Patients Acceptance of Nurse Practitioners

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Patients Acceptance of Nurse Practitioners Essay

Nursing is a broad field with limitless possibilities; one of those possibilities included is a nurse practitioner. A nurse practitioner is an advanced practice nurse that is capable of furthering care for patients. Nurse practitioners are able to see and treat their own patients, plus be a part of collaborative care. When patients visit the physician’s office, most are now being treated only by a nurse practitioner and may never actually see a physician. Although Nurse Practitioners are highly capable and educated to administer care to patients in all settings; patients are becoming unwilling and somewhat reluctant to be seen by anyone but a physician.Patients Acceptance of Nurse Practitioners Essay

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Nurse Practitioners, through schooling, clinical experience and workplace experience are exceedingly capable to deliver care to patients. Nurse practitioners are able to specialize and work in almost any field they desire, such as pediatrics, family care and gerontology but according to the Health Resources and Services Administration, “the vast majority of nurse practitioners, about 65%, are employed in ambulatory or primary care (as cited in Poghosyan, Lucero, Rauch, & Berkowitz., 2012). As of 2015, to become a nurse practitioner one must obtain a doctorate in nursing practice degree. With the increase in schooling, nurse practitioners are becoming even more educated and equipped to deliver high quality care. Although nurse practitioners receive the same schooling and are equally qualified to do their job, each state has their own scope of practice for what they can do. According to Pearson, “in some states, nurse practitioners provide care without any involvement from a physician. In other states, providing the same care requires that nurse practitioners Patients Acceptance of Nurse Practitioners Essay

heaalth care reform but in to place has now expanded the scope of practice for non-physician practitioners so more and more patients will be seeing nurse practitioners. Nurse practitioners are more than qualified for their jobs and are also compassionate, caring and empathic. If patients would become more accepting, nurse practitioners will have limitless possibilities with their career.

The United States health care system is being called upon to improve patient outcomes and the health of populations while delivering patient-centered care and reducing costs.1 To meet these seemingly incongruent goals, new models of care, such as the patient-centered medical home, have been suggested. Improved clinical outcomes and patient satisfaction are central to these proposed models.2 Changing the definition of ambulatory clinical productivity from patients seen per hour to one grounded in patient satisfaction and health outcomes is not a simple task. NPs should be well-positioned to achieve these productivity goals based on the knowledge of what it is that NPs actually do. However, NPs must make the case for what they actually do.

Repeatedly, ambulatory care research has shown that when providers spend more time with patients, patient satisfaction increases.3, 4, 5 The amount of time that providers spend with patients may affect the quality of care provided, especially for preventive services and education.6 For some time, NPs have posited that one of the reasons patient satisfaction has been high for NPs is the additional time the NPs spend with patients.7, 8, 9 However, studies have shown that NPs spend approximately the same time with patients as physicians or physician assistants as a result of clinic scheduling policies. Patients Acceptance of Nurse Practitioners Essay

If NPs spend the same amount of time with patients as other providers, yet have higher patient satisfaction, there must be another influencing factor. The answer may lie in the foundational philosophy and assumptions of advanced nursing practice. If NPs leave their professional philosophy unarticulated, NP practice will be defined by other system stakeholders, including administrators and physicians. By examining, naming, and claiming our professional philosophy, with supportive assumptions, NP practice will flourish in the new systems of care.

Professional philosophy and assumptions may be so foundational to the NP that they may be imperceptible—thus taken for granted. This profession-based philosophy and the assumptions that flow from it cannot be taken as “givens” in the current health system. They must be named, claimed, explained, and ultimately demonstrated if advanced nursing practice is to have its rightful place in systems of care. Therefore, the value of nursing needs to be made clear—among ourselves and to other stakeholders who have power and influence over our practice. National nursing leaders and strong nursing voices call for advanced practice nurses to provide solutions to health care problems that are desperately in need of repair and that can be solved by nursing.12 Nursing scholars remind us that, when practice is based on nursing’s foundational principles, the NP’s need for meaningful practice is satisfied and a distinctly unique care delivery model is advanced—one that promises to fill a gap not met in the current health care system.Patients Acceptance of Nurse Practitioners Essay
As the boundaries of advanced nursing practice and medical practice continue to merge, there is an imperative for NPs to clearly delineate their scope of practice. Given the combination of role expansion with a disease-based health care delivery system, a clear distinction between nursing and medicine practice by NPs is needed now more than ever.

Clear articulation of one’s professional philosophy of advanced nursing practice facilitates role identification to other disciplines. Hence, role-limiting terms such as “physician extender” or “midlevel practitioner,” which deny the heart of NP practice, may disappear from the health care administrative culture.

What is a Nurse Practitioner?
NPs (also referred to as Advanced Practice Registered Nurses or APRNs) are one of the four roles that encompass advanced practice nursing: nurse mid-wife, nurse anesthetist, nurse practitioner, and clinical nurse specialist. All four roles require graduate degrees in order to qualify as a practitioner. In most states, NPs must be registered nurses, graduates from accredited graduate programs, and hold certification that reflects the specialized nature of the graduate program (e.g. primary care certification if graduating from a primary care nurse practitioner program). In addition, as NPs become more commonplace in health care settings, the licensure, accreditation, and certification requirements continue to evolve in response to changing needs. In the United States, each state sets its own requirements for practice, and NPs must meet the particular state’s criteria in which they work. Because different practice requirements are confusing and in some cases can lead to inefficiencies in care, recent efforts on the part of nurse practitioner groups have been directed towards creating standards that are national in scope. For example, a new regulatory document finalized in 2008 and released by the National Organization of Nurse Practitioner Faculties, called the Consensus Model, set new national standards for core competencies, roles, and six population-based foci (individual/family health across the life span: adult-gerontology, pediatrics, neonatal, women’s health/gender, and psychiatric/mental health). Currently, states are in the process of revising practice acts, and schools of nursing are examining their APRN or NP programs to reflect the new model, which is expected to be nationally implemented by 2015 for new practitioners.[1]​​ Patients Acceptance of Nurse Practitioners Essay

