________________________
NP FAQ's
What do nurse practitioners do?
What is the scope of practice of a nurse practitioner?
What is the educational preparation of nurse practitioners?
Where can I find information about how to become a nurse practitioner?
How many nurse practitioners are there?
Where do nurse practitioners work?
How much money do nurse practitioners make?
Must NPs have national certification?
What are the types of nurse practitioners?
Does this website meet JAMA core standards for websites?
A. A nurse practitioner is an experienced registered nurse who has completed advanced academic education beyond their basic nurses training that then prepares them to assume some of the diagnostic and treatment responsibilities traditionally reserved only for physicians. Under the Nurse Practice Act of each state, these nurse practitioners are legally authorized to provide health care in a variety of settings. The majority of nurse practitioners have a primary care focus and most work in collaboration with physicians.
B. Nurse practitioners have also been called "midlevel health care providers", "non-physician providers," "nurses working in the expanded role," or "physician extenders." In the past, nurses with roles that assumed some of the tasks of physicians (nurse practitioners, clinical nurse specialists, nurse midwives and nurse anesthetists) often called themselves "advanced practice nurses." Under recent changes initiated by the American Association of Colleges of Nursing, most nurses who return to graduate education and receive a masters degree are now called advanced practice nurses. Thus, nurse practitioners prefer to be called "nurse practitioners" and not "advanced practice nurses" and clarify that they are the nurses with diagnosis and treatment ability.
C. There is general agreement that the term "nurse practitioner" may be confused with Licensed Practical Nurse, and thus, may not be the best title to describe this nursing role. However, because "nurse practitioner" has received some degree of acceptance and growing credibility among both consumers and legislators, nurse practitioners themselves have been reluctant to change the title. TOP
What do nurse practitioners do?
A. A nurse practitioner is an experienced registered nurse who has completed advanced academic education beyond their basic nurses training that then prepares them to assume some of the diagnostic and treatment responsibilities traditionally reserved only for physicians. Under the Nurse Practice Act of each state, these nurse practitioners are legally authorized to provide health care in a variety of settings. The majority of nurse practitioners have a primary care focus and most work in collaboration with physicians. TOP
A. The scope of practice is broad as the nurse practitioner often serves as a gatekeeper to other health care services, facilitating access into the health care system, providing continuity of care, and coordinating care as patients move from one part of the system to another.
B. Unlike physician assistants, nurse practitioners are already directly licensed as professionals, and as such, are legally accountable for their actions. While physician assistants work under the supervision of the physician, on the physician’s license and malpractice insurance, in most states nurse practitioners carry separate licensure or certification as a nurse practitioner, in addition to their licensure as a registered nurse.
For components of the client relationship involving traditional nursing practice, nurse practitioners engage in independent decision making. In the performance of role components traditionally reserved for physicians, the state Nurse Practice Act determines how close their relationship with a physician must be.
Many nurse practitioners independently manage many clients without consultation with a physician; however, nurse practitioners are educated to work within their specialty focus and experience level. Just as physicians and other types of providers do not work without collaboration, nurse practitioners also seek consultation, collaboration, and referral, as necessary.
C. As independent professionals, nurse practitioners carry their own professional malpractice insurance. Rates are relatively low as the incidence of litigation against nurse practitioners is very low. TOP
A. The original program preparing nurse practitioners started in 1965 at the University of Colorado as a master’s degree program for pediatric nurses.
Graduate programs require students to already have a B.S. preparation in nursing. Most require applicants to have two or more years of experience as a registered nurse. NP program applicants are required to meet the same requirements for entry into graduate school as other applicants. At the conclusion of the program, they receive a Master of Science degree.
NP programs usually require 1 1/2 to 2 years of full time study, build on the basic arts and science courses of the baccalaureate programs, and teach content at an advanced level. Many require a research sequence, or thesis. Courses have both didactic and theory content as well as clinical assignments where the student nurse practitioner practices diagnostic and treatment skills with clients while under direct supervision of physicians or nurse practitioner faculty or preceptors. The number of nurse practitioner programs being offered in schools has almost doubled in the last three years. This has led to questions by many observers about the quality of the faculty, the nature of the clinical experience the students receive, and the rigor of the curriculum.
B. The success of the nurse practitioner concept in the late 1960’s quickly led to the development of certificate programs, which accepted registered nurses without the baccalaureate degree. These programs do not award academic degrees. They require a minimum of 9 months of study, usually followed by a clinical internship in which NPs practice their new skills under close supervision of a physician or other nurse practitioner. While about 50% of the practicing nurse practitioners originally came from this type of program, few of these certificate programs remain.
C. While most NPs are educated at the
master's level, the American Association of Colleges of Nursing (AACN) voted in
2004 to establish the Doctorate of Nursing as the highest practice degree, and
the level of education appropriate for APNs. Subsequent to that, the AACN
established a DNP Essentials Task Force which released The
Essentials of Doctoral Education
for Advanced Nursing Practice in October 2006.
D. Due to the great applicant demand, many universities are accepting into their NP programs, students who already have masters degrees in another area of nursing. Because of courses they had previously taken, many of these students are able to complete the NP clinical and theory courses in one or one and a half years. These students do not earn a second master’s degree, but receive a certificate from a Post-Masters program.
