Simulation is an excellent tool that can be used to display one’s understanding of learned concepts. Simulation can be used to train participants for a variety of situations including emergency events, end of life care, interprofessional collaboration, and more. Instructors look forward to seeing their learners participate in a simulation scenario and display transference of knowledge. However, some instructors have anxiety about the behavior and knowledge that their learners will show in a simulated event but hope for the best.
Many participants often look to simulation time as a stressful period of time for them when they are put on display in a fishbowl and unable to perform up to their own standards. Why does this occur? Did they not understand what was taught? This occurs due to what this author calls the “Sim Brain Phenomenon.” Sim Brain occurs as a result of stage fright (they are being watched and filmed), a fear of judgement (they seem to think that simulation is for a grade, when it is not or that their actions are being looked at for nefarious means), and/or the inability to consult a reliable resource when they are unsure of their interventions.
There are some tools that can be used to alleviate the Sim Brain Phenomenon and ensure a meaningful learning experience for all. One of these tools would be the STAR corner: when a participant is using the STAR corner they will state that they need a STAR moment or they need to use the STAR corner. When they request a STAR moment the sim is paused for up to 60 seconds so they can collect themselves in the STAR corner. STAR means Stop, Think, Actively Reflect, and Respond to the situation at hand. While in the STAR corner, the participant may consider the root cause of the situation, if they need to call for help, or even if they need to call the doctor; once a decision has been reached or the 60 seconds is up they will resume the simulation session. The STAR corners that have been used by this author have had a star drawn or created for them; all learners and facilitators know of it and its purpose and has been utilized with much success.
Another method that can be used to combat the Sim Brain Phenomenon would be to have the clinical instructors serve as charge nurses. The clinical instructors would serve as a simulated charge nurse so they would not give out the answers but rather prompt the participants to help them come to a good decision. One may also use a participant as a charge nurse, but they would have to be instructed not to complete the scenario for the other learner but help them in demonstrating the best practice for this situation. Learners can also serve as resource nurses, but they will have to be assigned a task when they are called in and once that task is finished they leave, if they are seen to be loitering in the room or interfering in the simulation they will be called to “assist another patient in a different room.”
These methods have been found to assist participants who become overwhelmed or lack the confidence to actively participant in simulation scenarios to the best of their abilities. It is important to educate the participants about proper use of these tools so that it does not disrupt the learning experience or disrupt the achievement of the learning objectives. The instructions about the use of the tools should be included in simulation orientation.
National Association of Indian Nurses of America (NAINA) joined the Nursing Now global campaign in July 2019, and NAINA marked the official inauguration of its campaign activities at the 2019 Clinical Excellence conference held on November 2nd in New Jersey. As part of Nursing Now, NAINA is collaborating with the American Nurses Association as well as other local nursing organizations and global campaign supporters.
On February 27, 2018, Her Royal Highness, The Duchess of Cambridge Kate Middleton, patron for the Nursing Now campaign, officially inaugurated the campaign that runs through December 2020. The campaign was launched in response to the World Health Organization’s (WHO) Triple Impact report. The Triple Impact report accentuated that “developing nursing will improve health, promote gender equality and support economic growth.”
A Well-Timed Campaign
The year 2020 will be a historic year for nursing profession as it marks the 200th anniversary of the birth of Florence Nightingale.The nursing world is preparing to honor and celebrate this great nurse. As the global community prepares to celebrate nursing, momentous endeavors are in the planning. WHO has designated 2020 as The Year of the Nurse and Midwife. The WHO State of the World’s Nursing Report that highlights nurses’ role in Universal Health Coverage and the Sustainable Development Goals is anticipated in April 2020. The Robert Wood Johnson Foundation team is releasing another landmark report in 2020 as a follow up of the 2010 Institute of Medicine report, “The Future of Nursing: Leading Change, Advancing Health.” The RWJ report will highlight the nurse’s role in addressing the social determinants of health and health equity. To set the stage for these great events and to create global momentum to mark the epic year, Burdett Trust for Nursing in collaboration with WHO and the International Council of Nurses (ICN) launched the Nursing Now global campaign. As of October 2019, Nursing Now has spread to 103 countries.
