Nurse Practitioners - Partnering with Patients
|UPDATE: I wrote
the article about the education and skills of nurse practitioners (below
this update) in 2004. For the past 3 years we have given nurse
practitioners a good try as Primary Care Providers. And although they
can be very qualified, and provide excellent medical care, we have found some things lacking in the field.
Because of the foregoing, although we feel that nurse practitioners have excellent education and can be as qualified as GPs, we also feel that the restrictions placed upon them by the board of nursing and other factors may hinder them in a PCP situation as far as providing adequate medical care. Thus, we have decided to return to physicians for our medical needs.
The following article details the nurse practitioner paradigm which in its ideal form (without a less than educated, biased Board of Nursing to lay down inappropriate decisions against NPs) could and does in some cases, really add to good medical treatment.
If you are like most Americans, you may have heard the term ‘Nurse Practitioner’ but know very little about this dynamic role. Some myths that have been suggested in the past by the popular press include:
Some professional medical associations heartily with the above (in fact, they often feed the media with "facts" like the above!)
So it can be confusing. Let's examine each of these points.
1. They are junior doctors with less education WRONG.
Like many other people, I never questioned this one. After all, don't doctors go to school for 12 years? Well, partially true but let's take a closer look. The B.S. pre med program doesn't have much in the way of medical studies except for Anatomy and Physiology, a course which the B.S.N. program requires as well. It also, should be noted that physicians who are not going into a specialty, in other words, general practitioners, in addition to a general science B.S, may have 4 years of med school (2 of which are mostly practicum, not book learning) and 1 year of internship. It should be noted that their year of internship and any residency requirements they fulfill are NOT a requirement for graduation from medical school, but actually needed for licensing and employment purposes.
For example: School of Medicine - Admissions
Indeed this is all that is required to go into practice. To contrast, the NP has a BSN, a large part of which emphasizes medical training, patient care, pharmacology and practicum.
For example: AS(n) BSN Requirements
Then, for the MSN, another 2-3 years of medical training, patient care and pharmacology with 780 hours of patient contact (like an internship) to graduate with an FNP (Family Nurse Practitioner)!
For example: Family Nurse Practitioner Core
Bottom line, NPs have similar education compared to most GPs! (General Practitioners)
It should be noted that BSN's, MSN's and NP's study many of the same textbooks which GPs study! Additionally, they keep up their education with the same ’Continuing Education’ credits which physicians use and they read many of the same peer reviewed medical journals!
2. They don’t know much about the medications they prescribe. WRONG.
In our experience, NPs keep up on medications, attending the same seminars (usually held by pharmaceutical companies) that GP physicians attend. Since their pharmacology studies are similar to that of physicians, NPs can prescribe as well as physicians and in some cases, where they endeavor to know the patient, perhaps better...
It's becoming more and more clear that knowing the patient as a whole person and LISTENING to the patient might well make for LESS prescription errors in medicine. Because each body is different! (In fact, many physicians are beginning to pick up the paradigm of knowing their patients well - making themselves available in email etc).
3. NPs are just nurses:
First of all, NPs started as nurses but have gone far beyond nursing, however, nurses are often the primary healers in the medical chain and considered by many, to be the most trusted professionals working today. And secondly, NPs have utilized their nursing skills to become excellent medical providers. Finally many NPs have picked up specialties like cardiology, neurology and more and share this expertise with their patients, something which is not necessarily true of many GPs!
So why should you switch?
At this time, we do not recommend switching to a Nurse Practitioner as a primary care provider, although those working in ERs and other protected positions can definitely be trusted to provide excellent medical care. We sincerely hope that in the future, that the restrictions put upon nurse practitioners by the Board of Nursing, are removed so that they can be allowed to practice excellent medicine as a PCP. The paradigm is definitely without question, a good one.