Nurse Practitioners Help Fill Shortage of Doctors

Nov. 14--November -- National Nurse Practitioner Month -- is designated as the month to learn about nurse practitioners and what role they play in the medical field.

Marsha Lovick is a certified family nurse practitioner who works in pediatrics at Kinston Community Health Center.

Practicing for the past 32 years, she currently does well checks and sick visits with children from newborn to age 18 -- some of whom are the grandchildren of patients she saw in the early years of her career.

"As a nurse practitioner, I work in collaboration with a physician," she said.

Lovick said in addition to working under Dr. Khashana Blake, she is also monitored by the State Board of Nursing and the State Board of Medical Examiners.

NPs carry out many of the responsibilities as doctors do, but there are some differences. One is the amount of training. NPs may have a masters or doctorate degree, but they do not do a residency like doctors are required to do.

"It doesn't take quite as long for us to obtain our degree and our right to practice," Lovick said, "so there are more of us out there. ... We can see patients and be in collaboration with one physician who may be over a group of nurse practitioners."

The length of training makes certification more attainable.

Lovick earned a Bachelor of Science degree in nursing at what is now Barton College in Wilson. After working as a registered nurse for four years, she obtained certification from ECU in 1981 as an NP.

Sherry Smith was a registered nurse from 1985 to 2009, when she completed training at ECU and became an NP. She also served as an adjunct faculty member for ECU and Lenoir Community College.

"I just decided I wasn't doing quite enough, as far as patient care," Smith. "... For one thing, I love taking care of people. And my role as an educator, I felt like I was not at the bedside as much and I like taking care of people."

Being an NP would allow her more responsibility, she said.

Some medical facilities that are in need of physicians are willing to financially assist with their nurses' education to become NPs, with an agreement to remain employed for a specified period of time.

Smith said she was able to continue her education through an agreement with LMH.

Lovick said Dr. John Parrott, former health director, and former nursing director, Christina Maroules, were instrumental in helping a number of nurses at Lenoir County Health Department become NPs.

Smith started out in primary care, but now specializes in hematology and oncology.

After checking on the patients and analyzing lab work, she relates the information to Dr. Misbah Qadir at Kinston Medical Specialists -- which saves him time.

Many people are not aware of what role NPs play.

"Most people don't realize that nurse practitioners, we write prescriptions, we diagnose," Smith said. "In a specialty area, we do a lot more under the supervision of a physician."

Most of her patients have cancer and many are undergoing chemotherapy, she said. The seriousness of their condition requires more consultation with a physician than routine patient care, she added.

"In primary care, I think I worked a lot more independently than I do now," she said. "But the patients I see now are really a lot sicker or have something more acute going on. When they come to see a specialist, they really expect to see the physician."

For new patients, Smith will do the preliminary work and discuss it with the doctor. They will then go to the patient together to discuss their treatment.

The average salary of an NP makes them desirable for hiring.

"We don't demand quite the salary that physicians do," Lovick said, "and we feel like that we provide education at our visits -- hopefully in a preventative care role to help people to recognize symptoms, to recognize problems that they may have so that they can work on those problems at home so they don't become bigger problems."

With a shortage of physicians, NPs help lessen the workload of physicians by ensuring tests aren't being duplicated and spending time with patients to assess what medications to prescribe, Smith said.

They also focus on patient education, providing information to patients on healthy habits, such as nutrition, maintaining the proper weight and preventing illness.

"We're just everywhere," Lovick said, "trying to fill up that margin between the shortage of doctors and the medical care that people are demanding."

She said more people today understand the importance of NPs.

"Now, a lot of people would rather see the nurse practitioner," Lovick said, "because they realize we try to spend more time and do more education -- hopefully to keep them out of the office and keep them well at home."

Smith hopes the Affordable Care Act will bring about a national computerized system of health care records to avoid repeated tests.

Lovick said she believes what's commonly known as Obamacare will increase the number of people seeking health care.

"So we certainly hope that nurse practitioners will be able to fill the void between the shortage of doctors and the increased number of people with insurance who are going to seek health care," Lovick said, "So we hope we'll be right there leading the way in being able to provide quality care for all these people."

Margaret Fisher can be reached at 252-559-1082 or Margaret.Fisher@Kinston.com. Follow her on Twitter @MargaretFishr.

What nurse practitioners do

Autonomously and in collaboration with health care professionals and other individuals, NPs provide a full range of primary, acute and specialty health care services, including:

• Ordering, performing and interpreting diagnostic tests such as lab work and x-rays
• Diagnosing and treating acute and chronic conditions such as diabetes, high blood pressure, infections and injuries
• Prescribing medications and other treatments
• Managing patients' overall care
• Counseling and educating patients on health promotion and disease prevention.

Benefits of nurse practitioners

• Lower health care costs
• Patient satisfaction
• Primary care shortage solution

Facts about nurse practitioners

• There are about 171,000 NPs practicing in the U.S.
• 93 percent have graduate degrees
• 97 percent maintain national certification
• 18 percent practice in rural or frontier settings
• 43 percent hold hospital privileges and 15% have long-term care privileges
• 97 percent prescribe medications, averaging 19 prescriptions a day
• The early-2011 mean, full-time NP base salary was $91,310
• Average full-time NP total income was $98,760 in early 2011

Source: American Association of Nurse Practitioners

Copyright 2013 - The Free Press, Kinston, N.C.