May 1, 2012
As politicians and Supreme Court justices debate the Affordable Care Act (ACA), known as “Obama Care,” Mennonite College of Nursing is busy preparing students for the increase in demand of primary care providers, namely family nurse practitioners.
According to the U.S. Department of Health and Human Services, there are an estimated 49.9 million uninsured Americans, who will be coming into the health care system under ACA. “The question becomes, who is going to care for them?” asked Denise Wilson, Associate Professor of Nursing and leader of the Family Nurse Practitioner (FNP) Sequence at the College.
The FNP Sequence prepares students to provide primary care for patients across the lifespan. “Family nurse practitioners generally can take care of about 80 to 85 percent of the types of patients physicians see, freeing the physicians to see the patients with the most complex needs,” said Wilson.
The demand for nurse practitioners is growing, noted Wilson, especially in light of the new health care act. “The American Academy of Family Physicians projected that to meet the expected increase of patients, medical schools will need to graduate more than 4,400 primary care physicians a year by 2020,” said Wilson. “Currently, medical schools are graduating just over 1,000 general practitioners a year—a decline from 2,300 per year in 1997.”
Even as demand increases for primary care providers, “the majority of medical school students are choosing to specialize more and more,” said Wilson. “They want to go to dermatology, to cardiology, to surgery. It’s a continuing trend.” Wilson referred to a 2010 Journal of General Internal Medicine report which found the number of residents in medical school planning on establishing a general practice has plummeted from 54 percent in 1998 to just 24 percent in 2006. Conversely, according to the American College of Nurse Practitioners, 86 percent of nurse practitioners are in primary care.
The importance of primary care for patients cannot be stressed enough, according to Wilson, who explained primary care practitioners provide more than just referrals to specialists. “They are the point person for patient care,” she said. “Primary care pulls it all together, acts as an advocate and works closely with patients to help them achieve optimal health.”
According to Wilson, health care should be seen as a partnership between primary care practitioners and patients. “What people want in providers is someone who listens to them and with whom they can have a relationship, who knows their history and has the knowledge to help them in the management of their care,” said Wilson.
In her own active clinical practice, Wilson said she works with many patients on nutrition and preventative care. “So many of the problems we are seeing – hypertension, diabetes – comes from unhealthy lifestyles leading to such problems as obesity. I can offer patients the tools to help them improve their health, but there also has to be a relationship with the patient to understand the many factors affecting their life and health. For example, if the person is on a fixed income, I have to make sure any medications I order are both appropriate and affordable.”
All FNP candidates at the College have already earned a bachelor of science in nursing degree, and are licensed registered nurses. Wilson believes that makes them ideal candidates for primary care. “We have several outcomes we expect of nursing students, and one of them is caring. That caring element carries over as a primary care provider,” she said. Other essential elements include strong communication, assessment, diagnostic and critical thinking skills.
Currently, the FNP Sequence at Illinois State is at a master’s degree level, though plans are in place to raise the requirements to a doctoral level. “The American Association of Colleges of Nursing states that by 2015, all advanced-practice nursing should be at the doctoral level,” said Wilson, who added that a new Doctorate of Nursing Practice (DNP) program is now in development at Illinois State. “Health care is so complex, there is a need for more than clinical expertise. A strong knowledge of health policy, health care finance, leadership, outcomes and evidence-based practice is essential. The DNP, as the practice doctorate, provides this foundation,” she said, noting the DNP is considered the clinical practice doctorate, whereas the Ph.D. is research-focused.
No matter the level of degree, Wilson projects the demand for FNP graduates will only rise. “Recruitment for nurse practitioners is occurring through mail, through phone calls, even on billboards. Our students are successful in finding FNP positions,” she said. “Mennonite has a wonderful reputation — our FNP pass rate for first-time takers on the national certification examination is over 98 percent, compared to a national pass rate of 82 percent. Employers recognize the quality of our students.”
Last issue of Report for the semester. The first summer issue will be June 5.