It is no secret that nurse practitioners are becoming a popular career choice for many nurses who want to play a bigger role in the care of their patients. It is likely you have been seen by a nurse practitioner when you went to your annual physical or got stitches at urgent care. However, in general conversation, many people have no clue as to what a nurse practitioner is and what their role is in health care. When I introduce myself as a nurse practitioner I get, “What is that?” or “Is the doctor coming in after?” I then have to explain to them that a nurse practitioner is an advanced practice provider who is trained to provide care as a clinician, including assessment, diagnosis, and treatment. I obviously don’t phrase it like that, but often I have to tell patients that a nurse practitioner does not equate to them getting lower quality care or inferior treatment.
What do Nurse Practitioners do?
I can’t tell you how many times I introduce myself to patients and they get confused when I start going through their full history and chief complaint of why they are being seen. Once someone hears the word “nurse,” they already have an idea in their head of what I can and can’t do. Nurse practitioners are nurses, but their role in health care is different than what most have in mind. The exciting part about working as a nurse practitioner is the diversity in both the environments you can work in as well as what your day-to-day responsibilities look like.
At the core of the duties of a nurse practitioner is the assessment, diagnosis, and treatment plan for patients. Along with this comes interpreting labs, ordering prescriptions, and conducting procedures. Depending where you specialize, these could be anything from placing chest tubes to managing chronic diabetes. This flexibility and variation is a huge appeal to those who want to be a nurse practitioner. After hearing what a nurse practitioner does, you may be wondering what the difference is in their job from that of a physician. You are not alone in wondering this!
The Difference Between a Nurse Practitioner and a Doctor
The number one question I get from my patients when working as a nurse practitioner is what is the difference between myself and a doctor. The answer is not cut and dry, as there are many factors, but at the forefront is the amount of education needed. Nurse practitioners usually require six to ten years depending on the route taken. Doctors go through ten to fourteen years of school to obtain their degree. With this difference in years, physicians complete a residency and often go on to be board certified in a specialty.
There is also a difference in the independence of practice between nurse practitioners and physicians. In 28 states, nurse practitioners are required to have physician oversight. This means that some of their decisions have to be signed off by a supervising physician. In a state like Florida, you have to ensure a physician writes off on orders such as medications that are prescribed and treatment plans for a patient.
In the other 22 states, nurse practitioners have the coveted full practice authority. These states do not require any type of supervision by a physician. I have a friend who works as a nurse practitioner in Alaska, a full practice authority state, and she is the only clinician in her town. Full practice authority is sought by many because it means it is possible to provide care in places that don’t have access to a physician. Allowing nurse practitioners to provide care independently can change the outlook for health care where resources are limited.
The difference between an RN and an NP
It can be confusing in the nursing world because so many different positions such as CNA, RN, LVN sound similar. However, each title has their own roles and scope of practice. I worked as a CNA, then an RN, and finally an NP. All of those roles contribute to a healthcare team, but each has a different level of responsibility. It sounds obvious, but more years of education correlates to positions that have greater responsibility and independence. A registered nurse does not have the scope of practice to diagnose and treat patients. However, they work closely with nurse practitioners and carry out written orders such as medications to administer.
Why did I become a Nurse Practitioner?
Working as a registered nurse, I was always interested in working with my patients and having a long-term role in their wellness and health. At the time, I was working in an outpatient cardiology pediatric office that was affiliated with a children’s hospital. In this position, I had the opportunity to work with both inpatients and outpatients and I saw first hand how nurse practitioners were utilized. It was so exciting to see them order tests and medications for their patients, conduct follow-up visits, and manage their post-surgery care. All of them were trained in their specialties and had a wealth of knowledge to share with their patients and families. Many family members would remark on how they loved learning from the nurse practitioners because they often had more time to spend on the office visits in contrast to other providers who were spread thin. I knew this was a role that I wanted to pursue, because I have a passion for educating my patients and ensuring that they feel empowered in taking charge of their health.
Steps to Becoming a Nurse Practitioner
There are two main routes that you can take to becoming a nurse practitioner, depending on whether you have a background as a registered nurse or are new to the nursing world with no experience.
The traditional route
Let’s take a look at the more traditional route.
1) This route begins with candidates enrolling in school to become a registered nurse. A nurse practitioner is a registered nurse first and foremost, and this schooling lays the foundation of your care practice. In many of these nursing programs, you earn your BSN, or bachelor of science in nursing. This traditionally takes four years to complete. For those who obtain an Associate’s Degree in Nursing, often at a two-year program at the community college level, it is necessary to complete a bachelor’s degree before pursuing a nurse practitioner program.
2) Get some experience! Many nurse practitioner masters programs require that nurses have been working in the field for at least one to three years. Not all programs require this experience, but it definitely does not hurt to dip your toes into nursing. This doesn’t necessarily mean bedside nursing, as you have a variety of options on what you can do with your nursing degree.
3) Next you have to attend a graduate level nursing school for either an MSN, or Master of Science in Nursing, or a DNP, or Doctor of Nursing Practice. These programs vary in length, but most average two to three years. Here you will choose your certification specialty, such as family nurse practitioner or adult gerontology nurse practitioner. During this time, it will be similar to your registered nursing degree as 500 hours of supervised direct patient care are required. Many of my classmates decided to do more hours because they wanted to be adequately prepared.
4) The last step is passing the National NP certification board exam, which is specific to your population focus, and then you will obtain your nurse practitioner license. The best part about nurse practitioner boards is that you get your results immediately, unlike the dreaded wait for the NCLEX® (boards for registered nursing).
What if you don’t have a background in nursing but want to be a Nurse Practitioner?
These days, schools all over are offering what is called an ELMSN, entry-level masters of science in nursing degree. How can a MSN be entry level, you ask? It is a fancy way of saying that this is an option for those who have no background in nursing. Maybe you went to school for psychology twenty years ago and you want to change things up. This would be the route for you to take.
Most of these entry-level programs require a bachelor’s degree and a whole list of science prerequisites. This offers an opportunity for those who have gotten a bachelor’s degree in art, but are now feeling called to the medical field. With that art degree, you would still be required to take additional courses, usually consisting of subjects such as anatomy, general chemistry, biology, etc.
After you apply and are accepted into an entry-level MSN program, the curriculum starts with obtaining a RN license. Typically, this is done at an accelerated pace of around a year and a half to two years. After this, you start the MSN portion of the program while starting your career as a registered nurse. The MSN licensure is another two years of school, which is similar to the traditional route. Both the entry-level and traditional students take the same licensure exam.
Whatever path you take, the end-goal of becoming a nurse practitioner is an exciting decision with so much potential. There is much opportunity to thrive in this position, and the projected outlook for growth is bright.
