A Career As A Nurse Practitioner

Coco Sparks

Mr. Alburger

English III

9 November 2018
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Coco Sparks

Mr. Alburger

English III

9 November 2018

Nurse Practitioner

A registered nurse who has an advanced education and clinical training in a healthcare

specialty defines a nurse practitioner (Berkman). Nurse practitioners provide qualified healthcare

givers that have gone through the school necessary to help the demand for the need of

physicians. Nurse practitioners provide the same non-invasive or non-surgical services as

physicians (Berkman). Throughout history nurse practitioners have provided effective care, gone

through enough schooling, and will provide the solution to the lack of physicians in the future.

Many think that nurse practitioners have practiced for quite some time, but they believe

the common misconception. Nurse practitioners have only practiced this job for just under thirty

years, the nurse practitioner job came about because of the lack of physicians in the world

(O’Brien). Although the need for nurse practitioners exceeded the normal, it continued to

increase this job could not gain the recognition to become a noticeable job. In order to become

recognized as independent health caregivers the practicing nurse practitioners wanted a change,

therefore the took this issue to congress (O’Brien). When talking to Congress during the

meetings they conversed about their patients and they invited the congressmen to visit them

while giving care in the hospital(O’Brien). In 1993, a group called the American College of

Nurse Practitioners, formed in order to come together in this profession and to push this
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campaign to the next stage (O’Brien). This continued to raise issues and complaints and

eventually Congress passed the Balanced Budget Act of 1997.

The Balanced Budget Act of 1997 granted nurse practitioners the ability to give primary

care and allowed them to bill medicare for services in any place (O’Brien). The Balanced Budget

Act went through many processes in order to pass. The steps comprised which helped to

contribute to the passing of this include gaining the recognition of the nurses potential, they

documented the nurse practitioner values, they established standards, the NPs also used

organizations to empower these people, and lastly they mentioned opening up to becoming a

better profession at a time and not all at once (O’Brien). The Balanced Budget Act has taught

many different roles and lessons for other medical professions because they can now do the same

thing a these nurse practitioners did, which included wanting the respect from the Congress,

other doctors, and patients and them to consider this as a real job. Before the Balanced Budget

Act of 1997 the role of nurse practitioners could not recognize as a real profession therefore if

one person had this profession they would not have a “real” job although they still would have a

yearly salary.

Around the world nurse practitioners have also popped up here and there. Advanced

nurse practitioners came about in countries such as Holland, Ireland, and Great Britain around

the year of 1960 (Ljungbeck). This shows how other countries mainly in Europe have already

allowed this job. The United States adapted this thought from other countries and that could

cause concern to why Congress believe that it should not recognize as a real sustainable job.

In today's world nurse practitioners stand unquestionably important to the medical world.

NP’s provide a solution to the lack of physicians in the world. On the western side of the United
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States they have a higher demand more than the eastern side of the country (Berkman). Although

the high demand on the eastern side of the country helps with the job opportunities nurse

practitioners are still not known for. In the workforce they try to change the aspects of primary

care physicians and to focus it on nurse practitioners to lower the high demand for primary care

physicians (Maul). Nurse practitioners also play a role in other types of offices other than a

normal primary care physicians office, one including camps. Researches have said that nurse

practitioners could solve the jobs search for caregivers at summer camps (Erceg). They say this

because they find it difficult to find caregivers to take this job because of the liability they have,

but if a nurse practitioner does not run their own practice then they have no liability on them

(Erceg). Researchers also say that they feel as if this job opportunity provided the perfect fit for

nurse practitioners because of the lack of liability and the excellent care provided (Erceg). The

liability issue provides many concerns due to the fact no physicians in any way would want to

have this risk on them. This information shows the versatility of nurse practitioners in the

workplace.

The big issue in present times, the question of if nurse practitioners have the same

qualifications as doctors? Yes. Nurse practitioners hold a reputation to not know as much as

physicians because they do not have as much training as the regular primary physician. Nurse

practitioners qualify to know just as much as doctors and treat as well as them also. In the

training nurse practitioners train to look at the whole body and physicians only look at the part in

which they specialize in (Berkman). By looking at the whole body it gives you a better

understanding in which one looks for during an examination (Berkman). Nurse practitioners rate

high in customer satisfaction. Studies have shown that they give just as competent care as
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physicians. Researchers conducted an experiment to see if a group of how patients thought the

care by a normal physician compared to the care from nurse practitioners (Maul). After the study

finished the results came out as that nurse practitioners “have established a role for giving

competent care to patients in the primary care setting” (Maul). Although that's what they wanted

to look for they deciding to dig in deeper and study which the patients wanted as their caregiver.

