Nurse practitioner
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A nurse practitioner (NP) is a registered nurse who has completed advanced education (generally a minimum of a master's degree) and training in the diagnosis and management of common medical conditions, including chronic illnesses. Nurse practitioners provide a broad range of health care services.
[edit] Countries with Nurse Practicioners
[edit] Australia
[edit] Canada
[edit] United Kingdom
[edit] United States of America
[edit] Overview
Nurse practitioners provide much of the same care provided by physicians and usually maintain close working relationships with physicians. Nurse practitioners in certain states can be "psychiatric clinicians" and perform similar practice as a psychiatrist would. Nurse practitioners can prescribe medications and have a DEA registration number in most states. Nurse practitioners may bill for Medicare and Medicaid and private insurance for services performed. An NP can serve as a patient’s regular health care provider and see patients of all ages. The core philosophy of the field is individualized care. Nurse practitioners focus on patients' conditions as well as the effects of illness on the lives of the patients and their families. NPs make prevention, wellness, and patient education priorities. This can mean fewer prescriptions and less expensive treatments. Informing patients about their health care and encouraging them to participate in decisions are central to the care provided by NPs. In addition to health care services, NPs conduct research and are often active in patient advocacy activities.
NPs can work autonomously and some are able to open their own clinical practices. American NPs, according to the American College of Nurse Practitioners, are required in 28 states to practice in collaboration with a physician [1] though they may prescribe medications and carry a DEA number in 49 states.
[edit] Scope of practice
Because the profession is state regulated, care provided by NPs varies. A nurse practitioner's duties may include the following:
- Diagnosing, treating, evaluating and managing acute and chronic illness and disease (e.g., pneumonia, diabetes, high blood pressure)
- Obtaining medical histories and conducting physical examinations
- Ordering, performing, and interpreting diagnostic studies (e.g., lab tests, x-rays, EKGs)
- Prescribing medications
- Prescribing physical therapy and other rehabilitation treatments
- Providing prenatal care and family planning services
- Providing well-child care, including screening and immunizations
- Providing primary and specialty care services, health maintenance care for adults, including annual physicals
- Performing minor surgeries and procedures (e.g., dermatological biopsies, suturing, casting)
- Collaborating with physicians and other health professionals as needed, including providing referrals
- Counseling and educating patients on health behaviors, self-care skills, and treatment options
[edit] Practice settings
NPs practice in all states. The institutions in which they work include the following:
- Community clinics and nurse-managed health centers
- Health departments
- Health maintenance organizations (HMOs)
- Home health care agencies
- Hospitals and hospital clinics including ER and Urgent Care
- Hospice centers
- Nurse practitioner offices
- Nursing homes
- Nursing schools
- Physician offices
- Public health departments
- School/college clinics
- Veterans Administration facilities
- Walk-In Clinics
[edit] Education, licensure, and board certification
Most NPs specialize in a particular field of medical care, and there are as many types of NPs as there are medical specialties.
To be licensed as a nurse practitioner, the candidate must first complete the education and training necessary to be a registered nurse (RN).
Requirements for a registered nurse include an associate degree in nursing (ADN), a Bachelor of Science degree in nursing (BSN), or completion of a diploma program, as well as direct patient care for acutely or chronically ill patients. Associate degree in nursing programs, which are offered by community and junior colleges, usually take 2–3 years. BSN programs are offered by colleges and universities and take 4–5 years and diploma programs are administered in hospitals and usually take 2–3 years. Depending on the program attended, the candidate may fulfill some NP requirements while completing the RN degree.
In most states a master's degree is required. To become NPs, nurses with an ADN or diploma must enter a bachelor of science to master's program. They may be able to find a staff nursing position and take advantage of tuition reimbursement programs.
