As more health care moves beyond the hospital to other sites in the community, policymakers are looking especially to one type of advanced registered nurse -- the nurse practitioner (NP) -- to help meet the escalating need for high-quality and accessible health care.
With an eye toward balancing quality and cost, health planners are
relying increasingly on nurse practitioners as the providers of choice for a range of front-line health services, such as primary and preventive care, managing chronic health conditions, and teaching older patients how to avoid injury and the expense of hospitalization and nursing home care. Mounting studies show that the quality of NP care is equal to, and at times better than, comparable care by physicians, and often lower cost.
The number of nurse practitioners has climbed quickly to meet growing demand. Approximately 60,000 nurse practitioners were practicing in the U.S. in early 1999, up from an estimated 48,000 in 1992. Nationwide, more than 300 universities and colleges offer masterís-degree or post-masterís NP programs.
A nurse practitioner is a registered nurse who has advanced education and clinical training in a health care specialty. Recognized as expert health care providers, nurse practitioners deliver basic health care for infants, children, adults, and families in a wide range of outpatient and inpatient settings. Nurse practitioners provide information people need to make informed decisions about their health care and lifestyle choices.
NPs focus particularly on health promotion and maintenance, disease prevention, and diagnosing and managing acute and chronic illnesses. Nurse practitioner care is individualized, focusing not only on health problems, but also on the effects health problems have on people and their families.
Among their varied roles, nurse practitioners take patient histories; perform physical exams; diagnose and treat common acute illnesses and injuries; provide immunizations; manage high blood pressure, diabetes, and other chronic health problems; order and interpret lab tests; prescribe medication and nonpharmacological therapies; provide prenatal care and family planning services; and counsel patients on healthy lifestyles and health care options. Many nurse practitioners also work as educators and research scientists at schools of nursing, and are actively involved in legislative activities and health care policy to promote quality health care delivery for the nation.
NPs practice under the rules and regulations of the Nurse Practice Act of the state in which they work. Nurse practitioners can prescribe medication in every state and in the District of Columbia. In 21 states plus the District, NPs can practice independently without physician collaboration or supervision.
Many NPs have their own practices and can be reimbursed by Medicare, Medicaid, or other third parties.
Most nurse practitioners work in a clinical specialty, such as pediatrics, family practice, adult health, neonatal care, ob/gyn/womenís health, psychiatric/mental health, oncology, occupational health, school health, gerontological care, and emergency and acute care. Most NPs are certified by a national board or organization in their specialty area.
Nurse practitioners work in a wide array of urban and rural settings, such as:
- Primary Care Clinics
- Community Health Centers
- Emergency Rooms, Critical-Care Units, Clinics, and Other
- Hospital Departments
- School and College Health Clinics
- Nurse Practitioner Offices
- Public Health Departments
- Business and Industry Employee Health Settings
- Health Maintenance Organizations
- Physician Offices
- Nursing Homes and Hospices
- Home Health Care Agencies
- Schools of Nursing
- The Armed Forces and Veteransí Administration Facilities
Nurse practitioners must have strong critical thinking, decision making, communication, and patient teaching skills. In addition, NPs must have the ability to accurately evaluate the health and illness experiences of individuals, families, and communities, and to analyze and apply research findings in their clinical work. Nurse practitioners also must be skilled in developing patient education strategies, applying ethical and legal principles to complex health care situations, and developing effective care plans that consider patientsí life circumstances and cultural, ethnic, and developmental differences.
Most nurse practitioners are prepared in masterís-degree programs in a wide range of clinical specialties. A smaller number have received training in certificate programs that require up to two years of additional clinical training beyond the masterís degree in nursing.
In 1999, nurse practitioners nationally earned salaries ranging between $50,000 and $70,000 across a range of specialties, with an average of $60,000.
American Academy of Nurse Practitioners
P.O. Box 12846
Austin, TX 78711
FAX: (512) 442-6469
Web site: www.aanp.org
American College of Nurse Practitioners
503 Capital Court, NE, Suite 300
Washington, DC 20002
FAX: (202) 546-4797
Web site: www.nurse.org/acnp
Association of Womenís Health, Obstetric and Neonatal
2000 L St., NW, Suite 740
Washington, DC 20036
FAX: (202) 728-0575
Web site: www.awhonn.org
National Association of Pediatric Nurse Associates and Practitioners
1101 Kings Highway, North, Suite 206
Cherry Hill, NJ 08034-1912
FAX: (856) 667-7187
Web site: www.napnap.org
National Organization of Nurse Practitioner Faculties
1522 K St., NW, Suite 702
Washington, DC 20005
FAX: (202) 289-8046
Web site: www.nonpf.com
Advance for Nurse Practitioners (www.advancefornp.com)
The Nurse Practitioner (www.springnet.com/jrdescr/nursepractoc.htm)