Nurse practitioners are grouped with nurse anesthetists and nurse midwives by the U.S. Department of Labor because of their classification as advanced practice registered nurses, or APRNs They provide and coordinate patient care. Some also provide primary and specialty health care, depending on their work setting and employer.
NPs are employed in clinics, hospitals, emergency rooms, urgent care sites, private physician practices, nursing homes, schools, colleges and public health departments, according to the American Association of Nurse Practitioners.
“There is a wide range of responsibilities and actions, and nurse practitioners can serve in different capacities, depending on where they work,” says Joanna Black, a health care career consultant in New York. “NPs have become part of the larger health-care picture. They play a role in some of the important functions that have become essential to the overall treatment of an individual.”
According to the AANP, nurse practitioners are qualified to:
1. Prescribe medications and other treatments.
2. Order, perform and interpret diagnostic tests such as lab work and x-rays.
3. Diagnose and treat acute and chronic conditions, such as diabetes, high blood pressure, infections, and injuries.
4. Manage patients’ overall care.
5. Counsel and educate patients on disease prevention and positive health and lifestyle choices.
Jose Menendez, a nurse practitioner in Miami, Fla., says he sees his role as someone who is focused on the overall health of an individual.
“I look at all aspects of a patient’s wellbeing and try to work with them to either make adjustments to their lifestyle or help them find the appropriate doctor or health-care facilitator to serve their needs,” he says. “I feel like I can earn someone’s trust by treating their whole, rather than their parts.”
Menendez, who splits his time between a physician’s office and a medical clinic, says that trust is based on individual work and a team effort.
“No one is isolated in health care today,” he says. “There’s not a doctor making house calls who handles every single ailment in your family. Today, you have generalists and specialists. We all have to work together.”
A patient’s voice
Andrea Vitale, a nurse practitioner in Naperville, Ill., says she finds that her role is split between treating patients and listening to their concerns.
“You have to be a good listener anytime you come in contact with a patient,” says Vitale, who’s taking a three-month maternity leave after the birth of twins in June. “And good listening isn’t just silence. It’s eye contact, body language and the correct responses. It’s getting the patient to feel like they can trust you, and then getting to the point where they know you will be their mouthpiece when they have trouble communicating their issues.”
Vitale has first-hand experience with the communication issue. She says she dealt with two patients last year who had concerns they didn’t want to share with family members. In both cases, she helped them get the proper care they needed and worked with other members of her health-care team to keep the information private.
“We think that privacy issues center around teen pregnancies or major diseases, but that’s not always the case. There are a lot of private people and, for whatever reason, they view their health care as their business and no one else’s. Sometimes, they want privacy over issues like incontinence or memory loss. They want to ask questions and get answers before getting a spouse or a family member involved.”
Menendez, who earned his master’s degree in nursing from Florida Atlantic University, says he decided to seek NP status after realizing he wanted to have more of a say in his patients’ treatment.
“I was a licensed practical nurse for about five years and although I really enjoyed my work, I felt like I wanted to learn more about the big picture so my voice would be heard,” he says. “The doctors I’ve worked with have been incredibly open about input ,but you know that at times, it only goes so far. Now, as an NP, I feel like I have a seat at the table. I feel like my opinion is valued more than before.”
What it takes
Vitale says it’s important for prospective nurse practitioners to be open to new ways of seeing the world around them.
“It’s really important to look at things differently,” Vitale says. “You need to be receptive to knowledge not just from your classes, but also from the other members of your team and your patients.”
“You have to love learning,” he says. “You have to want to find out new ways to help others.”
Black says she finds that the nurse practitioners hired most often have professional demeanors that mix seriousness with a casual approach to others.
“I’m sure there are NPs who have larger-than-life personalities, but I find that the candidates who are hired most often have a strong, professional presence that comes through best by their informal and casual conversations with patients,” she says.