In recent years, the role of nurse practitioner has grown to be a vital part of the healthcare system in many countries, and their importance is only set to grow. In the US, for example, the American Association of Nurse Practitioners (AANP) states that some 355,000 nurse practitioners, or NPs, are currently licensed in the United States. This number is predicted to rise by 30-35% by 2030 as more NPs qualify and both professional and educational opportunities increase as medical institutions seek to meet demand.
NPs often act as a bridge between physicians and nursing staff and typically offer crucial expertise in a wide range of situations. Significantly, they also often work to fill the gaps in healthcare provision due to the shortage of physicians, particularly in remote or low-income areas. Today, nurse practitioners enjoy significant autonomy in many states in the US and often take on a level of responsibility comparable to that of a physician.
In this article, we examine the precise role of a nurse practitioner, what skills and knowledge are required to fulfill the position, and what qualifications are needed if you want to become an NP. We also take a look at how they are becoming an integral part of many local communities, particularly in rural areas and other instances where people have limited access to healthcare.
Greater responsibility, more autonomous
Just like registered nurses (RNs), nurse practitioners fulfill a variety of roles in the healthcare system. They usually perform a range of standard nursing duties, such as recording the patient’s history and current and past symptoms, performing routine and detailed examinations, and monitoring the patient’s development. At the same time, they usually take on a range of additional responsibilities, such as prescribing treatments, ordering tests, and diagnosing patients. They often supervise and manage nurses and other staff members and may even run their own practice.
In the US, the level of autonomy permitted to NPs ranges from state to state. In more than half of US states, they are granted full-practice authority, or FPA, which means they have complete autonomy to operate independently of physicians. While even in these states, NPs often work in tandem with GPs, specialists, and other healthcare professionals in the same medical facility, while others maintain their own practice. Naturally, however, even in this case, they continue to maintain a strong support network to ensure their patients always have access to specialist care whenever required.
In other states, NPs have ‘reduced practice authority’, which means that they can operate with a degree of independence but are not permitted to perform at least one element of full practice, such as prescribing medicines. In a third category, nurse practitioners only have ‘restricted practice authority’, meaning they are subject to career-long supervision or instructions and approval from another health provider to provide patient care. Overall, however, in the US and around the world, the tendency is to give greater autonomy to nurse practitioners in their work, and the demand for NPs is expected to grow in the coming decade.
One very good reason for this increase in demand is that so many countries are extremely keen to identify qualified health professionals who can ease the burden of doctors. Indeed, countries all over the globe, including the United States, are suffering from a dearth of physicians, particularly in offering primary care. As individual states look to resolve this issue, many administrators see nurse practitioners as crucial medical staff who can not only fill the gaps left by physician staff shortages but also offer additional first-class medical care and augment the scope of healthcare provided in a given community.
In addition, most Western countries have aging populations, which means that the number of people requiring medical treatment is almost certain to increase over time. With fewer younger people of working age available to support them, this problem is only likely to increase in the years to come as resources continue to be stretched. Significantly, the number of chronic diseases is also on the rise. This is in part because we are living longer – chronic diseases and conditions become more prevalent as people age – and changes in our lifestyles over the past century – more sedentary lifestyles, less nutritious diets, and obesity can all make chronic disease more likely – but also due to improvements in diagnostics and early detection. Again, this places an obvious burden on healthcare providers and offers up a clear opportunity for nurse practitioners, who can provide a high level of ongoing care, even in cases where a physician makes the original diagnosis.
Indeed, many nurses who have the requisite medical training and experience and go on to qualify as nurse practitioners will provide an alternative to treatment by a doctor. Typically, these nurses have worked for many years in healthcare and can offer a wide range of expertise and knowledge to patients. Some may also be younger and less experienced but want to enjoy a position with greater autonomy than a regular nurse. In either case, the main aim is to work hard to provide a greater scope of care for patients, particularly those who struggle to access primary care, and to improve health outcomes across the board.
The rise of nurse practitioners has coincided with a greater focus from healthcare institutions on the importance of patient-centered care. Naturally, any physician is capable of focusing on the patient and offering treatment that is tailor-made to their individual circumstances. Still, it is generally thought that NPs typically have a greater focus on the patient and their general circumstances.
This is partly because physicians tend to be trained and provide care according to the medical model. This means they are primarily focused on testing, diagnosing, and treating the disease and usually specialize in a particular branch of medicine. Nurse practitioners, on the other hand, are trained and provide care using the nursing model. This means that although they are also concerned with treating the disease, they are primarily focused on the patient and often specialize in a particular patient population rather than a specific type of medicine.
The importance of patient-centered care is not only more appealing to patients, who generally enjoy a more personal touch but has also been found to help improve health outcomes in the longer term. This is because offering targeted care and treatment based on not only the individual symptoms but also a wide range of other variables, such as lifestyle choices, related physical and mental health issues, and environmental factors. This approach can help both the medical team and the patient to address the symptoms at hand and work hard to tackle any underlying issues. Conversely, a blanket approach or an over-reliance on prescriptive medicine can often mean that a patient is committed to a course of treatment – such as heavy medication – that may not be wholly beneficial in the long term. Naturally, there are limits to such perspectives, and in many cases urgent medical care is required, but the overall emphasis remains on the patient.
