The Evolving Role of Nurse Practitioners: Advancing Patient Care and Bridging the Gap in Healthcare

The Evolving Role of Nurse Practitioners: Advancing Patient Care and Bridging the Gap in Healthcare

Posted on July 25, 2023 | by Michelle Woo, MPH, MS, BSN, RN | Leave a Comment

Nurse practitioners (NPs) play a dynamic and ever-expanding role in the healthcare landscape. With a combination of advanced clinical skills and a holistic approach to patient care, nurse practitioners are transforming healthcare delivery and bridging the gap in access to quality medical services. In this article, we will explore the evolving role of nurse practitioners, their impact on advancing patient care, and how they are filling crucial healthcare needs to create a healthier future for all.

From Pioneers to Mainstream Providers

The role of nurse practitioners traces back to the mid-1960s when the first NP program was established. Since then, nurse practitioners have continued to grow in number and gain recognition as valuable members of the healthcare team. Originally envisioned as a solution to the shortage of primary care physicians, NPs have now become mainstream providers with diverse specializations.

Today, nurse practitioners are found in various healthcare settings, including primary care clinics, hospitals, community health centers, schools, and specialty practices. Their unique blend of clinical expertise and patient-centered approach has made them highly sought-after providers, especially in underserved areas.

Advancing Patient-Centered Care

One of the most significant contributions of nurse practitioners is their commitment to patient-centered care. With a focus on building strong patient-provider relationships, NPs take the time to understand patients’ unique healthcare needs, values, and preferences. This personalized approach allows nurse practitioners to develop comprehensive care plans that consider not just the physical aspects of health but also the emotional and social well-being of patients.

By promoting open communication and shared decision-making, nurse practitioners empower patients to actively participate in their healthcare journey. This patient-centered approach has been shown to improve patient satisfaction, treatment adherence, and overall health outcomes.

Filling the Gap in Primary Care

In many parts of the world, there is a shortage of primary care providers, especially in rural and underserved areas. Nurse practitioners have stepped in to fill this crucial gap, delivering essential primary care services to patients of all ages. With their ability to diagnose and treat a wide range of common acute and chronic conditions, NPs have become the go-to providers for many individuals seeking timely and accessible healthcare.

Moreover, nurse practitioners often collaborate with physicians and other healthcare professionals to create integrated and comprehensive care teams. This collaborative model not only ensures that patients receive the best possible care but also maximizes the efficient use of healthcare resources.

Specializations Expanding Possibilities

While nurse practitioners have traditionally focused on primary care, the field has expanded to include a wide array of specializations. NPs can now pursue advanced education and training in family practice, pediatrics, women’s health, gerontology, mental health, and acute care.

This diversification of specialties allows nurse practitioners to align their careers with their passions and interests, making their roles even more fulfilling and impactful. Specialized NPs bring focused expertise to specific patient populations, contributing to improved health outcomes and tailored care plans.

Advocates for Preventive Care and Health Promotion

As advocates for preventive care and health promotion, nurse practitioners actively promote healthy lifestyle choices and disease prevention strategies. By educating patients on preventive measures, such as vaccinations, regular health screenings, and healthy eating habits, NPs work to reduce the burden of chronic illnesses and improve overall population health.

Furthermore, nurse practitioners are instrumental in community health initiatives, engaging in health education programs and outreach activities. Their dedication to preventive care underscores the importance of proactive healthcare measures and empowers individuals to take charge of their well-being.

Conclusion

The evolving role of nurse practitioners in advancing patient care and bridging the gap in healthcare is a testament to their dedication, expertise, and commitment to improving lives. With a focus on patient-centered care, preventive health, and expanding specialization possibilities, nurse practitioners have become invaluable assets in the healthcare system.

As the demand for accessible and high-quality healthcare grows, nurse practitioners will continue to be at the forefront of healthcare innovation, ensuring that patients receive the care they need, when they need it. Their passion for patient advocacy and dedication to lifelong learning position them as leaders in transforming healthcare delivery and creating a healthier future for all.

Dear NP Student, From a New Grad NP: Study Tips

Posted on November 13, 2020 | by Michelle Woo, MPH, MS, BSN, RN | Leave a Comment

Whether you are an undergraduate, new graduate, or a seasoned nurse, entering a nurse practitioner (NP) program is an exciting time. However, it can also be a stressful one. In fact, you may discover that NP school will be one of the most difficult academic endeavors you experience. At the end of the day, any advanced practice health provider role requires a great deal of studying and the ability to put complex material into practice.