Nursing Now Global Campaign
Nurses practice in many settings and in different roles. Nurses have different levels of education and competencies, which makes nurses capable of generating positive outcomes in health care. With their education and training, nurses are adroit in health care policy decisions. However, there is a paucity of nurses’ involvement in health care policy and decision making. As the WHO Triple Impact report highlighted, empowering nurses may create a paradigm shift in health care that will address global health care concerns. To highlight nurses and to improve the status of nursing, the campaign chose five focus areas:
- Health Care Policy – Create global awareness on positive impact of nurses and midwives in health policy decisions
- Clinical Practice and Education – Influence investment in nursing education and training
- Leadership – Empower nurses to assume leadership positions; increase the number of nurses in leadership positions.
- Research Priority – Identify areas where nurses have a potential for the greatest impact, explore impediments to achieving their full potential and practicing at the scope of their training, and generate practical solutions for workplace conundrums
- Best Practice – Share examples of best nursing practice
Nursing Now USA
American Nursing Association, U.S. Public Health Service Chief Nurse Officer, the University of North Carolina Chapel Hill School of Nursing, and the University of Washington School of Nursing collaborate in leading the Nursing Now USA campaign. With the vision, ‘Nurses Lead America to Health,’ Nursing Now USA is developing and leading activities focused on creating public awareness on nurses’ vital role in achieving equitable quality health care for all.
Nursing Now NAINA
National Association of Indian Nurses of America (NAINA) decided to join the global campaign as a local group because NAINA’s vision and goals align with the campaign focus. The official launch of Nursing Now NAINA campaign took place at the 2019 Clinical Excellence Conference. The theme of the Clinical Excellence Conference – ‘Population Health: Bridging Gaps and Improving Access to Care’ aligns with the overarching aim of the campaign. The Clinical Excellence Conference provided a venue for NAINA nurses to share examples of best clinical practice, which is one of the priority areas of the global campaign. Susan Michaels-Strasser, PhD, MPH, RN, FAAN, Senior Implementation Director & Associate Director for Nursing Programs at Columbia University discussed “Nursing Now: Empowering Nurses and Tackling Health Care Challenges” and NAINA lead the campaign. Letha Joseph, DNP, AGPCNP-BC discussed NAINA programs that commemorate with the campaign. Nursing Now NAINA will create opportunities for NAINA nurses to improve their competencies, maximize their professional contributions, and enhance their influence. NAINA’s campaign focus areas are enhancing clinical practice by ongoing education, empowering nurses to be leaders at bedside and beyond, and sharing examples of best nursing practice while recognizing nurses for their contributions to health care and professional nursing community.
More information on the Nursing Now global campaign is available at www.nursingnow.org. Updates on NAINA’s activities are available at www.nainausa.com.
A recent merger of several nutrition-focused organizations is highlighting the need for a new attitude about what people eat and drink. The opportunity for nurses to bring this into their daily practices is huge as they can help patients with the food choices that will have the greatest health impact.
The newly formed nonprofit American Nutrition Association is a merger of the American College of Nutrition; the Board for Certification of Nutrition Specialists; the Center for Nutrition Advocacy; the Accreditation Council for Nutrition Professional Education; and the American Nutrition Association Foundation. The new group sees better nutrition as a broad-sweeping problem that requires a broad scope of experts to help fix it. From the people who grow and distribute food to the policy proponents who can bring change into schools and neighborhoods to the funders who can support new initiatives, the group aims for an ecosystem approach to change.
The driving factor behind the new association is the enormous health risk poor nutrition brings to human health including those that are greater than known health-wreckers like smoking or a sedentary lifestyle. Food, in essence, is a nonpharmaceutical medicine people can use to improve their health.
