Nurse Practitioners (NP) are a great choice to manage and treat many medical conditions. NP’s are being utilized more often as the primary caregiver and the practice is continuing to grow. It is estimated in 2011 there were 140,000 NP’s nationwide (Moote, Krsek, Kleinpell, & Todd, 2011). NPs are helping to fill the gap in the numbers of physicians which is estimated by The Association of Academic Medical Colleges to be 124,000 to 159,000 physicians by 2025 (Moote et al., 2011). These estimates predated the new national health care reform act, which will bring an additional burden to the already strained health care system, with increase number of patients requiring care. NP’s will also play an important role in helping to relieve the burden of overworked physicians, cost containment, the quick expansion of the healthcare industry and an aging population. NP’s are trained differently than Medical Doctors (MD). NPs are trained to see the whole person and not just the disease that the patient has. A Nurse Practitioner should not be thought of as a poor substitute for the doctor, but rather be seen as high quality, effective medical caregiver.
Nurse Practitioners are a critical part of a medical team caring for patients in a variety of medical situations such as hospitals, rehabilitation centers, out patient clinics, home care and many more speciality fields. They practice in almost every clinical setting and every medical and surgical specialty (Moote et al, 2011). To be a NP, one must first be a Registered Nurse (RN). According to the Gallup Poll, Nurses have been the most trusted profession for 12 out of the last 13 years (CDC, 2012). The nursing profession as a whole “plays a critical role in improving patient outcomes, increasing access, coordinating care, and reducing healthcare costs” (CDC, 2012). Nurse Practitioners continue to develop the skills they learned while being an RN and then train in the medical model in order to examine, interpret laboratory and diagnostic testing, diagnosis medical conditions, and treat a variety of medical conditions. In order to practice as an Nurse Practitioner, one must have received a graduate level degree which places “practical emphasis on attention to patient education, individualization of care, active listening and more (Budzi, Lurie, Singh, & Hooker, 2010). The psycho-social aspect of a patients life is an important piece of the puzzle in treating many disease processes. NPs try to think holistically and speak to each patient about how their disease is going to affect their life and how by making lifestyle changes the patient might be able to better control their disease. While some physicians do try to spend time on lifestyle modifications, the NP training really brings this to the forefront of patient care. The ability to care for the whole patient is the defining strength Nurse Practitioners.
Patient satisfaction with care has been a known factor in patient compliance, health outcomes and reuse of the provider (Budzi et al, 2010). As a general consensus, Nurse Practitioners are seen to have more time and a better ability to listen to the whole patient, not just the problem at hand. The study done by Budzi et al. (2010) noted that when practices increased the number of NPs, the satisfaction scores of Veterans increase by 5%, while when the number of physicians was increase the satisfaction scores only increased by 1.8%. As stated earlier, increase satisfaction betters patient health outcomes. Besides providing high quality clinical care, Nurse Practitioners “focus on health promotion, disease prevention, health education, attentiveness and counseling” (Budzi et. al, 2010) which are seen as important pieces of care for patients. NPs focus on these important aspects that will keep patients coming back to care, which will ultimately, provide better patient outcomes.
Although some, including both lay and medically trained persons, may think that Nurse Practitioners are less educated, and therefore will have worse patients outcomes, this is simply not true. A systematic review, covering 18 years (1990-2008), conducted by Newhouse et al, (2011), established that NPs who collaborate with physicians had similar and better care in a variety of areas as compared to the results of MDs alone. The review analyzed 37 studies that looked at patient outcomes when cared by NPs or MDs. There was eleven patient outcomes that were looked it in the systematic review including patient satisfaction with provider/care, patient self-assessment of perceived health status, functional status, blood glucose, serum lipids, blood pressure, emergency department visits, hospitalization, duration of ventilation, length of stay, and mortality. Of the eleven patient outcomes, eight outcomes reported equivalent level of care between NP and MD. These outcomes were: patient satisfaction with provider/care, patient self-assessment of perceived health status, functional status outcomes, blood glucose control, blood pressure control, emergency room or urgent care visits, rates of hospitalizations, and mortality. NPs had better patient outcomes in managing serum lipid levels than their MD counterparts. This systematic review supports that NPs who collaborate with physicians are as knowledgeable, and potentially more successful, in providing care to patients than physicians alone.
In conclusion, Nurse Practitioner’s are a highly educated, caring and productive team members in all healthcare settings. NPs focus on high quality medical care while also keeping focused on the person as a whole during the treatment of the disease process. Nurse Practitioners also have been shown to provide treatment and care on a similar or better outcome level when compared to Medical Doctors. NPs “provide health care that is indistinguishable in quality from care provided by physicians (Budzi et al., 2010). This is why patients should choose to be seen by an Nurse Practitioner.
References
Budzi, D., Lurie, S., Singh, K., & Hooker, R. (2010). Veterans’ perceptions of care by nurse practitioners, physician assistants and physicians: A comparing from satisfaction surveys. Journal of the American Academy of Nurse Practitioners. 170-176. DOI: 10.111/
j.1745-7599.2010.00489.x
Center for Disease Control and Prevention. (2012). Announcements: National Nurses Week — May 6–12, 2012. Retrieved from http://www.cdc.gov/mmwr/preview/mmwrhtml/ mm6117a9.htm
Moote M., Krsek C., Kleinpell R., & Todd B. (2011). Physician assistant and nurse practitioner utilization in academic medical centers. American Journal of Medical Quality. 26:452-460. DOI: 10.1177/1062860611402984
Newhouse, R. P., Stanik-Hutt, J., White, K. M., Johantgen, M., Bass, E. B., Zangaro, G., Wilson, R. F. , Fountain L., Steinawachs, D. M., Heindel, L, & Weiner, J. P. (2011). Advanced Practice Nurse Outcomes 1990-2008: A Systematic Review. Nursing Economic$, 29(5), 230-251.
