NPs on the Front Lines of Change: National Nurse Practitioner Week

Lane Therrell FNP, MSN, RN, NP

Let's Celebrate National Nurse Practitioner Week

I became a nurse practitioner (NP) in part because I received excellent care from one years ago. I imagined myself helping others in a similar way, giving back to society by providing the kind of comprehensive, individualized, health care that had been so helpful to me personally. Little did I know that my work as an NP would put me on the front lines as the healthcare industry experienced a sea change in response to an aging population and the advent of new technologies.

You likely already know that NPs are registered nurses with additional education, at the masters or doctorate level, which allows them to diagnose and manage acute and chronic illnesses, prescribe medications, and order diagnostic tests and treatments. NPs also routinely integrate health promotion, disease prevention, counseling, and patient education to help patients understand the big picture of their overall health. This comprehensive approach to whole-person health is particularly useful in a population that is aging and plagued by chronic disease. Some 75 million baby boomers will become senior citizens over the next decade, and 50 million of them are expected to have multiple chronic conditions.

According to a 2012 Economist article on the future of medicine, the health problems of the 21^st century cannot be resolved by 20th-century approaches. The article also points out that because trends in medical education have consistently emphasized treatment of communicable diseases and acute injury, many of today's physicians are often not adequately prepared to care for patients with chronic conditions. An additional factor is that physicians graduating from medical school today do not often choose primary care or family practice as a career focus. Nurse practitioners are filling these gaps. According to the American Association of Nurse Practitioners (AANP), 234,000 NPs are currently licensed in the United States, and some 23,000 NP students graduate each year.

The NP role emerged in 1965, primarily as a response to manage an existing and anticipated physician shortage. Although the role of NP has existed in the United States for more than 50 years, evolving and responding to the needs of a changing population and industry, not everyone in healthcare or the public fully understands the role of a nurse practitioner. Here are some facts about NPs that are worth knowing:

The biggest difference between a medical doctor, a PA, and an NP is educational philosophy and background

NPs are NOT physicians, nor are they physician assistants; NPs did not go to medical school. Nurse practitioners are nurses first, which means their academic training is based on the nursing model, a fundamentally different way of thinking, distinct from the medical model under which physicians and physician assistants are educated and trained. Accredited nurse practitioner program curricula builds medical model concepts on top of a nursing model foundation.

Some NPs may be doctorally educated

Nurses who have earned a doctoral academic degree may be referred to as "doctor," even though they are not educated as physicians and did not attend medical school. This is not meant to be confusing to patients or colleagues, but sometimes it can be.

Licensure requirements for NPs vary from state to state

Although there are national certification exams for NPs, specific licensure requirements for NPs vary widely from state to state. NPs are able to diagnose and prescribe in all 50 states, with the ability to do so independently of physician oversight or prescription sign-off in 22 states and the District of Columbia.

NPs may be specialists

Beyond primary care, nurse practitioners may choose to further their education in oncology, gerontology, pediatrics, psychiatry and other specialty areas.

NPs represent one type of advanced practice nursing role

Other advanced practice nursing roles include nurse midwives, nurse anesthetists, and clinical nurse specialists. Each advanced practice role has its own specific educational, licensure and certification requirements.

The fact that the NP role is built on the nursing model is the key to the value of NPs in the changing world of healthcare. The nursing model is holistic and humanistic at its core, providing an ideal foundation on which to integrate the more reductionistic medical model approaches. An integrative approach that marries systemic thinking with mechanistic techniques will be needed to navigate the future trajectory of medicine. Recall that the nursing model is uniquely comprehensive and holistic because it addresses the patient's response(s) to health threats and treatments, both current and potential. As emerging technologies such as genome analysis, artificial intelligence, and wearable digital devices democratize individuals' access to medical data, an educational, humanistic view of how technology impacts health will be in high demand. As such, the nursing model provides an ideal foundation for graduate-level education, positioning NPs perfectly to integrate emerging technologies, such as genome analysis and digital informatics (wearables) into the next generation of healthcare delivery.

Whether you are already an NP, studying to be one, working with one or receiving care from one, take a moment this week, to consider the role of the NP. Ultimately, as health care continues to change, NPs will continue to provide high quality cost-effective, personalized health care - on the front lines, as part of a collaborative team in partnership with healthcare professionals at all levels.

The AANP is the largest professional organization for NPs of all specialties in the US, and promotes National Nurse Practitioners Week each November to showcase the NP role. The aim of NP Week is to acquaint local citizens with the role of NPs as providers of high-quality, cost-effective, personalized health care and to highlight the value of NPs. NP practice offers a unique combination of nursing and health care service to patients. For more information, visit AANP.org.