Nurses are proponents of good nutrition because they know the direct result it can have on all ages—from children’s development to chronic illness in adults. A lack of proper nutrition has far-reaching impacts where it can create problems in both physical and emotional health. Nurses also know some of the barriers patients face in having access to or preparing healthy meals. Personalized nutrition is one of the new group’s pillars, and nurses can use this as a way to talk with and help patients choose food that nourishes their bodies and is affordable and attainable. They can help them explore alternatives for their usual diet.
In addition to access, education is an essential part of a proper diet. For nurses, who are well-informed and educated about the benefits of kale over crackers, helping patients understand their choices and how that can fit into their lives provides an important foundation to build on. Showing patients what good nutrition looks like is a starting step.
Nutrition is also important because it is something people can change when they think about a healthier lifestyle. People can’t choose their genetics, but they can change what they eat for dinner or what they snack on. And it’s simple to make small changes. Patients don’t want to hear they have to make an entire overhaul of their diets (unless their illness forces that kind of top-to-bottom change). In fact, many people who think they have to cut out everything they love will find that kind of plan too overwhelming to even begin.
Hearing that you can still have a big impact on health with small modifications is often motivating. Patients can swap out a serving of pasta for a salad or a serving of vegetables. They can bring a lunch instead of relying on a takeout lunch that’s generally higher in fat, salt, and calories and lower in essential nutrients.
What kind of changes can you help your patient population with?
As rates of diabetes continue to rise, endocrine nursing is a specialty that will continue to have a pressing need.
Diabetes care is only one aspect of an endocrine nurse’s specialty—thyroid disorders and adrenal gland disorders also are endocrine system problems—but November’s designation as American Diabetes Month highlights this particular condition.
An endocrine nurse can choose to work with adult or pediatric patients, and they will see different presentations of the same disease across all populations. Because diabetes can present in varying ways for each individual and treatment plans can differ widely, an endocrine nurse must have a broad expertise in how diabetes impacts many body systems.
Cultural competence is especially important in this nursing specialty as traditions around food alone—eating, feasting, or fasting—will have an immediate and potentially dangerous impact on someone with diabetes.
Diabetes is so prevalent today that most people know of someone who has Type 1, Type 2, or gestational diabetes. The different types of diabetes stem from separate issues, but result in the same inability to use insulin.
According to BeyondType1.org, these are the more common forms of diabetes:
- Type 1 is a chronic autoimmune disorder that seems to have genetic and environmental causes and is something that cannot be prevented.
- Type 2 is when the body is unable to use insulin (also called insulin resistance). This type has several causal factors including lifestyle factors like obesity, inactivity, or smoking, but there’s some research that notes a genetic cause for some minority populations with Type 2.
- Gestational diabetes happens during pregnancy when hormones can interfere with the body’s normal use of insulin.
Like many chronic conditions, diabetes has a direct and significant impact on a person’s daily life and activities. Blood sugar rises and falls throughout a normal day, but other factors like an illness, stress, or travel can pose particular challenges for people with diabetes. They need to be vigilant and prepared for any red flags in their insulin numbers.
As an endocrine nurse, you’ll need to help your patient put the pieces of their personal diabetes puzzle together and then take it apart to examine all the factors that could change their typical treatment. Understanding your patient’s cultural norms will go a long way to developing a diabetes plan that will work and that the patient can and will follow.
Diabetes management will look different for each person, but it’s helpful to ask questions that might reveal religious or lifestyle preferences and choices that could play a part in how they can manage their condition. Children and teenagers can be particularly challenged by social pressures to keep on track. And many patients, young and old, go through a period of denial when they think they don’t need to worry too much about their disease. If you’re a nurse with diabetes, you know the challenges first-hand.
Educating patients about the severe complications that can arise from mismanaging this condition, no matter what type it is, is essential. But it’s also important to let people know how the diagnosis of a chronic condition like diabetes can cause changes in mental health and that help is available. You can share resources about the diabetes communities—both online and local—so that patients can learn from others and know they aren’t alone.
