Nurse practitioners fill demand for primary care

2014-04-27T00:00:00Z 2014-04-30T10:59:32Z Nurse practitioners fill demand for primary careBy Angela Pittenger Arizona Daily Star Arizona Daily Star

With demand growing and fewer physicians entering primary care residencies, the number of nurse practitioners is expected to rise dramatically by 2025.

There are now 171,000 NPs in the field nationally, says the American Association of Nurse Practitioners. That number is expected to climb to 244,000 by 2025.

Last year, there were 797 nurse practitioners in Tucson, said Judy Bontrager, a registered nurse and associate director of operations for the Arizona State Board of Nursing.

“There is a growing demand for NPs and this will only increase due to the shortage of primary care health providers,” said Terry A. Badger, professor and director of the community and systems health science division at the University of Arizona College of Nursing. “The increased number of people with insurance will only increase the demand for nurse practitioners.”

Nurse practitioner, registered nurse, physician’s assistant. What’s the difference?

A registered nurse has a diploma, associate degree, bachelor’s in nursing or master’s in nursing. Registered nurses practice under a physician and cannot prescribe medications.

A nurse practitioner is educated at the master’s or doctoral level, with specialty training to diagnose and treat patients independently in Arizona, Badger said. Education at the doctoral level is currently preferred, but will be required in a few years, she added. Nurse practitioners can diagnose and treat patients, as well as prescribe medications.

A physician’s assistant also has advanced education and training but works under the direction of the physician. The physicians delegate duties to physician’s assistants and, within that range of duties, he or she can make decisions, independently, for patient care.

Education

The course of study at the University of Arizona College of Nursing is about three and a half years from bachelor’s degree to doctoral degree. “We believe that advance practice is at the doctoral level and our degree is the Doctor of Nursing Practice, with students specializing in a type of NP practice,” Badger said. “We educate family nurse practitioners, adult-gerontological acute care nurse practitioners, pediatric nurse practitioners and family psychiatric-mental health nurse practitioners.”

The College of Nursing has admitted 75 students to its Doctor of Nursing Practice program each of the last three years. It had 12 graduates in 2013, and projects to have 35 in 2016. Badger said the school now has more students applying than it can educate, given the number of faculty.

Salary

According to a 2011 American Association of Nurse Practitioners compensation survey, the mean, full-time base salary was $91,310, with average full-time NP total income at $98,760.

Seventy percent of nurse practitioners see three or more patients per hour, the association says.

NP’s point of view

Being a nurse was something Cindy Elliott wanted to do since she was a child. After spending 20 years as a registered nurse, she went back to school and became a certified family nurse practitioner.

Elliott runs an independent practice — Abundant Health Family Practice — with certified family nurse practitioner Rachel Gordon. The practice has been independent of physicians since it opened almost six years ago.

“Cindy and I agreed that we wanted to have a practice and wanted to increase awareness and functionality of nurse practitioners to promote our field,” Gordon said.

Though the women’s practice does not work under a physician, they can do everything a family medical doctor can do, with the exception of prescribing home care. “Nurse practitioners are trained in pharmacology, pathophysiology and certain surgical procedures,” Elliott said. “We are trained to diagnose, understand how to treat and prescribe. A lot of people don’t realize that. NPs are huge into preventative care and education, so they can take a bigger part in their care.”

With more medical doctors going into specialty fields, Elliott and Gordon feel nurse practitioners can play a big part in meeting the demand for primary care.

“Nurse practitioners are able to function at general family level medicine,” Gordon said. “There are too many people in the world who need healthcare. It’s not about taking business away from anyone. It’s about meeting the needs of the vulnerable population and doing a good job.”

patient’s point of view

Melissa Rosinski, a 35-year-old social services supervisor, has been seeing a nurse practitioner for about 15 years. “The experience has been great,” she said.

The benefits of seeing the NP, for Rosinski, are the availability on short notice and the amount of time spent explaining things during the appointment.

“I see her for everything unless she refers me to a specialist,” Rosinski said. “I have never felt like I am compromising or getting less knowledge or experience. Sometimes I see the doctor at the office, and the experience is totally different. The doctor has less time to spend with me.”

Contact reporter Angela Pittenger at 573-4137 or apitteng@azstarnet.com.

Copyright 2014 Arizona Daily Star. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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