According to United States Department of Labor (2016), Nurse Practitioners (NP) can diagnose and treat acute, episodic, or chronic illness, independently or as part of a healthcare team, order, perform or interpret diagnostic tests, prescribe medications and educate patients and families on continued care. As of May 2016, the national estimates for NPs were 150,230 with a mean annual wage of $104,610 (United States Deparment of Labor, 2017), but by 2017, American Association of Nurse Practitioners (AANP) reported more than 234,000 NP members in the United States (American Association of Nurse Practitioners [AANP], 2018). Become a Nurse Practitioner requires a considerable time in school because you first need to be a registered nurse and have a bachelor’s degree completed including a passed test from National Council of State Board of Nursing. …show more content…
Thereafter, they must complete a master’s or doctoral degree program and an advanced clinical training to practice direct patient care in primary care, acute care, and long-term health care setting (AANP, 2018). Beside all the study and training, they also have to complete and pass rigorous examinations for national certifications offered by the American Nurses Credential Center (ANCC), the American Academy of Nurse Practitioners AANP), and specialty nursing organizations (Shi and Singh, 2015), as well as fullfill state-specific licensure requirements. Moreover, they have to follow ethical practice codes and be evaluated by clinical outcomes and periodic peer reviews, in conjuction with continue learning through continuing education programs for professional development and keep up clinical competency (AANP, 2018). In general, they undergo extensive training and rigorous credentialing process. Although NPs are not physicians, they focus in the health and well-being of the person as a whole, therefore, around 90 percent of NPs are certified in primary care areas like family, adult, and geriatrics, women’s health and pediatrics (AANP, 2018). Conversely, not all the states grant full practice rights for NPs and there are many physicians organizations opposing to this full practice rights. Physicians and NPs have different approach philosophy to care, while physicians spend more years studying diseases and are more attractive to medical specialties other that family practice (Carlson, 2017), the majority of NPs are skilled nurses trained on patient care in all aspects of their lives. Their knowledge of care overlaps and is complementary, but each has a core expertise that is distinct and unique. NPs work together with physicians in a variety different settings as primary care offices, physician group practices, community health centers, ambulatory surgical centers, urgent care centers, outpatient clinics and hospitals to mention some. Their scope and interaction with physicians depend mostly on the state in which they work. For example, there are 22 states plus the District of Columbia where the “Full Practice” is allowed (Alaska, Arizona, Colorado, Connecticut, District of Columbia, Hawaii, Idaho, Iowa, Maine, Maryland, Minnesota, Montana, Nebraska, Nevada, New Hampshire, New Mexico, North Dakota, Oregon, Rhode Island, South Dakota, Vermont, and Washington), 16 have “Reduced Practice” (Alabama, Arkansas, Delaware, Illinois, Indiana, Kansa, Kentucky, Louisiana, Mississippi, New Jersey, New York, Ohio, Pennsylvania, Utah, West Virginia and Wisconsin), and 12 “Restricted Practice” (California, Florida, Georgia, Massachusetts, Michigan, Missouri, North Carolina, Oklahoma, South Carolina, Tennessee, Texas and Virginia), (AANP, 2018). Basically, for 28 states, NPs have to collaborate or work under physician’s supervision. Another limitation or difference between NPs and physicians, besides the ones imposed by the state of practice, is that NPs do not perform surgeries, at least not complex surgeries (Wynne, 2015). According to an article published by the New York Times (Chen, 2013), the result of a questionnaire done to almost 1000 physicians and NPs, showed that almost all of them believed that the NPs should be able to practice to the full extent of their training