6 Steps NPs Can Take to Create High-Level Patient Care Teams

Before becoming a nurse practitioner, I worked as an emergency department (ED) and flight nurse. Most days, I was excited to go to work. I enjoyed learning and experiencing new patient adventures with the support of my "work family," which encompassed my colleagues, ED technicians, registration personnel, physicians, and other staff members. We knew that we all played a role in keeping the department flow organized, creating a positive experience, and ultimately providing the best possible care to patients.

When I transitioned to a nurse practitioner role, this team-centered dynamic changed with it. Working in a different department and new position, I began to feel somewhat isolated from the rest of the team. While finding my place took a level of trust and relationship-building, it allowed me to successfully redefine my professional goals. Career development requires a practitioner to work among strangers, gaining familiarity with an unknown culture and establishing trust with a different "work family." However, NP evolutions also offer the opportunity to create a new team leader.

Benefits of Patient Care Teams

Nurse practitioners are able to create and lead patient care teams. Essential to delivering patient-centered care, these teams offer the following benefits:

  • Improved coordination of patient care
  • Enhanced patient satisfaction
  • More efficient use of healthcare services
  • Shorter and fewer hospitalizations
  • Reduced medical errors
  • Better patient treatment compliance

Patient care teams consist of at least two people interacting in a dynamic and interdependent relationship. They engage in effective communication and share the common goal of providing the best care for patients. Although a shared level of responsibility is understood and routinely practiced in healthcare, the absence of high-quality teamwork leads to poor patient outcomes, medical errors, provider burnout, and increased healthcare costs.

Personal Values of Team Members

NPs must establish effective patient care teams in their practice. Before doing so, there are five personal values to consider. The Institute of Medicine identifies the following personal values as integral to high-level patient care team success.

  • Honesty: Team members strongly value effective communication within the team. This includes continuous transparency around aims, decisions, uncertainty, and mistakes. Honesty is critical for ongoing improvement and maintaining the necessary mutual trust for a high-functioning team.
  • Discipline: Team members carry out their roles and responsibilities with discipline— even when it seems inconvenient. Similarly, members seek out and share new information to enhance individual and team functioning—despite potential discomfort. This level of discipline allows teams to develop and abide by their standards and protocols while finding ways to improve.
  • Creativity: Team members are excited about the possibility of tackling new or emerging problems in a creative manner. They also view errors and unanticipated negative outcomes as valuable learning opportunities.
  • Humility: Team members recognize differences in training, but do not believe that one type or perspective is superior to another. They also acknowledge that they are human and mistakes are inevitable. A fundamental value of working in a team is the opportunity to rely on each other and help avoid failures—regardless of where they are in the hierarchy.
  • Curiosity: Team members reflect on the lessons learned in their daily activities and use these insights to continuously improve their individual work and the functioning of the team as a whole.

Principles of High-Level Patient Care Teams

After identifying these personal values in colleagues, the NP can move forward with developing a team.

The principles of high-level patient care teams include:

  1. Defined leadership– Effective leaders must facilitate, coach, and model effective communication skills.
  2. Shared goals– All members are involved in defining the team's purpose. This encompasses patient and family goals, as well as shared interest and ownership.
  3. Clear roles– Each team member has a clearly defined expectation of their role, responsibility, and accountability.
  4. Mutual trust and respect– Team members earn each other's trust and respect, allowing for diversity in opinions and continuous open-mindedness in reaching consensus.
  5. Effective communication– High-functioning teams make communication a priority and consistently seek ways to improve these skills among all members.
  6. Measurable processes and outcomes– Team members participate in a timely review and feedback of successes and failures. An impartial review enables process improvement and identifies any educational needs.

Studies show that healthcare teams are associated with the following professional advantages:

  • increased job satisfaction
  • more productivity
  • decreased stress levels
  • enhanced support for inexperienced workers

Creating a "work family" is a key priority for NPs. These tools allow NPs to lead, develop a strong team, and engage in effective communication. Leading to provider longevity, forming high-level patient care teams ultimately saves patients by improving the healthcare workforce.

DNP by 2025? 4 Reasons to Support DNP Entry-to-Practice

The Doctor of Nursing Practice (DNP) is a terminal degree that serves as an add-on program to the Master's of Science in Nursing (MSN). Currently, nurse practitioners (NPs) obtain an MSN and then return to complete a DNP program. As a rigorous degree with an emphasis on clinical expertise and leadership skills, the DNP program culminates with an evidence-based practice project. DNPs are prepared to translate evidence into practice, lead patient care teams, evaluate patient outcomes, and promote system change. There are currently over 300 DNP programs in the U.S. with more than 8,000 DNPs, which represents approximately 1% of NPs in the country. DNP programs strengthen the MSN by providing additional education around evidence-based practice, quality improvement, and systems leadership.

Why the DNP?

The value of the DNP models other health professions that transition to doctoral degrees such as physical therapy (DPT), pharmacy (PharmD), Psychology (PsyD), and Audiology (AudD). Doctoral education prepares today's health professionals for the complexity of modern healthcare due to:

  • The rapid expansion of knowledge underlying practice.
  • Increased complexity of patient care.
  • National concerns about the quality of care and patient safety.
  • Shortages of nursing personnel, which demand a higher level of preparation for leaders who can design and assess care.
  • Limitations of doctorally-prepared nursing faculty.
  • Enhanced educational expectations of other members of the healthcare team.

