NP's are okay to see if you have a cold, BUT...

  1. I want to become a nurse practitioner. At least, I'm pretty sure I do. I can't say with 100% certainty but it is definitely something I am interested in. I think I would like having my own clinic where I am the one who tells who to do what and when (though I'm not a control freak by any means).
    Anyway, I just wonder what the scope of practice is for NP's in a nutshell. I know I can check the state board of nursing but without getting lost in a long spiel a long spiel can anyone sum it up for me here?
    I assume, even though an NP can be a PCP, that an NP mostly treats colds, minor infections, gives physicals to truckers...but a NP certainly is not a doctor (even though the name on prescription bottles usually reads "Dr. so and so".)
    Anyway, thanks for any advice. And don't anybody bite my head off because I want the Reader's Digest version instead of a book.
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  2. 62 Comments

  3. by   NRSKarenRN
    np's interest in healthcare often guides what type practice setting they choose: can vary from working in family practice setting with on-site physician, specialty setting with admission privleges in hospital or running own practice /clinic setting hiring collaberative physician for chart review.

    need to obtain bsn then ms program or go through bsn/msn option program to become np today.

    see: nncc | national nursing centers consortium | nursing centers national nursing centers consortium, nncc, are nurse-managed health centers taking care of people in need.
    members are the trail blazers in philadelphia area for independent practice.



    video: dial up or cable/dsl or faster

    from: nurse-managed health centers are changing the face of health care
    nurse-managed health centers focus on...
    • wellness
      we treat, educate, and heal from a holistic perspective that integrates preventive care and wellness maintenance into primary care.
    • patients
      we know our patients and our patients know and trust us. we take the time to listen and to learn about the whole person, and consequently make the connections between a person's life and the state of his or her health.
    • families
      we treat the whole family, not as separate individuals but as a family whose members share an environment of health risks and health opportunities.
    • nontraditional and community-based services
      we expand our definition of health care to deal with some of the most serious problems facing american society today, including family, adolescent and neighborhood violence; drug, nicotine and alcohol addictions; grief, stress, and anxiety; and the environmental aspects of diseases such as asthma and birth defects.
    in the philadelphia region, nurses see their patients almost twice as often as other providers; their patients are hospitalized 30% less and use the emergency room 15% less often than those of other health care providers.

    care and interest i've received from np's in my pcp's office outstanding...only see the doc if np's time is booked.
    Last edit by NRSKarenRN on Oct 3, '06
  4. by   traumaRUs
    I'm a CNS (another type of APN) and I do primary care but also provide specialized care (chronic dialysis management). I also do hospital ER and in-patient care. I take care of complex ICU patients when I do call and make potentially life-altering decisions. Its certainly not minor care.

    There are many roles for APN's nowadays and that is what makes this field so exciting. Shadow some APN's - join a state nursing society, come to continuing ed meetings that gear towards the APNs.

    Good luck .
  5. by   NRSKarenRN
    [font=tte1e21588t00][color=#33339a]who are nurse practitioners?[font=tte1e21588t00][color=#33339a]
    [font=tte1e750c8t00]nurse practitioners (nps) are registered nurses who are prepared, through advanced education and clinical training, to provide a wide range of preventive and acute health care services to individuals of all ages. today, nps complete graduate-level education preparation that leads to a master’s degree.


    nps take health histories and provide complete physical examinations; diagnose and treat many common acute and chronic problems;
    interpret laboratory results and x-rays;
    prescribe and manage medications and other therapies;
    provide health teaching and supportive counseling with an emphasis on prevention of illness and health maintenance;
    and refer patients to other health professionals as needed.

    nps are authorized to practice across the nation and have prescriptive privileges, of varying degrees, in 49 states. the most recent health resources and services administration sample survey report (2004) shows 141,209 nurse practitioners in the united states, an increase of more than 27 percent over 2000 data. the actual number of nurse practitioners in 2006 is estimated to be at least 145,000.
    http://www.acnpweb.org/files/public/..._nps_may06.pdf


    nurse practitioners provide basic preventive health care to patients, and increasingly serve as primary and specialty care providers in mainly medically underserved areas. the most common areas of specialty for nurse practitioners are family practice, adult practice, women’s health, pediatrics, acute care, and gerontology...
    http://www.bls.gov/oco/ocos083.htm


    what is a nurse practioner and scope of practice?
    http://www.npcentral.net/consumer/about.nps.shtml
    Last edit by NRSKarenRN on Oct 3, '06
  6. by   sirI
    Thank you, NRSKarenRN for the excellent links. Thank you, traumaRUs, for the input.

    As an advanced practice nurse (APN), one can seek the Nurse Practitioner track, the Clinical Nurse Specialist (CNS) track and the Certified Nurse Midwife (CNM) track.

    Within the NP and the CNS tracks, there are many specialty areas:

    Neonatal, Pediatric, Family Practice, Mental Health/Psychiatric, Geriatric, Acute Care, Adult, OB-GYN (women's health).... just to name a few. There are combination NP/CNS tracks as well. One should do a search and see just what might be a good fit.

    Much of the scope of practice depends upon the individual states. One will need to check with the states' SOP to see what is expected of the NP. Some states require a physician collaboration and others not.

    Now, since Georgia has received prescription privileges, all states allow NPs to have Rx privileges. The NP will have a DEA number. And, the legal prescription will be issued by the NP with his/her name on the label.

    Also, one needs to search their own area and see what the demand is and/or what the market will bear when considering the APN role.

    As for the NP being only good for the treatment of colds, minor scrapes, minor infections, etc, one needs to spend a day in the life of an APN and see just exactly what goes on. This will enlighten any individual as to what we do on a daily basis.

