California Occupational Guides

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Detailed Guide for

Nurse Practitioners in California

May also be called: Advanced Practice Nurses

Specialties within this occupation include: Acute Care Nurse Practitioners; Acute Care Pediatric Nurse Practitioners; Adult Nurse Practitioners; Family Nurse Practitioners; Gerontological Nurse Practitioners; Neonatal Nurse Practitioners; Pediatric Nurse Practitioners; Pediatric Primary Care Mental Health Specialists; Psychiatric Nurse Practitioners; and Women’s Health Nurse Practitioners

What Would I Do?

Nurse Practitioners (NPs) are registered nurses (RNs) who have received additional training to become NPs, which are considered advanced practice registered nurses (APRNs). The NPs specialize in providing primary care services to patients and families. The NPs perform physical examinations, provide primary care procedures, such as immunizations, and refer patients to specialists when necessary. The NPs are trained to diagnose and manage illnesses. The NPs perform their activities under the supervision of a physician. However, NPs may perform independently if the activities are specifically approved through their facility’s standardized procedures.

The NPs may focus on serving a particular population. For instance, Family Nurse Practitioners see newborns, infants, children, adolescents, adults, pregnant and postpartum women, and older adults. These NPs have a broad knowledge of people, all ages, focusing on the family unit and its individual members. A few other specialty areas are listed below.

Gerontological Nurse Practitioners focus on older adults and the bodily changes that come with aging. In addition to the primary care of their patients, these NPs treat physical issues common in older adults, such as dementia. These NPs may also work with others in planning for skilled nursing care and end-of-life care decisions.

Pediatric Nurse Practitioners provide care to newborns through young adults. Pediatric NPs have a thorough knowledge of well child care and the prevention or management of illnesses common to children. The NPs specializing in pediatrics also take into account factors that affect a child’s development, such as culture and parenting styles. Pediatric NPs may subspecialize in primary care or acute care, where they manage the serious and urgent care needs of children in hospitals or home settings. Nurse Practitioners may specialize in mental health of children and adolescents.

Women’s Health Nurse Practitioners provide health services for women throughout their lives from general to reproductive health issues.

Within these specialties NPs often practice in subspecialty areas such as emergency, neurology, orthopedics, and pain management to name a few. For instance, Pediatric Primary Care Mental Health Specialists assess, evaluate, diagnose, treat, and monitor common behavioral and mental health problems. However, they coordinate with others to provide care for the complex mental health disorders.

Tools and Technology

Nurse Practitioners frequently use cardiac monitors, electronic blood pressure units, and endoscopes. They also use intravenous (IV) administration sets, suction kits, and surgical lasers. They use medical, e-mail, spreadsheet, Internet browser, and word processing software.

Important Tasks and Related Skills

Each task below is matched to a sample skill required to carry out the task.

View the skill definitions
TaskSkill Used in this Task
Prescribe medication dosages, routes, and frequencies based on patients' characteristics such as age and gender.Complex Problem Solving
Order, perform, or interpret the results of diagnostic tests such as complete blood counts (CBCs), electrocardiograms (EKGs), and radiographs (x-rays).Medicine and Dentistry
Analyze and interpret patients' histories, symptoms, physical findings, or diagnostic information to develop appropriate diagnoses.Inductive Reasoning
Develop treatment plans based on scientific rationale, standards of care, and professional practice guidelines.Science
Diagnose or treat acute health care problems such as illnesses, infections, and injuries.Monitoring
Prescribe medications based on efficacy, safety, and cost as legally authorized.Judgment and Decision Making
Counsel patients about drug regimens and possible side effects or interactions with other substances such as food supplements, over-the-counter (OTC) medications, and herbal remedies.Oral Expression
Recommend interventions to modify behavior associated with health risks.Psychology
Detect and respond to adverse drug reactions, with special attention to vulnerable populations such as infants, children, pregnant and lactating women, and older adults.Critical Thinking
Educate patients about self-management of acute or chronic illnesses, tailoring instructions to patients' individual circumstances.Problem Sensitivity
Diagnose or treat chronic health care problems such as high blood pressure and diabetes.Deductive Reasoning
Source: U.S. Department of Labor Occupational Information Network (O*NET)

Working Conditions

The NPs work practically everywhere health care is provided. Many may work in clean, sterile environments such as hospitals and clinics. Work settings for NPs vary with their specialty ranging from elderly patients’ homes, schools, long-term or acute care facilities, and private physician or NP practices. Work activities of NPs may require a lot of walking, bending, stretching, and standing. The work of NPs may put them in contact with potentially harmful drugs and people who have infectious diseases. Therefore, they must follow strict, standardized guidelines to guard against diseases and other dangers.

