DiversityNursing Blog

Can a Nurse Practitioner Do That? [INFOGRAPHIC]

Posted by Erica Bettencourt

Tue, Aug 16, 2016 @ 03:00 PM

blog_hero_CanNP_DoThat-02-e1470408521503.jpgThink you need to hire a physician to fill an opening at your hospital, practice, or organization? Not necessarily: A nurse practitioner (NP) may be able to get the job done, says Tay Kopanos, DNP, NP, the Vice President of State Government Affairs for the American Association of Nurse Practitioners. As an added bonus, it typically takes less time to find a locum tenens NP to fill an open position.

So, could bringing on an NP work for you? Use our infographic to find out www.bartonassociates.com:

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Topics: NP, nurse practitioner

The Gulf Between Doctors and Nurse Practitioners

Posted by Alycia Sullivan

Mon, Jul 01, 2013 @ 01:42 PM

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Not long ago, I attended a meeting on the future of primary care. Most of the physicians in the room knew one another, so the discussion, while serious, remained relaxed.

Toward the end of the hour, one of the physicians who had been mostly silent cleared his throat and raised his hand to speak. The other physicians smiled in acknowledgment as their colleague stood up.

“Nurse practitioners,” he said. “Maybe we need more nurse practitioners in primary care.”

Smiles faded, faces froze and the room fell silent. An outraged doctor, the color in his face rising, stood to bellow at his impertinent colleague. Others joined the fray and side arguments erupted in the back of the room. A couple of people raised their hands to try to bring the meeting back to order, but it was too late.

The physician had mentioned the unmentionable.

I remembered the discord and chaos of that meeting when I read a recent study in The New England Journal of Medicine of nurses’ and physicians’ opinions about primary care providers.

For several years now, health care experts have been issuing warnings about an impending severe shortfall of primary care physicians. Policy makers have suggested that nurse practitioners, nurses who have completed graduate-level studies and up to 700 additional hours of supervised clinical work, could fill the gap.

Already, many of these advanced-practice nurses work as their patients’ principal provider. They make diagnoses, prescribe medications and order and perform diagnostic tests. And since they are reimbursed less than physicians, policy makers are quick to point out, increasing the number of nurse practitioners could lower health care costs.

If only it were that easy.

Three years ago, a national panel of experts recommended that nurses be able to practice “to the full extent of their education and training,” leading medical teams and practices, admitting patients to hospitals and being paid at the same rate as physicians for the same work. But physician organizations opposed many of the specific suggestions, citing a lack of data or well-designed studies to support the recommendations.

In an effort to build consensus, the Robert Wood Johnson Foundation then invited a dozen leaders from national physician and nursing groups to discuss their differences. The hope was that face-to-face discussions would help physicians and nurses understand one another better and see beyond the highly charged and emotional rhetoric. The approach worked, at least initially; after three meetings, the group drafted a report filled with suggestions for reconciling many of the differences.

But an early confidential draft was leaked to the American Medical Association, a group that had not been invited to participate, and the A.M.A. immediately expressed its opposition to the report. Soon after, three of the participating medical organizations — the American Academy of Family Physicians, the American Osteopathic Association and the American Academy of Pediatrics — withdrew their support, and the effort to bring physicians and nurse practitioners together and complete the report collapsed.

Nonetheless, many health care experts remained confident, believing that the large professional organizations had grown out of touch with grass-roots-level health care providers. The guilds might oppose one another, but every day in medical practices, clinics and hospitals across the country, physicians and nurse practitioners were working side by side without bickering. Surely, the experts reasoned, providers who knew and liked one another would be receptive to trying new ways of working together.

Wrong.

Analyzing questionnaires completed by almost 1,000 physicians and nurse practitioners, researchers did find that almost all of the doctors and nurses believed that nurse practitioners should be able to practice to the full extent of their training and that their inclusion in primary care would improve the timeliness of and access to care.

But the agreement ended there. Nurse practitioners believed that they could lead primary care practices and admit patients to a hospital and that they deserved to earn the same amount as doctors for the same work. The physicians disagreed. Many of the doctors said that they provided higher-quality care than their nursing counterparts and that increasing the number of nurse practitioners in primary care would not necessarily improve safety, effectiveness, equity or quality.

