Nurse Practitioners and their role in U.S. healthcare
By: Hayder Alamar, Contributing Writer
Edited by: Fatou Kourouma, Editor; Elias Azizi, Editor in Chief
When people consider healthcare, they mainly think about doctors and nurses in the field. However, a more emerging front includes the impactful role of nurse practitioners (NPs), licensed practitioners who can work independently from physicians. You may have needed a refill on medication, or needed to urgently see your primary care physician, but your provider’s schedule was booked for weeks. In this case, a NP may have the authority to see you sooner and prescribe your medications. In fact, 96.2% of licensed NPs today are authorized to prescribe their patients medications. With an ever-aging population due to technological and pharmacological advancements, there is a desperate need for healthcare professionals to diagnose and treat a wide array of health conditions present today. Due to a shortage of doctors and a higher demand for caregivers, NPs are widely appreciated for providing their services in the healthcare sphere by undertaking such vital roles. They may provide their services in many settings, including but not limited to inpatient, outpatient, and home health environments. NPs provide increased access and effectiveness of health services by catering to a growing population with an increased life expectancy.
NPs are registered nurses (RN) who must attain a master’s or doctoral degree with additional clinical training in any particular field, hence why NPs are also known as advanced practice registered nurses, or APRNs. However, the key distinction between NPs and RNs is that nurse practitioners have the autonomy to diagnose patients, initiate treatment methods (including the prescription of medications), and conduct further evaluations and examinations, just like regular primary care physicians (PCPs). Nursing continues to be the largest healthcare profession due to the essential care they provide patients, with 325,000 nurse practitioners licensed in the United States today.
Why might NP be the perfect healthcare route to pursue for you? Compared to most working physicians, NPs are not expected to attend medical school and subsequent residency/fellowship, alleviating the burden that comes with additional years of schooling. This reduces the investment of time and money for school which may pose an appealing path for those who cannot afford accumulating student loan debts. Although NPs do not make as much as common physicians, they do make six figures on average, with the median base salary for NPs in 2020 sitting around $110,000. As long as one completes their respective nursing program, including a bachelor’s of science degree in nursing (BSN) or ABSN, and achieves RN license by passing NCLEX exam, they have the option to work as an RN for the time being until they choose to dedicate a couple more years to a Master of Science in Nursing (MSN) or Doctor of Nursing Practice (DNP). Once one passes board exams, they will finally be awarded an NP license and prescribing privileges. The average student takes around five to seven years to complete all education and training to become an NP, however the maximum time to become an NP could be about 14 years.
NPs can operate in most clinical settings, as long as they are in agreement with a physician. They are most commonly utilized in palliative care settings to provide the “best quality of life” for patients who require immediate attention and advanced planning for a chronic disease they may be facing. Due to the increasing prevalence of chronic diseases, extra care providers are needed to provide symptom management, psychosocial support, and medical interventions for patients. NPs are unique due to their focus on promoting lifestyle modifications, preventing disease and monitoring the treatment of their patients. Nurse practitioners manifest a versatile position to healthcare by providing essential primary care services depending on certain state regulations. There are differences across state boundaries regarding the amount of autonomy NPs are granted such as prescription authority and ability to manage clinics independently of physicians, according to the state board of nursing. This is evident in most rural areas where NPs see the most flexibility in their delivery of healthcare due to decreased availability of PCPs. In these cases, NPs may have full authority to prescribe medications and may even operate completely independently of physician overwatch.
Most NPs, more specifically 89.9% of NPs, are certified in primary care as this path allows nurse practitioners to serve broad populations of patients while being exposed to different work environments. The most common specialty track within primary care is family practice (69.7% of NPs), where NPs primarily work in outpatient settings, such as private practices, or for larger healthcare organizations, such as urgent care or emergency departments. FNPs, also known as family nurse practitioners, promote longevity and well-being of their patients by providing early treatment and monitoring both acute and chronic health conditions through preventative exams and annual health visits. This popular path may be an intriguing fit for those with a nonspecific desire to provide holistic care to a diverse class of patients, spanning from newborns to geriatric patients, while working besides a network of healthcare providers including MDs, PAs, and fellow NPs.
All in all, nurse practitioners offer a critical role to the healthcare industry by delivering their passion for medicine through hands-on support for the prevention and healing of Americans nationwide. Not only do NPs receive a high level of satisfaction, they are becoming a rather mainstream choice in the healthcare sector due to their emphasis on high quality care and individual health management. The number of nurses with doctoral degrees has steadily risen over the past decade to match the demands for healthcare and is expected to continue to grow over the next few years.