Proposing Change

In 2018, The National Organization of Nurse Practitioner Faculties (NONPF) committed to assisting all entry-level nurse practitioner (NP) programs with shifting to the DNP by 2025. In other words, the MSN exit point will dissolve and the DNP will become the common endpoint. NONPF emphasizes that the addition of curriculum around evidence-based practice, quality improvement, and systems leadership is critical for modern healthcare.

Since 2002, NONPF has promoted a seamless path for obtaining the DNP. In 2004, the American Academy of Colleges of Nursing (AACN) proposed that the DNP should be the entry-level degree for NPs. However, transitional challenges prevented the accomplishment of this goal. In 2006, NONPF announced plans for completing the transition by 2025.

Challenges to Change

Although support for eliminating the MSN varies across academia, there are more concerns outside of the educational realm. The AACN identifies the following barriers of removing the MSN step:

  • While the MSN continues to be the dominant pathway for APRN entry-into-practice education, there is some limited movement toward replacement with the BSN-to-DNP.
  • Two tracks toward the DNP will remain, as defined by schools' planning horizons: a single-step process (BSN-to-DNP) and two-step process (BSN-to-MSN followed by an MSN-to-DNP at a later date).
  • Requirement of the DNP for certification and accreditation is an important factor in schools' decisions to eliminate the MSN degree.
  • There is no demand for DNP-educated APRNs by employers.
  • Elimination of the MSN raises costs and budgetary concerns for many schools—particularly those that are not freestanding or autonomous.

Supporting the DNP Entry-to-Practice

Despite the difficulties involved in eliminating the MSN and promoting the DNP as an entry-level NP degree, the advantages are undeniable. In addition to ensuring the best quality care for patients, this degree offers the following benefits for the nursing profession:

  1. Higher income potential. DNP-educated NPs earn approximately $7,000 more per year than MSN-educated NPs. Learn more about NP salaries.
  1. More position choices. More education results in an increased amount of choices. DNPs can explore opportunities in nursing education, nurse leadership, and healthcare administration.
  1. Opportunity for advancement. As DNP knowledge and capabilities become increasingly mainstream, hospital networks have begun promoting individuals in this role to advanced positions. In fact, nurses must participate in shared governance to qualify for Magnet Hospital status. The DNP is an important part of this initiative.
  1. Greater job security. The expansion of nursing in today's healthcare system has led to increased recognition around the importance of DNP knowledge in advanced nursing practice, organizational leadership, and healthcare policy. This creates higher job security for the DNP.

In addition to elevating the position to the doctoral level, the universal DNP helps create an equitable environment among NPs, increase wages across the board, and expand professional opportunities. The DNP is not only an advanced practice provider, but a practice change agent as well. While creative change may be a challenge for academia, support from current DNPs and future NPs will propel professionalism and job satisfaction to new heights.

Have You Seen “FAANP” After a Nurse Practitioner’s Credentials and Wondered What It Means?

Inducted as a Fellow of the American Association of Nurse Practitioners (FAANP) in June 2020, Dr. Carol Gullo Mest, PhD., RN, ANP-BC, FAANP is the chair of graduate education at DeSales University in Center Valley, PA. In addition to 35 years of community NP practice, Dr. Gullo Mest’s career accomplishments include developing all of the MSN and DNP programs at DeSales. Dr. Gullo Mest successfully secured over $2.5 million in grants to support nursing students and faculty by starting a simulation program at the university as well as community health programs. She has served on many healthcare-related boards and is an active member of various nurse and nurse practitioner organizations. Her proactiveness has advanced the nursing profession and positively contributed to nursing education and community health. “I’m really a humble person at heart, but I'm at the age where you look back on what you've done and I thought my contributions are something that they're looking for," said Gullo Mest. "I want to be able to continue to contribute even after I retire. By being a fellow, I'll be able to do that."

Being elected as a Fellow of the American Association of Nurse Practitioners (FAANP) is the highest professional designation for a nurse practitioner. In the year 2000, 21 charter fellows vowed to create and support mentorship and leadership programs for nurse practitioners and NP students. This elite group fosters growth and professionalism for NPs. Less than one percent of NPs within the AANP are designated FAANPs.

FAANP Leaders

FAANP leaders make outstanding contributions to NP education, policy, clinical practice, and research. The fellows work toward furthering the NP profession, developing NP leaders of the future, and enhancing the AANP’s mission. Fellows are chosen on an annual basis after a rigorous application review. Currently, 874 fellows out of about 290,000 nurse practitioners serve coveted leadership roles as FAANPs.

RELATED: Six Nurse Practitioner Visionaries You Should Know About

How Do You Become a Fellow?

The process starts with self-assessment. Reflect on your career and ask yourself the following questions:

Am I an AANP Member?

Membership in the AANP governing body is a given. At least two years of membership is necessary for FAANP eligibility.

In My NP Career, Have I Demonstrated Exceptional Contributions?

Candidates must demonstrate contributions and outcomes in two of the following areas: research, clinical practice, education, and policy. Inducted fellows have started and advanced NP programs or participated in and published original studies. Other fellows opened community clinics or contributed to state and federal NP policy to ultimately advance the profession. Expanding NP leadership through company board positions or nonprofit management is also impressive.

How Do I Find a Sponsor?

FAANP membership is conducted via invitation from a current fellow that agrees to serve as a sponsor. NPs research fellow biographies to find one with a similar background and interests. The fellows are then contacted by the NP, who sends a professional letter of interest that incorporates their resume, previous leadership experience, and NP initiatives. A primary sponsor and a secondary sponsor are then secured. If a fellow agrees that the NP's contributions advance the nursing practice, the primary sponsor invites the NP to apply. Secondary sponsors are selected in the same way, but their role is to mentor the applicant throughout the process. If the NP meets the induction criteria, the next step is acceptance for mentorship and sponsorship.