A third of the doctors went so far as to state that nurse practitioners would have a detrimental effect on the safety and effectiveness of care.

“These are not just professional differences,” said Karen Donelan, the lead author of the study and a senior scientist at the Mongan Institute for Health Policy at Massachusetts General Hospital in Boston. “This is an interplanetary gulf,” she said, echoing a point in an editorial that accompanied her study.

The findings bode poorly for future policy efforts, since physicians are unlikely to support efforts to increase the responsibilities and numbers of advanced-practice nurses in primary care. And most nurse practitioners are unlikely to support any proposals to expand their roles that do not include equal pay for equal work.

Peter I. Buerhaus, senior author of the study and a professor of nursing at Vanderbilt University Medical Center in Nashville, is chairman of a commission created almost three years ago under the Affordable Care Act to address health care work force issues. But his group has yet to convene because a divided Congress has not approved White House requests for funding.

“We’re running out of time on these issues,” Dr. Buerhaus said. “If the staffing differences remain unresolved, we are just going to cause harm to the public.”

Still, by providing a clearer picture of the extent of these professional differences, the study should help future efforts. “It’s too easy to say that everyone should just get along,” Dr. Donelan said. “These arguments touch on the whole nature of these professions, their core values and how they define themselves.”

“It’s like when family members are warring over a sick patient,” she added. “We need first to acknowledge the others’ position and the full extent of our differences before we can reach any kind of resolution.”

Source: NY Times

Topics: doctor, nurse practitioner, NP

Nursing industry is growing, flexible

Posted by Alycia Sullivan

Wed, Jun 05, 2013 @ 12:18 PM

The job of nurse anesthetist comes with many attractions. There’s a high level of responsibility, a challenging work environment and the chance to do good for others. There’s also the prospect of virtually assured employment.

“I saw that there was going to be job security. It would pretty much always be there,” said Navy Reserve Lt. j.g. Loren Gaitan.

Gaitan, 33, is working on her master’s degree at Florida International University in a full-time, 2½-year program. A former neonatal nurse, she is looking to the anesthetist specialty as a way to increase her skills and take on more responsibility.

It could be a lucrative move: Salary.com puts median annual pay at nearly $180,000.

Nurse anesthetist is one of several fast-growing nursing specialties. Thanks to changes in national health-care laws, a range of concentrations in the nursing field are rising to the fore. With new mandates requiring employers to insure their workers, the health-care system will see a flood of new patients, said Connie White Delaney, dean of the University of Minnesota School of Nursing. “The opportunities across the nation will be just profound,” she said.

Job options

Any of these growing jobs could be an easy fit for a veteran with training as a military nurse:

Nurse practitioner: This person typically has a master’s degree as well as a certification from one of several national bodies. The practitioner may diagnose illnesses, examine patients and prescribe medication. “They are not just going to treat the symptom. They will say, ‘You need to diet. You need to exercise,’ where a physician might just give you a pill,” said Gerrit Salinas, director of the recruiting agency Snelling Medical Professionals. “A nurse practitioner can help people feel like they are more than just a number.” The American Academy of Nurse Practitioners puts the mean salary at $91,310.

Nurse informatics: With the rise of electronic medical records, the role of the informatics nurse has become increasingly significant. These workers don’t just convert paper into electronic records; they also must be well-versed in patient care, privacy issues and technology. They may work in medical settings but also in home health agencies, insurance companies and other entities involved in the management of digital records. The average salary is $98,702, according to the Health Informatics Forum.

Case management nursing: Here again, changes in health-care law are driving demand. As new care models evolve, providers will be expected to coordinate medical treatments in order to ensure efficient and effective care. That’s a big part of the case management job description. Case management nurses typically coordinate long-term treatment, especially for patients with chronic conditions. The average salary is $73,000, according to job site Indeed.com.

Geriatric nursing: Care for seniors is a fast-growing field as the nation’s aged population swells. Medical issues may include diabetes, respiratory problems, hypertension and other conditions. Geriatric nurses offer treatment, while also offering guidance to patients and families. The average salary for a geriatric nurse is $54,457, according to ExploreHealthCareers.com.

Home health nursing: As the name suggests, home health-care providers deliver services to those whose conditions allow them to stay at home but who still require ongoing medical attention. The field is growing fast, largely on account of the rapidly expanding population of older Americans. Salaries average around $40,000 but can vary widely by geography.

