WHAT IS A NURSE PRACTITIONER?
A nurse practitioner (NP) is a registered nurse (RN) who has completed advanced education and training in the
diagnosis and management of common medical conditions, including chronic illnesses. Nurse practitioners provide
a broad range of health care services. They provide some of the same care provided by physicians and maintain
close working relationships with physicians. An NP can serve as a patient’s regular health care provider.
Nurse practitioners see patients of all ages. The core philosophy of the field is individualized care. Nurse
practitioners focus on patients' conditions as well as the effects of illness on the lives of the patients and their
families. NPs make prevention, wellness, and patient education priorities. This can mean fewer prescriptions
and less expensive treatments. Informing patients about their health care and encouraging them to participate in
decisions are central to the care provided by NPs. In addition to health care services, NPs conduct research and
are often active in patient advocacy activities.
Because the profession is state regulated, care provided by NPs varies. A nurse practitioner's duties include the
following:
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Collaborating with physicians and other health professionals as needed, including providing referrals
Counseling and educating patients on health behaviors, self-care skills, and treatment options
Diagnosing and treating acute illnesses, infections, and injuries
Diagnosing, treating, and monitoring chronic diseases (e.g., diabetes, high blood pressure)
Obtaining medical histories and conducting physical examinations
Ordering, performing, and interpreting diagnostic studies (e.g., lab tests, x-rays, EKGs)
Prescribing medications
Prescribing physical therapy and other rehabilitation treatments
Providing prenatal care and family planning services
Providing well-child care, including screening and immunizations
Providing health maintenance care for adults, including annual physicals
Nurse practitioners provide high-quality, cost-effective individualized care that is comparable to the health care
provided by physicians, and NP services are often covered by insurance providers. NPs practice in all states. The
institutions in which they work include the following:
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Community clinics and health centers
Health departments
Health maintenance organizations (HMOs)
Home health care agencies
Hospitals and hospital clinics
Hospice centers
Nurse practitioner offices
Nursing homes
Nursing schools
Physician offices
Private offices
Public health departments
School/college clinics
Veterans Administration facilities
Walk-in clinics
Most NPs specialize in a particular field of medical care, and there are as many types of NPs as there are medical
specialties.
NPs and Women's Health
Women with serious conditions, especially those that require surgery, need the services of a physician. But when
women have typical health care needs, an NP can serve as the health care provider.
Some nurse practitioners focus specifically on obstetrics and gynecology. They provide services that include the
following:
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Care before and after menopause
Contraceptive care
Evaluation and treatment of common vaginal infections
Health and wellness counseling
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Midwifery
Physical exams, including Pap smears
Pregnancy testing and care before, during, and after pregnancy
Screening and referral for other health problems
STD screening and follow-up
Licensure and Certification
To be licensed as a nurse practitioner, the candidate must first complete the education and training necessary to
be a registered nurse (RN).
Requirements for a registered nurse include an associate degree in nursing (ADN), a bachelor of science degree
in nursing (BSN), or completion of a diploma program, as well as direct patient care for acutely or chronically ill
patients. Associate degree in nursing programs, which are offered by community and junior colleges, usually take
2–3 years. BSN programs are offered by colleges and universities and take 4–5 years and diploma programs are
administered in hospitals and usually take 2–3 years. Depending on the program attended, the candidate may
fulfill some NP requirements while completing the RN degree.
In most cases, professionals and employers in the field strongly recommend the BSN as a minimal requirement
for NPs, and some states require this. To become NPs, most nurses with an ADN or diploma enter a bachelor of
science program. They may be able to find a staff nursing position and take advantage of tuition reimbursement
programs to work toward a BSN.
Once registered nurse status is attained, the candidate must complete a state-approved advanced training
program that usually specializes in a field such as family practice, internal medicine, or women's health. The
degree can be granted by any of the following:
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A community college, which grants an associate in arts degree
A hospital-based program, which grants a 3-year diploma
A university, which grants a bachelor of science in nursing (BSN) degree
The variety of educational paths for NPs is a result of the history of the field. In 1965, the profession of nurse
practitioner was instituted and required a master's degree. In the late 1960s into the 1970s, predictions of a
physician shortage increased funding and attendance in nurse practitioner programs. During the 1970s, the NP
requirements relaxed to include continuing education programs, which helped accommodate the demand for NPs.
Currently, all three educational options to attain NP status are valid.
After completing the education program, the candidate must be licensed by the state in which he or she plans
to practice. The State Boards of Nursing regulate nurse practitioners and each state has its own licensing and
certification criteria. In general, the criteria include completion of a nursing program and clinical experience.
Because state board requirements differ, nurse practitioners may have to fulfill additional requirements, such as
certification by the American Nurses Credentialing Center (ANCC) or a specialty nursing organization. The license
period varies by state; some require biennial relicensing, others require triennial.
After receiving state licensing, a nurse practitioner can apply for national certification from the ANA or other
professional nursing boards such as the American Academy of Nurse Practitioners (AANP). Some NPs pursue
certification in a specialty. Several organizations oversee certification, including the following:
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American Association of Critical-Care Nurses
Board of Certification for Emergency Nursing
National Certification Board of Pediatric Nurse Practitioners and Nurses
National Certification Corporation for the Obstetric, Gynecologic, and Neonatal Nursing Specialties
Oncology Nursing Certification Corporation
A women's health nurse must have experience in direct patient care, education, administration, and/or
research. He or she must have graduated from an OB/GYN nurse practitioner program (1-year program that is
accepted by the National Certification Corporation for the Obstetric, Gynecologic, and Neonatal Nursing
Specialties). The NP must also complete a required number of teaching and clinic hours in an OB/GYN setting.
The National Association of Nurse Practitioners in Women's Health (NPWH) oversees the accreditation of
programs that prepare NPs in women's health.