Endocrine nurses have the responsibility of helping patients follow their treatment plans and of having the compassion to understand why it is so hard to do. Nurses who understand their patient populations have an advantage, so learning as much as you can about the cultural norms will help.
Nurses know all the reasons why heart health is so important. They don’t have to be a cardiac nurse to know that a healthy heart impacts everything from energy levels to brain health.
If you’re trying to take care of your heart by watching what you eat, getting enough exercise, and keeping your stress at a somewhat manageable level, you might be surprised to find your heart health is influenced by things you often just can’t control.
As a nurse, keeping some of these things in mind when talking with patients might be a flag for potential heart health trouble. Knowing a little more about those you treat can give you a broad picture of how events happening in their lives could impact their heart health.
People predisposed to heart disease because of their genetics can’t do anything about the genes they were born with. They can take steps to counter conditions such as high blood pressure or high cholesterol levels that are often handed down through generations. They should also be especially careful of their health, controlling the factors they can (diet and exercise are the big ones) and working with a health team to mitigate the ones they can’t.
Believe it or not, a recent American Heart Association report found that some jobs seem to increase a woman’s chances of poor heart health. According to this report, registered nurses are 14 percent more likely to have poor heart health, as do women in other health care roles such as a psychiatry, home health, or social work (36 percent more likely). Using data from approximately 65,000 postmenopausal women from the Women’s Health Initiative study, researchers found that women in some occupations show signs of poorer heart health than others.
Changing Economic Factors
Economic disparities have historically been linked with poorer health outcomes across regions, races, ages, and genders. But a recent report in the Journal of the American Medical Association showed a link between a significant drop in income and declines in heart health. Using data from the Atherosclerosis Risk In Communities (ARIC) study, the cohort showed that an income loss of 50 percent or more led to higher incident cardiovascular disease (CVD). Conversely, rising income levels resulted in decreased CVD.
Women lose the potentially heart-protective benefits of estrogen after menopause. Along with aging and the cumulative effects of other habits, this time in a woman’s life might increase her chances of heart disease. The American Heart Association recommends that women take stock of their health around this time and work to make changes that will be good for their hearts.
As you meet with patients and as you consider your own health, taking your heart into consideration is going to have on overall positive impact on your well-being. Understanding how other factors can have a significant impact on heart health is a great starting point for discussions about prevention, testing, monitoring, and lifestyle changes that will make the heart stronger and healthier.
The U.S. flu season is just beginning, and can last until May (with peak infections hitting between December and February). While it’s far too early to predict the severity of this year’s flu season in the U.S., physicians are encouraging everyone to vaccinate ahead of the anticipated peak infection times.
The following flu prevention resources from the CDC serve as a guide for healthcare workers, teachers, and concerned parents seeking additional flu-related facts and information.
Remember: stay healthy and stay informed!
Flu Prevention Resources
Flu Vaccination Resources
Flu Prevention Hygiene Resources
Institutional Prevention Resources
If you’re a nursing student equally fascinated by both medical and legal issues, forensic nursing might be just the career path for you.
Today is Forensic Nurses Day, falling at the end of Forensic Nurses Week (November 11-15). This observation gives nurses an opportunity to consider this distinctive area of their profession. Forensic nurses treat people medically but they are also responsible for uncovering the sources of injury, illness, or even death. The week is sponsored by the International Association of Forensic Nurses, the leading professional association for this nursing specialty.
Forensic nurses can practice in various settings and with roles that vary significantly. This is a good career choice for nurses who like to switch up their roles while still relying on a base set of expertise and skills. Nurses in this role have a passion and for helping people who are victims of violence. They balance their medical treatment with a deeply compassionate nursing approach to help a patient in the midst of a trauma, all while pulling together pieces of what happened to help find out more.
