Becoming certified for the first time can be a confusing process
I was inspired to write this series to serve as a guide for student and new nurse practitioners. I remember being faced with so many things to consider during my last year of my family nurse practitioner program and my first year after graduation, and wishing I had someone to guide me through that transitional time. Now that I have worked as an NP in a few different specialties, I have compiled information that I feel would benefit new NPs. I love teaching and using knowledge I’ve acquired to help others. It is my hope that this article can provide navigation for student and new NPs.
Part 1 provides students and new NPs with a guide to navigate specialty certification.
The FNP certification exam review course I took was offered by Fitzgerald Health Education Associates (FHEA; www.fhea.com). Review courses help new NPs prepare for the NP certification exam, independent of which certifying body you decide to test with. In addition to the preparation, contact hours for attending the seminar are provided and group discounts are available.
The FHEA review course provided a great review and excellent summary covering common conditions seen in primary care, as well as a deeper scope of practice from pediatric to adult and pregnancy. The instructors of the course offered advice about test-taking strategies and structure of the exam, which was an anxiety reliever when it came time to take the test. I would definitely recommend taking a review course before sitting for an exam.
Other organizations offering NP certification exam review courses include, but may not be limited to, Advanced Practice Education Associates (APEA) at http://www.apea.com/, Necessary NP Review at http://www.necessaryworkshops.com/, and Barkley & Associates at http://www.npcourses.com/.
Taking the Certification Exam
The two certifying bodies for FNPs are the American Association of Nurse Practitioners (AANP; handled by the AANP Certification Program or AANPCP) and the American Nurses Credentialing Center (ANCC). To make an informed decision about which certifying body to choose for your board exam, make sure you know the differences.
At the time that I took the exam, AANP was the only organization that provided provisional results (pass or fail) at the end of the test, so I chose the less stressful route. Additionally, I chose AANP because it was more affordable and I preferred the credentials NP-C over APRN, BC (which ANCC provided at that time). NP-C is shorter and possibly easier for the public to identify.
Steps to Getting Started in Practice
With few exceptions, recognition and practice as an NP in the U.S. requires certification through a national organization and licensure through the state board of nursing. Once you decide on the certifying body to test with and register accordingly, you will fill out a form ahead of time and send it in with your application. That form is what your certifying body (AANPCP or ANCC) will then notify the state board of nursing with once you pass.
For most states, certification through a national organization such as AANPCP or ANCC and the state Board of Nursing licensure are needed in order to practice.
You may be offered a position before passing boards; this is called a conditional offer. You must pass and have your license in hand within a certain specified time frame in order to remain employed at the workplace.
Once You’ve Passed the Test
NPI stands for National Provider Identifier. This is part of the Health Insurance Portability and Accountability Act (HIPAA) of 1996 mandate requiring a standard, unique identifier for healthcare providers. This number eliminates the need for other identifiers with all health insurance providers: Medicare, Medicaid, Blue Cross/Blue Shield, etc. The cost to apply is free. For an application, visit https://nppes.cms.hhs.gov/NPPES/Welcome.do Since it is possible that your employer may apply for you, check with them or contact the NPI first to find out whether you already have a number assigned to you.
A DEA license is only required for prescribing controlled substances. It is not required for prescribing antibiotics or non-narcotic analgesics. You should always check with your employer first, since you may or may not need to apply for your own DEA license. If you do, your employer may reimburse you for this. Because it is costly, check with your employer about prepayment or reimbursement.
The following is an example of a step-by-step guide for NPs to follow when applying for a DEA license. This guide applies to NPs who are first-time applicants and practicing in the state of Michigan, therefore the process may be different for NPs renewing their DEA license or working in other states.
How to Apply for Your DEA License in Michigan
- Go to www.deadiversion.usdoj.gov and click on DEA Forms & Applications on the right.
- Click on New Registration Applications to apply online.
- You want form 224 for midlevel practitioners (MLP). For business activity, select MLP-Nurse Practitioner. Hit “Begin.”
- The cost to apply is $731, and the resulting license is valid for 3 years.
- Fill it out online up to where it asks for your signature, then print it out, sign your name and fax it into your local DEA office along with copies of your RN and NP licenses, and (if required) a copy of the Delegation of Prescriptive Authority Agreement signed by your collaborating physician.
- Call your local DEA office 3 days after faxing all the necessary materials to make sure your application is complete and all necessary materials have been received.
Tips for filling out DEA application:
- For a business address, put the address of the facility where you will be practicing.
- A state controlled substance registration is not required for APRNs, including NPs, in Michigan.
- NPs in Michigan are to apply for schedules 3, 3N, 4, 5 unless they are working in a hospital, freestanding surgical outpatient facility or hospice setting in which the delegating physician also practices.
DEA license is current for 3 years, at which point it would then need to be renewed.
Professional Organization Membership
A final note about life after graduation. Get involved in your profession!
There are numerous benefits to joining a professional organization, including professional and political representation; “power in numbers” with regard to legislative issues such as securing independent prescriptive authority and securing direct reimbursement for NP services; foundation for networking among other NPs and primary care providers; and the opportunity to earn continuing education units through seminars/conferences/dinners, often free or discounted for members. A list of the primary national NP organizations is below:
- American Association of Nurse Practitioners (AANP): http://www.aanp.org/
- National Association of Nurse Practitioners in Women’s Health (NPWH): http://www.npwh.org/
- National Association of Pediatric Nurse Practitioners (NAPNAP): http://www.napnap.org/
- Gerontological Advanced Practice Nurses Association (GAPNA): http://www.gapna.org/
- National Organization of Nurse Practitioner Faculties (NONPF): http://www.nonpf.org/