Category: Nursing Types & Specialties

Applying to nurse practitioner (NP) programs is a competitive process where every component of your application matters—especially your letters of recommendation. These letters provide admissions committees with crucial insights into your clinical abilities, academic potential, and personal qualities that transcend what’s visible on transcripts or resumes. This guide will walk you through who to ask, how to approach them, and how to ensure your recommendation letters strengthen your NP program application.

Who Should Write Your NP Program Recommendation Letters?

Most nurse practitioner programs require 2-3 letters of recommendation. Selecting the right recommenders is perhaps the most critical decision in this process. See our guide to enrolling in an online NP program.

Clinical Nursing Supervisors and Managers

Nursing managers and direct supervisors make excellent recommenders because they:

• Have observed your clinical decision-making abilities
• Can speak to your patient care skills
• Understand your work ethic and reliability
• Can address your interpersonal skills with patients and healthcare team members

When selecting a supervisor, choose someone who has directly observed your nursing practice over an extended period and can provide specific examples of your clinical excellence.

Nurse Practitioners or Physicians You Work With

Healthcare providers who collaborate with you clinically offer particularly valuable perspectives:

• They can evaluate your clinical judgment from a provider’s viewpoint
• They understand the demands of the role you’re aspiring to
• Their recommendations carry significant weight as they’re writing from the position you’re working toward
• They can address your potential for advanced practice responsibilities

These recommenders are especially valuable if they practice in the specialty area you’re pursuing.

Nursing Faculty Members

If you’ve completed recent academic coursework, professors who know your academic abilities well can address:

• Your critical thinking capabilities
• Writing and research skills relevant to graduate-level work
• Classroom participation and engagement
• Academic potential for rigorous NP coursework

Faculty recommendations are particularly important for programs emphasizing research or academic excellence, such as DNP nurse practitioner programs.

Who to Avoid Asking

Not all recommendations carry equal weight. Avoid requesting letters from:

• Non-healthcare professionals who cannot speak to your clinical abilities
• Healthcare workers who have only known you briefly
• Friends or family members, even if they work in healthcare
• Colleagues of equal rank who cannot evaluate your performance
• Famous or high-ranking individuals who don’t know your work personally

How to Ask for Recommendation Letters

Once you’ve narrowed down who you will ask for a recommendation letter, developing a solid strategy will boost your chances of success. Below are some key considerations to think about.

Timing Your Request

• Ask early: Request letters 6-8 weeks before application deadlines
• Consider workloads: Avoid asking during especially busy periods
• Provide deadlines: Clearly communicate when the letter needs to be submitted

The Approach: In-Person vs. Email

While an in-person request is ideal, a thoughtful email can be appropriate depending on your relationship:

In-person request example:

“Dr. Johnson, I’ve valued working with you in the ICU over the past two years. I’m applying to nurse practitioner programs focusing on acute care, and I believe your perspective on my clinical skills would be valuable. Would you be willing to write a strong letter of recommendation for my application?”

Email request template:

Subject: Request for NP Program Recommendation Letter

Dear [Name],

I hope this email finds you well. I’m preparing applications for nurse practitioner programs with a focus on [specialty] and am reaching out because your assessment of my clinical abilities would be particularly valuable to admissions committees.

During our time working together in [setting], you observed my [mention specific skills or experiences]. I believe you could speak to these abilities in a way that would strengthen my application.

Would you be willing to write a strong letter of recommendation for me? The application deadline is [date], and I would need the letter submitted by [date—at least 2 weeks before deadline].

If you agree, I’d be happy to provide my resume, personal statement, and other materials that might help you write a detailed letter.

Thank you for considering this request.

Sincerely,

[Your Name]

Providing Materials to Your Recommenders

Once someone agrees to write a letter, provide them with:

1. Your current resume or CV
2. Your personal statement or statement of purpose
3. Information about the specific programs and their focus
4. Deadlines and submission instructions
5. A “brag sheet” highlighting accomplishments they may not be aware of
6. Any specific requirements from the programs regarding letter content

“Brag Sheet” Essential Elements

Category	What to Include	Example
Clinical Skills	Specific examples of exceptional patient care	Implemented new protocol for sepsis identification that improved response time by 22%
Leadership	Committees, projects led, initiatives started	Chaired unit-based practice council; mentored 5 new graduate nurses
Education	Relevant continuing education, certifications	Completed 40-hour trauma nursing course; CCRN certification
Patient Outcomes	Measurable impacts on patient care	Developed patient education materials that reduced readmission rates for CHF patients
Professional Growth	How you’ve developed as a nurse	Advanced from new graduate to charge nurse in 18 months

Following Up with Recommenders

• Send a gentle reminder 2 weeks before the deadline if you haven’t received confirmation
• Check application portals to verify submission
• After submission, send a thoughtful thank-you note expressing gratitude regardless of admission outcome

Common Questions About NP Program Recommendation Letters

How recent should my recommenders’ knowledge of me be?