E. The National Organization of Nurse Practitioner Faculties developed guidelines for nurse practitioner programs in 1995. Subsequently, they have supported the AACN position but have convened a task force to examine specific recommendations. More information can be found at the NONPF Practice Doctorate Resource Center. TOP
Where can I find information about how to become a nurse practitioner?
A detailed listing of all schools that offer nurse practitioner programs may be found at AllNursingSchools
How many nurse practitioners are there?
A. Due to variation in state laws licensing nurse
practitioners, it is difficult to document the exact number of nurse
practitioners. According to the "National Sample Survey of Registered Nurses
March 2004:Preliminary Findings" (Health Resources Services Administration,
2005), in March 2004, there were an estimated 141,209 nurse practitioners with
credentials as NPs in the United States, an estimated increase of 38,560 from
2000.
About 65.5 percent of NPs had completed a master’s degree program and an
additional 10.5 percent had a post-masters certificate as their NP preparation.
An estimated 87.7 percent of NPs were employed in nursing, with 65.7 percent of
NPs employed in nursing reporting the position title as “Nurse Practitioner.”
To read a copy of the 2005 "National Sample Survey of Registered Nurses"
published by the Health Resources Services Administration, click
HERE
Type of Nurse Practitioner Preparation
_______________________________________
Family Nurse Practitioners 31%
Adult Nurse Practitioners 18%
Pediatric Nurse Practitioners 18%
Other types Nurse practitioners 33%
_______________________________________
Many states require nurse practitioners to obtain and keep national certification as a nurse practitioner. The major certifying agency is the American Nurses Credentialing Center (ANCC). Other certifying bodies include the National Certification Board of Pediatric Nurse Practitioners and Nurses (NCB), National Certification Corporation for the Obstetric, Gynecologic and Neonatal Nursing Specialties (NCC), American Academy of Nurse Practitioners (AANP) and Nurse Practitioners in Women's Health (NPWH). The Pearson Report is an annual survey of variations in state law. In addition to information about certification, practice parameters including collaborative practice requirement, prescribing, billing and NP independence are included in the annual report.
Where do nurse practitioners work?
A. What nurse practitioners do and where they do it varies widely. They are extremely versatile and creative. They may practice is almost any setting in which health care is provided. Most NPs do not work alone in independent practice.
How much money do nurse practitioners make?
A. This is a difficult question to answer. Almost all nurse practitioners have a salary arrangement with the physician or agency that employs them. Services provided by the nurse practitioner are typically billed to the payer in the name (and at the rate) of the physician. Because of this reimbursement process, it is difficult to collect data about how much care is actually provided by nurse practitioners, what revenue they generate, and how that relates to what they are paid. The term "shadow provider" has been used to describe the nurse practitioner services data that is imbedded in data collected about physicians.
Most nurse practitioners generate three to four times their salary in practice revenue. This ratio may be much higher if there are substantial billable procedures provided in addition to the regular visits. Some nurses make less in their nurse practitioner role than in their previous registered nurse positions. The huge influx of nurses into the nurse practitioner role has driven down nurse practitioner salaries in many states recently.
B. There is a movement among many states to accept nurse practitioners as Medicaid or medical assistance providers, and reimburse them directly at the same rate as physicians. Current legislation has also been passed in Congress that would allow direct reimbursement of nurse practitioners under Medicare, at a percentage of what physicians receive. The Health Care Finance Administration (HCFA) is currently developing regulations for the implementation of this legislation. Nurse practitioners have mandated third party reimbursement in some states; are recognized providers by CHAMPUS and the Federal Employees Benefit Package.
C. Recent information about NP salaries can be found at NP Central
Must NPs have national certification?
Most states require NPs to have national certification is their area of preparation as a condition of state recognition/licensure as a NP. In this respect, certification is a condition of licensure rather than being recognition of professional competence as with medical specialty board certifications.
What are the types of nurse practitioners?
There are three major types of nurse practitioners:
Family Nurse Practitioners 31%
Adult Nurse Practitioners 18%
Pediatric Nurse Practitioners 18%
Other types Nurse practitioners (Women's health NP, School health NP, Occupational Health NP, Geriatric NP) 33%
It has been estimated that about 90% of the nurses with NP preparation are working in nursing. Fifty eight percent or 63,500 of those prepared as nurse practitioners are employed in positions with the NP title. Another 10 percent, or about 6,600 were employed in nursing education positions. The remaining nurses were distributed among a variety of other nursing positions.
Does this website meet JAMA core standards for websites?
Yes. NPA, Inc. complies
with the Journal of the American Medical Association's minimal core
standards for responsible print by including the following information:
Authorship:
Materials included on this website are written and/or edited by Marilyn W.
Edmunds, PhD, NP or Laurie Scudder, MS, NP. Information about contacting either
of these individuals is found under "Contact information".
Attribution: All
bibliographic material or copyright information is appropriately cited using
AAPA format.
Disclosure:
Nurse Practitioner Alternatives, Inc. is the sole owner and provides all funds
for construction and maintenance of this Website. It receives no additional
sponsorship, funding or financial support exclusive of advertising.
Currency: The date that content was first uploaded or last updated is posted in each website section as relevant. TOP