The Growing Role of Nursing in Health Care

When you visit a doctor for a regular checkup or common illness, do you find you spend more time with a nurse than the physician? Nurse training has become more extensive in recent years, with newly titled nurse practitioners (NP) and physician assistants (PA) shouldering a larger share of the health care workload.

Part of the new health care reform efforts include a focus on prevention, screening, nutrition and exercise through community-based care services — areas in which nurses often have greater training. For example, nurses may have more information about community resources. Or, they may spend more time talking to patients about how to adapt their medical regimen to their family situation and/or environment.(Click here to read “Expanded Roles for Advanced Practice Nurses”)

Consider the following guidelines to help you understand the role of various types of nurse positions and the qualifications of their advanced training.

Nurse Practitioners

NPs are registered nurses who must earn a master’s degree, a post-master’s certificate or a doctoral degree in nursing from an accredited program. NPs must be licensed by the state in which they practice, and most states require them to pass a national board certification exam. NPs also receive additional clinical training in diagnosing and treating illnesses. They are qualified to:

• Take medical histories
• Provide complete physical examinations
• Diagnose and treat acute and chronic illnesses
• Provide immunizations
• Prescribe and manage medications and other therapies
• Order and interpret lab tests and X-rays
• Provide patient education and supportive counseling

Physician Assistant

A physician assistant works under the direct supervision of a doctor. Many hold a PA bachelor’s degree and/or a PA master’s degree, and they are required to pass a national certification exam and be licensed by the state in which they practice. Under physician supervision, a PA is qualified to:

• Examine patients
• Diagnose injuries and illnesses
• Provide treatment and preventive care services

While a PA is required to work under the supervision of a licenses physician, in some states NPs have complete autonomy and can open their own clinic or office. Each state has difference scope-of-practice guidelines for NPs. For example, an NP practicing in Alaska can diagnose and prescribe all documentation of physician involvement in order to diagnose and prescribe.

Nurses with advanced training are providing a pivotal role in the country’s quest for health reform and helping to curb the cost of providing health care. With more autonomy, nurses free up physician time to be spent on more complex cases. Currently, there are more nurse practitioners entering the field of primary care than physicians, and it takes an average of six years to complete their education and training, compared to the average 11 to 12 years for physicians. Furthermore, NPs who work with Medicare patients are paid 85 percent of a physician’s rate, yielding higher savings for the government’s entitlement program. (Click here to read “Nurse Practitioners and Primary Care”)

Analyses conducted by the Congressional Office of Technology Assessment (OTA) revealed that the quality of care provided by nurse practitioners tends to be equal to, or even higher than, that of physicians – as NPs tend to score better in areas of communication and preventive care.

According to the American Association of Nurse Practitioners:

• There are more than 192,000 nurse practitioners practicing in the U.S.
• 95.1 percent have graduate degrees
• 96.8 percent maintain national certification
• 87.2 percent are prepared in primary care; 75.6 percent practice in at least one primary care site
• 84.9 percent see patients covered by Medicare
• 83.9 percent see patients covered by Medicaid
• 44.8 percent hold hospital privileges
• 15.2 percent have long-term care privileges
• 97.2 percent prescribe medications, averaging 19 prescriptions per day
• The majority (69.5 percent) see three or more patients per hour
• Only 2 percent have been named as primary defendant in a malpractice case
• Nurse practitioners have been in practice an average of 11.7 years

(Click here to read “NP Fact Sheet” )

Presently, about one-third of U.S. physicians practice in primary care, so nurses with advanced training clearly fill a void in the prompt and cost-effective delivery of health care services.

Furthermore, NPs are more prevalent in areas of the country with fewer numbers of physicians, such as rural areas and southern states, providing better access to health care for uninsured and Medicaid patients.

With this understanding of the critical role nurses play in today’s health care industry, perhaps you won’t be surprised if you hear, “the nurse will see you now” when you get a checkup.

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