Ideally, recommenders should have worked with you within the past 2-3 years, with more recent experience preferred.

What if I’m switching specialties?

If you’re changing specialties (e.g., from adult to pediatrics), include at least one recommender who can speak to your adaptability and learning capabilities. Learn about nurse practitioner specialties.

What makes a recommendation letter stand out?

Strong letters include specific examples of your clinical excellence, leadership potential, and personal qualities rather than generic praise.

What if I’ve been out of school for many years?

If you’ve been out of school for more than five years, focus on professional recommendations rather than academic ones.

Put Together a Robust NP Program Application

Strong recommendation letters can significantly strengthen your nurse practitioner program application by providing external validation of your capabilities and potential. By strategically selecting recommenders who know your clinical work well, approaching them professionally, and providing them with comprehensive materials, you can secure letters that highlight your readiness for advanced practice nursing education.

Remember that recommendation letters should complement other components of your application by emphasizing qualities that might not be evident elsewhere. When chosen carefully and prepared thoughtfully, these letters become powerful advocates for your admission to competitive NP programs.

From excitement and elation to fear and anxiety, a brand new nurse practitioner (NP) is likely to experience a wide range of emotions. Transitioning from the role of a seasoned nurse to a novice NP can be particularly stress-inducing. Although the past few years of formal schooling and practicum experiences have certainly been valuable, there is no handbook for handling this transition. When I graduated from NP school, I thought I had to know it all. (Spoiler alert—you don't!) From taking board certification exams to landing a job and establishing a new career, here are some of the things that I wish I had known when first starting out as a new NP.

Board Certification

The two certifying bodies for NPs are the American Association of Nurse Practitioners (AANP) and the American Nurses Credentialing Center (ANCC). New graduates often wonder if taking a review course for the board certification exam is worth it, as this adds another expense to the already costly process of becoming an NP. In my opinion, a review course is worth every penny. It helped me better organize my study materials, effectively prioritize the most important information, and develop a framework to prepare for the exam. I haven't met one NP who did not find an exam review course to be beneficial.

The Job Hunt

In some cases, practicum experiences in NP school can lead to a job upon graduation. However, this is not always the case. The new NP should start searching for a job when they are comfortable doing so. However, it's important to keep in mind that the process will likely take much longer than applying for and securing a new RN job. Some NPs aim to have a job waiting for them prior to graduation, while others prefer waiting until passing board exams to begin the search. The new NP should have an updated resume that suits their desired job and it should be tailored to each position they apply to. Many resources exist for support with resume writing, and these can be highly valuable tools for the new NP.

RELATED: Are You Stressed About Negotiating Your NP Contract? Follow These Four Steps to Success

Role Transition

Working as an NP involves a different set of tasks and skills than an RN role. However, the critical thinking skills developed while practicing as an RN will serve as a foundation for future NPs. These new skills will continue to build and advance—even many years into practice. Particularly when working in the same location, the line from RN to NP can be a tough one to cross. It can be challenging for others to see you take a new role with different expectations. Give yourself the grace to acknowledge that it's okay to not know everything and gaining confidence in this new position will take time.

RELATED: New Graduate Nurse Practitioners: Keep Learning to Build Confidence

Ask Questions

It's normal to have many questions as a new NP. Never be afraid to ask them, as this is how learning continues after graduation. Particularly during COVID times, practicum experiences may have had limited clinical opportunities. When starting out, a new NP will have unfamiliar experiences or situations daily. Understanding everything from the very beginning should never be expected.

Find Resources

Whether working in primary care or a specialty, a variety of invaluable resources are available for NPs to refer to. As a medical oncology NP, UpToDate and the National Comprehensive Cancer Network (NCCN) are resources that I continue to use daily— even 10 years into my career. Finding the most useful tools and bookmarking them for future reference will make practice much easier. As time goes on, a great deal of information will be committed to memory.

Collaboration

Serving as a crucial piece of providing excellent patient care, collaboration lies at the heart of the NP role. This includes teaming up with patients, RNs, and other staff members. In addition, the relationship with the collaborating physician should be strong. While some states offer full independent practice opportunities for NPs, many require some level of collaboration with a physician. The new NP needs to work alongside someone that they feel comfortable with and can turn to with questions without feeling judged. Furthermore, the NP should believe that the collaborating physician does a good job in their role. There may be a period of time where the new NP feels that they have to earn their trust and prove themselves. However, the physician also needs to earn the trust of the NP. Having a poor relationship with a collaborating provider can lead to significant job dissatisfaction. Even if working completely independently, establishing a strong dynamic with a more experienced healthcare provider can be invaluable.

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All experienced NPs will be able to recall some things that they wish they knew when first starting out. It's important for new NPs to remember that they will never be expected to know everything immediately and should embrace opportunities to work in positive environments that promote ongoing collaboration. Additionally, keep in mind that the first job after graduation may not be a perfect position. However, it will certainly offer much to learn from.

