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.
According to the AANP, approximately 248,000 nurse practitioners hold an NP license in the United States. The career is especially appealing as NPs generally have more autonomy than other nurses. In some states, NPs are able to practice on their own without physician oversight, and, in doing so, can provide a full spectrum of care. They assess, diagnose, treat, and make a continual care plan for patients, so they are involved in each step of the patient’s care. Because of that, NPs often form close, long-lasting relationships with those they care for. NPs are able to prescribe medications across the US and almost half hold hospital privileges as well.
Nearly 98 percent of NPs hold graduate degrees and more than 8 in 10 hold some kind of primary care certification. For all the education NPs earn, the Bureau of Labor Statistics reports that they are rewarded with a salary that hovers around $111,000 annually. The job outlook is growing faster than average with a 31 percent growth predicted by 2026.
If you’re interested in this in-demand career path, you’ll need to obtain a master’s in nursing degree along with plenty of extra credentials like certifications. NPs often hold more than one certification and the credentials can be in related areas like neonatal care and pediatric care. You’ll need to pass an NP state licensing exam so you can be registered to practice in your state.
Many nurses find the NP role helps them make a positive impact when access to healthcare is essential and sometimes not in easy supply. NPs can make big inroads into the health of communities as they are able to care for patients in a variety of settings and situations. Nurse practitioners who want to practice autonomously need to have the extra information to know how to do that while protecting themselves and their patients.
NPs can and should connect with peers and colleagues to share the challenges of the role and talk about the satisfaction of this role. Networking will help their professional development and the information learned will often improve their patient care as well.
The week kicks off today and runs through November 18 and honors the work NPs do both on the job and as ambassadors for the nursing profession.
Minority Nurse caught up with Dr. Scharmaine L. Baker, FNP, FAANP, FAAN, CEO at Advanced Clinical Consultants, to talk about the role of a nurse practitioner. After Hurricane Katrina, Baker’s New Orleans patient caseload swelled from 100 to 500 in three months. With a critical shortage of health care facilities and providers, Baker’s skills as an NP not only saved her patients, but also clearly showed how invaluable her thorough NP training is.
National Nurse Practitioner Week, says Baker, is a way to give nurse practitioners the recognition they often don’t receive. “National Nurse Practitioner Week gives us the positive spotlight that we deserve,” she says.
This kind of national attention to the nurse practitioner’s work shows the devotion nurses have to caring for a patient, and also helps clear up any misunderstandings about the role and how an NP works within a health care team. “Nurse practitioners don’t just prescribe a medicine and send you out of the door,” says Baker. “We take the time to listen to the patient stories about their children, spouses, pets, and job promotions. These stories often solve the complicated puzzle of making an accurate diagnosis. It’s called holistic care of the total man.”
When prospective nursing students are deciding on a career path, Baker urges them to consider a few things. Top in their minds should be the honest assessment of their commitment to making this career decision. Taking the time to complete the challenging NP studies isn’t easy, she says. “Once they have decided that this is indeed the right time to pursue an Advanced Practice Nursing degree,” she adds, “then the necessary preparations as far as letting family and friends know that they will be somewhat unavailable for the next three to four years because the schooling demands all of your time for successful completion.”
But when the degree completion and training are done, the potential for a lifelong career that challenges you, uses all your skills, and lets you connect with and help people is gratifying on many levels. As a nurse practitioner, you’ll be diagnosing, assessing, and treating medical conditions. You’ll also look at the whole patient. NPs take into account the interplay between a patient’s physical and emotional well-being as well as the environment they live in. By doing so, they can help treat every part of a patient’s condition.
“I get to hear the stories that make my patients happy or sad,” says Baker. “Then, I get to connect those stories to their physical state. They are always related. I enjoy providing health care on this advanced level. I get to take care of the whole patient.”
Baker also points out that while NPs continue to earn recognition and some states are allowing them to practice on their own, there is still work to be done. “The most challenging and frustrating part of advanced practice nursing is the many restrictive laws that prevent us from practicing to the full extent of our scope,” she says. “It’s downright ridiculous! I long for the day when all states will actively have full practice authority.”
Currently, nearly two dozen states allow nurses to have full practice authority where they practice without physician oversight. Baker continues to advocate for full practice authority among all nurse practitioners. She also urges NPs and the nursing profession to continue to honor the nurses who worked so hard to get all nurses where they are today.
“Many have fought for us to be where we are,” says Baker. “Every time we show up and provide stellar care, we make our founding nurses beam with joy. We must never forget their sacrifices.”
Celebrate National Nurse Practitioner Week this week and spread the word about these highly skilled professionals. Use #NPWeek to share photos and tags on your social media posts to help others see just what satisfaction a career as an NP can bring.
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