After research finished, the researchers talked to the patients about the treatment from nurse

practitioners, they asked if they would come back to the nurse and if they received the care

needed, 94% of patients said that they would return (Maul). The study proves how nurse

practitioners provide just as valuable care as physicians do and gives a better understanding

about how they provide effective and truthful facts about the illness one has.

Nurse practitioners can do many things such as prescribe medicine and perform surgical

operations if needed. Many have the thought that NP’s can only provide basic care, such as give

shots, test for flu and strep, and do yearly check ups. These people are wrong. Even if they

practice in a state where owning an independent practice still needs legalization they still can

prescribe medicine and make their own decisions while a doctor guides them. Another issue that

comes about includes that not all physicians accept nurse practitioners. Many states which will

continue to decline as nurse practitioners become more known around the United States have

limitations on which medications they can prescribe, mainly high dosage drugs or addictive pain

medications which holds nurse practitioners back from doing everything a doctor can “Erceg”.

Sooner or later they will come around for no other fact besides that “if a nurse practitioner is

used efficiently, she or he can increase the productivity of a solo practice physician by 70 percent

or more. (Berkman)”
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The department of Oncology, which deals with cancer, plays an important appearance in

the job search for the role of nurse practitioning. Oncologist require many years of schooling and

training, due to this the lack of oncologists continue to decrease throughout the year and will

continue into something that might become catastrophic in the United States. Nurse practitioners

can put a stop to the need of the shortages. By the year of 2020 studies have predicted that the

world will have a shortage of 4,000 oncologists (McNally). Nurse practitioners have an positive

effect and change in health care as new models arise in the healthcare delivery (Hahn). In school

hematology nurse practitioners learn about hematology, oncology, and they receive courses in

chemotherapy and the basics of oncology nursing (McNally). McNally states that these nurses

provide assistance when needed and easy accessible to other member of the healthcare team,

meaning that they have important parts in almost of all operations and visits. This has developed

into a successful service for patients who require complex treatments (McNally). NP’s are an

ideal position that affects the complications of the lack of oncologists related to cancer and

treatment (McNally). Many people enjoy this job especially the ones with the mindset of helping

people because it helps them to improve the care of hospitalized patients in oncology and

hematology (McNally). Hematology nurse practitioners service provided succession of care with

familiar faces to patients with an outcome of successful treatments.This fact shows importance

because it explains how nurse practitioners involve themselves in the practice that they choose to

work in.

Elderly people have a high demand for healthcare needs and this will continue to increase

throughout the years which will put a huge burden on healthcare (Ljungbeck). The use of nurse

practitioners over the world has shown to make healthcare more effective and increase the safety
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of the patient due to the connection of care to the access to the care (Ljungbeck). Nurse

practitioners will provide to the elderly and others while the physicians have other patients to

work with. Patients have a positive attitude regarding the care by nurse practitioners and they can

see the opportunities that nurse practitioners can have meeting the for increasing healthcare for

the elderly. Although elderly continues to rise as a big issue in the world nurse practitioners

provide care to patients throughout their lifespan. This shows how nurse practitioners can help

other doctors, surgeons, and nurses to provide the most excellent care needed.

The profession has many interesting misconceptions that many find factual and helps

people understand the job of a nurse practitioner. The first common misconception includes that

nurse practitioners to not receive advanced training. This misconception holds this title falsely

because they have the title of a registered nurses that have went through the rigorous training and

clinical experience to earn a minimum of a master's degree (Spiry). The second biggest

misconception would include that nurse practitioners can only provide basic care. This continues

to also not hold the right reputation because they can prescribe all medications and have the

authority to have an independent practice in twenty five states and this number continues to

increase and will continue throughout the years (Spiry). In the twenty five other states one can

not own one's own independent practice, but they have the opportunity to work under a physician

and they provide guidance which nurse practitioners look at as an advantage and as a plus in

somes minds (Spiry). Many people look at this as a wonderful entrepreneurial opportunity for

nurse practitioners (Hahn).Although in this case one under the management of the physician they

can still prescribe their own medicine and call their own shots. The third and final

misconception, people often say “you are better seeing the doctor if you can”, studies have
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shown that nurse practitioners provide good healthcare and that many people have stated that

they finished the appointment feeling satisfied with their visits (Spiry). They did a research study

and they compared physicians and nurse practitioners and they had them to a variety of tests such

as controlling blood glucose and lipid levels and they nurse practitioner placed higher in dong

them then the primary physicians (Spiry).

