Nurses presently form the largest sector of health care providers. The International Council of Nursing describes “nursing” as encompassing the promotion of health in individuals and communities, prevention of illness in all settings, and the care of ill, disabled and dying people. They educate, comfort, and assist the patients and patients’ families, coordinate and execute the plan for getting healthy, and above all, protect and care for the patient. Today, more than ever, nurse practitioners with extensive medical experience are taking responsibility of healthcare tasks traditionally held by doctors.
With the population increasing rapidly, the need for highly skilled and well-trained nurses is on the rise. While nurses in urban hospital settings are often the most publicized, there is a significant need for educated and capable nurses in small rural hospitals as well. A graduate degree, and increasingly so a doctorate-level degree in nursing is becoming a norm for nurse practitioners to meet the demands of health care today.
Registered Nurses
Registered nurses, also called RNs, are extremely important in providing healthcare. While the doctor provides opinions, diagnoses, and treatment suggestions, it is the nurse who provides aid and treatment to patients. Nurses perform a large part of the tasks in health care, from making beds and preparing food, to drawing blood and providing support to the patient and family. A doctor, however, must first authorize these tasks completed by nurses. The main difference between doctors and nurses is that nurses take the bigger share of the tasks and have less autonomy, whilst doctors take the bigger portion of the decision-making and get to do so independently.
According to the Bureau of Labor Statistics, registered nurses can specialize in a range of health care settings including:
- Ambulatory care nursing – treating patients with preventative care and alleviating injuries in clinics
- Critical care nursing – caring for patients with acute illnesses that require close monitoring that must adhere to complicated health protocols
- Trauma nursing – providing timely assessments and care for patients who come in with life-threatening conditions
In addition, nurses can specialize in niche areas such as radiology, psychiatric health, or transplant. Although the work responsibilities will vary from registered nurses working in different specializations, registered nurses are usually the first point of contact for many patients and provide valuable health care for patients in need.
Masters and Doctorate Nursing Programs
Registered nurses who complete a master’s or doctorate nursing program are eligible to become nurse practitioners. Most states in the United States require certification by the American Academy of Nurse Practitioners or the American Nurses Credentialing Center, while Canada’s nurse practitioners are licensed by respective provinces or territories. Much like a registered nurse, a nurse practitioner performs many of the different tasks involved in examining and treating patients. Unlike a registered nurse, however, a nurse practitioner may act as primary-care provider and does not require the supervision of a medical doctor. Not only does this allow a greater number of qualified and capable health care workers to meet the growing demand for health care, it also gives nurses greater autonomy in their work.
The roles of nurse practitioners vary greatly; they provide high-quality health care to patients including the diagnosis and treatment of health problems. Although it varies by location, nurse practitioners are often able to prescribe treatments, drugs, and therapies to their patients. They are often the first point of contact for a patient, conducting the initial physical examination and obtaining prior medical records for review. Nurse practitioners can assist in a variety of different procedures, surgeries, and other specialty care services, such as critical care, physicals, immunizations, and prenatal care. Like registered nurses, nurse practitioners provide education and counseling to patients about healthy lifestyles, preventative measures, and different treatment options.
The Doctor of Nursing Practice (DNP) and the Doctor of Philosophy (PhD) are currently the two highest graduate degrees available for registered nurses. The University of Virginia’s School of Nursing explains the difference between the two degrees: a DNP is designed to “prepare leaders with expertise in specialty practice who can utilize research evidence to effect practice change” while a PhD is aimed at preparing “nurse researchers to design, conduct and lead research projects.”
Controversial Doctorate Nursing Program Requirements in the U.S.
In 2004 the American Association of Colleges of Nursing voted to move the level of preparation for advanced nursing practice to the doctoral level by 2015. Given that the AACN is not a government agency, it would fall to the state legislatures to define their regulation of practice. However the idea that a DNP is required for entry into advanced practice has resulted in two very different schools of thought.
The AACN argues that the proposal is a response to the many changes in health care delivery and health care needs. According to their Position Statement, the main problem with the existing program is that in recent years, “the knowledge required to provide leadership in the discipline of nursing is so complex and rapidly changing that additional or doctoral level education is needed.” The Statement outlines thirteen recommendations, including the change to entry-level practice requirements, to the current status quo.
The opposing side cites studies that document the high quality and cost-effective care provided by masters-prepared nurses. On a more basic level, they also cite evidence that nursing programs could potentially face a shortage in upcoming years, given that fifty percent of current advanced practice nurses will reach sixty-five by the year 2020. In an article from The Medscape from WebMD Journal of Medicine Wendy H. Vogel asks, “Why would a new high school graduate want to consider a doctorate degree in advanced practice nursing? When one compares the time commitment of education with the potential remuneration of each profession, nursing may very well lose.”
The Importance of Nursing Programs
Regardless of the result of the current debate, it is clear that nurses will remain a vital and invaluable component to the healthcare industry. Nurses consistently execute the majority of tasks that need to be done in a health care setting. Doctors simply cannot provide the best care without nurses to follow their suggestions through, and nurses cannot function without doctors to make the judgment call about diagnoses and treatment options. Both nurses and physicians are essential and complimentary factors in what makes the health care industry provide health care advice, treatments, and aid to patients.