Psychiatric Nurse Practitioner Susan Ouellette, CRNP, CSP, APRN-PMH, (www.sueouellettespeaks.com), says she gets this all the time from people who don't know any better. When she tells them, no, it's different from a doctor, they respond, "Are you going to go back to school so you can get promoted to be a doctor?"

Family nurse practitioner Peggy O'Donnell, ANP, BC, MS, RN, hears it too. "People ask me all the time, do you wish you were a doctor?" she recalls. "And I'm like, oh no, I am such a nurse! It's just who I am."

Since nurse practitioners have gradually taken on many responsibilities formerly reserved for physicians, it's an understandable misperception on the part of patients. Hopefully, Ouellette says, public awareness of the nurse practitioner role will increase. "I just look at people and say, I don't want to be a doctor, I can do anything I want. A nurse practitioner's a totally different thing."

A Unique Style of Care

One of the key differences between physicians and nurse practitioners lies in their caregiving style. The medical model of healthcare tends to focus on the diagnosis and treatment of disease. The nursing model of healthcare, on the other hand, incorporates the treatment of the human response to disease and emphasizes the prevention of disease.

Compared to the medical model of care, the nursing model of care tends to be more holistic. For example, with a patient who has chronic pain, a nurse practitioner is likely to assess sleep patterns, family relationships, and the patient's daily routine, in addition to trying to identify pathology.

Of course, each provider has his or her own style of care, and you can't generalize about a provider's style just from reading the letters after their name. However, nurse practitioners occupy a unique niche in the nursing profession because their training bridges the gap between the two healthcare models. "With nurse practitioning, it's great, because you can draw from either arena when you need to," explains O'Donnell."I feel that caretaking model coming out all the time, but I can pull out of the 'cure bucket' too. I know how to diagnose, I know how to treat--and if I don't, I certainly have specialists who can help me through an issue--but I can follow the medical model with the caretaking of nursing, which is really nice."

O'Donnell recalls one patient who came to her from a specialist. "The specialist was having trouble because [the patient] was very emotional and needy and difficult and so on. I soon found out, after meeting with her twice, that she was grieving her son's loss, that he had committed suicide, and she had just come to terms with it. And the next time I saw the specialist, he was like, I had no idea, no idea."

Although new nurse practitioners may initially focus on mastering the skills needed to properly diagnose and treat patients, with experience comes the realization that "giving a pill" is the easy part, continues O'Donnell. "And of course, people need pills for their high blood pressure, so they don't have a stroke," she clarifies, "but that's not the hard part. The hard part is finding out what's behind the blood pressure and what we can do for that."

Patients who have been to a nurse practitioner can usually spot the difference in style. "There are so many people who come up to me and say, 'Oh, I always see the nurse practitioner when I go to the office because she talks to me,'" reports Ouellette, who might see as many as 30 patients a day in addition to other responsibilities.

Differences in Compensation

According to May 2008 Department of Labor statistics, the median annual wages of registered nurses were $62,450 and the median annual wages forprimary care physicians were $186,044. Nurse practitioners don't earn as much as physicians, but they are in the upper tier of nursing salaries. One recent job posting for a nurse practitioner in a correctional facility offered $120,000, and a hospital job posting offered 92,000. There's a wide range of possible salaries for nurse practitioners, depending on your location and area of specialty.

Ouellette thinks that the healthcare system changes on the horizon may affect salaries positively. "Hopefully, nurse practitioner salaries are on the rise and will continue to rise, because they're going to need us. Nurse practitioners are worth a whole lot more money than they're getting paid." (See Family Practice Docs Upset That Some Nurses Earn More)

State-Regulated Scopes of Practice

The practice of nursing is independently regulated by states, and there is significant variation regarding nurse practitioners' scope of practice. In some states, nurse practitioners are blocked from prescribing controlled substances or can practice only under a "collaborative agreement" with a physician.

The collaborative agreement varies in scope. "Some states, like Massachusetts, do it through the institution and it's no big deal," Ouellette says. "And then some states like Maryland do it, and it's this big long laborious process that you have to go through."
(See Nurse Practitioners Protest State-Governed Limits on Practice)

Decreased Cost to Healthcare System

With millions of Americans about to flood the healthcare system, hospitals may not be able to afford to hire more doctors. As the number of patients continues to swell, healthcare settings will need to find affordable solutions. In many rural areas, nurse practitioners have been quietly providing primary care to under-served communities for years.

"We give good care, and we are cost-effective, so we can see the same amount of patients as doctors do," explains Ouellette. "We're going to be the goldmines, because unlike physician's assistants who have to practice on a doctor's license, right now, in certain states you don't need anything to practice. People are looking toward us because we do cost less than physicians. We're moneymakers for the institutions."
(See Do Nurse Practitioners Hold Key To Health Care Reform Success?)

Nurse Practitioners Are Here to Stay

One thing is for sure: nurse practitioners aren't going anywhere, so their roles can only expand. And with the rising demand for qualified primary care providers, patients won't be fussy about who they see, as long as they can get the care they need. As the healthcare system evolves and nurse practitioning gains more visibility, perhaps the question on the proverbial man-on-the-street's lips won't be, "Is that the next thing below a doctor?" but "Are you accepting new patients?

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Olivet Nazarene University - Graduate and Continuing Studies
Campus

Advance your career with Olivet Nazarene University - Graduate and Continuing Studies. We offer continuing education certificates and master's degrees in history, counseling, religion, business, education, and nursing, plus a Doctorate of Education in Ethical Leadership.