What Do I Submit to The Sponsors?

Finally, NPs provide evidence of their career contributions and outcomes for the profession as a whole. This involves presenting completed research, policy and community health projects, and NP education successes to the sponsors.

What Do NP Fellows Do?

As part of the AANP, fellows work to advance the profession and set the stage for the next generation of NP leaders. The fellows' focus is to:

  • Promote nurse practitioner roles
  • Foster NP research
  • Positively impact healthcare
  • Change NP policy
  • Sponsor a mentorship program
  • Develop a policy education program
  • Share progress with AANP members through a quarterly newsletter, monthly podcasts, and website updates

Reaching New Heights

So when you see "FAANP" as the last NP credentials, you now know that person is a fellow and serves as a leader for nurse practitioners within the AANP. That NP leader positively influenced the practice landscape, educated nurses and NPs, and conducted and disseminated research. Both individually and as a group, the fellows continue to lead and promote NP practice and set an example for those who follow. If you think that you may have made a difference in NP practice, education, or policy, consider reaching out to a sponsor or applying for mentorship. This highest professional designation is worth working towards, as it will simultaneously advance your career and the NP profession.

5 Unexpected Perks of Joining a Professional Nurse Practitioner Organization

Kesha Walton, DNP, RN, FNP-C is a practicing family nurse practitioner who also serves as an officer in an NP professional organization. During a recent meeting, the members discussed the noticeable decline in membership. This conversation alerted Dr. Walton to a professional concern and sparked an idea for her DNP evidence-based capstone project. Research for the capstone project revealed the following reasons for low participation in NP professional organizations:

  • Personal and professional time constraints
  • Cost of membership
  • Working too much
  • Lack of understanding around the nature of the organization

Are any of these reasons keeping you from joining an NP professional organization?

What Is a Nurse Practitioner Organization?

While many organizations exist, the national group that represents all NPs is the American Association of Nurse Practitioners (AANP). The AANP charges one affordable annual membership fee that connects the NP to one of eleven regions. Each AANP region has their own regional director and state representatives. Many other specialty NP organizations exist in conjunction with the AANP. All professional organizations share similar benefits:

  • The ability to enjoy discounts on education and board certifications
  • Access to practice and career support services
  • The opportunity to engage in political advocacy
  • The chance to collaborate through networking events

Acknowledging the professional expectation of membership, many NPs will pay the membership fee and take advantage of a few discounts and services. Identifying the unique value that you offer the organization is critical to accessing additional perks that are only known by those who participate in the group. NPs who are willing to actively engage in the organization are able to experience these unforeseen benefits.

Top Perks of Joining a Nurse Practitioner Organization

1. Discover a New Arena to Demonstrate Skills and Expertise

Finding like-minded professionals to support NP efforts and exchange ideas about current and future healthcare challenges is the key to staying engaged in your patient care practice. Taking an active role in subgroups of a professional organization showcases your value and unique perspective.

2. Increase Your Social Acumen

Social acumen refers to making the most of every moment you have with others. This means becoming comfortable with the "meet and greet" moments and other social rituals we use to connect with each other. You will develop a sense of confidence in making your first impression, which is critical to establishing memorable relationships and serving as a notable presence in the organization.

3. Find New Resources and Best Practices

Expanding your network of NPs and healthcare leaders will expose you to creative changes in your own environment. NPs who are excited to share novel projects, initiatives, and successes with their networks are a great source of support for making positive adjustments in your own practice.

4. Discover New Career Directions or Make a Job Change

A shared environment is a great place to hear what other NPs are doing, learn about jobs, and let others know that you are interested in new opportunities. Policy is a critical element of nursing. As the highest employment group in healthcare, it's important that nursing has representation in the government to guide lawmakers in patient protection and healthcare law. Ask to represent NPs on national committees or take part in research and data gathering to help legislators advance the NP role. You can also consider taking part in the Multi-state Reimbursement Alliance, an organization that tackles NP insurance reimbursement and credentialing. Additionally, the field of healthcare informatics requires educated professional users to participate in discussions about future needs and patient protection in the current internet age.

RELATED: Tips and Tricks for Nurse Practitioner Networking

5. Gain Recognition for Your Accomplishments

Many professional organizations offer fellowships and mentorship connections, which showcase accomplishments and guide industry contributions. Review award nominations and set professional goals for future consideration. Inform other NPs that you're interested in the awards and adding to NP professional contributions. Speak up and never apologize for it – NPs are educated, communicative leaders who deserve recognition for their accomplishments. Your success will inspire others, leading to future mentorship and a respected position in healthcare.

The Bottom Line: Become an Active Member of Your NP Organization

Joining a professional group offers an opportunity to develop relationships, share ideas, and expand your network. Being an active member provides you with a venue to maximize your strengths and improve on weaknesses. Active membership is about more than paying an annual fee and taking advantage of a few discounts. Consider investigating current policy initiatives and notifying members through emails or phone calls. You can also write articles for the organization's blog, suggest ways to increase membership, or participate in different committees. When people see your work, they will have a better idea about your competence and reliability—two aspects of NP life that are highly trusted and valued. Active membership allows you to gain recognition for your contributions, which ultimately leads to personal and professional growth.

