Nurses have long been essential to effective health care delivery. While these impactful medical professionals continue to buoy mission-critical administrative and clinical workflows, the nature of their work is changing rapidly. Health systems and practices everywhere are asking nurses to assume more extensive duties due to various industry developments, including an ever-growing physician shortage. This has catalyzed the emergence of various advanced-practice roles in the nursing profession — most notably, nurse practitioner.
NPs handle a number of sophisticated clinical tasks once reserved for doctors. From evaluating patients and ordering and interpreting diagnostic tests, to offering diagnoses, creating treatment plans and prescribing medication, these highly knowledgeable medical professionals touch every phase of the health care delivery process.
The emergence of the NP
The NP role did not exist prior to the 1960s. Primary care doctors and specialists dominated the clinical landscape. However, population growth and an accompanying decline in hospital space — hospital beds per 1,000 patients dropped from 9.2 to 7.9 between 1960 and 1970, per data from the World Bank published in 2019 — forced stakeholders in the health care sector to seek out strategies for increasing access to care. Nurse educator Loretta Ford and pediatrician Dr. Henry Silver came up with a potential solution: upskilling nurses.
Nurses were numerous at the time, and Ford and Silver believed with some additional education, these professionals could move into more advanced roles and possibly take on some of the tasks that belonged to doctors. The two launched the first postgraduate NP program in 1965, according to information from the American Association of Nurse Practitioners released in 2019. Similar programs began popping up across the country, and by 1975 an estimated 15,000 NPs were working in the U.S., AANP researchers explained in a 2002 article published in the journal Clinical Excellence for Nurse Practitioners.
Today, around 270,000 NPs practice in the U.S., according to survey data from the AANP released in 2019. These indispensable health care professionals have full practice authority in 23 states and the three American territories of American Samoa, Guam and the Northern Mariana Islands, per research from the AANP published in 2019. Within this practice environment, NPs are permitted to evaluate patients, call for diagnostic exams, make diagnoses and prescribe medications, including controlled substances. They are subject to restricted practice in 16 states and two territories: Puerto Rico and the U.S. Virgin Islands. NPs in these locations do not have the ability to perform at least one of the industry-standard duties now associated with the role. A dozen states maintain highly restricted practice laws for NPs, meaning these professionals cannot perform at least one responsibility linked to the position and must adhere to tight heath care provider supervision statutes.
Despite these and other obstacles, NPs have an immense impact on patient populations, particularly those in rural areas where doctors are few and far between. In fact, physician availability has decreased in numerous communities across the country. Analysts for the Association of American Medical Colleges in 2018 estimated there could be a national shortage of 120,000 doctors — including between 33,800 and 72,700 primary care physicians — by 2030.
American health care providers are therefore boosting their NP hiring and recruitment efforts to minimize or prevent drops in service availability and quality. This is why researchers for the U.S. Bureau of Labor Statistics anticipate jobs for NPs to increase by 31% between 2016 and 2026, per a report released in 2019.
The NP experience
What does the average NP’s day look like? These medical professionals can start their shifts in a variety of locations, including community clinics, hospitals, private practices and urgent care centers. Around 70% of NPs see three or more patients per hour, per data from the AANP published in 2015. Most of these visits unfold as expected, with NPs assessing patients, offering diagnoses, ordering tests and eventually prescribing medications or specific treatment regimens. Some NPs navigate medical specialties such as acute care, gerontology and pediatrics. That said, the vast majority — more than 66% — work in family-based outpatient care settings, the AANP found in 2019.
The NP role is among the most versatile and demanding positions in medicine, which is why standards are high in the profession. Approximately 99% of these advanced practice nurses have master’s degrees, along with numerous certifications from government and external licensing groups, according to data from the AANP posted in 2019. However, the role is worth the work. Not only do NPs directly improve the lives of patients everywhere, but they also earn good salaries and benefits, per the AANP, which reported in 2019 that the median annual wage for the role was more than $105,000.
Registered nurses looking to make an impact in health care and open up new professional avenues would be wise to consider the NP career and look for a graduate program that can help them prepare for work in this growing and important profession.
The online Master of Science in Nursing — Family Nurse Practitioner program at Bradley University can offer the ideal instructional track for midcareer medical professionals who wish to expand their clinical skill sets and move into NP positions.
The program covers knowledge critical to success in this evolving field, including Advanced Pathophysiology, Advanced Pharmacology, Leadership in the Health Care Delivery System and Evidence-Based Practice. The online MSN-FNP track also includes five preceptor-supervised practicums, during which aspiring NPs apply their new skills within an operative clinic environment, serving a variety of patients. Students close out the program with a research-based capstone wherein they examine current issues in the health care arena.
With accreditation from the Commission on Collegiate Nursing Education and Higher Learning Commission, this online MSN-FNP track stands out among comparable programs. Health care professionals intent on cultivating careers as NPs can learn more about the program by visiting the Bradley University website.