What role do nurse practitioners play in the modern US healthcare system?


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Nurse practitioners (NPs) are registered nurses (RNs) who have decided to advance their careers with further training and higher education. Like any RN, they have taken the nursing degree and the entrance exam that allows them to practice, but they have also graduated with a master’s or doctoral degree. During the COVID-19 pandemic, their scope of practice was widened in many states to extend healthcare providers’ capacity and cut waiting lists.

A patient-facing role for ambitious nurses

In today’s hospitals, clinics, and private practices, NPs can offer most of the services a doctor provides. The main exception is surgical procedures, which they can assist with but not perform alone. Although their scope of practice is not as extensive in every state, their specialist skills make them an essential part of the US healthcare system. This is an exciting role on the frontline of primary care, with numerous opportunities for professional growth. Some working nurses may wonder if being a nurse practitioner is a good career option. These nurses should check out the Master of Science in Nursing – Family Nurse Practitioner program at Carson-Newman University. This online course includes an on-campus residency, a clinical placement, and expert tuition, enabling students to graduate in 32 months.

Various factors in the US and globally have led to a severe shortage of health professionals. The continued effects of COVID-19, the aging population, and the increase in patients with complex medical conditions mean we have a growing need for health professionals. NPs are an important factor when it comes to filling the gaps in healthcare because their training gives them a great deal of flexibility.

Working in a wide variety of specialisms

Wherever they are based, the key concerns of an NP are the same. They work to prevent disease, encourage a healthy lifestyle, and listen to their patient’s problems. Some NPs remain in primary care, the first point of contact for people who need to access care quickly. Others specialize while taking their master’s or through certification to focus on a certain patient group. These areas include orthopedics, oncology, pediatrics, and more.

What training is required to become a nurse practitioner?

In the US, NPs have to train for between six and eight years in medicine. They will start as an RN, requiring many years of study. This includes either a bachelor’s degree in nursing or an associate’s degree in nursing, followed by the National Council Licensure Examination, which licenses them to practice as an RN. Many then get nursing experience through several years on the job and may move between posts to gain a wider understanding of medical care.

Moving into advanced education

At this point, with a range of experiences and qualifications to their name, future NPs can start to think about their next move. They have to commit to a period of advanced training that exceeds the educational level of RNs and the standards required for licensure. If they have a BSN degree, they can move to a master’s program or a Doctor of Nursing Practice (DNP) program. If they choose the associate’s degree, they might need to take a bridge course to fulfill the entry requirements of an MSN program, though these requirements vary between institutions.

Is experience required for all NP courses?

To be considered for some of the specialty NP curriculum programs, students need at least one or sometimes two years of experience as an RN before they enroll. This is most commonly the case for entry to NP programs specializing in acute care or psychology, which prefer their students to have worked in an ICU or psych unit before applying.

What is included in an NP program?

Whether they study online or prefer a traditional learning route, NP students will learn in programs that include a range of experiences. There will be at least one clinical placement to give them insight into their specialism, coursework, classroom-style learning, and maybe a residency. Regardless of their area of interest, it is likely that the units will include tuition on pathophysiology, pharmacology, and conducting advanced health assessments.

What happens next?

After taking an MSN or DNP, NPs must become licensed like they did when becoming an RN at the beginning of their career. However, this time, they must earn an advanced practice nursing license, which is done differently between states. The process includes passing a standardized national certification exam and completing certificate programs should they work in specialties such as emergency or acute care.

Where can a nurse practitioner work?

NPs are found in several medical environments, depending on the branch of healthcare they specialize in. Many work in clinics and local or city hospitals, while others treat elderly patients in nursing homes or work in the community. A physician’s office might employ them or have their practice. Academia is another career route for qualified NPs, and many teach part-time in their local university’s health faculty and continue their clinical work.

What is a nurse practitioner’s scope of practice?

Depending on the setting, NPs often undertake many of the same tasks as RNs. They will manage most aspects of the patient’s overall care and offer an accessible service in primary care positions. When assessing a patient, an NP will take notes regarding their medical history and administer treatments, if required. However, compared to an RN, they have many more additional duties. These include diagnosing the health problems of their patients, preventive care, and managing long-term conditions.

How nurse practitioners dispense preventive care

NPs involved in preventive care help patients avoid serious ailments and aim to detect diseases early. This helps their patients prevent a severe illness or invasive therapy and lowers costs for the medical system. The preventive care work of NPs is usually dispensed over several appointments throughout the year.

  • Vaccinations and regular health checks

The annual check-up is a full health test where the NP looks at various areas of a patient’s mental well-being and physical health. This is a key method to identify illnesses early before they become more serious. Vaccinations are another factor in preventing disease, and the NP will dispense the initial shots to children and teens and then give boosters and other jabs to adults, as required. Flu shots are part of the standard vaccination schedule at most clinics, and these can protect the patient from the strains of flu currently affecting the population.

  • Screenings

Screenings are another form of preventive medicine that NPs provide in hospitals and some clinics. Two of the most common are mammograms offered to women over 40. These X-rays are taken so the patient’s breast tissue can be examined for signs of abnormality or the early stages of cancer. Colonoscopies are also offered, mainly to patients over 50, which can be useful in detecting signs of colon cancer.