RELATED: A 7 Step Health Policy Toolkit to Flex Your Political Muscle as a Nurse Practitioner

Six Nurse Practitioner Visionaries You Should Know About

Most nurse practitioners can recall the reason that they decided to advance their nursing practice and pursue advanced practice degrees. Whether it's experiencing the individual care of a gifted NP or witnessing a talented NP interact with a team of healthcare professionals, the impact that an NP leaves behind is truly magical and career-changing. In this current healthcare environment, it's especially important to remind ourselves of the talent surrounding us. Keep reading about these six nurse practitioner visionaries to boost your inspiration!

1. The Original Visionary

Loretta Ford, EdD, PNP, FAAN was the first nurse practitioner and founder of the nurse practitioner model and training program. In the 1960s, Dr. Ford recognized how a shortage of primary care physicians was affecting the care of families and children. Partnering with pediatrician Dr. Barry Silver, she began a nurse training program to extend care to these populations. Inducted into the List of Living Legends by the American Academy of Nursing and the National Women's Hall of Fame, Dr. Ford successfully transformed the nursing profession and made healthcare more accessible to the general public. Dr. Ford educated a variety of nurses and nurse practitioners, authored over 100 publications, and lectured and consulted across the country.

2. The Health Care Visionary

Courtney Vose, DNP, MBA, RN, APRN, NEA-BC is the Vice President and Chief Nursing Officer of Nursing and Patient Care Services at New York-Presbyterian (NYP)/Columbia University Medical Center, NYP/Allen and the NYP/Ambulatory Care Network. She is also a clinical instructor at the Columbia University School of Nursing. As a result of her transformational leadership, NYP/Columbia University Irving Medical Center achieved Magnet recognition from the American Nurses Credentialing Center. Magnet achievement honors the highest levels of nursing excellence and professionalism. Dr. Vose has co-authored many research studies related to nursing care and processes. She recently conducted research on the emotional toll of COVID-19 on health care workers and is advocating for frontline worker loan forgiveness. Serving as an ongoing champion for nurses and patients, Dr. Vose is an exemplary leader.

RELATED: Is Full Practitioner Authority Here to Stay? How COVID-19 is Advancing the Future of Nurse Practitioner Practice

3. The Nursing Informatics Visionary

Christopher Caulfield RN, NP-C, MSN is a nurse practitioner and the co-founder of IntelyCare, an on-demand mobile healthcare staffing company for post-acute facilities across the U.S. While working as a nurse administrator, he identified sources of nursing burnout and staffing challenges. He co-founded Intelycare to address these issues while highlighting the importance of nursing informatics in modern health care. Based in Massachusetts, IntelyCare helps facilities reduce nurse burnout, streamline administration, and improve overall care. It also provides nurses and nursing assistants with flexible shift scheduling, in-app education, and support to optimize patient care.

4. The Holistic Care Visionary

Herline Raphael, MSN, AG-NPC, CPCA is a holistic care nurse practitioner in Pennsylvania. Herline began her work in global care by founding Helping Hands and Beyond, a volunteer organization that offers aid to impoverished world populations. The organization has completed over 30 mission trips, supporting thousands of people in Haiti, Grenada, and the hurricane-struck Bahamas islands. Helping Hands and Beyond has built several clinics, as well as a girls’ orphanage in Haiti. As a nurse practitioner, Herline continues to serve her mission of providing healing and holistic care in her practice. BIX Homes and Wellness is a family-centered medical health and wellness center that combines east and west treatment modalities for all life stages. The center also offers disease management and coping and transition support programs that guide patients and families through illnesses, home care transitions, and health education. Herline's view of holistic care includes all aspects of patient life—physical and spiritual health, and family and social life.

5. The NP Education Visionary

Michael E. Zychowicz, DNP, ANP, ONP, FAAN, FAANP is an award-winning NP professor at the Duke University School of Nursing and the Director of the Duke-Durham VA Academic Partnership. Dual-certified in acute care and orthopedics, he leads the only Orthopedic NP specialty program in the U.S. Dr. Zychowicz is an active board member and the current treasurer of the National Organization of Nurse Practitioner Faculties, an organization driving nurse practitioner education. He was selected as a Fellow of the American Academy of Nursing in 2013 and the American Academy of Nurse Practitioners in 2007. He has edited several books, remains active in research, and frequently lectures at conferences. Dr. Zychowicz serves as a progressive educator for NPs on the cusp of change in the current U.S. healthcare climate.

RELATED: Guide to Enrolling in an Online Nurse Practitioner Program

6. The Political Visionary

Congresswoman Lauren Underwood (D), RN, MSN/MPH serves Illinois' 14th district, which encompasses the north and west suburbs of Chicago. Congresswoman Underwood is the first woman, a person of color, and a millennial to represent her community in Congress. She is also the youngest black woman to serve in the United States House of Representatives. President Obama appointed this health care and political champion as the disaster preparedness Senior Advisor for the US Department of Health and Human Services (HHA). Through her work with the HHS, she helped implement the Affordable Care Act and contributed to the new focus on quality and value in U.S. healthcare. She also educated nurse practitioners through Georgetown's online NP program.

RELATED: A 7 Step Health Policy Toolkit to Flex Your Political Muscle as a Nurse Practitioner

These non-conformist advanced practice nurses demonstrate strength, innovative action, and growth. We should continue to look to them as a source of inspiration for leading healthcare in a positive direction. Consistently included as a part of the most trusted profession, NPs have successfully advanced education, professionalism, and public support to implement change. Do you know an NP who inspires you?

