What is a Nurse Practitioner? (Part II)

Now that you know what a Nurse Practitioner (NP) is, and how to address her/him, here are 10 NP facts that provide important information and perspectives on the integral role of the NP in today’s healthcare system:

1. Nurse practitioners are educated using the nursing model. NP education provides theoretical and evidence-based clinical knowledge and hands-on, clinical experiences. It emphasizes development of professional, learning experience necessary for comprehensive primary-care and specialty-care practice in a variety of settings. An NP education concentrates on the specialized needs of patient groups. For example, pediatric NPs generally dedicate the entirety of their classroom and clinical education to the needs of pediatric clients.

2. Nurse practitioners are licensed by state and federally. To provide independent patient care, NPs need to be both licensed by their respective states and certified nationally. Licenses enable one to practice as a nurse practitioner, whereas board certifications demonstrate one’s proficiency in a given specialty. For example, a family NP (FNP), like me, will have either of the following credentials after her name, depending on the certification board: FNP-BC or FNP-C.

3. Nurse practitioners diagnose, treat, and prescribe medication. Like a physician, NP practice includes:

• assessment
• ordering, performing, supervising and interpreting diagnostic and laboratory tests
• making diagnoses
• initiating and managing treatment including prescribing medication and non-pharmacologic treatments
• coordinating care
• counseling
• educating patients and their families and communities.

4. Nurse practitioners are trained to consider patient needs beyond the physical. NPs offer a distinct, holistic approach to healthcare that considers the whole patient and all her needs—the “big picture”: physical, psychological, social, economic, access, and more. The nursing model used for NP clinician training prioritizes compassion and patient education—and thus patient empowerment.

5. NPs can practice autonomously in 28 states and in the District of Columbia. 28 states and the District of Columbia allow NPs to treat patients in a “full practice environment” or with “full practice authority to treat and prescribe without formal (physician) oversight,” just like our physician counterparts. In these states, NPs may own and run their own clinics or businesses. In addition to the District of Columbia, 14 of these states grant full practice authority as soon as NPs earn their licenses, while the others allow full authority only “after practicing with physician oversight for a set number of hours” (which in Virginia is 5 years and 9,000 hours).

Currently, 22 states restrict NP scope by requiring continual physician oversight, including California, Florida, and Texas. This may change, as an abundance of evidence shows that NPs provide safe, high-quality, and cost-effective healthcare services. Healthcare demands have never been greater, and “a large body of research has linked NP restrictions to a lower supply of NPs, poorer access to care for state residents, lower use of primary care services, and greater rates of hospitalization and emergency department visits.”

In the Golden State, where nearly 10% of all NPs practice, NPs must have a formal “collaboration” or supervision agreement with a physician who reviews the charts a few times each year.

Many nationally recognized policy organizations and government bodies are calling for more independence for NPs across the country, especially since the COVID-19 pandemic began. These include the Federal Trade Commission, AARP, Institute of Medicine, National Governors Association, and National Conference of State Legislatures

6. Nurse Practitioners elect to take a different path than their physician colleagues. Becoming a nurse and then pursuing higher education to become a NP is a personal endeavor. Don’t assume a NP wants to be a physician, or would be one if she could “do it all over again.” NPs are committed to nursing as a profession.

7. The majority of nurse practitioners choose primary care—many in underserved areas. While NPs pursue advanced degrees and specialties such as acute care, dermatology, neonatal, oncology, and mental health, the vast majority are prepared in primary care (which is where I began my career). Currently, 89.7% of NPs are certified in primary care, and 69.0% of all NPs deliver primary care. Many help to fill in healthcare service gaps by practicing in underserved areas, including rural and frontier settings.

8. The nurse practitioner workforce in the U.S. continues to grow, and will be crucial in meeting healthcare demands. According to a Rand Corporation study published in July 2012, there will be 244,000 by 2025, an increase of 94% from 2008. Meanwhile, the Association of American Medical Colleges estimates a shortfall of between 46,100 and 90,400 physicians by 2025. As we face national physician shortages, NPs are stepping up to fill in the gap and meet increasing patient demand as the population ages and lives longer.

9. More than 50 years of research shows you are in good hands with NPs. Since the NP profession’s origin in 1965, over 50 years of peer-reviewed, independent analyses show that the outcomes of NP-led care are equivalent and sometimes better than those of physician-based care. Based on these data, you should not presume you are receiving lesser care if you receive treatment from an NP rather than a physician.

10. Nurse practitioners are no longer the new kids on the block. 2020 marked 55 years for the NP profession. The role of the NP continues to evolve and respond to changing societal and healthcare needs of Americans. As leaders in primary and acute healthcare, we embrace our roles as providers, mentors, educators, researchers, and administrators.

For up-to-date NP statistics, check out this AANP Fact Sheet.

If you’re interested in an excellent pro-NP (and pro-PA) read, check out this article, written by a collaborative, practicing medical doctor (MD).