Once an NP has carried out a health check or screening, they can diagnose a diagnosis or order additional diagnostic tests. These might be blood work, X-rays, or other types of imaging. Once a patient is diagnosed, their NP will provide the necessary treatment and help them self-manage their condition. In some states, an NP can write a prescription directly to a patient, while in others, such as California, they will mostly work with a physician who can supervise their prescribing.

Is the role of a nurse practitioner very different from that of a doctor?

Although they can independently prescribe medication in certain states and work as primary care providers, NPs are not doctors. NPs are trained differently, and their training is shorter than a doctor’s. To work as a doctor, students must attend medical school and gain a postgraduate qualification, such as a Doctor of Medicine (MD). In all, this can take between 10 and 14 years, whereas NP training takes around half that time.

What role do nurse practitioners have in the healthcare system as a whole?

NPs are trained using a nursing model of care, meaning their practice will focus on the patient. This makes them different from physicians, who are taught using a medical model focusing on diagnosis and treatment. As a result, their skills and abilities are other and uniquely impact US healthcare.

  • Bringing quality healthcare to underserved communities

NPs work with rural and urban communities across the US, bringing high-quality care to people who struggle to gain medical assistance. In these areas, there is often limited access to physicians and clinics, which makes it difficult for ill people to get treatment and amplifies health disparities. NPs can work as part of outreach teams to provide primary care and vaccines or use telehealth to reach people in remote locations.

  • Treating patients as individuals

NPs are trained to treat patients as individuals rather than a set of symptoms to be diagnosed. They look at the whole person when conducting a health check or getting to the heart of an ailment. This includes the patient’s physical health, mental well-being, and more. They might involve a patient’s family in their ongoing care or refer them to a specialist to manage their illness more effectively.

  • Educating and empowering patients

A key part of nursing is the education of patients. The NP’s information will be customized to suit the patient’s needs. It might include information about birth control, following a course of medication, or eating a healthy diet. In each case, the aim is to deliver enhanced health outcomes for the patient so that visits to the emergency room are reduced and hospitalizations are less likely.

  • Preventing the shortage of physicians from impacting patient outcomes

According to a report released by the Association of American Medical Colleges (AAMC), the US is experiencing a dramatic shortage of physicians. The study suggests that by 2034, there could be a shortfall of 37,800 to 124,000 qualified physicians. This includes the doctors who run local offices and those who work in specialty care areas. NPs will step in to meet the health needs of people nationwide. They can operate independently in many states, while in others, they need minimal supervision from a physician. This means more people can be seen and treated before their condition worsens, and hospitals will not become overwhelmed with emergency patients.

  • Providing a listening ear to concerned patients

Thanks to their experience in frontline care and training, NPs are good listeners. They do not rush patients who want to share their health worries or ask questions. This means patients are more inclined to disclose their symptoms and comply when following a care plan. Doing this can save time and resources in the long run because they build a relationship marked by trust.

  • Ensuring that healthcare policies are effective

The college education and clinical experience of NPs mean that they are perfectly placed to request changes in healthcare legislation because they understand how these might impact frontline staff and patient outcomes. NPs can also suggest changes to their facility’s functions by conducting research projects and presenting their findings. Finally, they could write to federal and state legislators to discuss a bill. They could advise on more effective disease management, cutting healthcare costs, and lowering wait times. By informing and advocating for policy changes, NPs ensure that their profession and the healthcare system develop positively.

  • Promoting healthy living

By promoting healthy living and encouraging patients to participate in health checks and screenings, NPs emphasize preventive care. They will remind patients to attend the appropriate screenings for their gender and age group, which can lead to an early diagnosis. By catching a disease early, the NP gives their patients every chance of a better prognosis and a less invasive treatment plan.

  • Maintaining the financial health of their practice

By staffing physicians’ offices and keeping the doors open when there is a shortage of care providers, NPs can keep increasing the facility’s revenue. The average NP can see and treat between 15 and 20 patients daily. This means that their clinic or office can afford to purchase the latest medical equipment and keep their current devices well-maintained. Furthermore, a thriving practice that highly supports a standard of care is very competitive. Therefore, it continually attracts new patients and remains open to serve the local community.

  • Making sure that patients are satisfied with the care they receive

Research suggests that patients enjoy greater satisfaction after engaging with an NP. In part, this is due to the abilities and attitudes of the individual nurse, but there are other factors at play. Patients associate an NP with accessible care, cost-effective help, and useful information. This leads to them being able to manage their condition at home, and they have fewer ER trips and inpatient stays. When these stays are required, they tend to be shorter because the patient’s condition is generally under control, thanks to the care they have received from the NP.

For patients with chronic conditions in particular, NPs work to teach them about staying in control of their symptoms and quickly noticing when there is a change. As a result, they are more likely to request advice before their illness flares up and they need more intensive treatment. Furthermore, because NPs are trained to listen, they tend to form a closer bond with the individuals in their care, which helps to boost patient satisfaction.


NPs across the US help improve individual patients’ health and educate communities. Their role positively impacts the entire population, whether it’s through advocating for underserved populations, reducing costs, or boosting engagement. Their work means serious illnesses can be identified and treated more quickly, and chronic disease is controlled through carefully planned measures. NPs use their advanced training daily to make patients feel cared for and comfortable. In the long term, they are shaping the future of healthcare, making it more accessible, affordable, and effective.