The Development of Nurse Practitioners
The development of nurse practitioners commenced in the late 1950s, physicians mentored nurses who had clinical experience. More physicians began to specialize in medicine leading many areas into a shortage in primary care. Starting in 1965, Medicaid and Medicare programs provided coverage for low income families, elderly, and people with disabilities, increasing the demand of primary care services. Due to so many physicians not specializing in primary care anymore they were unable to meet the demand. Nurses believed they were qualified to step up and expand their role to meet the need. Two individuals by the name of Loretta Ford and Henry Silver created the first training program for nurse practitioners. The program’s studies focused on health promotion, disease prevention, and the health of children and families ("How Nurse Practitioners Obtained Provider Status: Lessons for Pharmacists"). Society's demand for primary care services and nurses’ potential were the reason for the development of nurse practitioners. More than half a century later their roles have branched out from primary to also acute and specialty care for patients of all ages. They are important to having a healthy community and their positions will continually need to be fulfilled. By 2026, the Bureau of Labor Statistics projects that the nurse practitioner profession will have grown by 36% compared to 37% for physician assistants and 13% for physicians (“Number of Nurse Practitioners Hits New Record High”). However, there are many advantages and disadvantages of being a nurse practitioner.
Nurse practitioners are constantly needed because of their abilities to do a gamut of tasks and primary care services. Alternatively, a career as a nurse practitioner has several disadvantages. Other than the extensive training, finding a job after graduating can be very difficult because many employers look for experienced providers. The more diverse background, the more likely they are going to be hired. Not to mention they work long hours and there may be on-call expectations, Dr. Stephen Ferrara says, “I am not the biggest fan of being tied to a pager/cellphone.” (“The Pros and Cons of Being a Nurse Practitioner”). They work at least 40 hours including weekends and night shifts if they work at hospitals. Long hours may affect the nurse’s family and social life. Nurse practitioners have more control over their hours when they independently practice or work in non-emergency clinics. Also, nurses in clinics or hospitals have higher risks as they are exposed to blood, contagious diseases, or side effects of any chemicals and medicine they are around. If they are not cautious, they can develop the disease they come in contact with. Another challenge they could face are legal risks because in most states nurse practitioners can diagnose, treat patients, and prescribe medicine. This leaves them open to lawsuits from patients that believe they are a victim of malpractice. This occurs if patients are unhappy with their treatment, do not recover, or medications are given in the wrong doses. In addition, if the patient dies the patient’s family may also file a lawsuit against the nurse practitioner. Malpractice insurance can be purchased but would take a large amount of a nurse practitioner’s income since they do not make as much as a doctor. Sometimes malpractice coverage is included as an employment benefit. Not only do nurse practitioners have to worry about lawsuits but some deal with stress daily. It is like their patients’ lives are in their hands, if they come with a problem/injury it is a nurse practitioner’s job to provide a treatment plan. Although, in some cases, a patient cannot be treated or saved which causes the nurse to deal with angry or grieving relatives. On top of this emotional stress that is created they can often have conflicts with the doctors about the diagnosis and/or treatment plan. As shown above being a nurse practitioner does have its cons, but they are things that can be overcome.
On the other hand, there are great advantages of being a nurse practitioner including increased independent practice, prescriptive authority, competitive compensation, and endless opportunities. They can gain relationships and trust with their patients. Both their patients and their patients’ families are supported by the nurse. Nurse practitioners monitor the health and lifestyle of their patients at a preventative approach instead of treating a medical problem after it happens. They hold a higher position than a registered nurse but equal to a physician even though they only obtain a master’s degree. Also, they do not have to go through medical school and internships required for doctors. All this allows them to cut the time it takes to start their career. Nurse practitioners have the power to specialize in a specific medical field, such as cardiology or oncology, also focus on a specific area of practice. They have so many potential paths they can choose from and can change their path at any time. A nurse practitioner is not limited to their usual clinical setting. They could take on educating other nurses, conduct medical research, hold a medical-related corporate position, and more. Furthermore, nursing can be very interesting, it is rare that they see the same exact situation more than once. There are new challenges and opportunities to learn everyday they walk into their work place. Another pro is that nursing is a highly secure career pathway due to the shortage of doctors. Most nurse practitioners can practice independently and start their own private practices. In 21 states and District of Columbia nurse practitioners are allowed to practice without a physician.
Independent practice is growing rapidly as more and more legislatures are removing the barrier that prevents nurse practitioners from providing healthcare services. Nurse practitioners or nurse practitioner students have a lot of support. For example, they can join the AANP (American Association of Nurse Practitioners) they are known as “The Voice of the Nurse Practitioner.” This is a group that provides yearly conferences, an online job center, and a place for nurse practitioners to list their businesses. Membership also includes discounted liability insurance and long-term care plans. Dues for the AANP costs $55 a year for a student and $125 a year for an employed nurse practitioner (“ANCC vs. AANP Certification). Although the path to certification is challenging, it comes with rewarding benefits.