A nurse practitioner (NP) is a
registered nurse (RN) who has completed advanced education (a minimum of a
master's degree) and training in the diagnosis and management of common medical
conditions, including chronic illnesses. Nurse practitioners provide a broad
range of health care services. They provide some of the same care provided by
physicians and maintain close working relationships with physicians. An NP can
serve as a patient's regular health care provider.
Nurse practitioners see patients of all ages. The
core philosophy of the field is individualized care. Nurse practitioners
focus on patients' conditions as well as the effects of illness on the lives of
the patients and their families. NPs make prevention, wellness,
and patient education priorities. This can mean fewer prescriptions and
less expensive treatments. Informing patients about their health care and
encouraging them to participate in decisions are central to the care provided by
NPs. In addition to health care services, NPs conduct research and are often
active in patient advocacy activities.
Because the profession is state regulated, care
provided by NPs varies. A nurse practitioner's duties include the
following:
Collaborating with
physicians and other health professionals as needed, including providing
referrals
Counseling and educating
patients on health behaviors, self-care skills, and treatment options
Diagnosing and treating
acute illnesses, infections, and injuries
Diagnosing, treating,
and monitoring chronic diseases (e.g., diabetes, high blood pressure)
Obtaining medical
histories and conducting physical examinations
Prescribing physical
therapy and other rehabilitation treatments
Providing prenatal care
and family planning services
Providing well-child
care, including screening and immunizations
Providing health
maintenance care for adults, including annual physicals
Nurse practitioners provide high-quality,
cost-effective individualized care that is comparable to the health care
provided by physicians, and NP services are often covered by insurance
providers. NPs practice in all states. The institutions in which they
work include the following:
Community clinics and
health centers
Health departments
Health maintenance
organizations (HMOs)
Home health care
agencies
Hospitals and hospital
clinics
Hospice centers
Nurse practitioner
offices
Nursing homes
Nursing schools
Physician offices
Private offices
Public health
departments
School/college clinics
Veterans Administration
facilities
Walk-in clinics
Most NPs specialize in a particular field of
medical care, and there are as many types of NPs as there are medical
specialties.
NPs and Women's Health
Women with serious conditions, especially those
that require surgery, need the services of a physician. But when women have
typical health care needs, an NP can serve as the primary health care provider.
Some nurse practitioners focus specifically on
obstetrics and gynecology. They provide services that include the following:
Care before and after
menopause
Contraceptive care
Evaluation and treatment
of common vaginal infections
Health and wellness
counseling
Midwifery
Physical exams,
including Pap smears
Pregnancy testing and
care before, during, and after pregnancy
Screening and referral
for other health problems
STD screening and
follow-up
Licensure and Certification
To be licensed as a nurse practitioner, the
candidate must first complete the education and training necessary to be a
registered nurse (RN).
Requirements for a registered nurse
include an associate degree in nursing (ADN), a bachelor of science degree in
nursing (BSN), or completion of a diploma program, as well as direct patient
care for acutely or chronically ill patients. Associate degree in nursing
programs, which are offered by community and junior colleges, usually take 2–3
years. BSN programs are offered by colleges and universities and take 4–5 years
and diploma programs are administered in hospitals and usually take 2–3 years.
Depending on the program attended, the candidate may fulfill some NP
requirements while completing the RN degree.
In most cases, state regulations require and
professionals and employers in the field strongly recommend a master's degree
as a minimal requirement for NPs. To become NPs, nurses with an ADN or diploma
enter a bachelor of science to master's program. They may be able to find a
staff nursing position and take advantage of tuition reimbursement programs to
work toward a BSN.
Once registered nurse status is attained, the
candidate must complete a state-approved advanced training program that
usually specializes in a field such as family practice, internal medicine, or
women's health. The degree can be granted by any of the following:
Community college
(grants an associate degree)
Hospital-based program
(grants a 3-year diploma)
University, which grants
a bachelor of science in nursing (BSN) degree; a master's of science in
nursing (MSN) degree, which is the minimum degree required; or a doctorate
in nursing
The variety of educational paths for NPs is a
result of the history of the field. In 1965, the profession of nurse
practitioner was instituted and required a master's degree. In the late 1960s
into the 1970s, predictions of a physician shortage increased funding and
attendance in nurse practitioner programs. During the 1970s, the NP requirements
relaxed to include continuing education programs, which helped accommodate the
demand for NPs. Currently, educational options require a master's or doctorate
to attain NP status.
After completing the education program, the
candidate must be licensed by the state in which he or she plans to
practice. The State Boards of Nursing regulate nurse practitioners and each
state has its own licensing and certification criteria. In general, the criteria
include completion of a nursing program and clinical experience. Because state
board requirements differ, nurse practitioners may have to fulfill additional
requirements, such as certification by the American Nurses Credentialing Center
(ANCC) or a specialty nursing organization. The license period varies by state;
some require biennial relicensing, others require triennial.
After receiving state licensing, a nurse
practitioner can apply for national certification from the ANA or other
professional nursing boards such as the
American Academy of Nurse Practitioners (AANP). Some NPs pursue
certification in a specialty. Several organizations oversee certification,
including the following: