Nurse Practitioner

The NP is now recognized as a registered nurse with specialized skills and knowledge in health assessment and promotion, counseling, disease prevention, and management of selected health problems. While both the PA and the NP undertake medical functions, the NP does so as a registered nurse, applying advanced nursing knowledge. In collaborative practice, NPs and physicians provide health care to a specific population of patients, sharing authority for providing care within the scope of their practice. NPs have shared competencies with physicians and other health professionals, and upon completing specific education have been delegated to perform selected medical functions.

NPs demonstrate a high degree of professional autonomy; working in environments where they are supervised employees of physicians (in a family practice office), in collaborative practices (as in a geriatric ambulatory clinic), or in solo practices (community health care drop-in centers). NPs bring additional skills to the care of patients, including provision of disease-prevention counseling, health education, and health promotion activities, as well as more time than physicians to spend talking to patients. The physician will always be the primary professional providing diagnosis and treatment in complex cases and managing patients with critical and unstable medical conditions.

Gerontological nurse practitioners (GNPs) provide elderly persons with services specifically tailored to frail individuals. Their scope of practice involves management of the patient from the community consultation, through diagnosis and treatment (emergency, outpatient, or inpatient), through home visits following discharge, including a comprehensive discharge plan. These activities have reduced hospital readmissions and costs of care, and have improved the continuity of care. Medical directives and protocols for specific problems, such as cardiac irregularities, delirium, and sudden shortness of breath, are examples of medical functions delegated to the GNP.