Go anywhere

There are numerous avenues into nursing, including specialized fields. The American Nurses Association,http://www.nursingworld.org/, offers guidance.

To support veterans in the field, the government’s Health Resources and Services Administration makes grants to colleges and universities with expedited curricula that help train vets for careers as physician assistants. The Veterans Affairs Department employs a range of nurses.

“We recognize this as an opportunity to support veterans who have served the nation, and as a chance to help fill some shortages in the health care area. It’s a win-win situation,” said Joan Wasserman, Advanced Nursing Education Branch chief for HRSA’s Bureau of Health Professions.

Many schools offer programs of various lengths for those looking to get into the field. Advocates say it’s worth the effort.

“Nursing is one of the best careers you can get into because it is so flexible,” said Pat Harris, associate director of a program at Arizona State University Online that helps practicing nurses earn the Bachelor of Science in Nursing degree. “No matter what changes are in the wind in health care, you are going to be in a key position. Once you have that license to practice medicine, you can go anywhere.”

Source: Marine Corps Times

Topics: nursing, career, ANA, NP, growing

VCU dentists and nurse practitioners collaborate on patient care

Posted by Alycia Sullivan

Sat, Apr 20, 2013 @ 03:49 PM

Dominiquea Rosario sees a dentist regularly for debilitating jaw pain, but at her last two dental appointments at Virginia Commonwealth University she also saw a nurse practitioner who checked her blood sugar and blood pressure.

In a new practice model, dentists and nurse practitioners at VCU are teaming up to see patients together, with goals of increasing access to care, better understanding the connection between oral health issues and disease elsewhere in the body and lowering health care costs.

“It’s a new model … so that you can have sort of one-stop shopping,” said Nancy Langston, professor and dean of the VCU School of Nursing.

“Dentistry has always been about health promotion and disease prevention. Nurse practitioners have been about early recognition, risk reduction and health promotion. We are putting them in the same environment to see if we can truly matter in reducing risk and increasing health promotion,” Langston said.

The new VCU Neighborhood Partners Practice is being provided primarily to patients enrolled in VCU’s Virginia Premier Health Plan, a managed care plan for Medicaid enrollees.

The combined practice is located in the oral medicine suite in the Wood Memorial Building on the MCV campus.

“We’ve found when we have been looking at the literature that a lot of patients who visit the dentist haven’t seen a primary care provider in about three or four years,” explained nurse practitioner Judith Parker-Falzoi.

“There are a lot of chronic health problems that come up in the course of a dental exam that can impede the progression of their dental treatment plan,” she said.

The combined practice project is modeled after a New York University partnership in which dentists and nurse practitioners work together. VCU nursing professor Debra Lyon, chairwoman of VCU’s Department of Family and Community Health Nursing, is overseeing the VCU project.

The dental visit is the entry point.

“We are using the well-established, prevention-oriented delivery system of dentistry to see if we can harness that to apply to other disease,” said David C. Sarrett, dean of the VCU School of Dentistry. “So that patients who are coming for dental care, and if they also have other chronic issues, we can encourage them or facilitate them to pay some attention to those other things.”

At Rosario’s visit to the combined practice Tuesday, she saw dentist Bhavik Desai, an assistant professor of oral medicine and temporomandibular joint disorder, about the jaw pain and then went down the hall to see Parker-Falzoi, the nurse practitioner.

Parker-Falzoi checked her overall health, Rosario said. One item that did get red-flagged this time was her fasting blood glucose level. It came back a little high.

“I didn’t know I might have diabetes,” Rosario said later. “I had gestational diabetes a couple of years back when I was pregnant with my son,” said Rosario, whose children are ages 2, 3 and 4.

“And I was feeling … where I was craving salt, a lot of water and using the bathroom a lot.”

Rosario is scheduled for a follow-up visit with her regular primary care doctor next week.

Langston said the combined practice also promotes a more holistic look at health in training.

“Another piece of this is teaching nurses to do better assessments of the oral cavity and teaching our dental students and future practitioners to look more holistically at the human being in their chair and not just the mouth. So we will be doing some cross education,” she said.

Source: Times Dispatch

Topics: nurse practitioners, dentists, NP, patient care, collaboration

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