Despite being a full-time graduate student who was no stranger to hard work, I still remember the stress of my first semester. Luckily, my program provided some insightful resources that helped me recognize the importance of learning how to study to achieve success. Based on my experience, here are some useful strategies for new NP students.

5 Tips for Didactic Study

Most NP programs will begin with one to two semesters of didactics. This means that there are no clinical rotations just yet. Whether they are enrolled part-time or full-time, students will juggle two to three classes at a time. Here are my five tips for success during didactic semesters.

1. Time Management

Prior to beginning the program, reflect on when and where you study best. Also, understand that you need a resting period. Someone once told me that graduate school is like a job and it should be treated like one. When working as a nurse, consider a per diem or part-time schedule to help ease the transition into NP school. Remember that graduate school is not like undergraduate work.

2. Invest In a Tablet

If you have the funds (and that is a big if), a tablet can boost efficiency. You can write, type, download notes, and more, and it is highly portable. While it's not a necessity, having a tablet was beneficial throughout my entire graduate experience.

3. Student-Life Balance

You will likely hear that NP students "have no life." While I had to learn to say no to certain social events, I also knew that life existed outside of school. I would typically study from 8AM to 5PM every day including weekends, reserving evenings for time with family and friends.

4. Know Your Study Style

There is an overwhelming amount of material that NP students are expected to learn. In addition to adjusting to the transition of graduate student life, you're also required to maintain certain grades to stay in the program. My recommendation is to know your study style. Louisiana State University has a great resource with surveys to help you determine your best study methods.

5. Know the Course's Objectives

This is something that I wish I knew sooner. The course's objectives offer incredible insight into what students should focus on when studying. Most of these objectives align with the necessary knowledge for boards. Therefore, be sure to review them in the course syllabi and weekly modules.

Clinical Rotation Study Tips

When you enter the clinical rotations phase, it's important to factor in travel time and patient entries as well as other additional assignments. Both can be time-consuming. Here are some tips to study effectively.

1. Listen to Relevant Podcasts

I often played medical podcasts in the car while driving home. As a Family Nurse Practitioner student, my favorites were American Family Physicians and The CurbSiders Internal Medicine. Many of my colleagues purchased MP3s from multiple board review sources such as APEA and Fitzgerald.

2. Learn in Rotations

Rotations offer an opportunity to apply didactic knowledge in hands-on situations. From suturing cysts to pelvic exams, it's critical to advocate for your participation. Learn how to assess for abnormalities while allowing preceptors to educate you. You will utilize these skills when practicing professionally.

3. Review Material

If there is material that you're unfamiliar with as a student, take the time to review it and gain an understanding of differentials and treatment plans. Even after graduating, it's crucial to become accustomed to reviewing and staying updated on current guidelines for treatment and preventive care. Making this a habit during rotations is important for doing well in clinicals and achieving long-term professional success.

Becoming an NP is a path that can only be understood by those who have experienced it. As a new graduate, I can empathize with the difficult transition to student life and working to pass exams every semester. I hope that new students can learn from my experience and utilize my tips. The journey is tough, but ultimately it is a rewarding one.

Securing Nurse Practitioner Preceptors: Why Are Some Schools and Students Paying for the Privilege?

Posted on October 27, 2020 | by Michelle Woo, MPH, MS, BSN, RN | Leave a Comment

"Get a medical student. The medical schools pay you."

As a nurse practitioner (NP) student, it was shocking and discouraging to hear my physician preceptor say this to his colleague. Whether students are attending a school that supports them with placements or working toward securing one independently, securing preceptors for clinical rotations is a challenging task. Unfortunately, many are desperate enough to pay agencies to find preceptors for them. Has advanced practice education really come to this — all because medical schools pay offices to take on students?

According to a 2014 article from the Society of Teachers of Family Medicine, 23% of medical schools offered payment for community preceptors. In fact, 63% of those who received payment for precepting were also paid by other learners. The article cites the increased competition among other healthcare schools to place students in community settings as the leading reason for providing payment. This ultimately leads to decreased opportunities for NP students, which is why many are having a difficult time securing placements.

