If you have visited any kind of healthcare organization in the past few years, the chances are that you will have come across a nurse practitioner. They work with a great deal of authority, and they are skilled at providing exemplary care to their patients.
Over the next ten years or so, it’s predicted that the number of nurse practitioners working in healthcare organizations will increase by around 45%, which is a much larger increase than is expected in many other sectors. Around 65% of all nurse practitioners are certified family nurse practitioners, and it’s this area where we are likely to see the biggest increase.
There are a few reasons behind this increase, which we will explore, but first, let’s clarify what exactly a family nurse practitioner is and how they differ from physicians and registered nurses.
What is a nurse practitioner?
A nurse practitioner is a registered nurse who has continued their education at a postgraduate level and specialized in a specific area of medicine.
This advanced level of education means that nurse practitioners are afforded more autonomy over the care of their patients, having the authorization to request tests, diagnose illness, recommend treatments, and prescribe medicines.
The scope of a nurse practitioner’s authority varies according to the state they are working in. In some states, nurse practitioners are able to work completely autonomously and take full responsibility for the care of their patients. In others, they will need to work under the supervision of a physician, but they will still have more authority over patient care than registered nurses.
Some of the areas of medicine that a nurse practitioner might specialize in are:
- Family medicine – looking after the whole family with a focus on preventative healthcare and education.
- Geriatric – focusing on elderly patients.
- Cardiac – specializing in patients with heart conditions.
- Acute care – looking after patients who have serious chronic or life-threatening conditions.
- Neonatal care – looking after infants, often those who are born prematurely or with a health condition that needs specific treatment.
- Oncology – specializing in looking after patients during treatment for cancer, providing them with support and advice so that their treatment is as successful as possible.
- Psychiatric and mental health – looking after patients of all ages in various settings who have been diagnosed with a mental health disorder. They might administer treatment and also work with families to ensure that the patient receives the best possible support.
What is a family nurse practitioner?
Family nurse practitioners work with patients of all ages, from infancy right the way through until old age. They often work in areas that are underserved by other healthcare providers and will work with patients in their area right the way through their lives which can make it a highly rewarding career choice. There are a lot of opportunities to form meaningful relationships with patients and have a real impact on their lives.
One focus of a family nurse practitioner is generally around preventative care and education. They will work with the families in their area to educate them on lifestyle choices that will promote good health and longevity, for example, healthy eating choices and ways to incorporate exercise into your life as well as ways to prevent disease.
They will also provide diagnosis and treatment for injuries and illness in much the same way that a primary care physician would.
A brief history of nurse practitioners
The nurse practitioner career first came about in 1965. It was a time when Medicaid and Medicare were first being introduced, which was great news for patients, but it did put a lot of extra strain on the healthcare system because so many more people were now able to access it.
Loretta Ford, a registered nurse, and Henry Silver, a pediatrician, founded the first nurse practitioner program at the University of Colorado. Their goal was to increase the number of people able to provide primary care by giving nurses the opportunity to further their education and become part of the primary care workforce. This program went on to become the first masters-level nurse practitioner program.
Allowing nurses to take on primary care work eased the strain on physicians and meant that more people were able to quickly access the primary care that they needed.
Ever since the inception of the career, there have been those who have doubted the skills of nurse practitioners and questioned whether they should have the level of authority that they do. However, these doubts have been dispelled numerous times as it has been shown that the addition of nurse practitioners to a healthcare team means that more well-rounded care is provided and patient outcomes actually improve.
The difference between a family nurse practitioner and a physician
There are a lot of similarities between family nurse practitioners and primary care physicians. Depending on the state and the precise area of medicine, both nurse practitioners and doctors are able to:
- Carry out initial consultations with patients.
- Order tests and diagnostics to gain further information on the health of a patient.
- Interpret the data provided by said tests.
- Diagnose illnesses and recommend treatment accordingly.
- Prescribe medication. In some states, nurse practitioners may be limited to the prescription of certain types of medication, or they may have to prescribe medication under the supervision of a physician.
- Updating patients’ charts and records with the progress of their condition.
Nurse practitioners will take on more of a managerial role when it comes to looking after patients, overseeing their day-to-day wellbeing, and providing holistic services such as counseling. As they have come from a patient-centric background, their approach to treatment will often be centered around the patient first. Physicians will tend to act as more of a specialist and overall authority, so they won’t take on as much of the day-to-day management of patient care. Instead, they will act as an authority on questions of medical treatment.
