In this paper, we are studying the impact that Nurse Practitioners are having in the field of health care. This is accomplished by looking at: how this is affecting accountability, quality, costs / the impact of health promotion and risk reduction. Once this takes place, is when we will discuss the changing responsibilities these individuals are playing inside primary care facilities.
¶ … Providers
Over the last several years, the majority of graduating medical students (90%) has been focused on careers in specialized care. (Pickert, 2009) This is because they will make more money in comparison with doctors that are working in a primary care environment. As a result, a shortage has developed with many health care providers turning to Nurse Practitioners. These are nurses with some kind of advanced degree in Nursing. Their job is to diagnose / treat patients and prescribe medication. To fully understand what is happening requires looking at how this trend is having an impact on accountability, quality, costs / health promotion and risk reduction. These different elements will provide the greatest insights as to how Nurse Practitioners are having an effect on a health care environment.
The Current Trends with Nurse Practitioners
There is a crisis happening with many primary care providers. The number of doctors working in these facilities has been decreasing with a variety having shortages of up to 30%. This makes is difficult for hospitals to be able to keep up with demand. (Pickert, 2009) To deal with these challenges many of facilities began to use Nursing Practitioners. These are trained nurses, who have advanced degrees (in Nursing) and several years of experience working in the field. The results are that this has helped to decrease the cost of providing basic primary health care services. This is because the cost for Nurse Practitioners is less in comparison with physicians. Evidence of this can be seen by looking at the below table (which is showing the total number of Nurse Practitioners and the average weekly salary)
The Total Number of Nurse Practitioner in Comparison with the Average Weekly Earnings
Year
Total Number of Positions
Average Weekly Salary
2009
98,535
$747.00
2010
99,927
$751.00
2011
100,294
$762.00
("Earnings of Wage and Salary Workers," 2012)
These figures are lower than the average weekly salary for doctors' (which is $2,664.85). ("Physician Salaries," 2011) This is illustrating how: the cost of Nurse Practitioners in primary care is less, there is better quality and more personalized attention. The big challenge going forward is being able to ensure that the training standards and experience continue to remain high in the future.
Accountability
This will have an impact on accountability by establishing higher standards. These must be followed by someone who wants to become a Nurse Practitioner. Currently, most programs are focused on the experience, previous education and the areas of nursing that were practiced. This is designed to serve as way of finding individuals who have the ability to effectively treat patients and address minor issues. ("Scope of Practice," 2010)
In the future there will be pressure for the industry to provide more Nurse Practitioners. This is a part of an effort to deal with the challenges facing health care facilities (i.e. rising demand and increasing costs). The problem is that when demand and costs are high many providers will often overlook qualification guidelines. This is when some of the standards for serving in the position could be reduced such as previous education or experience. If this were to occur, the quality of Nurse Practitioners could decline. This is the point that patients will receive inferior services. ("Scope of Practice," 2010)
To avoid these kinds of challenges, there will be a series of standards of accreditation established by professional organizations. This will create basic requirements that everyone must meet in order to become a Nurse Practitioner. Once established, these principles need to be applied across the entire country. This will ensure that everyone has the proper amounts of training when dealing with patients on the primary care level. ("Scope of Practice," 2010)
Quality
The way that this will have an impact on quality is to provide more health care professionals to hospitals. This reduces the odds of a facility becoming overcrowded (which can lead to mistakes). When there are Nurse Practitioners that are filling in for doctors, this can improve quality. The way that this takes place is to have these individuals work with select amounts of patients. This creates smaller teams and more personalized attention in providing these services. This is when mistakes will decrease with health care professionals doing more for everyone. Once this happens, is when the underlying quality of care will rise. ("Scope of Practice," 2010)
Cost / Impact of Health Promotion
Like what was stated previously, the cost of having Nurse Practitioners in place of doctors is lower. This is because their salaries are much less and the cost structure is lower. Evidence of this can be seen with Medicare and Medicaid. These government sponsored programs will pay for 85% of these services in comparison with doctors. This is important, because it is showing how the lower cost structure is one reason why Nurse Practitioners are playing a major role inside a health care environment. (Pickert, 2009)
The way that this can have an impact on health promotion efforts is by having Nurse Practitioners educating patients about certain issues (i.e. obesity of diabetes). What is happening is most individuals will learn about their health and how to deal with a host of conditions from their primary care provider. This is because the majority of insurance companies will restrict the patient's access to specialists (based on a referral from their primary care doctors). Nurse Practitioners will help to teach patients about how their lifestyle choices can have an impact on their health. This is based on the fact that these professionals will play a more dominant role in working and treating various conditions. Over the course of time, this can create relationships that are similar to that of patients and doctors. This is when the Nurse Practitioner can teach patients about how certain activities can make their condition worse. ("What is a Nurse Practitioner," 2011)
Risk Reduction
The way that risk reduction will occur is with Nurse Practitioners working in conjunction with doctors. This takes place by having these nurses monitor the patient for any kind of changes in their condition. In the event that there is some kind of sudden shift, is when they can step in and make decisions to deal with these issues. This increases the patient's chances of survival by providing them with immediate assistance from a trained health care professional vs. waiting for doctors to arrive.
Evidence of this can be seen with observations from Allen (2011). He found that when patients are given greater amounts of personalized attention the odds of survival increase by 50%. This is because they are receiving additional support that will help them to deal with the challenges associated with their condition. As a result, these kinds of nurses can offer specialized attention that will give patients more of a reason to take control of their health. (Allen, 2011, pp. 403 -- 411)
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