The NPs working for clinics may be required to travel to multiple sites. Those who work in offices, schools, and other places keep regular business hours. Some NPs work flexible hours including evenings and weekends, especially those working in facilities providing 24-hour care.

According to a 2010 survey conducted by the University of California, San Francisco for the California Department of Consumer Affairs, Board of Registered Nursing (BRN), Certified Nurse Practitioners (CNPs) averaged working about 34-35 hours per week with few working overtime or on call.

Nurse Practitioners may join a union, such as the Nurse Alliance of California or the California Association of Nurse Practitioners.

Will This Job Fit Me?

Those who like frequently working with, communicating with, and teaching people may find this occupation gratifying. In addition, those who enjoy helping or providing services to others may find fulfillment in this occupation.

What Wages and Benefits Can I Expect?

Wages

The median wage in 2020 for Nurse Practitioners in California is $132,748 annually, or $63.82 hourly. The median is the point at which half of the workers earn more and half earn less.

Change to Hourly Wages
Annual Wages for 2020Low
(25th percentile)
Median
(50th percentile)
High
(75th percentile)
California$117,211$132,748$159,326
Source: EDD/LMID Occupational Employment Statistics Survey, 2020 Wages do not reflect self-employment.
View Wages for All Areas

Benefits

Typical benefits for NPs include medical, dental, life, and vision insurance as well as vacation, sick leave, and retirement plans. Some employers also offer malpractice insurance. Some offer assistance with federal loan repayment, requiring a commitment to work a specific period of time for the employer.

What is the Job Outlook?

Employment growth for Nurse Practitioners will be strong as the number of primary care physicians decrease. In addition, their demand will be fueled by the effects of healthcare legislation, an increased emphasis on preventative care, and the demand from a large, aging baby-boom population for healthcare services as they live longer and more active lives than previous generations.

Projections of Employment

In California, the number of Nurse Practitioners is expected to grow much faster than average growth rate for all occupations. Jobs for Nurse Practitioners are expected to increase by 35.1 percent, or 4,600 jobs between 2016 and 2026.

Estimated Employment and Projected Growth
Nurse Practitioners
Geographic Area
(Estimated Year-Projected Year)
Estimated
Employment
Projected
Employment
Numeric
Change
Percent
Change
Job
Openings
California
(2016-2026)
13,10017,7004,60035.112,000
Source: EDD/LMID Projections of Employment by Occupation
View Projected Growth for All Areas

How Do I Qualify?

Education, Training, and Other Requirements

An individual must become a licensed registered nurse before training to become a NP. California’s NPs tend to initially earn a bachelor of science degree or higher to become a registered nurse. Then, the licensed registered nurse completes a master’s degree or higher in a Nurse Practitioner program approved by the BRN. Applicants for state licensure must pass the BRN’s background check.

Experience

Frequently, employers that focus on specific clientele require one to three years of experience in their field of practice, such as pain management or oncology. Additionally, NPs must complete a minimum of 500 hours of clinical supervised practice in their specialty to be eligible for certification. In order to obtain a furnishing number from the BRN to provide controlled substances, the NP must first obtain six months of supervised experience furnishing drugs.

Early Career Planning

It is recommended that those who want to become Nurse Practitioners take college preparatory courses. Classes such as English, math, science, social studies, and a foreign language will be helpful. Additional courses like biology, chemistry, health science, and computer literacy will help prepare for the college classes necessary for this occupation. Volunteering in a health care setting will provide exposure and skills to help prepare for a health career. Introductory courses in health care are offered by some Regional Occupational Programs (ROPs) for those wanting to explore the field of health care. To find an ROP program near you, go to the California Association of Regional Occupational Centers and Programs Web site.

Work Study Programs

Supervised clinical experience is an integral part of the training to become a nurse. Additional clinical experience is also part of the Nurse Practitioner training program.

Continuing Education

In order to continually improve the quality of care that NPs provide, it is important for them to keep up with research and relevant regulations. To renew the RN license and NP certifications, nurses must obtain varying units of continuing education. Contact the agency that issues the license or certificate for specific information.

Licensing and Certification

The BRN issues the registered nursing license and the two-year, advanced practice certificate to Nurse Practitioners. To obtain the RN license, applicants must pass the National Council Licensure Examination (NCLEX-RN), pass a background check, and pay the appropriate fees. There are three methods for RNs to obtain an advanced practice certification for Nurse Practitioners from the BRN. Additional information is available at http://www.rn.ca.gov/applicants/ad-pract.shtml. Contact the agency that issues the license for additional information. Click on the license title below for details.