The Difficulty with Precepting Nurse Practitioner Students

During NP school, I saw the many challenges that preceptors faced. From meeting quality measures to seeing patients and charting, providers were required to fit teaching students into their already hectic schedules. According to "Incentives & Barriers to Precepting Nurse Practitioner Students" the stress involved in the daily workflow of the clinic makes it difficult for providers to precept students – despite their desire to give back to the next generation. If productivity is impacted, a provider's income is affected as well. It is not uncommon to hear providers question their capacity to take on students when they can barely sustain themselves. This is why many providers ultimately choose not to precept students, although they would ideally like to teach.

In the same article, the authors mention the potential benefits of providing some sort of stipend to preceptors as an incentive. While this may help students secure preceptors more efficiently, it won't be useful for a student who is already paying a hefty tuition to serve others.

Thoughts About Payments to Precept

As a newly minted family nurse practitioner (FNP), I decided long ago that I would eventually precept the next generation of FNPs. As one of my preceptors put it, "I'm going to be under the care of you one day. Therefore, I'm going to teach you my ways so that you can care for me and not kill me!" These words always stuck with me, and I've since committed to give back to the next generation by becoming a mentor. Seeing the work that NPs and other providers put in, I know it won't be easy. However, I also know that the issue of paying for preceptors isn't going anywhere.

Precepting students as a nurse practitioner has traditionally been done free of charge. It was a service that NPs committed themselves to as a way to encourage and empower new NPs to effectively serve their communities. However, the shift of medical schools now paying clinical sites to host students has affected both NP and physician assistant students. Some schools are paying up to $100-$450 per week, with anecdotal research revealing that agencies such as NPHub will pay preceptors up to $3,000 per month. Whether it's the school or students who pay for preceptors, it's the student who is ultimately affected.

Looking back at my experience overhearing my physician preceptor and his colleague, I recall my hours being rushed to completion in order for them to take on a medical student. This led me to the realization that incentivized stipends for preceptors can lead to poor clinical experiences. If clinics and their providers are interested in empowering the next generation of practitioners, more support needs to be provided outside of stipends and financial incentives. Should this trend of paying for preceptors continue, I'm curious to see the implications on students' clinical experiences at rotations and the way they practice upon graduation.

Clinical-Community Linkages: Why Public Health Needs Nurse Practitioners

Posted on October 24, 2020 | by Michelle Woo, MPH, MS, BSN, RN | Leave a Comment

Public health and healthcare agendas can seem to run parallel to each other rather than together. Some clinicians lament that public health agencies don't understand the difficulties of primary care services. On the other hand, providers often discuss how overwhelmed they can get by 15-minute appointments, as it prevents them from spending quality time with their patients.

Public health agencies and nurse practitioners have the same overall agenda — improving people's health. Despite maintaining similar goals, they work on separate tracks. Public health and nursing — specifically nurse practitioners — can work together to improve the health of their patients and communities through clinical-community linkages (CCL).

Why Nurse Practitioners and Public Health Go Together

Nursing focuses on the health of all people. Florence Nightingale, a renowned nurse who was known as the Mother of Nursing, paved the way for professional nursing in the mid-19th century by utilizing scientific approaches and health education across the community. Nursing has since evolved, with opportunities ranging from working inpatient in hospitals to outpatient in research and a variety of other careers. Nurse practitioners take this one step further, gaining additional education to reach specific patient populations. According to the American Public Health Association, public health promotes and protects the health of people and the communities where they live, learn, work, and play. Based on both descriptions, advanced-practice nursing and public health can join forces to improve the health of individuals and communities.

What Are Clinical-Community Linkages?

Clinical-community linkages are one of the many ways that nurses, nurse practitioners, and public health agencies can work together. This extends beyond working in a government agency, such as Health and Human Services. Instead, clinical-community linkages are connections that community organizations and clinics form and utilize to better serve individuals within the local community.

According to the Agency for Healthcare Research and Quality, CCL offers the following benefits:

Patients receive more help with changing unhealthy behaviors
Clinicians are supported in offering services to patients that they cannot provide themselves
Community programs are connected with clients who their services were designed for

Here's an example of how clinical-community linkages can work. A patient who is at risk for diabetes visits a community clinic for a follow up. A nurse practitioner has approximately 15 minutes to talk to the patient about what it means to be at risk for diabetes and how to prevent it, and then sends them on their way. Through CCL, a nurse practitioner can network with organizations in the community that may provide free diabetes education classes, such as the National Diabetes Prevention Program, community walking groups, and more. This type of linkage provides opportunities for healthcare clinicians to help patients connect with community organizations to improve their health. As a bonus, some of these programs are free.

