Written by Shanna S. RN, BSN.
Emerging Role of Nurse Practitioners as Essential Partners in Primary Care
As the landscape of healthcare in the United States continues to evolve, Nurse Practitioners (NPs) are increasingly being recognized as essential partners in the provision of primary care services. As a result of the Affordable Care Act, the number of Americans with access to health insurance coverage is rapidly expanding. Healthcare.gov notes that more than 6 million individuals enrolled for health coverage as of January 2014, creating an influx of people that will be accessing primary care, who may not have had the resources to do so before. Expanded healthcare coverage represents a step forward in efforts to increase nationwide access to primary healthcare services, but it carries with it an increase in the demand for primary care providers.
With a physician shortage of anywhere from 50,000 to 150,000 doctors anticipated over the next two decades, increasing the number of Nurse Practitioners is essential to bridging the gap between the supply of primary care providers (PCPs), and the demands placed upon them. By entering and completing a Nurse Practitioner program, you can help to bring high quality, affordable primary care services to millions of Americans.
At BestNursingDegree.com, we are dedicated to connecting nurses like you with the advanced educational opportunities you seek. We have compiled a database of all the accredited Nurse Practitioner programs across the United States to shorten your search time and give you access to the information you need.
Take some time to look over the Nurse Practitioner programs on this page, and request information from those schools that offer the Advanced Practice Registered Nurse (APRN) programs you are interested in.
There are several specialty tracks and focus areas to choose from, so if you are undecided about which segment of healthcare you would like to practice in, you can request from multiple different programs to help you decide. All of the information on this page is free, and is intended to help you expand both your education and your nursing practice in the way that works best for you. If, at any point, you have a question about becoming a Nurse Practitioner, or about the variety of programs offered, please contact us at firstname.lastname@example.org.
What Are My Nurse Practitioner Study Options?
Nurse Practitioners represent a crucial component in the effort to reshape healthcare in the United States into a more efficient and patient friendly system. Utilizing the knowledge of advanced practice nurses to treat patients in a primary care setting has been shown to be just as effective as using a traditional physician-only approach. In fact, multiple studies have shown that NPs often provide care that results in improved outcomes, when compared to care provided solely by MDs, which you can read about here.
As the U.S. continues to strive to cut costs, improve quality and expand access to healthcare, more and more Americans are turning to Nurse Practitioners for their care, whether it be in a women's clinic, a retail care setting, a traditional clinic, or in a nurse managed clinic. In fact, there is a good deal of government funding from the Health Resources and Services Administration (HRSA) that supports both the training of NPs and the development of nurse managed clinics in which you can practice as an APRN. As a result, now is a great time to investigate the possibility of returning to school to advance your nursing education.
There are currently two routes to become a Nurse Practitioner, either through a Master's Level program in which you earn a Master's of Science in Nursing (MSN) degree or by earning your Doctor of Nursing Practice (DNP) doctoral degree. There is a push nationwide to set the DNP as the entry point for practicing as a Nurse Practitioner, however at this point, it is not required in all states.
As you learn more about becoming an NP, you will find that there are also several different focus areas available for study. According to a summary document jointly prepared for the Department of Health and Human Services by the National Organization for Nurse Practitioner Faculties (NONPF) and the American Association of Colleges of Nursing (AACN), there are five primary specialty areas that represent over 75% of all NP graduates.
These five primary care areas of study for Nurse Practitioners include:
- Adult Nurse Practitioner
- Family Nurse Practitioner
- Gerontological Nurse Practitioner
- Pediatric Nurse Practitioner
- Women's Health Nurse Practitioner
In addition to the above options, there are multiple specialty tracks and certifications that can be added to many degree programs, which prepare you for specific settings and/or patient populations. Some of these specialties include:
- Acute Care
- Psychiatric/Mental Health
- Diabetes Education
In most cases, the primary focus areas can be combined with a specialty track, resulting in programs such as Family Mental Health Nurse Practitioner, Pediatric Oncology Nurse Practitioner, Adult or Pediatric Acute Care Nurse Practitioner, and so forth. If you already have an area of practice in mind, or a specific patient population that you prefer to work with, you may be able to find a program easily, simply by requesting materials from the schools listed on our site that are noted to offer what you are looking for. You will want to learn more about clinical and course requirements, as well as admissions procedures at each of the schools you are interested in.
If you are uncertain about what type of NP program may be right for you, we recommend requesting information from several different schools, with a variety of programs, in order to learn more about each.
You can also learn more about several aspects of becoming a Nurse Practitioner by visiting the American Association of Nurse Practitioners website at www.aanp.org. They offer valuable resources and a wealth of information and support for the profession.
