What is a nurse practitioner, or NP? It’s a common question, even though nurse practitioners are everywhere in our clinics, hospitals, and communities. Many people don’t understand what NPs do or how they are different from other health professionals. At the clinic or hospital, a patient often doesn’t choose whether or not to see a nurse practitioner, but that doesn’t mean it’s not important to know what they are.
A nurse practitioner is an advance practice registered nurse (APRN). Nurse practitioner is one of the four roles in advance practice nursing, along with nurse anesthetist, clinical nurse midwife, and clinical nurse specialist. Direct patient care forms the core of APRN practice, which makes them different from nurse educators, nurse researchers, or nurse administrators. APRNs have graduate degrees and they specialize in care populations such as family, adult- gerontology, or women’s health for example. Many nurse practitioners hold a doctor of nursing practice (DNP) degree, but their job titles and licenses are the same as NPs with a master’s degree. North Dakota and Minnesota allow nurse practitioners to practice with full autonomy which means they have the freedom to open their own practices and work without physician oversight.
A nurse practitioner is not a physician assistant (PA). Nurse practitioners follow the nursing process in their work and build on the skills of the registered nurse. They practice in the context of human, environment, health, and nursing and treat the patient with a holistic approach. They are licensed through the Board of Nursing in each state. In contrast, physician assistants do not have to be nurses. They, too, have practice autonomy in North Dakota, but PAs are educated using a medical approach similar to physicians. They are licensed through the Board of Medicine in each state (or sometimes a Board of Physician Assistants). Though there is some overlap in practice between NP and PA, they each have a different philosophy in treating and preventing disease and promoting health.
A nurse practitioner is not a “physician extender” or a “midlevel provider.” These ambiguous terms have no real definitions. Loretta Ford, one of the founders of the nurse practitioner role in 1965, felt that viewing NPs as physician extenders turned her life’s work into “Hamburger Helper.” It invokes images of the health care industry turning physicians into some kind of “Stretch Armstrong” for profit. The term “midlevel” doesn’t mean anything in patient care. We have strong evidence that shows that NPs have good patient outcomes and high levels of patient satisfaction.
Nurse practitioners are helping change the landscape of American health care. NPs recognize that race and social determinants of health such as unemployment or lack of transportation are major factors in health outcomes. They are influencing health policy at the state and national level. NPs are helping to bring high quality service to underserved populations with poor access to health care. By implementing evidence-based practice, NPs are helping to close the gap between research and practice.
Are you still a bit confused? Don’t worry – the role of the nurse practitioner may vary slightly from state to state and is still evolving across the world. The NPs of tomorrow will be different from the NPs of today. If you are a patient, the main thing you should know is that there is a team of health care professionals ready to collaborate with you when you need them. This is essential in the fast-changing world of health care. In the current pandemic, health has become a critical priority for all of us. Maybe you would like to talk to someone about your health and what it means to you.
Have you seen your nurse practitioner lately?
Eric Christofferson is a graduate student in the Family Nurse Practitioner track at the University of North Dakota.