I decided to write this post in honor of "Nurse Practitioner Week" (November 8-14, 2015) and the 50th anniversary of our profession, but more importantly, because so many people don't really know what a nurse practitioner is. It's not really their fault. Our healthcare system is confusing at best. I've been called "Dr. Nigro" and I've also been the butt of many a "nurse wiping up poop" joke. I've been patronized by surgeons and embraced by patients and families whose lives I've saved. I've frequently been incorrectly called a PA (physician assistant), even by some of my direct superiors and co-workers. I've also been given ill-defined labels such as "advanced practice provider" and frankly, more demeaning ones like "mid-level provider" or "noctor"... but most people just call me "Brianna." I love my job.
So, what exactly is a nurse practitioner anyway? Let me clear it up for you. A nurse practitioner (NP) is a registered nurse who has completed years of education beyond his or her bachelor's degree, usually a Masters of Science (and now even a Doctorate) in Nursing. In grad school, I delved more deeply into learning about how the body functions, different disease states, how to formulate diagnoses, and treat common medical problems. Upon completing grad school, NP's take board certification exams and must maintain an active NP license in the state(s) in which they practice. While I had many physician preceptors and guest lecturers throughout my graduate program, NP education, licensure, and certification is not regulated or managed by doctors. It is regulated by nurses.
In my current role of hospital medicine, I take care of hospitalized patients with conditions ranging from chest pain and heart failure to pneumonia and other serious infections. It's not uncommon for me to take a thorough medical history, perform several physical exams, order a CT scan and a handful of laboratory tests, counsel someone about smoking cessation, prescribe various medications, and assist in planning a complicated hospital discharge in just an hour on the job. NP's often work in primary care, but many also work in "specialty" areas, such as Cardiology or Dermatology. Others perform procedures, such as insertion of dialysis catheters in Interventional Radiology, for example. Most NP's are employed by hospitals or physicians, but many actually work independently if their state regulations allow them to do so.
Research has shown similar outcomes between patients who were treated by physicians compared to patients treated by NP's. But, I personally think NP's have an edge... they are nurses first. Patient education, advocacy, and holistic care are at the very core of nursing philosophy. To a nurse, especially to me, a patient is not just the disease he or she has; a patient is a person first, with a complex host of physical, emotional, environmental, and spiritual parts that complete the larger, truer portrait of their health. Patient education has always been one of my favorite things about my job, because knowledge is empowering.
Today, people are living longer, patient care is more complex, and there are shortages of medical providers across the board. Nurse practitioners are competent, integral parts of the healthcare "team," and I am constantly inspired by so many of the NP's I know. So, the next time someone asks you, "what's an NP anyway?", I hope you reassure them that they're in good hands. I can guarantee we are going to be around for another 50+ years to come! :)
Brianna Nigro, MSN, RN, ACNP-BC