Career Outlook for Nurse Practitioners
One of the most important things to consider when you are looking into becoming a Nurse Practitioner is the scope of practice legislation in your state, as well a laws governing reimbursement for services. Nurse Practitioners are educated to diagnose and treat a variety of health conditions, but not all states currently allow NPs to do so independently. There are some states, including California, Texas, Georgia, Florida, Massachusetts, and others, that require NPs to have physician oversight and/or a collaborative agreement in order to legally diagnose and treat patients, as well as to prescribe medication.
There are also several states where Medicare/Medicaid reimbursment for NP services are at a lower rate than that of physicians. There may also be coverage limitations, dictating what treatments a Nurse Practitioner can perform without prior authorization from insurers. You will learn more about these business and legal related matters in your NP program, as most NP programs include business, health system delivery and organizational systems courses as part of the required curriculum.
The laws and regulations vary widely across states, and though there is a call for expanding the scope of practice rights of Nurse Practitioners nationwide, many states are yet to relinquish physician control of practice. The variances in legality can also be a bit confusing. For instance, some Nurse Practitioners are not allowed to prescribe medications at all without the oversight of a physician, while some can prescribe independently, and yet others can only prescribe certain types of medication independently. As you can see, it is essential to learn about the regulations in your state, as they may have a profound impact on the autonomy with which you can practice.
To help make the differences between states a bit easier to understand, the National Institutes for Healthcare Reform displays a simple map on their website, outlining the "State Variation in Scope of Practice Laws Governing Nurse Practitioners", which we share below.
Keep in mind that legislative efforts are currently underway in several states, so the laws in your state may be different now than they will be when you graduate. To learn more, contact the State Board of Nursing in your state and inquire about current scope of practice and reimbursement laws, as well as any legislative initiatives that may be underway.
Regardless of the state in which you practice, the Bureau of Labor Statistics (BLS) lists Nurse Practitioners as a career with a "bright outlook", meaning that job creation is expected to continue at a rate faster than other selected professions. Additionally, there is potential to increase your earnings as a Nurse Practitioner, with BLS noting the mean annual salary for NPs at $91,450. With experience and specialization, you may be able to increase your earnings even further, resulting in a nursing career that is both financially and intrinsically rewarding.
As stated previously, there are several schools where you can study to be a nurse practitioner. If you want to narrow it down a bit, please check out our listings of nursing schools by state, online masters in nursing programs, online nurse practitioner programs, family nurse practitioner programs, or psychiatric/mental health NP & CNS programs.
Below, BestNursingDegree.com speaks with family nurse practitioner, Margaret (Peg) O'Donnell, RN, NP. O'Donnell works in one of the busiest family practices in Long Island, New York and was previously awarded the New York State NP Advocate Award by the American Academy of Nurse Practitioners. She is also the former president of the Long Island Chapter of the Nurse Practitioner Association of New York State.
Sabrina Loring, RN, MSN, ANP-C, began as a Surgical Technician over 30 years ago, and went on for an AD in nursing. She received her BSN and MSN from the University of South Maine and has practiced as an Adult Nurse Practitioner in Internal Medicine and Orthopedics. Most recently she has been teaching LPN nursing students, writing medical articles and raising her family.
Nurse Practitioners provide a unique blend of nursing with medical care. Many have been practicing as registered nurses for many years prior to becoming a NP. This extensive background in nursing gives them a different perspective from the traditional medical model practiced by physicians and PAs (physician's assistant) in that they treat the patient as a "whole person," not just the complaint or problem. For example, a patient may come in with symptoms as simple as a sore throat. An NP will deal with that, and ask "is there anything else bothering you today?." NPs are skilled, therapeutic listeners and can "hear what patients can't or won't say." Patients typically feel very comfortable with an NP. I had a female patient tell me once that, "No one in the medical field has ever listened to me prior to this visit." We went on to have a close, professional relationship for several years.
NPs' duties include educating patients, especially about preventative measures such as tobacco cessation, diet and exercise programs, and how to make healthier choices. They diagnosis and treat acute and chronic conditions such as high blood pressure and diabetes, infections and injuries. They prescribe medications, order diagnostic tests, lab work and x-rays. They work collaboratively with other health care providers and refer to specialists. They report high patient satisfaction because they take time with their patients and really listen. In many states NPs can practice independently after working full-time for 2 years under a physician's supervision. This means they can have their own patients and manage their overall care. NPs practice in rural, urban and suburban communities and practice in many types of settings. These include clinic, hospitals, private physican or NP practices, nursing homes, correctional settings, schools and colleges.
As an NP starting out I worked in Family Practice and Internal Medicine for several years to become proficient in all aspects of patient care. I also worked per diem in a Correctional Facility. That experience was fantastic. It was so satisfying to help a population that tends to be forgotten. I have worked in Gastroenterology, Orthopedics and am currently teaching in an LPN program. I have found being an NP is extremely satisfying and offers a variety of employment opportunities.