Because of the patient population they serve, forensic nurses work closely with the judicial system. Nurses in this role may care for patients who have suffered sexual violence, partner violence, elder abuse, child abuse, or another kind of injury that is often, but not always, intentional. Some forensic nurses work in the corrections system.
While they treat patients, they are often collecting evidence to help the legal system’s potential prosecution of the person or persons who hurt them. They may work with police officers to gather evidence or with prosecutors to relay information about the injuries.
Nurses who deal with trauma have to have a deep well of compassion and a steely focus to help the patient while trying to uncover as much information as possible. They rely on excellent nursing knowledge and skills to work with patients who come to them while processing a traumatic event or long-term trauma and often scared. But they also must develop a delicate expertise in injury—particularly the cause of it, where it is, and how long it has been present.
Forensic nurses can specialize in particular areas as well – focusing on elderly populations, psychiatric cases, or children. Still others may become specialists in situations where a person died as the result of violent acts, and they help the investigation with their medical knowledge. Nurses who become trained to assist victims of sexual assault and violence can become a Sexual Assault Nurse Examiner (SANE) nurse.
Forensic nurses work in the world of trauma so they need the emotional, physical, and spiritual resources to support their own reactions to seeing so much intentional injury. The stories and cases can overwhelm even the most seasoned nurse at times. Coping skills are a forensic nurse’s magic cape, so being able to recognize, accept, and mitigate job stress are essential.
While they deal with people who have been hurt, forensic nurses have a front-line view of the issues surrounding violence and work as advocates for violence prevention. They may even be expected to appear in court to relay information about a specific case.
Forensic nurses are allies to patients who are hurt both physically and mentally. They deserve a shout out of thanks this week for all they do.
With millions of surgeries taking place annually across the nation, a career as a perioperative nurse is one that is both secure and exciting. This week’s recognition of Perioperative Nurses Week (November 10-16) lets people know about the critical work these nurses do throughout a surgical process.
Perioperative nurses serve the vital role of helping patients before and after surgery to ensure they are safe, informed, and comfortable. These nurses also take on the role of being the patient’s advocate when they are in surgery and unable to speak for themselves.
Organizations such as the Association of periOperative Registered Nurses (AORN) are excellent resources of information and education in this career. Perioperative nurses depend on a variety of medical, critical thinking, social, and analytical skills every time they report to work. No day is every the same as the one before, and perioperative nurses know even routine surgery isn’t always routine.
With this responsibility, perioperative nurses are experts at understanding how a human body reacts under surgery and how human emotions can be unpredictable pre- and post-surgery.
Patients see perioperative nurses before they go into the OR. All the talk that goes on isn’t just idle chit chat, as perioperative nurses have specific expertise in chatting with patients to find out more about them. They are naturally interested in learning more about the patient, but they are also looking for information they can use when the patient is coming out of anesthesia.
People can become confused, agitated, happy, or sad when they are waking up from surgery, and an experienced perioperative nurse knows just how to guide the situation so the patient feels safe, is medically stable, and can get reoriented. Nurses will use the information they gained pre-op to talk to the patient. Maybe the person likes golf or talked about family or mentioned a quilting habit. Bringing up those familiar and happy associations helps patients enormously and also makes a nurse’s job easier. Managing a patient who is calmer makes their recovery easier, faster, and safer.
Many people don’t know the nurse who cares for them before and after surgery is also present by their side during surgery. During Perioperative Nurses Week, nurses can make a point to let people know of the complexities of this role.
They are patient advocates, but they are also a core part of the surgical team as well. Nurses in the surgical suite must be experts at preventing problems and spotting any issues immediately. With their attention fully on the patient, they are in charge of noticing if a patient is reacting poorly to any part of the process. They keep track of the monitors to see blood pressure, oxygen levels, and heart activity, but they have to continually assess the patient visually. They will notice any change in the patient’s physical body—from breathing patterns to skin color changes—that could indicate a problem.
The perioperative nurse relies on a toolbox that holds a little bit of everything—an intense focus, up-to-date medical skills, keen attention to the patient, social ease, and compassion—to help patients through surgery.
