledge and unique skills have created a surge in demand for them across the healthcare landscape. This demand provides several opportunities for FNPs in various settings, including:

Primary care

As primary healthcare providers, FNPs are often the initial and most frequent point of contact for patients within the healthcare system. Their role is particularly significant in rural areas without enough physicians.

In these underserved communities, FNPs treat patients with varying health conditions, from common illnesses like the flu or sinus infections to chronic diseases such as diabetes and hypertension.

FNPs in primary care settings can conduct regular check-ups and preventive screenings for individuals, administer immunizations for children, and provide health education and counseling to community members. They can also prescribe medications and therapies and refer patients to specialists if needed.

FNPs don’t just prescribe; they also follow up on their patients over time, helping them manage their health across different life stages. It helps them build long-term relationships with patients, and this relationship enables them to understand their patient’s health history, lifestyle, and preferences.

The role of FNPs as primary care providers in North Carolina is especially prominent due to the state’s significant rural population and physician shortage. This gap in healthcare services has led to an increased reliance on FNPs to meet the primary care needs of these communities. And while they often work independently, FNPs also collaborate with physicians, depending on the specific practice regulations in the state.

Specialty practices

FNPs have unique skills and training that allow them to care for patients during their time of treatment. However, they also have the opportunity to choose an area of specialty to cater to specific patient populations. This area of specialty may be pediatrics.

FNPs with an interest in caring for children, infants, and adolescents can decide to work in pediatric clinics, children’s hospitals, or school-based health centers. Here, they can provide check-ups, immunizations, growth and development monitoring, and cater to acute challenges for common or complex childhood illnesses. They can also play a critical role in health education for children and their parents.

FNPs hoping to specialize in a field can also choose geriatrics. As the population ages, there is an increasing demand for healthcare professionals who focus on health promotion, chronic disease management, cognitive impairment, and end-of-life care for older adults. They often work in primary care clinics, long-term care facilities, and home health care to ascertain the health of adults for as long as medically possible.

You can also decide to work in the area of women’s health. These professionals offer services around reproductive health care, prenatal and postnatal care, menopause management, and preventive screenings like mammograms and Pap tests. They often work in OB/GYN practices, women’s health clinics or family planning centers to ensure that women’s health remains a priority before, during, and after pregnancy or other reproductive health issues.

FNPs can also work on mental health to provide counseling, prescribe medications, and manage treatment plans for patients with mental health conditions. If you’re interested in oncology, you can help coordinate care for cancer patients, provide emotional support to families, and ensure that the latest medical approaches are ingrained into their care. Any of these areas of specialty will keep you fulfilled while doing tangible work for a population that needs your input.


FNPs play an essential role in hospitals, integrating their skills, knowledge, and adaptability to different care scenarios. For example, they are the first healthcare providers to evaluate patients in emergency departments. The goal is to conduct urgent assessments, stabilize patients, order and interpret necessary diagnostic tests, and initiate timely interventions.

In intensive care units (ICUs), FNPs manage complex and critically ill patients by monitoring their conditions, interpreting advanced diagnostic tests, and creating a treatment plan that meets their needs. Their critical thinking skills are crucial in this high-stakes environment where patients’ health statuses change rapidly.

FNPs in surgical departments assist in procedures, provide pre-and post-operative care, and educate patients and families about the surgical process and recovery. They work with surgeons, anesthesiologists, and other healthcare professionals to ensure patients get the best treatment procedures.

FNPs also serve as hospitalists to provide comprehensive care to hospitalized patients. They operate well in specialized departments such as cardiology, neurology, oncology, pediatrics, and more. All these let them collaborate with a multidisciplinary team to provide specialized care to patients.

Long-term care facilities

FNPs also work in nursing homes and assisted living facilities to provide regular care to residents with chronic conditions. In this setting, they do more than care for patients. They perform regular health assessments to spot symptoms and manage chronic conditions in the aging population. These could be diabetes, heart disease, dementia, and arthritis. They are also skilled at identifying changes in a resident’s condition, which is crucial for early intervention to avoid potential complications.

FNPs also manage medication regimens for residents. They review patient medications, check for potential interactions, and adjust dosages as necessary. They also assess the effectiveness of the medications and monitor for any side effects.

In addition to physical health, FNPs pay close attention to residents’ mental and emotional well-being. They are trained to recognize symptoms of depression, anxiety, and other mental health problems that may affect older adults, particularly those in long-term care facilities. They can then provide counseling, prescribe appropriate medications, and coordinate with mental health professionals.

These professionals can also collaborate with others to offer the best service possible. Their flexibility and desire to provide quality healthcare services may demand working with physicians, nurses, physical therapists, dietitians, and social workers. FNPs must be able to manage this multidisciplinary team, ensure the patient receives the best care possible, and help enhance their quality of life.


Digital health has opened up a new dimension in healthcare delivery, with telemedicine being one of its most significant innovations. FNPs can now leverage this technology to extend their reach and improve patient care.

Telemedicine is the delivery of healthcare services through digital platforms. It allows patients to see and discuss their healthcare providers without leaving the comfort of their homes. They may consult their provider through video calls, and the healthcare professional may monitor their patient’s vitals using digital devices.

For FNPs, telemedicine helps them care for people without the constraints of geographical location. This is particularly beneficial for patients with mobility issues who may find it difficult to visit the healthcare center regularly. Its technology simplifies FNPs’ responsibilities and makes it easier to care for their patients.


Family nurse practitioners (FNPs) are essential players in contemporary healthcare. Their roles and responsibilities are evolving with the changing needs of patients and communities, and these professionals continually enhance the quality of their services to match these needs, whether serving as primary care providers or leading their own practices.