Return to table of contentsdeliberations, AACN introduced what is still a seminaldocument, The Essentials of Master’s Education forAdvanced Practice Nursing (1996). The recommendationsin it, and the fact that contributing participantswere from state nursing boards and federal governmentagencies as well other nursing organizations, effectivelyset in stone core curriculum standards by which NPprograms could secure or lose accreditation. Specifically,the Essentials required that all NP master’s students (aswell as those in other advanced nursing programs) takedidactic courses in advanced health and physical assessment,advanced physiology and pathophysiology, andadvanced pharmacology. (See Education and training ofNPs for more on the AACN’s Essentials document.)One year later, in 1997, Congress ushered in Medicaremanaged care programs that allowed NPs to independentlybill for their services. State nursing boardsquickly came under greater pressure to expand NPs’prescribing rights—though it was still too early to assesshow well nursing schools programs had implanted thenew curriculum essentials, including pharmacologyand prescribing.To address that issue, in 1998 the then-named U.S.Department of Health and Human Services’ HealthResources and Services Administration published itsCurriculum Guidelines and Regulatory Criteria for FamilyNurse Practitioners Seeking Prescriptive Authority to ManagePharmacotherapeutics in Primary Care. The documentwas developed by the NCSBN and NONPF to helpstate nursing boards evaluate the quality of pharmacologyeducation that FNPs received in their master’s-level nursingprograms. This document and the accompanyingNONPF Model Pharmacology and PharmacotherapeuticsCurriculum Guidelines recommended that all FNP studentstake a discrete one-semester, 45-contact-hour coursein advanced pharmacology and that pharmacology beintegrated into all content, especially clinical courses.It stressed “appropriate application” of the pharmacotherapeuticscontent and advised that faculty havea graduate-level pharmacology or pharmacotherapeuticdegree. 61Hoping to further prove NPs’ competence (and helpthem command higher salaries), 62 the American NursesCertification Commission (ANCC) worked with curriculumexperts to develop the first certification examsfor various NP specialties. In 1981 the ANCC offeredits first NP certification exam. Soon other nursingspecialty societies began creating their own certificationexams (at times competing with ANCC), creatingburdensome work for the state nursing boards, whichwould themselves have to assess whether each exam wasa valid assessment of NP competence. (See NP specialtycertification for more information.)Despite the confusion, or perhaps because of it, all statesnow allow NPs some degree of prescribing privileges.In fact, 12 states have granted NPs the autonomyto prescribe medications independent of physicianinvolvement or oversight. 63DemographicsIn 2006 the total number of licensed NPs reported by 48state nursing boards (Washington and Maryland did notsupply numbers) was 119,712. (See Figure 1.) Verispan,a service that collects and rents mailing lists of professionals,reported 131,532 NPs in the United States as ofDecember 2007. 64 Various surveys have determined that94 to 95 percent of NPs are female. Although it did notsupply details of NPs’ years in practice, an AmericanAcademy of Nurse Practitioners (AANP) report aboutits 2006 member survey stated that in 2006 the meannumber of years in practice for the 5,308 NPs who completedthe survey was 8.9 years. 65Employment types and localesFrom 7,800 NPs across the country who responded toa 2007 salary survey, the AANP determined that thelargest practice settings for NPs are physicians’ offices(31.8 percent), hospital-based outpatient services(11.4 percent) and hospitals (10.2 percent). The preliminarysurvey results, released in March 2008, werenot complete, but it appears, from responses by full-timeNPs who reported their salary levels, that approximately61. Health Resources and Services Administration. 1998. Curriculum Guidelines and Regulatory Criteria for Family Nurse Practitioners Seeking Prescriptive Authorityto Manage Pharmacotherapeutics in Primary Care. Appendix E, p. 37. www.eric.ed.gov. Retrieved April 1, 2008.62. Several certifying organizations mention the higher salary potential in their promotional materials.63. Pearson L. The Pearson Report (2008). The American Journal for Nurse Practitioners. February 2008, Vol. 12, No. 2.64. Verispan. Healthcare List Division. Retrieved February 26, 2008. www.ehealthlist.com/general_nppa.asp?UserId=&UserFN=&Loggedon=.65. American Academy of Nurse Practitioners (AANP). AANP 2006 membership survey. www.aanp.org. Retrieved March 24, 2008.Scope of Practice Data Series: Nurse practitioners • III. Nurse practitioner profession14
Return to table of contents5.4 percent worked in emergency departments or urgentcare settings, 4.8 percent were in community healthcenters, 3.5 percent were in independent practice and3.4 percent in Veterans Affairs facilities. 66From 6,279 NPs across the country who responded to a2008 salary survey, the AANP determined that the largestpractice settings for NPs are physicians’ offices (30.3percent), hospital-based outpatient services (11.6 percent)and hospitals (9.8 percent). Of the 2,737 full-timeNPs who reported their salary levels, the survey datashow 5.8 percent working in emergency departments,4.5 percent in community health centers, 2 percent ina private NP practice. 5.2 percent in Veteran’s Administrationfacilities and 2.8 percent in occupational/employee health.A 2007 survey, performed by Advance for Nurse Practitioners,found that of 6,162 respondents, 23 percentpracticed in a rural setting, 39 percent in suburbs and 38percent in cities. That same study also found that 3 percentof NPs owned their practice and 11 percent morehoped to own their own practice within five years. 67,68Salary dataThe 2008 AANP survey also reported the mean basesalary (not including benefits, bonuses and other compensation)for full-time NPs as $84,250 (down from$87,400 in 2007). Emergency and urgent care NPsreported a mean base salary of $96,270, and for NPs inindependent private practice it was $87,250. Mean basesalaries for those working in community clinics and physicianoffices were $79,120 and $80,430 respectively. 6966. AANP. 2007 AANP National NP Compensation Survey, June 2007. p. 1–2. www.aanp.org. Retrieved March 24, 2008.67. Web. Advance for Nurse Practitioners, 2007 National Salary and Workplace Survey of Nurse Practitioners, nurse-practitioners.advanceweb.com. RetrievedFeb, 25, 2008. Checking this Web site on April 1, 2008, we found that the full survey results no longer appear on this Web site. Instead there is an editorialsummary, which does not include the practice setting figures shown here.68. Advance for Nurse Practitioners is owned by Merion Publications and offers various services, publications, and online resources for NPs.69. AANP. 2008 AANP National NP Compensation Survey. www.aanp.org/NR/rdonlyres/36CEA27C-144A-4846-86AE-6C812E86D7B2/0/NPCompensation2008.pdf. Retrieved December 27, 2008.Scope of Practice Data Series: Nurse practitioners • III. Nurse practitioner profession15
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