If you’re a perioperative nurse, take some time this week to celebrate the care you give your patients, the teamwork you contribute, and the way your work elevates the entire nursing profession.
Nurses are integral in the care of patients and their health. Exploring a plant-based diet may be beneficial to patients so they can take back their health. It is time for health care disciplines to be aware of a plant-based diet and to dispel any myths that exist. In fact, a plant-based diet is not a diet—it can be viewed as a way of life. A plant-based diet are foods consumed that is devoid of animal ingredients, such as dairy and meats. A plant-based diet relies on foods that are grown from the ground such as fruits, vegetables, whole grains and nuts, and seeds.
People are living longer, but we are also living with more chronic diseases, with heart disease being at the top of the list. Heart disease, diabetes, and hypercholesterolemia are contributors to sickness where medicine is the answer. Health care providers tell patients to lose weight by restricting food intake. While patients may see results initially, they usually do not adhere to this long term as it is not sustainable for them for a variety of reasons. In addition to that, the medications with their side effects usually do not highlight many benefits. One-third of animal products in the American diet are very concentrated in calories and are deficient in antioxidants and vitamins. Needless to say, the vast majority of chronic illness is highly correlated to what we eat. There is a different biological effect of meat versus plant-based protein such as beans. The body can store these amino acids and complete them without overshooting the hormone, Insulin Growth Factor 1 (IGF 1). On the contrary, processed foods and meats produce a lot of IGF1 where insulin ends up storing a lot of fat. It is also attributable to cancer and inflammation.
People have long touted the benefits of a plant-based diet. Brooklyn Borough President Eric Adams reversed his diabetes Type 2 due to a plant-based diet. He was already suffering from nerve damage as a result of his disease with a hemoglobin A1C of 17 (anything over 6.5% is considered diabetic), so his was very high and the doctor was surprised that he was not in a coma. Adams was placed on medications, but he also sought the help of Caldwell B. Esselstyn, Jr., the same doctor who treated Bill Clinton and author of the book, Prevent and Reverse Heart Disease. He was informed by doctors that he would be on insulin for the rest of his life. He was placed on medicine for his acid reflux, medicine for his high cholesterol, and medicine for his burning and tingling of his hands and feet. His family is diabetic and was told that it runs in his family.
This past August, there was a launch of a plant-based lifestyle program at Bellevue Hospital in New York City. Doctors, nurses, dieticians, and life coaches will help at least 100 patients across all five boroughs adopt healthy eating patterns focused on legumes, whole grains, fruits, vegetables, nuts, and seeds while reducing animal products, fried foods, refined grains, and added sugars. Michelle McMacken, director of NYC Health + Hospitals/Bellevue Adult Weight Management Program, is director of the program.
At Montefiore Hospital, Dr. Robert Ostfeld spearheaded the Cardiac Wellness Program where plant-based nutrition is the prescription for management of cardiac disease. The population most affected by these diseases are non-white populations. Dr. Kim Williams, past President of the American College of Cardiology, advocates for a plant-based diet for heart disease prevention. Affronted with a high cholesterol, he decided to take measures into his own hands, and adopt a plant-based diet.
While medical doctors are beginning to advocate this lifestyle, nurses should also set an example of this lifestyle approach. Nurses are part of the health care discipline and minority nurses, especially, need to set an example. We want patients to take control of their lives. We can teach patients eating a plant-based diet instead of a standard American diet, as a form of primary prevention. Like any diet, it may take time to adjust, but this is not just a diet, it is a lifestyle. Patients would need to make an informed decision as to whether they would want to incorporate it into their lifestyle or not. There is enough supportive evidence out there that a patient can access such as documentaries, “Fork Over Knives” and “Fat, Sick, and Nearly Dead.” There are a variety of resources, including the 21-Day Vegan Kickstart program, to include in dietary prescriptions to help patients treat and prevent obesity, type 2 diabetes, and heart disease. This will require support from the patient’s primary provider, and, whether the provider is an advocate of this lifestyle or not, it should be considered. Benefits such as less medication, weight loss, and improvements in mood as well as cholesterol have been shown. Dispel the myths about a plant-based diet and protein.
