Expanding Role Of Nurse Practitioner And Health Staffing
By: Connie Blaszczyk, Managing Editor, Resource Center
As reported in Monster’s 2011 Health Care Job Conditions Report, health care continues to be the healthiest labor-market sector, a trend driven in part by the growing demand for experienced nurse practitioners.
To help explain the expanding role of the nurse practitioner in health care, we spoke with Dr. Penny Kaye Jensen, President of the American Academy of Nurse Practitioners and Assistant Professor (Clinical), University of Utah, College of Nursing.
In this interview, Ms. Jensen discusses how nurse practitioners will shape tomorrow’s health care hiring needs as well as the competitive recruitment landscape for nurse practitioners.
Monster: Is the demand for nurse practitioners changing health care recruitment practices?
Jensen: While health care consumers are increasingly more aware of the contributions of NPs, employers are also becoming more familiar with advantages provided by NPs. As the market becomes more competitive for NPs, recruiters may be offering better benefit packages and salaries, as we are seeing this evolve.
Monster: What services do NPs provide?
Jensen: Nurse practitioners (NPs) are expert clinicians with advanced training who provide primary, acute and specialty health care services.NPs provide a full range of services such as:
- Ordering, performing and interpreting diagnostic tests such as lab work and x-rays.
- Diagnosing and treating both acute and chronic conditions such as diabetes, high blood pressure and asthma.
- Prescribing medications and other treatments, managing patients’ overall care.
- NPs focus on the health and well-being of the whole person. What sets this group of health care providers apart from others is their unique emphasis on helping patients to make educated health care decisions.
When considering productivity measures, employee compensation and the cost of education, NPs are cost-effective providers of health services.
Monster: In what areas of the country are NPs most in demand?
Jensen: NPs are in demand in all areas of the country, along the distribution of the population. For instance, 19-20% of the US population resides in rural areas and 18-19% of NPs practice in rural areas. However, in cities where there are more health care consumers, NPs are more heavily concentrated. Some states have more restrictive practice environments for NPs; those states might be less appealing to NPs, but we do not have any evidence to indicate that they are less likely to practice in those states/communities as they simply figure out how to do their roles.
Monster: How competitive is the recruitment landscape for nurse practitioners? How will those trends change over time?
Jensen: It is competitive and we anticipate the recruitment landscape becoming increasingly so. There is a growing unmet need for high quality primary care and specialty providers so that NPs are increasingly available to fill these needs. Particularly in primary care, where the NPs are the only ones increasingly available for this practice, it will be more and more competitive.
Monster: What sort of benefits and training should employers be prepared to offer nurse practitioners?
Jensen: As cited in a AANP compensation study report nearly all (80% or more) NPs receive vacation, sick leave, liability insurance, health insurance, educational leave. However the majority of NPs also receive professional leave, disability insurance, life insurance, and retirement plan. So the benefits should be robust if a recruitment package is going to be competitive.
Monster: How are nurse practitioners likely to help address an ongoing health care employment trend -- the lack of primary care physicians?
Jensen: Nurse practitioners (NPs) are the fastest growing health care profession in primary care, growing at close to a 10% rate in primary care; physicians are growing at less than 2% in primary care. Nurse practitioners are the best solution to fill the great need for access to primary care.
As well, we see that twice the percentage (18%) of nurse practitioners practice in rural areas compared to physicians (9%) who are practicing in rural areas. While one in five US residents live in rural areas, only one in ten physicians practice in those areas (Bodenheimer and Pham, 2010).
Monster: Will physician assistants (PAs) also help to address this need?
Jensen: The Robert Wood Johnson Foundation (RWJF) Nursing Research Network commissioned Kevin Stange, University of Michigan, and Deborah Sampson, Boston College, to plot the provider-to-primary care physician ratio for NPs and physician assistants by county, calculated as the population-weighted average for states with available data. Between 1995 and 2009, the number of NPs per primary care MD more than doubled, as did the number of physician assistants per primary care MD (RWJF, 2010©.)
These figures suggest that it is possible to increase the supply of both NPs and PAs in a relatively short amount of time, helping to meet the increased demand for care.
Monster: How do educational costs compare with NPs and PAs?
Jensen: Last year, we surveyed all FNP programs and medical (DO/MD) preparation. We reported that the total NP program cost is less than two-thirds of the cost of one year of medical school. Our findings are consistent with the older information reported in the Institute of Medicine (IOM.)
That means that the number of advanced practice registered nurses (APRNs) that can be trained for the cost of training 1 physician is between 3 and 14.
Assessing the costs of education is a multidimensional problem, due primarily to the complexities of deriving the production cost to the institution. One study, sponsored by the Association of Academic Health Centers (Gonyea, 1998) attempted to compare the educational cost for various health professions. It concluded that for every 1 physician (4 years), 14 advanced nurse practitioners or 12 physician assistants could be produced (Starck, 2005).
Monster: How are nurse practitioners likely to impact the way health care is practiced in the future?
Jensen: In addition to providing excellent primary, acute and specialty care, NPs bring a unique perspective to health services in that they place emphasis on both care and cure. NPs also focus on health promotion, disease prevention, and health education and counseling, guiding patients to make smarter health and lifestyle choices.
By providing both high-quality care and health counseling, NPs can lower the cost of health care for patients. For example, patients with NPs as their primary care provider have fewer instances of emergency-room visits, shorter hospital stays and often have lower medication costs. This can be attributed to the fact that NPs partner with patients for their health and provide the necessary information so that they know when early intervention is needed.
As rules and regulations governing NP practice change, allowing greater access to NP-delivered care and allowing NPs to practice to the full extent of their education and training, more and more people will receive the expert patient-centered care that NPs bring to those they treat. This is just one way that NPs will impact the way health care is practiced in the future.