Introduction
The role of a nurse practitioner in modern day world has seen its share challenges from other physicians. According to Lowe, Plummer and Boyd (2013), nurse practitioners target to improve healthcare delivery. Nurse practitioners offer a huge advantage in helping to reduce the doctors’ shortage, but there has been opposition from doctors to expand the role of a nurse practitioner.
One of the roles of a nurse practitioner is managing care environments and modifying the care delivery to ensure the attainment of patient's needs (Lowe, Plummer and Boyd, 2013). As such, many people view the role of the nurse practitioner as entirely involving the solving of healthcare problems that relate to access and equity of healthcare. The introduction of the nursing practitioner roles and their sustainability differ in terms of execution concerning in different healthcare settings or countries. According to some countries, the nursing practitioner roles are directed to help the disadvantaged communities. Additionally, the nurse practitioners roles enhance or aim to improve quality care and provide cost-efficient healthcare. It also ensures that workforce resources in healthcare are supplemented enough especially with increasing healthcare workers and doctors shortage.
The role that has been challenging for the nurse practitioner involves the issue of autonomous decision-making. According to Lowe, Plummer and Boyd (2013), autonomous decision-making opposition from doctors and other nurses makes the nurse practitioner feel isolated. The isolation is accompanied by professional jealousy that may be attributed from the lack of clarity in the nurse practitioner’s role. It becomes important for another healthcare staff to become familiar with the nurse practitioner role to enhance the nurse practitioners role. According to Lowe, Plummer and Boyd (2013), this will ensure that other nurse colleagues are comfortable working with the nurse practitioners. Furthermore, senior executives providing support to the nurse practitioner role can be helpful in ensuring effective implementation of nurse practitioner roles. The senior executives need to integrate the roles of the nurse practitioner in the normal workforce rather than using or introducing them when gaps develop.
According to Naylor and Kurtzman (2010), nurses constitute the largest portion of the healthcare workforce in the United States. Nurse practitioners constitute four of the distinct nursing workforce roles, which include nurse anesthetists, nurse midwives and clinical nurse specialist. The nurse practitioner provides primary care in both small and big private and public practices. According to Naylor and Kurtzman (2010), a nurse practitioner can function in both independent and collaborative capacities. Consequently, this enables the nurse practitioner to take up lead management, accountability and clinical roles in different primary care models. (Naylor and Kurtzman, 2010).
Nurse practitioners contribute significantly to high value primary care. Study findings indicate that patients experience the same level of satisfaction and mortality similar to ones they get from physicians. Since cost is a very huge factor in healthcare, nurse practitioners role may seem to be important in reducing the cost or access to healthcare. In most cases, physicians’ costs are normally higher, and this may limit the poor from accessing healthcare. As such, nurse practitioners role provides high-end value care at lower costs (Naylor and Kurtzman, 2010).
Certain challenges seem to affect the full implementation of nurse practitioners role. For instance, varying state laws on the nursing practice may limit a nurse practitioner from fully implementing comprehensive care services. Laws in certain areas are very restrictive, which causes migration of nurse practitioners to other less restrictive states resulting to a reduced access to nurse practitioners in these restrictive states. Naylor and Kurtzman (2010), indicate that the unequal payment plans between the physicians and nurse practitioners for the same services rendered creates raises concern on the issue of healthcare spending.
Nurse practitioners are already treating patients in some of the states in America where laws have been passed giving the nurse practitioner full authority to practice. According to Golden (2013), a nurse practitioner spends more time with the patient and provides services such as counseling and care organization. Empirical studies have indicated equal levels of patient outcomes for both physician and nurse practitioners.
The issue in nurse practitioners role arises in the concept of autonomy and supervision. Medical doctors indicate that the nurse practitioners need to work and practice under a physician supervision. However, this has generated much strife between the two parties. Experts note that to ensure primary care is enhanced, nurse practitioners need not be given more autonomy but instead teamwork needs to be fostered between the physician and nurse practitioners. On the other hand, Dr. Blackwelder (2013) indicates that the nurse practitioners patient outcomes emanate from collaboration with physicians. As such, it becomes difficult to substitute physicians with nurse practitioners since literature based solely on nurse practitioners role in healthcare is limited or literature support does not exist.
Conclusion
The nurse practitioner role in today’s healthcare is critical. However, challenges such as lack of clarity of roles, issues of funding, state laws and payments policies have made the effectiveness of nurse practitioners to be difficult. Furthermore, physicians are battling the complete autonomy of nurse practitioners citing different reasons, and this has resulted to increased division in healthcare delivery.
References
Golden, A., & Blackwelder, R. (2013, June 17). Should Nurse Practitioners Be Able to Treat Patients Without Physician Oversight? Wall Street Journal - Eastern Edition. p. R4
Lowe, G., Plummer, V., & Boyd, L. (2013). Nurse practitioner roles in Australian healthcare settings. Nursing Management - UK, 20(2), 28-35.
Naylor, M. D., & Kurtzman, E. T. (2010). The Role of Nurse Practitioners in Reinventing Primary Care. Health Affairs, 29(5), 893-899
