Nurses constitute the largest category of health practitioners in the US healthcare system, and they are usually the first ones who contact patients in hospitals. The number of the registered nurse practitioners (NPs) continues to grow and the demand for high-quality care and well-developed skills and competencies in medicine increases as well. According to the National Institute for Health Care Management (NIHCM) (2014), a great number of current registered nurses hold a master’s degree or a doctorate in nursing; by 2012, there were over 150.000 licensed NPs in the country, and over 125.000 of them provided healthcare service (p. 1).
The increasing number of NP graduates and the higher degree of expertise means that NPs can deliver service consistent with professional standards accepted in their sphere of practice, as well as national and state regulations, and achieve a high level of patient satisfaction. As mentioned by Kralewski et al. (2015), the employment of more NPs is “one of the most promising ways to expand the capacity of medical group practices to meet the projected needs for primary health care” (p. e366). It is observed that many provisions of the Affordable Care Act, such as investments in the development of nursing staff, support of education in nursing, NP training, and promotion of team-based care models, represent NPs as an essential element of the healthcare workforce (NIHCM, 2014, p. 1). Thus, it is possible to say that nurses play one of the key roles in the current and future health care system.
Nowadays, NPs work in many primary health care, acute care, and long-term care settings. Contrary to physicians who usually have a limited time for patient interaction, NPs spend more time observing and communicating with patients. As stated by Spencer and Hanania (2013), limited physician time may result in inaccuracies in the diagnosis and management of diseases and infections (including treatment-related infections); moreover, frequently the awareness of illness and comorbid symptoms among patients is quite low (p. 60). As a result, the compliance with patient safety principles can be impeded. Thus, in the context of poor communication between patients and care providers, nurses can play a major role in the management of adverse conditions by improving patient education and communication.
Within the disease management team, the scope of nurses’ practice may significantly vary from one setting to another, but primary clinical NPs’ tasks usually include diagnosis, prescription of drugs and procedures, patient monitoring, evaluation and refinement of treatment when needed (Spencer & Hanania, 2013, p. 60). However, it is possible to say, that such non-clinical activities as patient communication and education are NP role priorities because they contribute to the development of safety culture and achievement of better patient outcomes.
NPs spend a lot of time handling patient concerns, and when a nurse establishes a continual dialog with a patient, he or she stimulates patients’ adherence to treatment and minimizes the risks of the occurrence of side effects (Spencer & Hanania, 2013, p. 61). The ongoing nurse-patient dialogs allow NPs to understand the essential areas of patients’ concerns and provide practical education about the identified issues, diseases, or treatment procedures. In case patients are provided with comprehensive information about self-management and home-based treatment techniques, risks, potentially serious side effects, etc. during their stay in the hospital, they leave the clinic with sufficient knowledge about what actions they should undertake in what situations, and feel more encouraged to fill the prescription.
The recognition of patient needs and concerns through communication and education helps to develop an individual patient-oriented approach to treatment (Spencer & Hanania, 2013, p. 61). But as mentioned by Walsh, Moore, Barber, and Opsteen (2014) in their expert opinion article, NP education role is not limited by nurses’ collaborations with patients but also refers to the training of other staff members (p. e316). The findings of their recent qualitative research study reveal that the less experienced residents of the clinical settings perceive NP educational role as helpful because, in comparison to physicians, NPs are available and willing to assist more often (Walsh et al., 2014, p. e319). It means that in the context of staff education, learners usually have a positive view of NPs’ teaching of general skills and competencies in the areas of their expertise. And it is possible to say that nursing activities which have a high educational value may significantly facilitate team function and improve the overall performance within a hospital.
Both clinical and non-clinical NP roles serve to provide evidence-based, patient-focused care. Although, nowadays, there are many barriers in the organizational settings to the effective implementation of all NP roles and use of their competencies to a full extent, the increase in NP role autonomy and the development of understanding of NP functions in all staff members can help to improve nursing practice outcomes (Sangster-Gormley, Martin-Misener, Downe-Wamboldt, & DiCenso, 2011, p. 1181). It is possible to assume that by performing non-clinical NP roles – provision of health and risk information, education, and patient communication, – specialists may reduce the inadequate perceptions of diseases, symptoms, and their treatment; help to build confidence in both patients and junior clinical residents. In this way, NPs can encourage the compliance with safety principles; stimulate the achievement of greater productivity among clinical team members, increased patient satisfaction, and improved treatment outcomes.
References
Kralewski, J., Dowd, B., Curoe, A., Savage, M., & Tong, J. (2015). The role of nurse practitioners in primary healthcare. The American Journal of Managed Care, 21(6), e366-e371.
National Institute for Health Care Management. (2014). Meeting the demand for primary care: Nurse practitioners answer the call. Web.
Sangster-Gormley, E., Martin-Misener, R., Downe-Wamboldt, B., & DiCenso, A. (2011). Factors affecting nurse practitioner role implementation in Canadian practice settings: an integrative review. Journal Of Advanced Nursing, 67(6), 1178-1190. Web.
Spencer, P., & Hanania, N. A. (2013). Optimizing safety of COPD treatments: Role of the nurse practitioner. Journal of Multidisciplinary Healthcare, 6, 53–63.
Walsh, A., Moore, A., Barber, A., & Opsteen, J. (2014). Educational role of nurse practitioners in a family practice centre: Perspectives of learners and nurses. Canadian Family Physician, 60(6), e316–e321.