Nurse Practitioner: Your Advanced Practice Registered Nurse
What is a nurse practitioner?
A nurse practitioner (NP) is a healthcare provider who practices a mix of nursing and medicine, often in collaboration with a doctor. An NP is a registered nurse (RN) with advanced education, training and skills in preventive, diagnostic and treatment services. While NPs can work in any area of medicine, they often work in pediatrics, geriatrics, family medicine, and internal medicine.
NPs practice in different ways in different states, settings and specialties. They work in doctor’s offices, schools, clinics, hospitals, and community health settings. Some NPs run their own private practices, but many work as part of a group practice or a hospital or clinic healthcare team. Like all healthcare providers, NPs consult with doctors and other providers as appropriate.
In general, an NP:
Evaluates a patient’s medical history and educates the patient about wellness and disease prevention
Provides routine and preventive healthcare services including immunizations, sports and school physicals, pelvic exams, birth control counseling, and sexually transmitted disease (STD) screenings
Orders and interprets laboratory and imaging tests and prescribes medications
Diagnoses and treats acute diseases and conditions including infections and injuries
Screens, treats and monitors a range of chronic health conditions, such as high blood pressure, diabetes, thyroid disease, heart disease, and depression
Screens for cancer including Pap tests and skin and thyroid exams
Performs minor procedures including removing foreign objects and stitching cuts
Works closely with doctors and other healthcare providers to ensure patients receive optimal, seamless healthcare
NPs may also be known by the following names: nurse practitioner-certified (NP-C) and advanced practice registered nurse (APRN).
Who should see a nurse practitioner?
Anyone can see a nurse practitioner (NP), including infants, children, adolescents, adults, and the elderly. In private medical practices, NPs often work as a patient’s primary care provider.
Seeing an NP should feel no different than seeing a doctor. They can take care of all your routine health needs, such as physicals exams and vaccinations. NPs can also diagnose and treat acute and chronic diseases. Specialized NPs provide care for specific groups of people, such as a neonatal NP taking care of premature infants.
NPs are trained to know when medical issues are beyond their abilities to diagnose or treat properly. Your NP will consult with a doctor if there is a concern about an unstable or serious disease or if you have symptoms that are difficult to diagnose.
If you do not currently have a primary care provider, consider seeing a qualified nurse practitioner.
When should you see a nurse practitioner?
You should see a nurse practitioner (NP) once a year, or as recommended, for a physical exam and to monitor your general health and risks factors for disease. You should also consider seeking care from an NP if you develop symptoms or conditions that cause you concern including:
Chronic or acute pain
Engagement in high-risk behaviors including excessive use of alcohol or using illegal drugs, and high-risk sexual behaviors, such as having multiple sexual partners and not using condoms
Headaches that occur frequently or are accompanied by other symptoms including fever and coughing
High fever (for adults, higher than 103 degrees Fahrenheit)
Mild wheezing or shortness of breath (You should seek immediate emergency care for moderate to severe shortness of breath, or call 911.)
Minor injuries that you cannot treat at home with bandages and antiseptic cream
Unexplained fatigue or weakness
Unusual anxiety, stress, sadness, or other emotional problems
Urinary symptoms including frequent or painful urination
What conditions and diseases does a nurse practitioner treat?
A nurse practitioner (NP) may work independently or consult with doctors and other members of your healthcare team to provide the most effective treatment. An NP treats a wide variety of diseases and conditions, including:
Minor injuries including small cuts, sprains and fractures
Skin problems including acne, minor burns, and rashes
Weight problems including obesity, eating disorders, and malnutrition
What tests does a nurse practitioner perform or order?
A nurse practitioner (NP) can order, perform and interpret a wide variety of diagnostic and screening tests for chronic and acute health issues. An NP will consult with a collaborating doctor as needed to evaluate tests and the need for more testing. These tests include:
Abuse screening including evaluations for neglect and physical, sexual and mental abuse
General health tests including height, weight, development, vision and hearing screening, blood oxygen level (pulse oximetry), blood pressure, and mental health screenings
Imaging tests including X-rays, computed tomography (CT) scans, and ultrasounds
Laboratory tests including complete blood count (CBC), urinalysis, blood glucose (sugar) test, liver function tests, cholesterol panel, thyroid hormone tests, and drug, alcohol and toxicology tests
Reproductive health tests including pelvic exam and sexually transmitted disease (STD) tests
What procedures and treatments does a nurse practitioner perform or order?
A nurse practitioner (NP) can order or perform various procedures and treatments to manage many health conditions. NPs may consult with a collaborating doctor as needed at any point during a treatment plan.
NPs provide referrals to surgeons and other specialists to diagnose or treat complex or advanced conditions that they cannot manage themselves. Common procedures and treatments performed by NPs include:
Family planning prescriptions and treatments including birth control pills, hormone patches and shots, and intrauterine devices (IUDs)
General health procedures including physical exam, pelvic exam, eye exam, neurological exam, and immunizations
Healthy lifestyle counseling including eating habits, exercise recommendations, and quitting smoking
Medications including antibiotics, heart medications, high blood pressure medications, pain medicines, insulin and other diabetes medications, intravenous (IV) fluids, and breathing treatments for asthma and emphysema
Minor procedures including immobilizing fractures, removing foreign objects including splinters, removing warts, stitching minor cuts, and removing stitches or staples
Nurse practitioner training and certification
Education and licensing requirements for nurse practitioners (NPs) vary among states. However, certification by the American Academy of Nurse Practitioners (Nurse Practitioner-Certified, NP-C) is one key element in establishing an NP’s level of competence.
In general, an NP has:
Earned a bachelor’s degree in nursing and passed a state board examination to become a registered nurse (RN)
Successfully completed an accredited NP program leading to a master’s degree (MS) and possibly a post-master’s certificate or doctoral degree (doctor of nursing practice, or DNP)
Obtained a state license to practice as an RN and an NP. To obtain a license, most states require passage of the American Academy of Nurse Practitioners National Certification Examination in adult, geriatric or family practice.
To recertify, NPs must pass the appropriate examination or meet clinical practice and continuing education requirements every five years.
Nurse practitioners (NPs) can earn board certification in many practice areas from the American Nurses Credentialing Center or another certifying organization. Certification requirements generally include specialized education and training and passing a certification exam.
After becoming board certified (BC), NPs can use additional credentials with their name. Specialties include but are not limited to:
Acute care nurse practitioner (ACNP-BC) focuses on providing care to patients with acute conditions, as well as underlying chronic diseases.
Adult nurse practitioner (ANP-BC) focuses on providing primary care to older adolescents and adults.
Adult psychiatric and mental health nurse practitioner (PMHNP-BC) focuses on providing care to adults with psychiatric, emotional, and mental health conditions.
Family nurse practitioner (FNP-BC) focuses on providing primary care to the whole family and patients of all ages.
Neonatal nurse practitioner (NNP-BC) focuses on providing care to premature infants.
Gerontological nurse practitioner (GNP-BC) focuses on providing care to elderly patients with acute and chronic diseases.
Pediatric nurse practitioner (PNP-BC) focuses on providing primary care to infants, children and adolescents.
Women’s health nurse practitioner (WHNP-BC) focuses on providing primary and female-specific care for adolescents and women.
Requirements to maintain certification vary, but generally include completing continuing education and practice requirements within a certain period of time.