The Personality Pandemic: Managing 6 Common Character Traits During COVID-19

Throughout this strange time of COVID-19, we encounter many personalities. The public has several ways of obtaining information about the virus including detection, prevention, and death rates. The frustration of quarantine, coupled with parents acting as teachers while working remotely, creates entirely new levels of stress. We are living outside of the norm, which can result in amplified shifts in personality traits. Amid all of these changes, NPs continue to be relied on for treating and counseling patients. Both in the office and on the street, NPs share advice and answer questions about the virus as the public strives to return to normalcy in their personal and professional lives.

RELATED: Is Full Practice Authority Here to Stay? How COVID-19 is Advancing the Future of Nurse Practitioner Practice

How Nurse Practitioners Can Approach 6 Different Patient Personality Types

It’s essential to first understand the different types of personalities to properly handle them, while simultaneously providing sound information to calm the madness. You don't need to be a psychiatric-mental health NP to communicate effectively with different patient personalities. The following six personality types are common across patients and the public. As nurse practitioners are often asked to weigh in on COVID-19, these personalities should be carefully considered when doing so.

1. Reframe Public Guidance For the Rebel

Rebels do what they want to do when they want to do it and typically resist taking direction from authority. For instance, the rebel will likely not agree to wear a mask or practice social distancing. It's important to remind rebels what they want and how their actions affect them. Rebels are concerned about being true to themselves, and they can embrace a habit if they view it as a way to express their identity. The rebel might agree to wear a mask if they realize that it will keep them healthy and give them control over not infecting anyone else.

2. Have Fun With the Narcissist, But At a Distance

The narcissist cannot think communally, lacks empathy, and thinks that he or she is exempt from COVID-19 restrictions. Educating the narcissist, and asking this personality type to be considerate of others will not be successful. However, continually pointing to scientific facts might persuade the narcissist. Despite being fun and dynamic people, it's best to avoid narcissists as they can be dangerous to your health!

3. Be Creative With the Exasperated

Exasperated people are fed up with restrictions and mask requirements. They don’t want to talk about COVID-19 anymore and seek to break social standards. This exhausted and wary group needs adequate education about restrictions to be delivered in brief and simple terms. They also require proof of how the limits are helping to reduce the spread of the pandemic. Aim to make mask-wearing fashionable, and explain to them that they are helping the community by following social guidelines.

4. Share With the Social Media Blabber

The social media blabber is receiving most of their information from social media outlets such as Facebook and Instagram. This group needs a dedicated page for daily readable updates. Providing positive and hopeful data is helpful to the social media blabber (and their followers).

5. Save Your Energy For the Overwhelmed

Individuals who are overwhelmed feel anxious about breaking free from quarantine restrictions. They only talk about the worst-case scenarios of COVID-19 and have difficulty recognizing that 90% of patients recover with mild to moderate illness. This group needs one-on-one conversations and frequent updates about the spread of the virus, including when safe vaccines are available and progress on treatment.

6. Prepare to Correct the Conspiracy Theorist

According to a June poll, approximately 25% of Americans believe that there is some element of conspiracy associated with COVID-19. The infodemic includes a group of educated “Front Line Doctors” touting that there's a secret cure for COVID, protest public mask-wearing, and fight for an open economy. With the help of social media, a documentary by a shamed virologist called Plandemic reached millions of people. Even celebrities message their followers who question the science. It is easy to spread misinformation and difficult to correct it with ever-changing scientific data.

The Bottom Line

For all of these groups, open-ended questions and active listening techniques are key to easing anxiety, stopping the spread of unreliable information, and creating a trusted relationship between you and the public. Share reliable and up-to-date information with patients and the community members using public and scientific data. Show interest in their changing lifestyles and offer personal anecdotes. It's important for providers to avoid letting patients lose sight of current health problems and openly discuss concerns about the pandemic. This includes the possibilities of depression, poor coping mechanisms, and unsafe living conditions.

Information around COVID-19 changes every day. Therefore, it's crucial to present patients with the latest data and convey it with a sense of professionalism and unwavering confidence. The best websites for up-to-date information and patient-friendly resources include the Centers for Disease Control and Prevention (CDC) COVID-19 Information page and the Johns Hopkins Coronavirus Resource Center.

Is the DNP Worth It? Four Reasons Why Nurse Practitioners May Feel Cautious

Nurse practitioners who earn the Doctor of Nursing Practice (DNP) are exceptional nurse leaders who are well-prepared to translate research evidence into clinical practice, serve patients at the highest level, and ultimately improve patient outcomes. Many NPs do not pursue the DNP after the already high level of hard work involved in MSN programs and NP certifications, which are often completed while working as registered nurses.

In 2004, the American Association of Colleges of Nursing (AACN) announced the endorsement to change the minimum level of NP education from the MSN to the DNP over the next decade. Since then, there has been a great deal of debate around the revision. Why? Because nursing is historically complicated. There are multiple avenues of entry into the nursing field, as well as numerous attempts to fix the issue. The efforts to solve these nursing education challenges can vary, depending on the current need for nurses. This is why the DNP terminal degree caused turmoil when it first appeared. A doctoral degree, which differs from a Ph.D., complicated nursing even further. Nursing and medical communities questioned how this new path in NP education would support health care.

DNP Controversy: Why Are Some NPs Apprehensive?

As in any profession, some individuals welcome change while others challenge it. Conformist NPs chased the DNP without question, embracing the AACN's decision to advance nursing and healthcare. After all, there is a certain thrill to completing an evidence-based project and making a difference in healthcare. To the conformist, the benefits of obtaining the DNP are clear. This NP group appreciates the overview of healthcare, which was absent before the DNP. The holistic view of the DNP sparked its success.