In 2010 the Institute of Medicine recommended that the United States get rid of

Advanced Practice Registered Nurses, which are nurse practitioners who have their own practice

(Hahn). Many disagree with this statement and protested against this problem. These practices

“provide cost effective care with high quality outcomes”(Hahn). Having these practices allow

opportunities for practicing nurse practitioners because the difficulty to find the job in the first

place. It also allows them to maximize their patient care because they want the patient to come

back with positive reviews. With the opening of these new practices it will allow access to care

for so many more people especially the ones who need care immediately and those who don't

have enough money to pay for the physician. It also provides a fair competition ground for all the

new and upcoming students. Having these practices offers high-profitability without huge

investments of time. The only troubles with owning a practice follows with landing the patients

due to the fact no physician overlooks what goes on. Owning a practice comes with ups and

downs and practicing nurse practitioners will learn along the way.

Although many do not know this nurse practitioners can have their own practice in

twenty five different states. While having a practice of your own you have much more

responsibility on the different aspects of the office. If a nurse practitioner has their own practice

they have no physician advising them. Since a nurse practitioner that has their own practice does
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not have a physician over them they have all liability of his or her patients (Hahn). Some do not

like the thought have having nurse practitioners having a practice, such as the Institute of

Medicine (Hahn). Others would disagree with the Institute say that these practices provide cost

effective care with high quality outcomes (Hahn). Independent ownership allow nurse

practitioners the opportunity to maximize their patient care. Also opening these new practices

will allow people who can not afford expensive care to receive health care for a lower price for

his or her family. The job search may require extensive hours of searching due to the lack of jobs

opportunities in this field. Allowing the opening of new practices will allow more job

opportunities for the ones who currently searching for a job. Owning an independent practice

requires an extreme amount of work and time commitment but in the long run the continuous

patients that come back and bring more they will soon find that their hard work will pay off.

Due the misconceptions of the lack of education this will prove that nurse practitioners

qualify and have the certification needed to oncology practice their speciality. In order to earn a

nurse practitioner degree one will have to go through an extensive process. When a student

leaves they will leave with a masters degree with an advanced didactic and clinical preparation

beyond that of the basic registered nurse which typically only needs a bachelor's degree

(Berkman). This process adds another three years of schooling to the student. “Nurse

practitioners are registered nurses who have undergone another two to three years of rigorous

training and clinical experience to earn a minimum of a master's degree (Spiry)”. This shows that

people come up with misconception based on lack of knowledge. Students have the requirement

of having a doctorates degree of nursing practice (Spiry). Nurse practitioners, although they have
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not gone through all of the schooling as physicians they still have to go to more schooling than

the requirement and have to earn the minimum of a masters degree.

During school a student studying to be a nurse practitioner needs to pick a study which

might include emergency medicine, family practice, oncology, and many more options. At the

end of the students schooling they will then have to pass a test which would base upon the area

of speciality in which they studied. The training differs from the training of physicians in many

aspects. One would include that because they are training as a nurse they are trained to look at

the white person unlike the physician who looks at the specific cause or problem. By looking at

the whole body it gives them a better understanding about the resonon in which the patient

booked the appointment in the first place.

Nurse Practitioners also make a decent living based on their salary. A survey conducted

in 2006 shows the annual average amount that a nurse practitioner makes around seventy to

eighty thousand dollars per year (Newland). The aspects put into this calculation also includes

the different gender, where they work, and how much they work (Newland). They also have very

flexible hours if needed. You can work one to two days a week or you can work all five days it

up to the person's choice.

A practicing nurse practitioner answered some question regarding their job and what their

day to day life included. Andrea Kokoszka specializes in pediatric oncology. Day to day life

looks like any other job, one wakes up and goes in to work around eight o’clock in the morning

and comes home a decent hour at around four or five in the evening (Kokoszka). During the day

they are always busy and different varieties of things to do such as helping kids, taking blood,

discuss information, and many other things. Kokoszka said they prescribe, diagnose, and then go
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and discuss with the doctor to see if this diagnosed correctly (Kokoszka). Picking this job had

difficulties for Kokoszka but working with kids came first as a top priority. Helping people came

second on another top priority as well. At the end this job made the most sense allowing her to

have flexible hours, decent salary, and hit all the top priorities. Kokoszka also discussed some

helpful classes to take in college that helped prepare her in the workforce. One requirement for

this job would to have a bachelors in the science of nursing so taking classes that relate to this

degree would help tremendously because one needs it in order to pursue this career (Kokoszka).