Nurse practitioners are typically educated to masters level but can sometimes be educated to doctorate level. They spend around four years getting their bachelorsdegree in nursing (BSN) and then a further two to four years getting either their masters of science in nursing (MSN) or doctorate of science in nursing (BSN). Doctors typically train for eleven years to gain their qualifications, including a bachelors degree, medical school, and then a residency.
How to become a family nurse practitioner
For a nurse to become a family nurse practitioner, they must first be a registered nurse that is licensed to practice in their state. The requirements to qualify to become a registered nurse differ from state to state, so you will need to check with your individual state, but in general, you will need to have a degree in nursing plus a certain number of supervised clinical hours. You will also need to take a licensure exam.
There are two types of nursing degrees available, the ADN (associate degree in nursing) and the BSN (bachelor of science in nursing). The medical profession as a whole is leaning towards every nurse having a BSN rather than an ADN, so if you have an ADN, you may need to complete an ADN to BSN conversion course before you can attain your license. If you intend to carry out further study to become a nurse practitioner, you will definitely need to have your BSN.
As soon as you are licensed as a registered nurse, you can apply to study at the postgraduate level to become a nurse practitioner. However, some people prefer to gain some experience in the field before they go on to postgraduate study as this allows them to get a better idea of what direction they want to take their career in before committing.
To become a family nurse practitioner, you will need to choose a postgraduate nurse practitioner course with a focus on family medicine, such as a BSN to MSN FNP. A lot of postgraduate nurse practitioner courses are available to study part-time, on a remote basis, making them easier than ever to fit in around your work schedule.
Once you have completed your postgraduate nurse practitioner training, you will need to gain a certain number of supervised clinical hours and then undertake a licensure exam. The number of hours and the nature of the exam will vary from state to state.
Career prospects for family nurse practitioners
The Bureau of Labor Statistics (BLS) rates the employment prospects for family nurse practitioners as highly favorable.
The salary for nurse practitioners varies depending on the area of the country and the type of institution they are working in. For example, a nurse practitioner working in a large teaching hospital in a city is likely to have a higher wage than a nurse practitioner working in a rural healthcare center. That being said, the cost of living in cities is also likely to be higher, so it’s worth researching salaries based on where you would like to live and work specifically.
Nurse practitioners are often able to work more regular hours than a registered nurse, particularly family nurse practitioners, as they will often work in institutions like health centers which operate during the day, during the week. This does depend on where the nurse practitioner works, however, as some specializations will require shift work.
The average salary for nurse practitioners in 2019 was $115,000 per year, with the lower 10% of nurse practitioners earning $81,410 or less and the higher 10% earning $152,160 or more.
The number of nurse practitioners is expected to increase by 45% between 2019 and 2029, due mostly to the high demand for healthcare services and a shift in focus towards preventative care.
The physician shortage
A recent study by AAMC predicts that the US will be facing a shortage of between 54,100 and 139,000 physicians by 2033.
There are a few factors that are contributing to this projected shortage:
- The population is aging. The ‘baby boom’ generation is living longer and more active lives than any of the generations that came before them. Between now and 2033, the percentage of the population aged 65 and over is projected to grow by 45%. This is the group of people that generally requires more healthcare, and so as they age, the strain on the healthcare system is likely to increase.
- Physicians are reaching retirement age. A study found that two out of every five physicians will reach retirement age within the next decade. Although reaching retirement age doesn’t necessarily mean retirement, the fact that there is a higher burden on healthcare professionals at the moment means that it is more likely that physicians will reach burnout and want to retire, with many retiring early.
- Rates of chronic illnesses are rising. There are more people dealing with chronic illnesses such as obesity and type 2 diabetes in the US, and this means that more healthcare providers are needed.
It’s projected to be difficult to meet the demand for primary care physicians under the current healthcare model, with the current levels of students enrolled in medical school.
How nurse practitioners are helping
The main way in which nurse practitioners are helping to ease the strain on the healthcare system and on physicians is through the provision of primary care. The more primary care that can be provided by nurse practitioners, and in particular family nurse practitioners, the less has to be provided by physicians, which naturally eases the strain on them.
It’s for this reason that there is a drive for nurse practitioners to be allowed greater autonomy, particularly in the states where they are still required to work under the close supervision of physicians. By allowing nurse practitioners to work with full autonomy and work to the full potential of their training, means that a bottleneck is removed, and more patients can receive the treatment they need more quickly.
Nurse practitioners are also key in lessening the demand on the healthcare system through the work they do to educate their patients on healthy lifestyle choices. Through work like this, numbers of people with chronic conditions such as obesity and type 2 diabetes will be lowered, which in turn will lower demand on the healthcare system.