Conversely, rebellious NPs questioned the benefits of earning the DNP. While they are not against additional education, the idea of another degree seemed drastic. A rebellious NP's questions include:

Is the DNP Expensive?

The average cost of an accredited, online DNP program is around $30,000 – though this can vary widely due to school, program type/specialization, and other factors. After paying for a BSN and MSN, some NPs find it difficult to add another educational expense. However, many apply for tuition reimbursement and scholarships.

NPs can also apply for the Johnson and Johnson/AACN Minority Nurse Faculty Scholars program, which aims to simultaneously increase the amount of diversity and nursing faculty to address nurse faculty shortages. Additionally, federal and income loan forgiveness programs are available for those who have completed the DNP.

Is DNP Salary Higher than MSN Salary?

Unfortunately, the DNP does not automatically result in higher salaries compared to NPs with MSN degrees. There are just too many other factors that determine pay for nurse practitioners, and degree level is just one of them.

However, according to a 2018 national salary survey, NPs with a doctoral degree earned $7,000 more than Master's-prepared NPs and men commanded higher salaries than their female NP colleagues. Therefore, contract negotiation is a critical skill to have. It is imperative that nurse practitioners proudly declare satisfaction with their DNP and share how it can benefit the practice and patients to support why DNP-educated NPs deserve a higher pay grade.

RELATED: Nurse Practitioner Salary Guide

Will the DNP Advance My Clinical Role?

If you plan to transition to leadership, the DNP is beneficial. DNP-prepared NPs can teach in undergraduate and graduate nursing programs, manage education teams, and lead provider teams in guideline development. In other words, the DNP degree can open doors to just about any area of nurse practitioner employment, whether it's bedside care, higher education, or behind-the-scenes administrative roles.

Will I Be Called "Doctor"?

The use of "doctor" when referring to NPs remains an ongoing debate. Some states such as Arizona and Delaware forbid the use of "doctor" for nurses, pharmacists, or other doctorally-prepared professions unless they immediately clarify their role. Other states allow DNPs to use "doctor" if they are not in a clinical setting. For instance, nursing faculty and administrative DNPs are free to use the term. Nurse practitioners often refrain from introducing themselves as "doctor" if management explains that patients are confused about their role. For now, it's best to follow state and facility rules about the title.

RELATED: NP Practice Authority

DNPs and the Future of Advanced Practice Nursing

Despite the existence of these issues, there is power in numbers. More than 290,000 NPs in the U.S. contribute to the largest healthcare workforce in the country. This volume of NPs can represent and advance the nursing profession, but it's critical to maintain consistency in earning the highest terminal degree for all. A skilled DNP-educated population is a key to changing health outcomes in the U.S. The DNP is a significant commitment of time and money but as clinical and leadership skills expand, upward mobility and earning potential increase with it. In 2018, The National Organization of Nurse Practitioner Faculty (NONPF) committed to moving all entry-level NP education to the DNP by 2025. This initiative prevents NP education from ending at the MSN and promises doctoral education for all NPs. While the next generation of NPs will not debate the value of the DNP, it's important for current NPs to support higher pay, clinical advancement, and respect from other healthcare professionals for this achievement.

A 7 Step Health Policy Toolkit to Flex Your Political Muscle as a Nurse Practitioner

Gail Adcock, MSN, FNP, FAANP, FAAN, and North Carolina state representative, describes herself as "a nurse by grace, a North Carolinian by choice, and a politician by necessity.” Representative Adcock is a nurse practitioner and the Chief Health Officer for a global data analytics company. Despite her busy professional and personal life, Representative Adcock made time to respond to an important call to action.

Per the 2011 Institute of Medicine report "The Future of Nursing: Leading Change, Advancing Health," the call to action is: "Nurses must see policy as something they can shape rather than something that happens to them." This report outlines the vital role, power, and influence of NPs and nurses in the healthcare system.

Why Aren't There More Nurse Practitioners in Political Positions?

The answer is that politics is definitely out of their comfort zone. Busy NPs are often unfamiliar with and intimidated by the political process. However, as patient care champions, NPs also offer a unique view of community and health care needs. Nurse practitioner qualities that translate to health policy include the following:

  • Nurse practitioners advocate. Nurse practitioners advocate for patients on a daily basis and advocating health policy and legislation is equally important. An upstream approach to advanced practice, nursing, and health care issues impact communities and patients on a broader scale.
  • Nurse practitioners vote. 89% of NPs vote in national elections, compared to just 69% of the US population (O'Rourke, et al., 2017). Therefore, it's important to encourage both your NP and nurse colleagues to vote.
  • Nurse practitioners and nurses are the most trusted profession. For nearly 20 years, Americans have rated nurses as the most trusted professionals. And why wouldn't you want somebody you can trust in office? Honesty and integrity are important assets for holding leadership positions in both community organizations and public office.
  • Nurse practitioners are part of the largest sector of the U.S. healthcare workforce. Over 3 million NPs and nurses provide direct care to patients and communities. Nurse practitioners administer care in patient homes, neighborhoods, and health networks, and identify social and healthcare needs in a unique way that is unlike any other health profession.

How Can Nurse Practitioners Respond to This Call to Action?

NPs need to expand outside of their comfort zone, discover their collective voice, spark others, take interest in the legislative process, and translate the patient care experience into action. Remember that it's okay to start small! This seven-step health policy toolkit serves as an NP blueprint for health policy involvement.