Once registered nurse status is attained, the candidate must complete a state-approved advanced nursing education program that usually specializes in a field such as family practice, adult health, acute care or women's health. The degree can be granted by:
- A university, which grants a master's of science in nursing (MSN) degree which is now the minimum degree required
- A university, which grants a doctorate in nursing
The variety of educational paths for NPs is a result of the history of the field. In 1965, the profession of nurse practitioner was instituted and required a master's degree. In the late 1960s into the 1970s, predictions of a physician shortage increased funding and attendance in nurse practitioner programs. During the 1970s, the NP requirements relaxed to include continuing education programs, which helped accommodate the demand for NPs. The certifying organizations, states, and employers require a minimum of a master's degree for new NPs (already established NPs with lesser education were grandfathered in). Some professional organizations, such as the American Nurses Association (ANA), have recommended that by 2015, all accredited NP programs should be at the doctoral level (DNP, DrNP).
After completing the education program, the candidate must be licensed by the state in which he or she plans to practice. The State Boards of Nursing regulate nurse practitioners and each state has its own licensing and certification criteria. In general, the criteria include completion of a master's degree in nursing and certification by an accrediting body (AANC, AANP). The license period varies by state; some require biennial relicensing, others require triennial.
Before or after receiving state licensing, a nurse practitioner can apply for national certification from one of several professional nursing organizations such as the American Nurses Credentialing Center (ANCC) or the American Academy of Nurse Practitioners(AANP). Contrary to popular belief, the American Nurses Association (ANA) does not offer certification, but is linked with the ANCC. Some NPs pursue certification in a specialty. Several organizations oversee certification, including the following:
- American Association of Critical-Care Nurses
- American Psychiatric Nursing Association
- Board of Certification for Emergency Nursing
- National Certification Board of Pediatric Nurse Practitioners and Nurses
- National Certification Corporation for the Obstetric, Gynecologic, and Neonatal Nursing Specialties
- Oncology Nursing Certification Corporation
- American Holistic Nurses Association
[edit] Post-nominal initials
- See also: List of nursing credentials
Post-nominal initials NPs may use include:
- NP-C (nurse practitioner - certified; if certified by the AANP),
- APRN, BC (advanced Practice Registered Nurse, Board Certified; if certified by the ANCC)
- CNP (certified nurse practitioner)
- ACNP-C (Acute Care Nurse Practitioner, Certified)([2])
- CPNP (pediatric NP when certified by the pediatric nursing certification board (PNCB)
- CRNA (Certified Registered Nurse Anesthetist)
- CRNP (certified registered nurse practitioner) used primarily in Pennsylvannia ([3])
- MSN (master of science in nursing)
- MN (master of nursing)
- RN (registered nurse)
- FAAN (Fellow of the American Academy of Nursing (AAN)
- FAANP (Fellow of the American Academy of Nurse Practitioners (AANP)
- CDE (certified diabetic educator)
- ND (nursing doctorate)
- DNP (doctor of nursing practice)
- DrNP (clinical doctorate in nursing)
- Initials of the NP's specialty may also follow their name:
- ACNP (Acute care NP)
- APN (Advance Practice Nurse)
- AHN (holistic NP)
- ANP (adult NP)
- FNP (family NP)
- GNP (geriatric NP)
- NNP (neonatal NP)
- PMHNP (Psychiatric and mental health Nurse Practitioner)
- NPP (Nurse Practitioner in Psychiatry)
- PNP (pediatric NP)
- WHNP (women's health NP)
- CNM (certified nurse midwife)
- BC, PCM (board certified, palliative care management)
- RN(EP) - RN (Extended Practice), Manitoba, Canada
[edit] See also
- Nurse
- Nursing
- Advanced practice nurse
- Clinical Nurse Specialist
- Nurse Midwife
- Physician Assistant
- Nurse Anesthetist
- Registered Nurse
[edit] External links
- American Academy of Nurse Practitioners (AANP)
- American Nurses Association (ANA)
- American Academy of Nursing (AAN)
- American Nurses Credentialing Center (ANCC)
- American College of Nurse Practitioners (ACNP)
- The National Organization of Nurse Practitioner Faculties (NONPF)
- The American Academy of Physician Assistants (AAPA)
- Advance for Nurse Practitioners journal
- The Nurse Practitioner: The American Journal of Primary Health Care
- The Center for Nursing Advocacy
- NP Central
- NPACE - Nurse Practitioner Associates for Continuing Education
- Australian Nurse Practitioner Association (ANPA)
- South Australian Nurse Practitioner Association (SANPA)
- NPCanada.ca (The Canadian Nurse Practitioner)
