The role of family nurse practitioner (FNP) first was developed in the mid-1960s as a certificate program designed to equip practicing nurses with more skills and responsibility. The program’s purpose was to educate nurses to provide more comprehensive medical care to children, particularly in areas experiencing shortages of physicians.
This FNP certificate program evolved into education programs offering a bachelor’s or master’s degree in the 1970s. Population focus also expanded to include adult/gerontology, women’s health, neonatal and other specialty roles. Present day education for FNPs requires a Master of Science in Nursing (MSN) or a Doctor of Nursing Practice (DNP) degree.
The role of the FNP evolved out of the need to increase care in underserved communities, and meeting that demand remains a significant objective of FNPs today. Present-day FNPs assume various roles that include caring for ethnically diverse, underserved populations within an aging society and across many health care settings.
The problem of underserved communities
According to the U.S. Health Resources and Services Administration (HRSA), underserved communities are composed of groups of people who struggle to access health care for any number of reasons. These groups officially are known as Medically Underserved Populations (MUPs), with some of the most common groups of MUPs including:
- Individuals with limited income.
- Individuals without health insurance.
- Individuals who qualify for Medicaid and other forms of government assistance.
- Native Americans.
- The homeless.
- The elderly.
- Individuals with limited mobility due to disability.
In addition to monitoring MUPs, HRSA examines the problem of underserved communities by monitoring certain areas of the country where access to primary care is most compromised. Known as Medically Underserved Areas (MUAs), the places that can fit this designation include areas of cities, counties or a collection of counties.
The Henry J. Kaiser Family Foundation reported that close to 60 million Americans belong to an underserved medical community. Although MUAs can be found nationwide, the problem is particularly severe in five states plus the District of Columbia, where over 30 percent of people live in Health Professional Shortages Areas (HPSAs). These states are Mississippi, Alabama, Louisiana, New Mexico and Arizona. Even though the aforementioned states are primarily rural and southern, the inclusion of the nation’s capital on the list signifies the prevalence of underserved populations in urban centers, as well.
Compounding the problem of underserved communities is the fact that the demand for primary health care is set to increase in the coming decades, due in large part to people living longer. According to the U.S. Census Bureau, the world’s population is growing older rapidly due to advances in health care and declining fertility rates.
The issue is exacerbated further given that rural doctors are, as a population, aging out of the workforce without enough younger physicians to replace them, according to the National Conference of State Legislatures. A study from the Rural Health Research and Policy Centers indicated that young doctors — below the age of 40 — make up just 20 percent of medical professionals working in rural areas, which typically are underserved. When one takes into account the fact that just under 30 percent of physicians working in rural areas are close to retirement, the situation becomes clear.
How can FNPs help?
FNPs can be a solution to the above issues in a couple of notable ways, including:
Working in rural areas
Given the clear demand for medical professionals in underserved areas, particularly in rural communities, FNPs likely will continue to be the answer to this problem in the coming years. As the National Conference of State Legislatures made clear, a number of studies already have indicated that FNPs are assuming roles in underserved rural communities in large numbers, likely due to the increased demand. Furthermore, the benefits of having FNPs and physicians assistants working in these areas are clear. The Institute of Medicine reports that hospitalization rates for the elderly tend to drop when FNPs work in rural areas and that attendance at clinics tends to increase. In sum, FNPs and other non-physician medical providers can help increase access to health care in underserved areas.
Providing quality care
According to the National Conference of State Legislatures, research has indicated that although FNPs have less authority to make consequential medical decisions, they often are able to provide a level of care that is on par with that delivered by a physician, especially in terms of overall patient satisfaction. For example, research has indicated that patients tend to respond more positively to FNPs and that FNPs spend a greater amount of time on average discussing health concerns with patients. Furthermore, patient outcomes in terms of reduced hospitalization, recovery from illness and so on are virtually the same among patients served by physicians and those served by FNPs.
Consider Bradley University
If you are interested in expanding your nursing career, consider the online MSN-FNP or DNP-FNP program from Bradley University. Taught by a renowned faculty and designed to enable you to study at a time that best suits your professional schedule, these online programs are an important step toward becoming an FNP.