In today’s rapidly evolving health care environment, the need for health care practitioners who provide primary care as well as specialty care has never been higher. One of the aforementioned positions is the nurse practitioner (NP)—a highly advertised position at the doctorate level with advanced clinical training, which involves significant in-person time seeing patients, and one that continues to gain responsibility in health systems globally. NPs function at the intersection of nursing and medicine—as they provide care that adds the diagnostic and treatment aspects of physicians to their holistic approach to nursing care. The service care models that NPs practice provide access and availability to health care and are focused on a patient-centered, financially responsible model of care. A nurse practitioner is a specific type of advanced practice registered nurse who has completed his or her master’s or doctoral level education in nursing after being licensed as a registered nurse (RN), however advanced clinical education that NPs have completed, does evaluate patients, diagnose disease, prescribe medications, and regularly follows up with on-going care. NPs, if they are practicing in primary care, are most often the first contact for patients coming from rural or underserved situations, and help provide continuity and health promotion through wellness and disease prevention.
What is a nurse practitioner?
A nurse practitioner (NP) is a licensed, educated health care provider with advanced education in nursing with clinical experience. Usually this education is received through a Master of Science in Nursing (MSN) or Doctor of Nursing Practice (DNP) program that includes a clinical placement or log of training or direct patient experiences. NPs have received sufficient preparation to examine and provide treatment for medical conditions; perform a physical examination; order and interpret diagnostic tests; prescribe medications, controlled substances and medical products. In most states or territories for cancer and non-cancer related patient care, an NP can practice as an independent clinician without the direct supervision of a physician. Although nurse practitioners are educated in the medical model, just like physicians, nurse practitioners continue to incorporate nursing practice principles (patient/patient-centered practice, and preventative and education) into practice because this is ultimately the practice of nursing. Each portion is an important part of the NP’s practice that promotes a holistic model of care while treating individuals, families, and communities.
The educational path to become a nurse practitioner
Nurse practitioners can pursue nurse practitioner training after serving as a registered nurse (RN). Most nurses are RNs, or bachelor’s of science in nursing (BSN) graduates, after 4 years of school. After gaining experience as an RN and working in a clinical setting, nurse practitioners must complete a master’s of science in nursing (MSN), or doctorate of nursing practice (DNP) program that includes both didactic (classroom) and clinical experiences.
The advanced level of nursing education learning provides coursework in advanced pharmacology, advanced pathophysiology, advanced health assessment, and specialty trained courses, (ie. Pediatrics – family care or mental health, etc.) After the completion of their educational training, they may apply to be tested to qualify to take the national certification examination for their specialty focus.
Roles and responsibilities of a nurse practitioner
Nurse practitioners have undergone training on how to assess illnesses, perform physical exams, order diagnostic tests, and prescribe medications. They manage acute and chronic issues for patients with an emphasis on patient education and preventive health care. NPs develop the treatment plan and are responsible for ensuring the patient is well managed and progressing in their care as appropriate, and also provide referrals to specialists. In many practice settings, NPs are the primary care provider for their patients, providing holistic, patient-centered clinical care for their patients of all ages and all medical conditions.
Nurse practitioners in primary care
Nurse practitioners provide a significant share of primary care, particularly in regions with a shortage of access to physicians. In some rural areas and underserved urban populations, nurse practitioners may be the only providers available to deliver routine medical care. Often, nurse practitioners are perceived as part of the solution to the persistent primary care physician shortage, providing care in a more available and cost-effective manner. Studies show that the quality of care given by nurse practitioners is comparable to physicians’ care, especially in primary care, and that patients actually had a greater satisfaction rating with nurse practitioner care due to the time spent with them and having more personal attention during appointments.
Challenges faced by nurse practitioners
Nurse practitioners face a variety of obstacles. Lacking full practice authority, they may not be able to provide the fullest care to patients despite their qualifications to do so. There is also pushback from physician groups that are concerned about the overlap or competition.
Future of nurse practitioners
The future is very positive for the nurse practitioner profession. Healthcare systems will continue to evolve and transition to meet the needs of growing, aging populations while also trying to be more equitable in care. Although nurse practitioners are primarily focused on providing care, they will continue to assume larger roles. Nurse practitioners will also have new roles as telemedicine, artificial intelligence, and collaborative healthcare models continue to improve and expand.