How Nurses and NPs Can Get Involved

Healthcare doesn't have to be secularized to only a provider or a clinic. As healthcare moves toward an interprofessional model, clinicians can look outward and determine which community organizations can serve their patients' needs. It can be remarkable to see so many organizations involved in community-clinical linkages. However, they often lack a key player — healthcare providers. Public health agencies are often reluctant to receive feedback from clinicians on their programs and associated implementations. While these groups need to be more accessible to clinicians (i.e. scheduling times when clinicians aren't seeing patients or charting), it’s surprising that many clinicians who want their voices heard on improving others' health do not attend these work groups.

Nurse practitioners and clinicians can play an active role in supporting individuals' health within a community. It can be as simple as emailing local public health agencies about opportunities to be involved in public health initiatives, attending public health webinars or conferences, and networking with community organizations.

A Personal Connection

Working in public health, I have been able to learn about all of the excellent resources that are available on a local scale. While studying to be a family nurse practitioner, I was told about how important it is to educate older patients about falls. However, we were never provided with resources or available classes where patients could learn more about fall prevention Through public health networks, I eventually learned about the National Council on Aging and where I could access fall prevention resources. However, it's likely that not all clinicians know about these resources. That is why clinical community linkages are so important.

Public health and healthcare don't have to work on separate tracks towards the same goal. With the help of clinical-community linkages, both groups can network together and build strong links within the community to effectively serve patients.

Public Health Simulations: How I Learned What I Thought I Knew

Posted on August 11, 2020 | by Michelle Woo, MPH, MS, BSN, RN | Leave a Comment

"Health happens outside of a medical office."

This is a common saying in healthcare. It means that beyond a standard 15-30 minute clinical appointment, a person's health occurs in their daily lives. This includes where they live, work, and play, as well as what they eat, their transportation, and more. We may think that we understand these factors, but do we truly understand how it all works?

In nursing school (pre-licensure and beyond), simulations provide an insightful experience that helps students prepare for both inpatient and outpatient situations in the clinical setting. Simulations can range from a medical emergency in a primary care office to a pregnant woman with undiagnosed eclampsia. Simulations have personally taught me how to function in a team setting, work under pressure, and learn from my mistakes without harming anyone. These lessons are all highly valuable.

The public health simulation that I participated in during my baccalaureate pre-licensure program was my favorite. This simulation showed me that I didn't understand what Americans struggle with as much as I thought I did. If there is one critical simulation for nurse practitioner (NP) students to experience, it's a public health simulation.

What Is a Public Health Simulation?

A public or community health simulation is a non-threatening activity that nursing students participate in. The activities involved in this simulation vary from school to school. While these simulations are not as popular as a traditional simulation in an acute care setting, they are critical in helping students understand disease prevention, population health, and social determinants of health. In the article "Preparing Today's Nurses: Social Determinants of Health and Nursing Education," Thornton and Persaud discuss how simulations can help students understand the health inequities that exist today. Such simulations offer incredible insight into why health disparities exist, as well as provide reflective and thought-provoking moments for nursing students that can help improve their practice as a nurse or advanced practice provider.

At my baccalaureate program, I participated in an activity with a group of student colleagues where we each played a community member with very limited resources. This particular group was a family unit, and mine included a single parent, a child under 5, a teenager, and a live-in grandparent. Our family had no car and the single parent worked two jobs. Scenarios ranged from needing to visit the county building to renew services to taking the children or grandparent to see a doctor. Our family even had our "money" stolen during one event. The experience was incredibly eye-opening. I experienced stress, despair, anger, and hopelessness throughout the simulation. I also felt frustrated with the system. How can somebody who works two jobs make it to the county office to sign for continued services for food or other resources? While I understood that life was difficult for many families in America, I did not fully grasp the extent of it until participating in this four-hour simulation. It truly humbled me. I recognized where I've placed judgment and identified implicit biases that I hadn't previously noticed. That experience made an impression that lasted all the way through my NP program, in both didactic and clinical settings.

Incorporating Community Simulation Programs for NP Students

As I look back on my time as a graduate student, the one simulation that I believe every NP program should invest in is a community/public health simulation. As NPs, we provide disease prevention and management. Therefore, we must go beyond understanding our patients and see the perspective of patients who may not have access to necessary resources. A community or public health simulation provides students with a realistic example of the challenges that many Americans face today. From learning empathy to understanding humility, this type of simulation is critical for future nurses and nurse practitioners to care for patients to the best of their abilities.