1. Learn About the Political Process of Local and State Governments

Investigate local governments and governing bodies in your town and community. Next, learn how laws are introduced and passed in your state. You can find this information through state legislation websites. These websites also allow for bill searches using specific keywords. Search for "nursing" or "health care" to stay up-to-date!

2. Vote

There is strength in numbers for NPs and nurses, and this political strength begins with voting! Aim to include health care policies in your legislative decisions, and discuss these policies with your NP and nurse colleagues.

3. Join Nursing Organizations and Find a Mentor in the Advocacy Group

Professional nursing organizations have expanded from education and certification resource centers to include political advocacy groups. The American Nurses Association (ANA), National Council of State Boards of Nursing (NCSBN), and Campaign for Action are some state and national nursing organizations that offer health policy guidance. Additionally, NP organizations such as the Gerontological Advanced Practice Nurses Association (GNPA) offer health policy resources that are applicable to the specialty NP group.

4. Seek Nursing Leadership Positions

Advancing nurse practitioner responsibilities beyond patient care into policy builds increased public confidence in the NP role and demonstrates that nurse practitioners are educated, trusted, and reliable leaders.

5. Participate in Community Groups

As health professionals, gaining NP input on Parent Teacher Associations, support groups, and fitness and nutrition groups is beneficial. Nurse practitioners can contribute health and safety strategies, assess community needs, and offer valuable health and illness-related guidance.

6. Identify a Bill That You Are Passionate About and Write to Your Legislator for Support

Nurse practitioners are valuable constituents due to their close proximity to stakeholders and community needs. Search your state government website for health care bills, and then research local politicians to ask for support. An NP letter template can be found here. In your letter, mention your community and how the bill impacts your patients.

7. Apply for a Health Policy Fellowship

Distinguished programs developed through organizations like the American Association of Colleges of Nursing, National Academy of Medicine, and Robert Wood Johnson Foundation seek nurse practitioner leaders to participate in national policy development. As NPs evolve into policy leaders, these fellowships provide a stepping stone into health policy development positions.

READ MORE: Nurse Practitioner Practice Authority

Nurse practitioners can answer this call to action in various ways, and every little bit helps! By following the simple actions included in the toolkit, even the busiest NPs can begin the path to understanding and participating in health policy.

Are You Stressed About Negotiating Your NP Contract? Follow These Four Steps to Success

Whether you're a newly graduated nurse practitioner or an experienced NP, contract negotiation can be intimidating to even the most confident people. Poor salary negotiation doesn't only affect you – it reflects on our profession and sets a precedent for NPs interviewing behind you. If you accept less, then the NPs below you will be offered less as well.

Why Is Contract Negotiation Difficult for NPs?

Negotiating goes against a nurse's nature. The best qualities of nurses – caring and empathy – work against us during negotiation. Place these traits aside and bring your communication capabilities, attention to detail, and leadership skills to the forefront.

There is a gender gap in negotiating. Men earn almost 25% more money than women because they negotiate more aggressively. Traditional gender roles and the nature of nursing ultimately compound the gender gap. Nurses – and women in general – are often expected to be accommodating, considerate of others, and relationship-oriented. These traits can make it difficult for women to be assertive negotiators. In contrast, the societal expectation of male nurses – and men in general – involves a competitive, profit-oriented, and aggressive personality. As a result, men are more comfortable negotiating pay and benefits.

Nurse practitioners are more needed and valued than ever! According to the 2011 Institute of Medicine report "The Future of Nursing: Leading Change, Advancing Health," NPs will lead the country in caring for aging baby boomers, serve as champions in primary care, and continue to be a part of the largest health care workforce in the U.S. A fair salary is essential to reflect the value of NPs, and reasonable salary negotiations benefit the profession as a whole.

Confidently Negotiate Your Contract by Following These Four Steps

1. Prepare For the Conversation

a. Research NP salaries. In the U.S., this can vary by location and hospital network. An online search can help, but the best resources will be your NP peers. Call previous clinical preceptors or ask professors what salary to expect after graduation.

b. Gather background information about the practice. What is the community and patient population? How many physicians and providers are in the practice?

c. Practice confidence! Perfect your body language by sitting up straight and avoiding fidgeting. Keep your tone of voice pleasant and maintain eye contact throughout the conversation.

2. Say No To The First Offer

If the first salary offer seems below average or is not where you’d hoped it would be, it may be a low-ball number. So how do you know what to counter offer?

a. Aim to add at least 10% to the initial proposal. It’s also a good idea to research the market rate for the position in your area, taking into account your education and experience level, and calculate your counter offer accordingly.

b. Be prepared with reasons as to why you are requesting more. Do you hold additional credentials or certifications? Do you have extensive niche experience? If an employer wants to know why you are counter-offering with a higher salary figure, be sure to highlight why you are worth it.

