History and Development of the Nurse Practitioner Role

Exploring the profession of Nurse Practitioner

“People will forget what you said, they will forget what you did, but they will never forget how you made them feel,” said Maya Angelou, a famous American poet, singer, memoirist, and civil right activist. Although this phrase was used in the context of using appropriate words while communicating with others, it holds so true in the health care industry. Health care field, America’s largest service industry is facing a healthcare crisis past many decades. While the policymakers struggle year to year to bring in the balance between the rising demand for health care needs and the number of professionals catering it, the dearth of health care professionals continues. Increase in the number of births and aging seems to be the hindering factor in maintaining this balance. To address this issue, America came up with the solution of evolving midlevel providers such as Nurse Practitioners (NP), Advance Practice Registered Nurses (APRN), and Physician Assistants (PA). The profession of NPs has leaps and bounds past few decades. NPs are trying to fulfill the most crucial demand of this time by attaining rigorous training and performing excellently. 

The profession of NP has seen detailed history overtime. The first NP program was founded in 1965 by Loretta Ford, EdD, PNP, FAAN, and Henry Silver, MD, at the University of Colorado (Cronenwett et al. 9) in response to the scarcity of primary care providers, particularly for children, in urban and rural areas of the United States. The NP is a registered nurse with advanced training, graduation from an accredited NP program, and successful completion of the state licensing exam. The NP profession grew so rapidly from its infancy of 15,000 NP in the year 1979 to 205,000 in the year 2015 (Pulcini and Wagner, 51). Per the statistics of American Association of Nurse Practitioners, there are more than 270,000 NPs licensed in the U.S. (“2017 National Nurse Practitioner Sample Survey Results”). 

The education for NP is very rigorous and time-consuming. It begins with enrollment into a BSN program of two to four years depending upon the college. The associate degree in the same stream can be obtained in as quick as nine months through accelerated programs. Not to forget that the enrollment is competitive and requires the completion of general education courses like English composition 1 & 2, anatomy and physiology, college algebra, chemistry, general biology, and Test of Essential Academic Skills (TEAS). Once the BSN is completed, one can certify their degree as a Registered Nurse (RN) by completing the National Council Licensure Examination (NCLEX) exam in either NCLEX-RN or NCLEX-PN. The latter is used for practical and vocational nursing graduates. 

As a certified RN, one can practice in their choice of field to gain experience. To earn a graduate degree, preferably post two years of clinical practice, there are two choices of either pursuing a master’s degree (MSN) or a doctoral program (DNP). Although, the American Association of College of Nursing (AACN) recommends the new standard for entry becomes the DNP starting 2015 so the NPs could gain more autonomy, work without any supervision, and provide advanced care in par with other intraprofessional education. There are very few colleges who have accepted this policy while others are still proceeding with the master’s program, with the hope that eventually it will all following the same policy. Post completion of MSN or DNP, state licensing is mandatory for an NP to practice. Licenses are issued by the State while the certification is awarded by the national agencies. Five different agencies issue this certificate depending upon the specialty. The license must be renewed every 3-5 years depending upon the specialty. What is lucrative for the current generation is NP degree can be obtained even online, while one continues to work so there is no economic burden for pursuing this profession.

NPs not only play a demanding but challenging role. Independently and in collaboration with other health care providers, NPs provide a broad range of primary, acute, specialty health care services. At first, NPs primarily worked in pediatrics but soon they ventured into other health care specialties such as family medicine, adult health, gerontology health, neonatal health, oncology, psychiatric/mental health, women’s health, etc. Besides, there is no subspecialty in medicine where NPs are restricted to work. The data published by Bureau of Labor Statistics in 2017 showed the effectiveness of NPs in reducing the hospitalization rates and attaining better client satisfaction (Occupational Employment and Wages, May 2018) proving that this model is not only successful but is also fulfilling the healthcare crisis to a larger extent.

  The importance of NPs has been explored in several surveys and research studies. With such intensive training and several years of education, NP is ranked second in the U.S. News list of best healthcare jobs in 2017 (2017 National Nurse Practitioner Sample Survey Results). This ranking is based on things like great demand in the healthcare sector, best-paid salary, future growth, greater work satisfaction, and work-life balance. The AANP National Nurse Practitioner Sample Survey of 2018 reported that the mean, full-time base salary for NPs was $107,480 per year in 2017, of course, this varies from specialty and the location of practice (Occupational Employment and Wages, May 2018). The majority of NPs (57.4%) see at least 3 patients per hour assuring job satisfaction (2018 AANP National Nurse Practitioner Sample Survey). The average age of NP is 49 years proving that they have tremendous experience even before they attain their degree and it is never too late to become an NP (2018 AANP National Nurse Practitioner Sample Survey). As of today, there are 21 states and D.C allow NPs to practice on their own and this number is expected to rise with time. 

Becoming an NP unites the nurse’s compassion and skills with the autonomy to practice, diagnose, and treat patients holistically. NPs have proven to be extremely valuable to the medical community and patients. With intensive training, increasing demand, challenging and rewarding career, NPs seems to be the best possible answer to the healthcare crisis of America. 

Works Cited

• Cronenwett, Linda, et al. "The doctor of nursing practice: A national workforce perspective." Nursing Outlook 59.1 (2011): 9-17
• Pulcini, Joyce, and Mary Wagner. "Nurse practitioner education in the United States." Clin Excell Nurse Pract 6.2 (2002)
• “Nurse Practitioner Role Grows to more than 270,000.” AANP, 28 Jan. 2019, www.aanp.org/news-feed/nurse-practitioner-role-continues-to-grow-to-meet-primary-care-provider-shortages-and-patient-demands>
• “Occupational Employment and Wages, May 2018 29-1171 Nurse Practitioners.” United States Department of Labour, www.bls.gov/oes/2017/may/oes291171.htm. Accessed 16 September 2019.
• Snider, Susannah. “Unveiling the best jobs of 2017.” US & World Report News, 11 Jan 2017, www.money.usnews.com/money/careers/articles/2017-01-11/unveiling-the-best-jobs-of-2017.
• “2017 National Nurse Practitioner Sample Survey Results.” AANP, 08 Aug. 2018. www.aanp.org/news-feed/2017-national-nurse-practitioner-sample-survey-results.