Lorry Schoenly, PhD, RN is a nurse writer and educator with over 25 years of experience. She has been certified in five different clinical specialties including critical care and emergency nursing. Starting as an associate degree registered nurse, she continued her schooling in traditional and distance-learning settings to obtain a BSN, MSN, and PhD in nursing while working full-time and raising a family. Lorry teaches nursing in a variety of settings including webinars and online nursing courses.
There are so many opportunities for nurses with graduate degrees. A graduate degree (MSN or NP) begins a specialization process that will influence your career options.
What do you like about nursing?
To decide which degree is best for you, first consider what you like about nursing? If you have a strong interest in diagnosing and treating illnesses, you may prefer a nurse practitioner (NP) position and therefore seek a graduate degree in an NP specialty. If you prefer managing and improving the systems of nursing care delivery or gravitate toward developing new staff members, you may wish to pursue a master's degree in nursing (MSN). This degree will help you move into a nurse manager position or a nursing faculty position.
Which degree will help you find a job?
Either an MSN or an NP degree will open doors. There is a projected increased need for Nurse Practitioners and Master's Prepared Nursing Faculty in the decade ahead. You have prospects for an advanced position no matter the route you select.
The American Association of Colleges of Nursing (AACN) developed a Nursing Faculty Shortage Fact Sheet that outlines some specific needs. Almost two-thirds of schools of nursing listed faculty shortages as a reason for turning away potential students. The average age of nursing faculty is advancing, indicating future need due to retirement. Another reason cited for the current shortage of nursing faculty is the salary comparison to the clinical sector. The average salary of a US nurse practitioner, according to the American Academy of Nurse Practitioners, is $89,450. By comparison, the average salary of master's prepared nursing faculty is $69,489.
What are the pros and cons of an NP degree? An MSN?
Considered only from the salary perspective, the nurse practitioner degree would be the most promising. In addition, Money Magazine, among other sources, lists Nurse Practitioner as one of the Best Jobs in America. Job growth over the next decade is projected at 23 percent. Nurse practitioners are a cost-effective method of providing health care in many areas of the country making it a position of interest in the health care reform currently underway. Some states already allow nurse practitioners to practice independently of physicians, and there has been a push for expanding the nurse practitioner role in other states as well. With all the positive aspects of the position come some challenges, including dealing with a potentially heavy workload and 'haggling' with insurance companies.
Nurse educator positions can also be very satisfying, though challenging, jobs. The lower salary may come with greater flexibility and increased down-time. Faculty positions may blend well with other obligations or include reduced tuition benefits for dependent children.
Overall, you cannot go wrong with an advanced nursing degree if you are careful to evaluate your preferences and the job opportunities in your geographic location.
Learn more about MSN and NP careers with the interviews below:
Chris O'Brien received her BSN from Auburn University and her Master's inPublic Health degree from Emory University. With a background in cardiac care, home health, nursing research & education, and medical writing, she now enjoys the dual paths of being a freelance medical writer and yoga teacher in Decatur, GA.
For starters, medical doctors (MDs) go to medical school and nurse practitioners (NPs) go to nursing school. MDs go to school for a minimum of eight years whereas NPs go for six.
There are also legal differences in terms of what MDs and NPs can do with patients. MDs can prescribe drugs, but NPs can't do that in all states. Both MDs and NPs can function independently or as part of a healthcare team, so either one could open an office and start seeing patients, but NPs are more limited by state laws in terms of what they can do for patients and what they can bill insurers for. MD licensure can be used across state lines, which is not true for NPs who are required to get a separate license for each state where they practice.
Framework for Practice
MDs are trained from a medical practice model, which has a problem-focused illness approach, whereas NPs are trained from a nursing practice model, which has a holistic preventive approach. NPs are trained health educators and work well in settings where disease prevention and wellness can be emphasized. However, NPs also commonly work in acute care settings like clinics and hospitals and treat sick patients, working side-by-side with MDs. Because NPs are trained to look at the whole person, not just the part that's creating a problem, they may spend more time educating patients and family members on ways to prevent problems, as the work setting allows.
MDs earn more than NPs and they often have greater legal responsibility, in some cases supervising the work of NPs. NP salaries, like MD salaries, vary depending on the specialty. I have a brother who is an emergency room doctor and a sister who is an MD in a family practice setting. They have very different lifestyles because of their work schedules and there is a big difference in what they make as well. Of course some of the pay difference has to do with location and years of experience, and also who they work for. My sister, the family practice doctor, works for the state, has great holidays, and makes a good living. My brother works for a private hospital, has what I consider a non-family conducive schedule, and makes a really good living. Now my brother-in-law is a NP who switched from a higher paying emergency room position to a clinic position, mainly so he could have more time with his family. The nice thing about nursing is the ease with which you can move around, but compensation is often less in environments that are less stressful, and that's true for both medicine and nursing.