This is a plea as something to consider to take better care of ourselves and take control of our lives. There have been many initiatives and programs to lose weight. Drastic measures have also occurred due to the outcomes of being overweight, such as drastic surgery and restrictions from carbohydrates. Patients are sometimes misinformed and have to get rid of the idea that medications will solve the problem—it only delays the problem. There is a possibility of reversing diabetes and cardiac disease. This is a decision that the person has to make: continue with their lifestyle with animal protein and processed carbohydrates or see a reduction in their overall weight and health by incorporating a plant-based diet.
A plant-based diet may be considered “extreme” by some people in altering their lifestyle. But given the choice between a plant-based diet or open=heart surgery, it can be posed to the patient which one they consider as extreme. Again, it is a personal choice, an evaluation of familial and cultural values would be assessed to fit the needs of the patient. Surgery can be viewed as a band-aid in that it will manage the symptoms temporarily unless the patient alters their lifestyle. Of course, it helps if the patient has a supportive network to embrace the lifestyle. It can start off as small, simple steps, as little as incorporating a plant-based meal in their day and slowly add these meals to their lifestyle. There are vegan starter kits to kick a healthier you.
Operating with the highest level of autonomy, nurse practitioners are lifelines for many patients.
This week’s designation as National Nurse Practitioner Week (November 10-16) is an excellent time to examine the roles nurse practitioners (NPs) play in the nation’s healthcare system.
The American Association of Nurse Practitioners is a leading professional organization for NPs and also leads advocacy for issues relating to NPs. A nurse practitioner has achieved an educational path that brings them to Advanced Practice Registered Nurse (ARPN) designation. That gives them essential nursing knowledge and combines it with the ability to use it in a more comprehensive manner than a registered nurse (the first step to becoming an NP).
One of the biggest challenges facing NPs today is achieving full-practice authority (FPA) in all states. Because NPs have wide-ranging responsibilities that include examining and treating patients, diagnosing illness, and prescribing medications, they often work at the level of a physician. In some states, a nurse practitioner is not mandated to work under the supervision of a physician or required to have a physician sign off on some of their treatments. In states that don’t recognize the full practice authority of an NP, that additional layer of physician sign-off is required.
A nurse practitioner is able to “hang a shingle” and operate as a solo practice in any location. Many NPs choose to do so in remote areas where practicing physicians are hard to find or in urban areas where transportation to a medical office is a barrier to care. They are a vital cog in the healthcare wheel. They often assume many of the responsibilities of a primary care physician, developing relationships and providing preventive and long-term care. They see and treat patients with chronic diseases like asthma or diabetes and work in conjunction with a specialized care team as well.
If upping your career to a nurse practitioner level interests you, there are steps to get started. NPs require a master’s in nursing (with a focus on the population you intend to serve) and achieving a PhD in nursing is desirable for this role. After becoming a registered nurse, completing the BSN and MSN, you’ll need to earn your state-level advanced practice nursing license.
While NP authority is determined on the state level, there is progress toward achieving a national model. For now, some states participate in the APRN Contract, which allows a nurse holding an APRN license to essentially have authority to practice in several states. Not all states are part of the ARPN, so you’ll need to check to see where your own practice location, or intended location, fits in.
Career outlooks for NPs are stable. As the number of family practice physicians decline and the population increases, NPs are there to help patients on a high level. They are also able to work with communities that may not have had reliable medical care in years. The freedom to develop deep and lasting multigenerational relationships with patients and families is a routinely cited reason for working in this busy role.
If you’re an NP, National Nurse Practitioner Week is a good reminder to let people know of the training and skill set required of nurses in this area of nursing. And it’s a good time to give yourself a pat on the back for all you do.