The Evolution of the Nurse Practitioner Movement
A major factor that supported the development and evolution of the Nurse Practitioner role in the 1960s was lack of access to health services. The American public’s struggles to gain access to primary care and preventive services are certainly nothing new, and this need crosses socioeconomic lines. Although health reform efforts promise to bring over 30 million Nurse Practitioner Loretta Ford with unidentified nurse and babyNurse Practitioner Loretta Ford with unidentified nurse and babypreviously uninsured people into the health system, those currently without health care access are not the only ones who sometimes have difficulty finding quality services. For instance, insured Americans find they cannot get urgent care or primary care health services when needed. Nurse practitioners are situated to provide greater access to high quality, reasonable cost care if allowed by state regulations to practice to the fullest extent of their knowledge and skills.Patients Acceptance of Nurse Practitioners Essay

NPs are part of the constant change, however subtle, in how the public decides who has the authority to provide health care. Physicians traditionally were considered the normative providers of medical services by patients and the state. Indeed, it is the physicians’ perspective that guides much of what is understood about patients, health policies, and institutions. However, as access to physicians has dwindled, it has been midwives, nurse practitioners, and physician assistants that have emerged as primary care providers within the mainstream health care system. For example, independent nurses and lay providers were and are the norm in many rural clinics, but, until recently, not in urban academic institutions or in places with many physicians. One of the only consistencies across types of practices is the satisfaction of patients with nurse practitioner services which has always been and remains quite high.Patients Acceptance of Nurse Practitioners Essay

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Over the years, the role of the nurse has expanded in response to advances in scientific knowledge and changes in health care needs. As a consequence of the broadening of the role of the nurse within health care, the need for additional formal education and training became more commonplace. Such was the case with the development of the advanced practice nurses.[2]

Many contextual factors supported the development and growth of the nurse practitioner clinical role. For instance, by the 1960s, American medicine had become highly specialized with growing numbers of medical students moving into more economically and socially lucrative specialty practices. The general practitioner, long a staple for primary care in suburban and rural communities, was slowly disappearing from the health care landscape. At the same time, the demographics of the American public were changing and marked by an aging population as well as a growing number of chronically ill adults and children. Medical education, situated primarily in academic acute care hospitals, failed to reconceptualize​ medical education and residency offerings in a way that could offset the specialization trend.Patients Acceptance of Nurse Practitioners Essay Even the development of family practice specialties and medical schools that focused on community-based medicine could not counterbalance a trend that was supported by higher payment and status for specialists. At the same time, nurses were looking for ways to apply the skills and knowledge they already possessed through experience or their own education programs. Nursing’s growth occurred organically in clinics, as well as visiting nurse associations and private offices, where daily interactions with physician colleagues facilitated a vast amount of new and advanced knowledge and skills. Over time, it became clear that many in the nursing profession were particularly eager to formalize further and expand their clinical practice responsibilities. In pockets across the country, in poor rural and urban areas, individual nurses and physicians began to work together in response to the shortage of primary care physicians, growing numbers of people with health insurance, and population changes to improve patient care. Soon, formal education and training programs followed at the University of Colorado, spearheaded by nurse Loretta Ford and pediatrician Henry Silver; at the University of Kansas, with Barbara Resnick and Charles Lewis and at the University of Rochester, with nurses Joan Lynaugh and Harriet Kitzman and physicians Barbara Bates and Evan Charney—the latter funded by the Division of Nursing of the U.S. Public Health Service.Patients Acceptance of Nurse Practitioners Essay

As reports of these experiments were published, the number of programs for nurse practitioners grew rapidly, supported in part by federal funding through the Nurse Training Acts in the next two decades, and through the largesse of private foundations which supported new types of service models and training programs. Nursing education responded to both the opportunity for funding and to the numbers of nurses demanding access to nurse practitioner programs. The number of programs increased, and so did specialization. Early on, pediatrics and gerontology programs were the most common programs, but by the 1990s, NPs specialized in oncology, neonatology, and cardiology. Certification programs that focused on training the practitioner to work in a specific field followed specialization, and were sometimes tied to state licensure requirements.

By the early 1980s, nurse practitioner education moved into graduate programs and by 1981, most states required graduate degrees for nurse practitioner practice. In response to the scientific knowledge explosion, programs kept adding new courses, expanding their length and their credit loads. By the turn of the 21st century, most nurse practitioner programs credit hours far exceeded those in other graduate programs. At the same time there was a growing movement towards practice doctorates in other professions and this led educators to think about new types of nurse practitioner programs. By 2005, the Doctorate of Nursing Practice (DNP) became the newest level of practitioner training, giving credit for the breadth of content in the nurse practitioner programs.Patients Acceptance of Nurse Practitioners Essay

Today, NPs have proven their effectiveness in delivering high quality, lower cost heath care services. Health care consumers, recognizing the value of a good service flock to NPs for numerous health care needs. While it remains unclear at this time how health care reform effort will change health care delivery, it is abundantly clear that nurse practitioners will be a vital component of future American health care services. Patients Acceptance of Nurse Practitioners Essay