Greater access for patients
Many nurse practitioners operate in larger towns and cities. Although their qualifications and main responsibilities are often the same as NPs working in the countryside, nurse practitioners operating in urban areas typically enjoy greater support from physicians and specialists. After all, in a large city there is no sense of isolation, even for independent NPs. There is always a doctor or other professional on hand to offer advice or a second opinion.
That is not to say that NPs in urban areas do not enjoy great autonomy. In many cases they provide primary care, entailing diagnosis and the prescription of medications on a regular basis. And although NPs operate in all possible fields and locations, they are particularly crucial in many low-income areas. Here, access to healthcare can be more limited, and waiting lists are often at a critical level. Naturally, if patients can access primary care faster and receive treatment, this can make a positive difference in health outcomes.
At the same time, the role of an NP can be even more vital in rural settings, where there are fewer available medical resources and, in many cases, patients have significant trouble accessing a doctor or receiving timely and appropriate care. Studies have also shown that rural communities in the US tend to be older, have higher levels of unemployment, are more impoverished, and are more prone to chronic conditions.
Reaching out to the community
As anyone familiar with the role of Melinda Monroe, the famous nurse practitioner in the hit TV series Virgin River will testify, NPs can become vital members of the local community. Naturally, the real-life role of an NP is not always as glamorous as Hollywood might have us believe, but one thing is for sure: they play a crucial role in countryside life and medical care. Indeed, in rural areas, patients are more likely to be seen exclusively by NPs instead of physicians, while rural nurse practitioners are also more likely to practice independently and prescribe medication.
In these areas, NPs frequently take the lead in healthcare and ensure that an increasing number of people have access to first-rate medical aid. Nearly half of all rural primary care practices employ at least one NP, and in many low-population areas, NPs are the first port of call for patients seeking medical assistance. Indeed, NPs interested in rural communities, particularly more remote ones, must be comfortable dealing with a wide range of medical emergencies – such as a heart attack or a serious workplace injury – without initial assistance from a physician.
However, it should also be stressed that regardless of whether nurse practitioners operate in rural or urban locations, their general position, duties, and responsibilities are often broadly similar. Wherever they work, they almost always become key members of the community. Nurse practitioners are highly appreciated medical professionals and perform essential roles in managing chronic conditions, dealing with acute illness, and often providing crucial emergency care for patients suffering from life-threatening injuries.
The right knowledge and skills
So what does it take to be a good NP, and is becoming a nurse practitioner a good career choice? As mentioned above, while being a nurse practitioner is frequently even more demanding and brings more pressure than working as a registered nurse, they are also typically better paid and enjoy greater independence. Indeed, the opportunity to work more independently is one of the main reasons nurses train to be NPs and choose to enroll in an accredited program like the one offered by Carson-Newman University. Job satisfaction is typically higher than for general nurses, and many other professions in healthcare and beyond.
There is no question that being a good nurse practitioner requires not only practical nursing experience and in-depth knowledge of the profession but also a willingness to take on responsibility, excellent awareness of the crucial relationships between patients and healthcare staff, and also the ability to manage a team, and in many cases an entire practice. Nurse practitioners work in a wide range of areas and might be responsible for offering primary care, trauma care, pediatric care, mental health care, and women’s and maternal health. Though some NPs specialize in more specialized branches of medicine, it is common to focus on particular sectors of the population, such as offering family or pediatric care or caring for older people.
It is also important to gain the necessary qualifications to work in this field. In the US, NP may have the title of advanced practice registered nurse (APRN), while the term advanced registered nurse practitioner (ARNP) is also frequently used. To qualify as an NP, you must first train to become a registered nurse. Then, it is necessary to complete a Bachelor of Science in Nursing (BSN), complete an NP-focused graduate master’s or doctoral nursing program, and successfully pass a national NP board certification exam.
These courses are designed to provide students with the ability to provide excellent nursing care and take the lead in diagnosing and treating illness, devising treatment plans, and working to improve health outcomes across the board. In addition, graduates of a nurse practitioner course will also emerge with the skills and knowledge needed to run their own practice, with a focus on additional theoretical and practical grounding in patient and staff management, long-term healthcare trends, and even sound financial management.
An increasingly vital profession
Over the last 50 years or so, in countries such as the US and UK, nurse practitioners have become an essential part of the healthcare system, and this level of importance is becoming increasingly reflected in not only legal and medical guidelines but also through higher pay levels and the improved level of autonomy offered to qualified NPs. Not only is the rise of the nurse practitioner profession a hugely positive step for the healthcare industry, but it is also great news for nurses who enjoy their jobs but are interested in developing their careers and taking on greater responsibility.
Today, the role of nurse practitioner is one of the most trusted professions in the world. Just like other registered nurses, they offer a vital service to patients, provide crucial support to physicians, and make a significant contribution to the care and attention that patients deserve. Their greater range of expertise and ability to operate autonomously means that, in many cases, they can make an even more significant contribution to providing timely care, reducing waiting lists, and improving health outcomes across the board.
The importance of this role is even more crucial in rural areas, where access to health services is often limited, and physicians can be thin on the ground. Here, the presence of nurse practitioners means that people can access regular healthcare and receive treatment that they would otherwise have found almost impossible. It is no surprise, then, that most developed countries are looking to increase the number of NPs available so they can help to offer a higher level of care to all.