Family Nurse Practitioner

The Changing Role of FNPs in America

The United States has taken significant steps to improve access to health care for Americans and has opened the door for Nurse Practitioners to expand access and lower overall cost without compromising quality care. With the implementation of new stages of The Affordable Care Act (ACA) in early 2014, about 30 million Americans found themselves with health coverage they never had before — driving up the need for quality providers to care for them. However, many medical school graduates have chosen higher paying specialty practice over the traditional primary care role and left significant staffing gaps — an estimated 90,000 doctors will be needed by the year 2020 — that are being filled by Nurse Practitioners.

What Can Nurse Practitioners Do?

Nurse Practitioners are Registered Nurses who have completed advanced clinical training and hold at least a Master of Science in Nursing or higher degree. Family Nurse Practitioners treat patients across the lifespan and manage both acute and chronic conditions in the same way a primary care physician would. FNPs can diagnose, order, and interpret medical tests or diagnostics, and prescribe medications. They are licensed to practice in all 50 states, but guidelines for scope of practice vary widely from state to state. FNPs may choose to specialize in specific areas of practice, and can be found in neurology, cardiology, emergency medicine, and many other fields in addition to primary care. FNPs make up almost half of all Nurse Practitioners in the U.S. and offer significant flexibility and cost-effective care for health care employers with the same quality health outcomes.

Independent Care, Quality Outcomes, and the Opposition

While Nurse Practitioners have been practicing since the 1960s their role has evolved from assistant to independent care. This change, however, hasn’t always been smooth. Physicians argue that Nurse Practitioners lack the years of training and clinical expertise to care for complex patients properly and that they should not be allowed to practice without physician supervision — but the facts say otherwise. Multiple studies have shown better patient satisfaction scores, and equal clinical outcomes for NPs compared to physicians and it’s being done for a lot less.

Nurse Practitioners have become a smart move for many health care organization budgets as they save companies millions — and in some cases billions of dollars in the long term. According to the National Nursing Centers Consortium, Nurse Practitioners utilized in Massachusetts saved the state more than $4.2 billion dollars over a ten-year time frame. In just about every setting where Nurse Practitioners practiced, patients received better health counseling and education and health promotion activities than those who saw physicians. Costly visits to emergency departments and urgent care centers were also reduced.

More Businesses Getting on Board

Despite challenges from some of the medical field, many businesses are recognizing the benefit of Nurse Practitioners for their customers and patients. Walgreens pharmacies currently employ only Nurse Practitioners in their 370 Take Care clinics where they practice independently. In an interview with the Leonard Davis Institute of Health Economics, Heather Helle COO for the company said, “NPs are uniquely positioned to deliver high quality, affordable, convenient care.” Other companies that utilize Nurse Practitioners in their clinics include Walmart, CVS pharmacies, Target, and some Kroger stores. This business model is showing even more benefit as visits to Nurse Practitioners in these locations costs 30 to 40 percent less than a trip to the doctor’s office and 80 percent less than a visit to the emergency room.

[box type=”note”]Health care as the United States has known it in the past is changing. Years of the physician-only setting are gone, and the widespread shortage of medical providers in rural and urban settings alike is driving up the demand for providers who can get the job done. Nurse Practitioners are meeting this need and will continue to play an integral role in the future of this country’s health system.[/box]

• Meet the Author • Carly Dell


Carly Dell is the community manager for the innovative online family nurse practitioner and online rn to bsn programs offered through Simmons College. In her free time, Carly enjoys traveling, binge-watching HGTV, and trying new restaurants. Follow her on Twitter @carlydell2 and Google+.


1 comment… add one
  • While I am not an ER nurse, I am a registered nurse in Colorado who recnetly graduated from nursing school. In order to be an ER nurse, you only have to be a registered nurse (RN). Depending on the state you live in, there are two ways to get your RN. You can go to a 2-year college, like a community college and get your RN, or you can go to a 4-year university to get your RN. You do not have to get a separate degree in children. The starting pay for a nurse is also dependent on where you live. In Colorado, a new graduate nurse makes between $21 and $23 per hour, and usually works 12 hour shifts, three days per week. There are also other certifications to consider getting before becoming an ER nurse. These include ACLS (Advanced Cardiac Life Support), PALS (Pediatric Advanced Life Support) and TNCC (Trauma Nursing Core Course). All of this will make more sense once you are in nursing school. I think it best to try to find a mentor at your local hospital who is an ER nurse and get advice from them. Good luck!!!

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