Prior to enrolling in the nurse practitioner (NP) program, all students are registered nurses who typically already have experience in various clinical settings. However, the NP program can still present additional challenges, particularly as it pertains to the clinical rotation portion of the curriculum. Becoming a lifelong learner is part of being a successful nurse, but for an RN with prior clinical experience, it can be hard to take on these NP opportunities with fresh eyes. Here are four tips to maximize your NP learning experience.

Tip #1: Get to Know Your Clinical Preceptor, Staff, and the Community

Arrive early on the first day to clarify expectations and preferences with your preceptor.

Address the following questions:

• How should the NP student present themselves at each patient visit?
• Will the preceptor come in and see the patient first, with you seeing them afterward? Or will you and the preceptor come in at the same time?
• What are the preceptor's preferences for case presentations?
• Do you only observe on the first day, and can you take notes? Should you ask questions while seeing the patients, or wait until you are out of the room? Also, see tip #4.

Learn the names and roles of the clinical staff and consult with them as appropriate. Be sure to say "thank you" often!

Regarding the community, proactively ask about the patient's age, gender, ethnicity, socioeconomic status, and typical conditions seen in their population. You should also know how to locate all nearby ER, labs, hospitals, pharmacies, and specialists. Do a drive-by to explore the housing conditions, demographics, neighborhood safety, and environmental hazards. This will give you a sufficient understanding of your patient's experiences.

RELATED: Securing Nurse Practitioner Preceptors: Why Are Some Schools and Students Paying for the Privilege?

Tip #2: Prioritize a Patient's List of Concerns at Every Visit

Many patients will have a long list of active medical diagnoses. While you should be knowledgeable about these conditions, you might not be able to address everything in one single visit. Therefore, it is important to prioritize and shape patient expectations. You may start with asking the patient, "What brought you in today?" It is critical to avoid missing new and potentially serious concerns while still addressing key management goals of chronic conditions. It may be helpful to set an agenda with the patients. Try saying, "There are a lot of important concerns. Let's focus on your new onset of heart palpitations and hypothyroidism management today. We will discuss your diabetes, gout, and chronic back pain management at the next visit since we only have 15 minutes for today, okay?"

Tip #3: Learn to Communicate Well with the Patient

Prior to seeing the patient, aim to review charts, look up conditions as needed, and formulate a tentative plan. When seeing the patient, introduce yourself while maintaining good eye contact, listen carefully, and establish the agenda and expectations. It is imperative that you ask for permission before laying hands on your patient's body. Additionally, as you perform your physical exam maneuvers, make sure to communicate your findings and clarify what you are looking for to ease your patient's comfort.

RELATED: How NPs Can Tackle Difficult Conversations with Patients and Families

Tip #4: Learn to Give a Well Thought-Out Patient Presentation to the Preceptor

Check with your preceptor to determine the process for presenting new and established patients. Keep a go-to template to adjust as needed to suit your preceptor's preferences. Here is an example:

TEMPLATE: Patient's name, sex, age, presenting concerns, list of medical diagnoses, current medications, and newest lab results.

Concern #1: Chronological history of present illness. Relevant physical exam findings. Treatment plan. Questions for the preceptor.

Concern #2: Same as above.

Other concerns: Follow-up plan.

CASE EXAMPLE: Mrs. Jane Doe, 63-year-old female, is here for a new onset of chest palpitations. History of hypertension and hyperlipidemia, diabetes, and hypothyroidism. On Metformin 500mg BID, Atorvastatin 20mg QD, Levothyroxine 100 mcg QD. Latest lab results from 3 months ago at annual visit include HbA1C at 7.1, TSH at 2.8, Lipid panels (list lab values), CBC (list lab values), CMP (list lab values).

Chest palpitations. She noticed the chest palpitations about two months ago. It occurs abruptly while at rest at a frequency of approximately once a week and a few seconds at a time. No other associating symptoms such as tingling in the arms, shortness of breath, or dizziness. Heart rate and rhythm normal with pulse at 88, 12-lead EKG shows normal sinus rhythm. Because she has hypothyroidism, her Levothyroxine may not be at the therapeutic level, causing the palpitations. My plan is to re-check the TSH level. Could there be other explanations and treatment plans for her concern?

Hypothyroidism. She has had hypothyroidism for one year and it is currently well-controlled. Her Levothyroxine dosage was increased to 100mcg from 75mcg at the annual visit three months ago. During the exam, skin is warm, dry, and intact with no lesions; thyroid is not palpable. I would like to re-check her TSH lab level due to a recent increase in dosage and the new onset of palpitations. Is there anything else I should be checking?

Other concerns. We did not discuss her diabetes today. I would like to schedule an appointment in two weeks to address this.

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With a few tips like this in your back pocket, you can rest assured that your NP clinical rotations will help prepare you for a long and rewarding career.