Certification by the BRN is required to practice in California as a Nurse Practitioner. The BRN accepts some national associations’ certifications as evidence of meeting the BRN’s requirements for certification. To be able to order or provide controlled substances to patients, they must obtain a two-year renewable furnishing number from the BRN and a three-year furnishing number from the U.S. Drug Enforcement Agency. Additional information is available at www.rn.ca.gov/applicants/ad-pract.shtml.

The AANPCP issues national certification in three specialties: adult, gerontologic, and family. Licensed nurses who have earned a master’s or higher in an approved Nurse Practitioner program may take the certification exam. This certification can be renewed every five years by passing an exam or completing the required clinical and continuing education hours. Contact the certification board for details at www.aanpcertification.org.

The Pediatric Nursing Certification Board (PNCB) issues certification to those who pass an exam and meet their criteria. The PNCB requires completion of a master’s or higher. The PNCB also requires licensure and certification by the BRN. The PNCB also recommends applicants obtain continuing education and a minimum of 1,000 hours of clinical experience in pediatric behavioral mental health.

The American Nurses Credentialing Center (ANCC) offers five-year certifications for Nurse Practitioners in several specialties. For information, refer to ANCC’s site at www.nursecredentialing.org/Certification.

The National Certification Corporation (NCC) offers three-year Nurse Practitioner’s certificates in neonatal, obstetrics, and women’s health. Certification details can be found on the NCC’s site at www.nccwebsite.org.

Many employers require CPR or Basic Life Support certification. In addition, employers may want their NPs to have certifications unique to their specialty, such as chemotherapy for those working in oncology. For more information, go to the U.S. Department of Labor's Career InfoNet Web site and scroll down to "Career Tools." Click on "Certification Finder" and follow the instructions to locate certification programs.

Where Can I Find Training?

There are two ways to search for training information:

  • Search by Field of Study to find what programs are available and what schools offer those programs. You may use keywords such as: Family Practice Nurse or Nurse Practitioner.
  • Search by Training Provider to find schools by name, type of school, or location.

Contact the schools you are interested in to learn about the classes available, tuition and fees, and any prerequisite course work.

Where Would I Work?

The largest industries employing Nurse Practitioners are as follows:

Industry TitlePercent of Total Employment for Occupation in California
Offices of Physicians46.8%
Outpatient Care Centers21.2%
General Medical and Surgical Hospitals15.3%
Colleges and Universities3.4%
Local Government2.5%
Source: EDD/LMID Staffing Patterns

Finding a Job

Direct application to employers remains an effective job search method. The Internet, college placement offices, medical recruiters, health care staffing agencies, and professional associations are sources for job leads. In addition, clinical experience during training provides networking opportunities.  Online job opening systems include JobCentral at www.jobcentral.com and CalJOBSSM at www.caljobs.ca.gov.

To find your nearest One-Stop Career Center, go to Service Locator. View the helpful job search tips for more resources. (requires Adobe Reader).

Yellow Page Headings

You can focus your local job search by checking employers listed online or in your local telephone directory. Below are some suggested headings where you might find employers of Nurse Practitioners.

  • Community Health
  • Family Health
  • Health
  • Hospitals
  • Medical
  • Physicians
  • Women's Health

Find Possible Employers

To locate a list of employers in your area, go to "Find Employers" on the Labor Market Information Web site:

  • Select one of the top industries that employ the occupation. This will give you a list of employers in that industry in your area.
  • Click on "View Filter Selections" to limit your list to specific cities or employer size.
  • Click on an employer for the street address, telephone number, size of business, Web site, etc.
  • Contact the employer for possible employment.

Where Could This Job Lead?

Some NPs may move into management of ambulatory, acute, home-based, and chronic care businesses. Others may become postsecondary teachers in colleges or universities.

Related Occupations

Below is a list of occupations related to Nurse Practitioners with links to more information.

OccupationOccupational
Guide
Industry
Report
Occupational
Profile
Nurse AnesthetistsGuide
Nurse MidwivesGuide
Nursing Instructors and Teachers, PostsecondaryProfile
Profile

Other Sources

  • California Department of Consumer Affairs, Board of Registered Nursing
         www.rn.ca.gov
  • American Academy of Nurse Practitioners
         www.aanp.org
  • California Association for Nurse Practitioners
         www.canpweb.org
  • The National Certification Corporation
         www.nccwebsite.org
  • Pediatric Nursing Certification Board
         www.pncb.org

These links are provided for your convenience and do not constitute an endorsement by EDD.

For the Career Professional

The following codes are provided to assist counselors, job placement workers, or other career professionals.

SystemCode
SOC - Standard Occupational Classification29-1171
O*NET - Occupational Information Network
   Nurse Practitioners29-1171.00
   Interest Codes (RIASEC)SIR