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Leadership Presentation on Nurse Practitioners
- 1. Nurse Practitioner’sNurse Practitioner’s Role in the ChangingRole in the Changing Healthcare SystemHealthcare System M. Diane RusterucciM. Diane Rusterucci NURS 4200 Concepts of the Nurse asNURS 4200 Concepts of the Nurse as Leader/ManagerLeader/Manager Summer 2014Summer 2014
- 2. What is a Nurse Practitioner? • RN with advanced education – Master’s Degree – Doctor of Nursing Practice
- 3. Leadership Issue: • Nurse Practitioner’s role in the changing healthcare system. • Supply and demand required to service the growing numbers of chronic care and elderly
- 4. Challenges to Change: • Removing barriers for APRN to be able to practice to the fullest extent • Standardizing the process
- 5. Projecting the Supply and Demand for Primary Care Practitioners through 2020 Provider Type/Specialty 2010 2020 Supply Nurse Practitioners 55,400 72,100 Physician Assistants 27,700 43,900 Demand Nurse Practitioners 55,400 64,700 Physician Assistants 27,700 32,700 Supply and Demand Nurse Practitioners * 7,400 Physician Assistants * 11,200
- 6. Conclusion • The Nurse Practitioner will be a leader for change in the future of healthcare.
- 7. References American Nurses Association. (2014). Advanced Practice Nursing: A New Age in Health Care. Retrieved from www.NursingWorld.org: APRNMediaBackgrounder.pdf Health Resources and Services Administration. (2013). Retrieved from bhpr.hrsa.gov/healthworkforce/supplydemand/usworkforce/primarycare/ Institute of Medicine. (2010, October). Retrieved from http://www.iom.edu/Reports/2010/The-Future-of-Nursing-Leading-Change-Advancing- Health.aspx
Editor's Notes
- Requirements for a registered nurse (RN) include either an Associate of Science in Nursing (ASN), a Bachelor of Science in Nursing (BSN), or completion of a diploma program, as well as direct patient care for acutely or chronically ill patients. ASN programs, which are offered by community and junior colleges, usually take 2 years plus prerequisites. BSN programs are offered by colleges and universities and take 4 years plus necessary prerequisites before acceptance into the program. - While not every state includes specific language requiring a masters degree for NPs, the majority of states do require a masters degree, post-master's certificate or doctoral degree. Further, the current nurse practitioner programs offered by all universities and colleges are at the masters or post-master's certification level. Lastly, all states require national board certification for nurse practitioners before they are permitted to practice and the two biggest certifying bodies, the American Nurses Credentialing Center and the American Academy of Nurse Practitioners, do require applicants to hold a masters degree or post-master's certificate to be eligible to test for certification. To become a Nurse Practitioner (NP), nurses trained at the associate degree or diploma level must first complete a Bachelor of Science in Nursing (BSN) or enter various programs offering an ADN-to-MSN "bridge program," some of which award the bachelors degree while completing the requirements for the masters; others, upon completion, only award the MSN with only the BSN coursework being completed instead of an actual degree awarded. Once state licensure as a registered nurse is attained by successful completion of the NCLEX-RN, the candidate must complete a state-approved advanced nursing education program that usually specializes in a field such as family health, gerontology, acute care, women's health, etc. The degree can be granted by a university which grants an MSN or doctorate in nursing. (NP) is a registered nurse who has completed specific advanced nursing education (generally a master's degree or doctoral degree) and training in the diagnosis and management of common as well as a few complex medical conditions. Nurse Practitioners provide a broad range of health care services.
- As the government has brought comprehensive changes to the U.S. health care, they have concentrated on the more than 50 million under- and uninsured Americans. The new users are expected to overwhelm an already challenged system by expanding the numbers of elderly, outpatient and chronic care. It is also estimated that “66 million Americans face threats to their health because of limited access to front-line primary care.” (American Nurses Association, 2014) The lawmakers are focusing on the advanced practice registered nurses to deliver more of the nation’s health care. The experts have determined that the demand is growing rapidly because of hospitals focusing on the sickest and most unstable patients and moving the majority of the services to be lead by the nurse practitioners in the homes, community health centers, nurse-managed clinics, schools, birthing centers and other venues.
- The Institute of Medicine put out a report in 2010 that outlined 4 key messages and 8 recommendations for the future of nursing. The key messages were “Nurses should practice to the full extent of their education and training; Nurses should achieve higher levels of education and training through an improved education system that promotes seamless academic progression; Nurses should be full partners, with physicians and other health care professionals, in redesigning health care in the United States; and Effective workforce planning and policy making require better data collection and improved information infrastructure.” (Institute of Medicine, 2010) The recommendations were to “remove the scope of practice barriers; expand opportunities for nurses to lead and diffuse collaborative improvement efforts; implement nurse residency programs; increase the proportion of nurses with a baccalaureate degree to 80 percent by 2020; double the number of nurses with a doctorate by 2020; ensure that nurses engage in lifelong learning; prepare and enable nurses to lead change to advance health; and build an infrastructure for the collection and analysis of interprofessional health care workforce data.” (Institute of Medicine, 2010) The Institute of Medicine authors warned policymakers of restrictions such as in state practice acts and Medicare and Medicaid reimbursement policies that prevent nurses from “responding effectively to rapidly changing health care settings and the evolving health care system. These barriers need to be overcome to ensure that nurses are well-positioned to lead change and advance health.” (Institute of Medicine, 2010) The also urged that the scope-of-practice barriers should be removed so that nurses are able to practice to their fullest extent. Standardizing the process is another challenge in this process of change. While the new health care reform law has increased the patient’s access to high-quality nursing care, the proliferation of nursing specialties, ongoing debates on appropriate credentials and scopes of practice, and a lack of uniformity among state regulations continue to pose barriers to where APRNs can practice and who they can treat. In 2008, the Consensus Model for APRN Regulation: Licensure, Accreditation, Certification, and Education was completed and endorsed by 44 organizations, and when this document is fully implemented, it will finally provide patients with the essential patient care they need by standardizing each aspect of the regulatory process.
- In this table, it demonstrates the need for primary care practitioners in 2020 versus what was needed in 2010. The number of Nurse Practitioners needed will be an additional 7,400 and 11,200 for Physician Assistants. It is encouraging that Nurse Practitioners will still outnumber Physician Assistants by almost 2 to 1. (Health Resources and Services Administration, 2013)
- The growing demand for Nurse Practitioners to alleviate the supply and demand needed for the growing numbers of Americans, will continue to expand the role of the Nurse Practitioner our healthcare system. It is important for all involved to work hard to further standardize the process and break down the barriers to practicing to the fullest extent of the Nurse Practitioner’s education and training. Through the efforts of everyone the Nurse Practitioner will be a leader for change in the future of healthcare.