Fnp Role and Setting

Family nurse practitioner is a member of a specialized group of healthcare providers. "Nurses represent the single largest group of health care providers in the United States and are the initial point of patient contact in many settings" (Naylor & Kurtzman, 2010). Within the overall group of nurses, there is a specialized group of nurses known colloquially as nurse practitioners, and professionally as advanced-practice registered nurses. Nurse practitioners have specialized training in an area of medicine, which expands their licensing beyond that of the average nurse, so that they may deliver a broader range of care and engage in medical care duties that have traditionally been seen as the duty of doctors in the American medical model. One group of nurse practitioner is the family nurse practitioner. Family nurse practitioners may have the broadest specialization of any nurse practitioner; like doctors specializing in family care, family nurse practitioners need to have a comprehensive understanding of family medicine, which means that their true specialty is having extensive background knowledge of health issues at all age ranges. Moreover, family nurse practitioners serve as the primary medical care professional for many people in areas where access to doctors is limited. As one may imagine, this means that family nurse practitioners need to be able to handle a wide degree of medical issues and emergencies, but also have the knowledge of when to refer a patient for treatment by a specialist.

It is important to realize that the structure of the healthcare landscape in America is changing. The number of doctors entering into family practice is steadily declining. Moreover, it is well documented that workforce shortages lead to gaps in quality. The family nurse practitioner is stepping in to fill the role that has traditionally been filled by family practice doctors. In fact, "the nation is benefiting from the relative growth among NPs, whose per capita supply is projected to increase annually by an average of 9%" (Naylor & Kurtzman, 2010). Furthermore, patients seem to experience an economic benefit as well, as visits with nurse practitioner rather than physicians appear to provide substantial costs savings without having a negative impact on patient health (Naylor & Kurtzman, 2010).

Family nurse practitioners may be the primary health care professionals accessed by the patients who see them, though, in today's medical climate, patients may not see a consistent health care professional. "Nurse practitioners help patients manage acute and chronic illnesses. They conduct physical exams and perform diagnostic tests and procedures. Nurse practitioners in the family practice specialty diagnose and treat patients from childhood to adulthood" (Britt, 2012).

How expansive the nurse practitioner's role is can depend greatly on the state where the nurse is licensed to practice. However, in many respect, nurse practitioners have the same abilities and responsibilities of many family practice doctors. In many states, nurse practitioners can independently prescribe medications, while, in other states, nurse practitioners have to work with supervising doctors to prescribe medications for patients that are ill. This supervision can come in multiple forms. It is not unusual to see stand-alone clinics that are staffed by nurse practitioners with a supervising doctor who does not routinely appear at the clinic. In other instances, family nurse practitioners may work with doctors in family medical care centers, so that they literally work together on a daily basis. One of the more interesting, but also somewhat controversial, uses for family nurse practitioners is the role of the mobile nurse who visits rural areas and provides healthcare to people who would otherwise not have access to a primary healthcare professional. Those nurses may work almost completely independently of doctors, only utilizing them when a patient needs a referral for care.

One thing that does seem to separate the family nurse practitioner from the family doctor is nursing's emphasis on a collaborative care model. "Family nurse practitioners approach patients with an understanding of the value of collaborative, family-centered care" (Britt, 2012). In other words, nurses focus on treating the family rather than just the patient. This can be especially useful when dealing with chronic diseases, such as diabetes, where lifestyle changes aimed at disease management should involve the entire family dynamic.