3. Annual Salary Isn't the Only Consideration – Be Prepared to Address Additional Perks

a. Negotiate orientation time – An appropriate mentored orientation time – especially for a new graduate – is three to six months. Make sure to include this orientation time in the contract, as informally-discussed orientation times can end up shorter than agreed upon.

b. Are you taking after-hours calls? Get paid for it. In some practices, after-hours and weekend call time is a regular part of employment. Expect additional pay for on-call hours.

c. Negotiate your contract yearly. It's not unusual for an employment agreement to automatically renew annually. Holding a yearly review of your work and a discussion for new contract terms is standard and allows you to renegotiate salary and other contract terms.

d. Remove any restrictive covenants. A restrictive covenant (or a non-compete clause) is set to prevent you from working within a specific area (usually within 25 miles) of the practice and can be in place for one to five years after your employment ends. Never agree to sign a contract with a restrictive covenant. These restrictions force NPs to move or commute long distances and if you leave the organization for any reason, the restrictive covenant still stands.

e. Termination. Both parties should share the same terms to end the employment agreement. Health care providers give three months notice when they resign and conversely, the practice should be required to provide the NP with the same three months notice of termination. It takes 90 days or more to find another job and complete the credentialing process.

f. Negotiate a bonus. It is possible to receive an annual bonus based on performance and practice success. Sometimes, Relative Value Units (RVU) determine bonus pay. RVU, used by insurance companies to pay providers, is based on the extent of the provider's work, necessary resources, and expertise in providing patient care. Physician partners receive year-end rewards and so should you!

4. Sleep On It

Don't give an immediate answer. Take at least a day to consider the proposal and decide if the job and contract detail is right for you.

Negotiating the right contract delivers professional satisfaction and respect from practice management, which ultimately benefits the NP profession. Never be afraid to get out of your comfort zone and negotiate!

Conquer Uniqueness: 5 Novel Ways to Educate Yourself and Expand Your Advanced Practice Nursing Career

You're an experienced nurse practitioner (NP) who meets all the standards: inquisitive, analytical, compassionate, communicative, and a strong leader. You're the NP whom others look to for clinical advice, and have autonomy and respect in your field. However, you know that there is more to your advanced practice role than this and you just can't shake that nagging feeling that you haven't mastered it all. Does this sound familiar? Explore the following opportunities to find additional value in your NP role.

1. Explore New Areas of Expertise

Have you ever dabbled in areas outside of the traditional NP practice? Here are some new areas of expertise that can broaden your scope and give you the opportunity to leverage valuable skills:

Do you love travel and adventure? Consider a career as a foreign affairs NP. These federal government positions care for United States citizens and their families serving abroad – typically in remote countries. Foreign affairs NPs relocate every two to four years. After all, there's no better education than real-world experience!

Explore medical writing as a potential career. Medical writers prepare continuing education, contribute to professional articles, and provide health literacy content throughout the industry. You can learn more about medical writing (and editing) here.

Are you the nurse practitioner who answers clinical questions for staff and orients all of the new practitioners? Harness that valuable skill set and pursue a nurse practitioner educator role. These highly communicative nurse practitioners are often sought after to educate future nurses and nurse practitioners within universities, hospitals, and medical device/pharmaceutical companies.

Like flexibility and no commute? Try telemedicine. Serving as a significant growth area during the past 10 years, telemedicine is now more popular than ever! Telemedicine connects remote patients and providers through the use of medical electronics and video or telephone communication. If you don't have access to telemedicine in your practice, consider becoming the telemedicine point person and start offering increased flexibility for patients and bringing more creative revenue to the practice.

Advanced nurse practitioner education and experience is a solid foundation for legal nurse consulting. Legal nurse consultants (LNC) require strong knowledge about the legal system, as the role involves reviewing medical records, health care timelines, and organizational policies and procedures. The LNC is a valuable team member in hospitals, law firms, and court systems.

2. Become a Political Advocate for Nurse Practitioners and Nursing

Nurse practitioners are crucial to transforming health policies and creating an environment for independent practice and professional advocacy. Despite having the trust of the public, advanced education, and professional standing, nurse practitioners often underestimate their political power. Ryan & Rosenberg (2015) explain how nurse practitioners can maximize their political influence and be a voice for change. Visit the advocacy pages of state nursing and nurse practitioner associations such as the American Association of Nurse Practitioner (AANP) advocacy page to learn about the latest political goals and how you can help advance both the NP practice and your leadership career.

RELATED: A 7 Step Health Policy Toolkit to Flex Your Political Muscle as a Nurse Practitioner

3. Obtain Additional Certifications in Your Field

Nurse practitioners can obtain specialty certifications outside of their population focus to advance their practice in specialized areas. There are specialty certifications in emergency medicine, orthopedics, palliative care, oncology, dermatology, nephrology, and cardiology. Many certifications require a certain number of clinical hours, in addition to continuing education and testing.

4. Pursue an Additional Post-Master's Certificate

To maximize your career variability, consider an additional post masters certificate outside of your population focus. You can choose to cross over to a different specialty or add to your population focus. For instance, family NPs may consider the psychiatric nurse practitioner realm, or acute care NPs might want to add a pediatric NP role to their resume. If you are interested in health care business management, a Master's in Business Administration (MBA) or Master's in Health Administration (MHA) are good options. A newly popular choice, the health informatics master's program, focuses on nursing electronic systems support, management, and data monitoring.

5. Participate in Continuing Education in a New Way

While on-site conferences are a traditional way to learn new skills and collaborate with colleagues, they are also expensive and the associated travel is typically not conducive to the busy lives of NPs. Luckily, there are many online webinars and conferences available to NPs for continuing education credit.

Other alternative ways to participate in continuing education include:

  • Podcasts offer continuing education credits
  • Portable education
  • Searchable subjects of interest
  • Doximity– read peer-reviewed articles and your continuing education credits are tracked and easily uploaded
  • Publish articles
  • Present at web conferences

Innovative NP education provides unique clinical experiences, fosters leadership, and expands our world view. Combining traditional education with unique clinical experiences expands an individual's NP career, and provides an upstream view of health care and the world. Contribute, be creative, and continuously meet your personal and professional goals!