    To the OP, if you desire a blow-by-blow of what a typical day is for me, I'll be happy to speak with you privately. I think you will be surprised and maybe a little pleased to see what great responsibilities and challenges the NP faces on any given day.
    Last edit by sirI on Oct 3, '06
  7. by   gauge14iv
    Funny thing is - the majorly sick folks somehow end up on my schedule because I will have openings for same day appointments when my doc is already booked solid. I definately see MUCH more than minor infections, colds and physicals! Diabetics, CHF, all kinds of chronic illness in crisis in addition to the bronchitis, pnuemonias, migraines, colds, sinusitis and UTI's...
  8. by   Jo Dirt
    I certainly don't want to minimize what NP's do, especially since I want to become one, but I think there are certain things only a doctor is qualified to diagnose. What got me to realize this was about a month ago. My psychiatrist used to be an oncology surgeon and I brought my 5 yr old to my appointment with him. He got really upset and pointed out the side of her neck was swollen, had a big hard knot the size of a baseball. I thought her face seemed a little puffy on that side but her hair is long and I hadn't looked at closely it as it was the first day I noticed it.
    But anyway, he made me promise to take her to a pediatrician or family doctor. I couldn't get an appointment with our regular doctor so I took her to a pediatric clinic. The only person available was a PA. She was nice but she looked at my daughter and said the only thing she could think it was would be the mumps. So, we had her checked and the results came back negative and the swelling was as big as ever. So I am really worried and I finally get her in to see a doctor at a family medical clinic. He examined her much more thoroughly and told me the nodes that were swollen on her were not the nodes that get swollen when a child has the mumps. He told us after doing a CBC that it looked more like a virus and if the swelling did not go down in two weeks he wanted her to go in for a biopsy. Thank goodness the swelling went away, but talking to the doctor put my mind at ease.
  9. by   EricJRN
    No matter our credentials, we're all on the same team and we will all have individual strengths and weaknesses. It seems evident that the PA in your case would have benefited from involving another provider. A similarly stumped MD would be best served by doing the same thing.

    When I worked for a pediatric clinic, the NP would sometimes consult one of the physicians if she wasn't comfortable with a particular assessment finding. The docs would also consult her frequently, especially in regard to her area of special interest (child abuse/sexual assault issues).
  10. by   hrtprncss
    Hello, to all practicing NP's especially the one's in primary care. I just have a question...If you're an FNP or ANP who functions as sole Primary care provider for your own patients in a clinic for well care, and then your patients become acutely ill, does that mean you would have to consult an internist to manage the patient and maybe do an admission? Or are most ANP and FNP usually have admitting priviliges that they can manage the patient in the hospital? If not, and you're an ANP or FNP, then would you need to be certified as an ACNP to have admitting priviliges in the hospital, handling the patients hospital stay, rounding on your in hospital patients? Is that within a scope of an ANP or FNP, how bout if they're dual certified as ACNP, would that be within their role? Or is that encroaching upon the role of Internal Medicine Physician?
  11. by   Multicollinearity
    Quote from motorcycle mama
    I certainly don't want to minimize what NP's do, especially since I want to become one, but I think there are certain things only a doctor is qualified to diagnose. What got me to realize this was about a month ago. My psychiatrist used to be an oncology surgeon and I brought my 5 yr old to my appointment with him. He got really upset and pointed out the side of her neck was swollen, had a big hard knot the size of a baseball. I thought her face seemed a little puffy on that side but her hair is long and I hadn't looked at closely it as it was the first day I noticed it.
    But anyway, he made me promise to take her to a pediatrician or family doctor. I couldn't get an appointment with our regular doctor so I took her to a pediatric clinic. The only person available was a PA. She was nice but she looked at my daughter and said the only thing she could think it was would be the mumps. So, we had her checked and the results came back negative and the swelling was as big as ever. So I am really worried and I finally get her in to see a doctor at a family medical clinic. He examined her much more thoroughly and told me the nodes that were swollen on her were not the nodes that get swollen when a child has the mumps. He told us after doing a CBC that it looked more like a virus and if the swelling did not go down in two weeks he wanted her to go in for a biopsy. Thank goodness the swelling went away, but talking to the doctor put my mind at ease.
    When I had chicken pox at age 20, the MD didn't know what the spots were or what was wrong with me. He stepped out and brought in an NP. She took one look at me and quickly said "chicken pox." She was right.

    See my point?
    Last edit by Multicollinearity on Oct 6, '06
  12. by   Patti 2nd gen RN
    I love going to see the NP because she listens better than the doc's most of the time--coming from a foundation in nursing and not doctoring changes thier perspective on treating the whole person--on top of which NP's seem less likely (from personal experience) to be closed minded about 'alternative' care. I have worked in the military and several different states--what an NP gets paid, and what her scope of practice is does change state to state. And don't forget--specialty education increases what each specialty can do---just like with any other profession. Be aware though--insurance rates go up. Good Luck--I wish I had done that when I had the chance, but now working full time andbeing a mom, I can't manage the time or money to follow my dreams---don't miss your chance!!!!
  13. by   gauge14iv
    Your experience with the PA and your childs neck lump wasnt a PA vs MD issue but a 1 provider vs another issue.

    One MD might have said the same thing the PA did. And another PA or NP might have said the same thing the MD did - depends on the person, their background, experience and exposure. Not the credentials. Give me a tenth year NP over a first year MD any day.
    Last edit by gauge14iv on Oct 6, '06
  14. by   Jo Dirt
    Quote from multicollinarity
    When I had chicken pox at age 20, the MD didn't know what the spots were or what was wrong with me. He stepped out and brought in an NP. She took one look at me and quickly said "chicken pox." She was right.

    See my point?
    That seems unbelievable. Did that doctor get his medical degree out of a cereal box?
    Any doctor who is not able to recognize chicken pox should be reported to the medical board.

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