Andrea Kokoszka provided much knowledge needed and answered some of the questions

difficult to find while researching this topic.

A nurse practitioner has pros and cons but mostly pros. A job as a nurse practitioner

comes with flexible hours and a decent salary which will both beneficial later in life. Pursuing

this career would require extensive amounts of schooling, time, and effort. This job will continue

to grow in positive ways to help the lack of physicians in the United States. In the end of it all the

outcome will show that the effort put in came out in a positive way
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Works Cited

Berkman, Sue. “Nurse Practitioners Are Here to Stay.” ​Fairfield County Business Journal​, vol.

37, no. 23, June 1998, p. 9. ​EBSCOhost​,

<​http://search.ebscohost.com/login.aspx?direct=true&db=b9h&AN=732303&site=eds-li

ve&scope=site​>

Erceg, Linda E. “Locating and Working Effectively with a Supervising Physician/Nurse

Practitioner.” ​Camping Magazine​, no. 6, 2017, p. 20. ​EBSCOhost​,

<​http://search.ebscohost.com/login.aspx?direct=true&db=edsggo&AN=edsgcl.51858908

5&site=eds-live&scope=site​>

Hahn, Joyce A., and Wesley Cook. “Lessons Learned from Nurse Practitioner Independent

Practice: A Conversation with a Nurse Practitioner Entrepreneur.” ​Nursing Economics​,

no. 1, 2018, p. 18. ​EBSCOhost​,

<​http://search.ebscohost.com/login.aspx?direct=true&db=edsgao&AN=edsgcl.52949013

8&site=eds-live&scope=site​>

Kokoszka, Andrea, Interview. December 4 2018

Ljungbeck, Birgitta, and Katarina Sjogren Forss. “Advanced Nurse Practitioners in Municipal

Healthcare as a Way to Meet the Growing Healthcare Needs of the Frail Elderly: A

Qualitative Interview Study with Managers, Doctors and Specialist Nurses.” ​BMC

Nursing​, no. 1, 2017. ​EBSCOhost​, doi:10.1186/s12912-017-0258-7.

Maul, Timothy M., et al. “Patient Preference and Perception of Care Provided by Advanced

Nurse Practitioners and Physicians in Outpatient Adult Congenital Clinics.” ​Congenital

Heart Disease,​ vol. 10, no. 5, Sept. 2015, pp. E225–E229. ​EBSCOhost,​

doi:10.1111/chd.12273.

<​http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=110279894&site=ed

s-live&scope=site​>

McNally, Gretchen A., et al. “The Evolution of a Malignant Hematology Nurse Practitioner

Service.” ​Clinical Journal of Oncology Nursing​, vol. 19, no. 3, June 2015, pp. 367–369.

EBSCOhost​, doi:10.1188/15.CJON.367-369.

<​http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=102869278&site=ed

s-live&scope=site​>

Newland, Jamesetta A. “2006 Nurse Practitioner Salary & Practice Survey.” The Nurse

Practitioner, no. 5, 2006, p. 39. EBSCOhost,

<​http://search.ebscohost.com/login.aspx?direct=true&db=edsgao&AN=edsgcl.14617467

4&site=eds-live&scope=site​>

O’Brien, John Michael. “How Nurse Practitioners Obtained Provider Status: Lessons for

Pharmacists.” American Journal of Health-System Pharmacy, vol. 60, no. 22, Nov. 2003,

pp. 2301–2307. EBSCOhost,

<​http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=11298419&site=eds-

live&scope=site​>

Spiry, Sue. “The Nurse- Practitioner.” ​BusinessWest,​ Jan. 2013, pp. 11–12. ​EBSCOhost,​

search.ebscohost.com/login.aspx?direct=true&db=b9h&AN=85323429&site=eds-live&s

cope=site.
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<​http://search.ebscohost.com/login.aspx?direct=true&db=b9h&AN=85323429&site=eds-

live&scope=site​>