Programs:

Certification - Family Nurse Practitioner
Master of Science in Nursing - Family Nurse Practitioner
Master of Science in Nursing

Campus Locations:

Bourbonnais

University of Phoenix
Campus

As the largest private university in North America, University of Phoenix has more than 200 locations, and is available online in most countries around the world. Whether you're seeking a college degree at an associate's, bachelor's, master's, or doctoral level, we can help you reach your academic goal—and sooner than you might think.

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MS in Nursing/Family Nurse Practitioner
BS in Nursing (RN Required)
M.S. in Nursing

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Henderson

Salida

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Portage

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Georgetown University School of Nursing & Health Studies
Online

Founded in 1789, Georgetown University is the nation's oldest Catholic and Jesuit university. Today, Georgetown is a major international research university that embodies its founding principles in the diversity of our students, faculty, and staff, our commitment to justice and the common good, our intellectual openness, and our international character.

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Nurse Midwifery/Womens Health Nurse Practitioner
Family Nurse Practitioner

Kaplan University
Campus

Advance your career and get the distinct competitive advantage you need with an online degree from Kaplan University. And do it without missing a day of work.

Programs:

MS in Nursing
RN to MS in Nursing
RN to BS in Nursing

Campus Locations:

Fort Lauderdale

Walden University
Online

Balance your personal and professional commitments while earning a respected Ph.D., master's degree, or bachelor's degree online at Walden University. Programs offered in management, education, psychology and health and human services.

Programs:

M.S. in Nursing (MSN) - BSN Track
Post-Masters Certificates in Nursing - Nursing Education
B.S. in Nursing (BSN)

Medtech
Campus

Start your career with an education from Medtech. We offer programs in biotechnology, health care management, medical assisting, medical billing and coding, medical lab technology, and nursing, plus several short-term career courses.

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School of Nursing

Campus Locations:

Fort Wayne

Sanford-Brown Institute
Campus

Get everything you need for the medical career you want. Sanford-Brown Institute's advanced programs allow you to complete your certificate or degree program in as little as 9 months. Learn more today.

Programs:

Nursing

Campus Locations:

Melville

Florida Career College
Campus

Train for the real-world skills that help you launch a successful technology or healthcare career with a degree, or diploma from Florida Career College.

Programs:

Associate's Degree - Nursing RN
Diploma - Patient Care Technician

Campus Locations:

Boynton Beach

Miami

Pompano Beach

Clearwater

Hollywood

West Palm Beach

CollegeAmerica
Campus

Finally, a college that delivers. CollegeAmerica is truly unique in that their curriculum is designed for one purpose and one purpose only: to prepare students for success.

Programs:

Bachelor of Science Completion in Nursing (Online)
Associate Degree in Nursing
Bachelor of Science Completion in Nursing Administration (Online)

Campus Locations:

Flagstaff

Phoenix

Colorado Springs

Denver

Fort Collins

Cheyenne

Grand Canyon University
Campus

Don't Miss a Day of Your Future! Grand Canyon University is offering Bachelor and Master degrees through our College of Education, Ken Blanchard College of Business, College of Nursing & Health Sciences, College of Liberal Arts, and College of Entrepreneurship. Classes start soon!

Programs:

M.S. in Nursing: Public Health
M.S. in Nursing: Public Health (Bridge)
M.S. in Nursing: Health Care Informatics

Campus Locations:

Phoenix

Stevens-Henager
Campus

For more than 119 years, Stevens-Henager College has worked to train generations of graduates for new careers. Stevens-Henager College is accredited by the Accrediting Commission of Career Schools and Colleges (ACCSC). Our degree programs, designed to help graduates compete in the ever-evolving employment market, include Medical Specialties, Respiratory Therapy, Healthcare Administration, Surgical Technology, Business Management and Accounting, Computer Technology and Networking, Computer Programming, Computer Science, and Graphic Arts*. Online programs are offered via Stevens-Henager College, Salt Lake City/Murray. Stevens-Henager College Idaho Falls is a branch campus of the CollegeAmerica, Flagstaff, AZ, main campus.

*Check each campus for program availability.

Programs:

Bachelor of Science Completion in Nursing
Associate Degree in Nursing Education
Master of Science in Nursing Administration

Campus Locations:

Layton

Boise

Ogden

Saint George

Orem

Logan

Lehi

Idaho Falls

Murray

Nampa

Kaplan College - KHE
Campus

Don't wait another day to take the next step forward in your career. Kaplan College can give you the real-world knowledge and skills you need to succeed in your chosen field.

Programs:

Associate of Science: Nursing
Diploma: Practical Nursing
Diploma: Patient Care Assistant/Technician

Campus Locations:

Las Vegas

Indianapolis

Corpus Christi

San Antonio

Keiser University Campus
Campus

Keiser University offers accredited degree programs in today's high-demand careers: Healthcare, Technology, Paralegal, Business, Nursing and Legal Studies.

Programs:

Nursing, BS (Online Only)
Nursing, AS
Nursing, MS (Online Only)

Campus Locations:

Sarasota

Lakeland

Jacksonville

Tampa

Fort Myers

Orlando

Port Saint Lucie

Fort Lauderdale

Melbourne

Tallahassee

Lincoln Technical Institute
Campus

Lincoln Technical Institute provides career-focused, hands-on training programs with industry experienced instructors. Get the skills for a rewarding in-demand career.

For more student consumer information, please visit www.lincolnedu.com/lincolnconsumerinfo

Programs:

Nursing

Campus Locations:

Paramus

Edison

Hamden

Casselberry

Shelton

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Fortis Institute
Campus

Looking to prepare for your dream career? Fortis Institute can give you the skills and training you need to succeed in the fast-growing and high-demand healthcare field. * Programs vary by location * Please contact each individual campus for accreditation information * Fortis Institute - Indianapolis advertising code is AC-0163.

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