This paper examines the role development of the family nurse practitioner (FNP) as an advanced practice nursing specialty. It traces the historical origins of nurse practitioners to the 1965 Medicaid and Medicare expansions, reviews educational and credentialing requirements, and surveys major professional organizations that support the role. Drawing on a telephonic interview with a practicing FNP in Oklahoma City, the paper illustrates how the COVID-19 pandemic reshaped clinical responsibilities — reducing routine patient visits while increasing demand for breastfeeding support services. The paper also applies career development theory to identify personal traits and learning goals relevant to pursuing the FNP role, concluding with a brief educational and professional development plan.
The paper demonstrates effective use of primary source data (practitioner interview) alongside secondary literature review. By weaving the interviewee's firsthand observations into broader scholarly and regulatory context, the author shows how qualitative field data can corroborate and extend published findings — a technique particularly valuable in applied health professions writing.
The paper follows a clear four-part structure: (1) a literature-based overview of FNP history, regulations, and practice settings; (2) a detailed interview report illustrating current practice realities; (3) a reflective personal development section using career theory; and (4) a brief synthesis conclusion. This progression moves logically from the general to the specific to the personal, which is appropriate for a role-development assignment at the graduate nursing level.
One of the defining characteristics of the family nurse practitioner role is its growing ubiquity. More than two-thirds of the advanced practice nurses in the United States today hold family nurse practitioner credentials. According to nursing educators, "Family nurse practitioners (FNP) earn high salaries working in a variety of settings [and] the occupation is among the most popular specialized nursing roles with about 67% of nurse practitioners across the nation [holding] the FNP credential" (Family nurse practitioner overview, 2020, para. 3).
Some of the current practice settings for the nearly 300,000 nurse practitioners in the U.S. include family health, medical/surgical units, and research. Family nurse practitioners also work in physicians' offices, hospitals, schools, and health care clinics (Advanced practice nurse fact sheet, 2020). Moreover, a growing number of advanced practice nurses enjoy strong collaborative relationships with their health care team members, and professional nursing organizations continue to advocate for full practice authority for these professionals (Family practitioner overview, 2020). Other authorities are calling for the implementation of nursing residency programs and the elimination of scope-of-practice barriers for advanced practice nurses (Skiba, 2015).
The historical development of the nurse practitioner role dates back a half century. In 1965, an expansion of the Medicaid and Medicare programs — extending coverage to disabled people, the elderly, and women and children — created heavy demand for health care services that existing resources were unable to meet. In response, nurse practitioner programs were introduced across the country to address this growing demand, especially in rural areas (Family nurse practitioner overview, 2020).
The current regulations for education, certification, credentialing, and competencies for advanced practice nurses vary by jurisdiction. However, the provisions of the Balanced Budget Act of 1997 authorized nurse practitioners to receive direct reimbursement, and the profession became legally recognized in all 50 states. Today, obtaining an advanced nursing practice degree generally requires a master's degree and a specified amount of clinical experience.
In general, advanced practice nurses must provide the following information and documents to receive credentialing and privileging from a health care provider:
A curriculum vitae or résumé that specifies the applicant's education, work experience, license(s), board certification(s), special certification(s), and references. A diploma or certificate along with an official transcript from the applicant's nurse practitioner program, used in part to demonstrate the necessary education and training to function in a particular role. Some agencies may also require a letter or skills checklist from the applicant's program director indicating which specific skills were obtained during the course of study. Certain agencies may wish to examine case reports, histories and physicals, acute care notes, and other supporting materials as evidence of competency in a specific role. Any clinical logs kept during the applicant's studies will also help establish areas of competency. Additionally, completion of a delineation form is required, indicating which activities the applicant feels competent to provide. This assists the agency's credentialing and executive committee in determining which privileges should be granted (McMullen & Howie, 2020, p. 93).
Several professional organizations support the role of the advanced practice nurse. The American Nurses Association (ANA) established the Council of Primary Care Nurse Practitioners in 1974, an action that provided significant credibility to the emerging profession (Family nurse practitioner overview, 2020). The American Association of Nurse Practitioners was established in 1985 and currently represents the interests of advanced practice nurses across the country (Family practitioner overview, 2020).
The research showed that advanced practice nursing is legal in all 50 states and that increasing numbers of jurisdictions are authorizing these health care professionals to diagnose, prescribe certain classes of medications, and otherwise treat patients for a wide range of disorders. The research also showed that a majority of advanced practice nurses specialize in family medicine, and this percentage will likely continue to increase as the nation's health care system faces growing demands. In the final analysis, the path to becoming an advanced practice nurse is demanding and challenging, but the professional rewards make the effort worthwhile.
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McMullen, P. C., & Howie, W. O. (2020). Credentialing and privileging: A primer for nurse practitioners. The Journal for Nurse Practitioners, 16, 91–95.
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Skiba, D. J. (2015, September–October). Connected care quotient (CCQ) and the future of nursing. Nursing Education Perspectives, 36(5), 345–349.
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