Hamric, et al., (2013) states the role of a Primary Care Nurse Practitioner follows the Institute of Medicine (IOM) guidelines for primary care of providing accessible healthcare for all patients across their lifespan, by building and sustaining a personal relationship built on mutual respect and trust. While this certainly includes assessment, diagnostics, and forming a treatment plan for both acute and chronic illness, such as what Physicians currently provide, the Primary Care Nurse Practitioner’s practice is much more holistic and includes such things as health promotion and disease prevention through education.
The difference between a Primary Care Nurse Practitioner and other Advance Practice Nursing roles is the time frame of when care is provided. While Primary Care Nurse Practitioners provide care to patients across their lifespan, identified as direct care, other Advance Practice Nurses will only provide care to a specific patient population that falls under their targeted specialty, such as mental health, or women’s health, identified as indirect care (Lowe, et al., 2011). While the time period the patient is under their care is much different, all other aspects of care remain the same in providing patient centered, holistic care.
To explain the difference in roles between primary care and other Advanced Nurse Practitioners to colleagues or patients, I would us the current physician’s model of practice as an example since most patients are familiar with it. Primary Care Nurse Practitioners provide the same care as Primary Physicians, at a lower cost. If a specialist is needed in areas such as Obstetrician/Gynecological, referrals can be made to other Advance Practice Nurses who specialize in that area. Unless the State of service has restrictions on Nurse Practitioner’s scope of practice, this would be the best explanation of the differences in advance practice nursing.
Iglehart (2013) reports when Advanced Practice Nurses and Physician’s work side by side, there is much collaboration and a spirit of a team approach in the best interest of the patient, not the status quo. This is seen today at the local level and as the need for physicians increase due to a shortage of physicians, a growing population (Pankau, 2021), and healthcare’s push to provide patients better access, lower cost, and quality care, Advanced Nurse Practitioners will be used more in every health care setting and seen as a valuable member of the healthcare team. The remaining hurdle is National standardization of terms, roles, and scope of practice for this much needed provider of healthcare.
Hamric, B. A., Hanson, M. C., & Tracy, F. M., & O’Grady, T. E. (2013). Advanced practice nursing: An integrative approach (5th ed.). Elsevier. ISBN:
Iglehart, J. K. (2013). Expanding the role of advanced nurse practitioners — Risks and rewards. New England Journal of Medicine, 368(20), 1935-1941.
Primary Care NP Role vs. APN Roles
An advanced practice nurse (APN) is defined as someone who has gone above and beyond with 2-4 years of basic nursing education, obtained a bachelor’s degree, and is now certified by the National Nurse Organization (American Nurses Association, 2021). There are multiple types of nurse practitioners as it is not a one-size-fits-all type of profession. For instance, family nurse practitioners, gerontology and adult acute care nurse practitioners, pediatric, neonatal, and psychiatric nurse practitioners as well as women’s health nurse partitioners (Gwynedd Mercy University, 2021). Although, the specialty may differ the scope of practice remains the same. All nurse practitioners are responsible for assessing, diagnosing, and treating a disease process (Nurse Journal, 2021). Some states allow nurse practitioners to perform independently without resorting to a medical physician (Nurse Journal, 2021). However, other states such as Florida still require nurses to be supervised by a medical director (Medline Plus, 2020).
Acute care nurse practitioners mainly care for patients who are quickly deteriorating in a critical state, with a higher-than-normal probability of procuring complications, or patients dealing with ill complexes (University of Texas Arlington, 2018). Taking this into account, they can work in different settings such as emergency rooms, operating rooms, clinics, and ICUs (Medline Plus, 2020). In addition, they are also qualified to work with patients who are suffering from heart attacks and septic shock (Medline Plus, 2020). A primary care NP is more flexible when treating a variety of people of all ages. They usually are more involved in physical exams, prescription medication, formulating treatment plans, and ordering diagnostic exams that pertain to the patient’s current illness (American Association of Nurse Practitioners, 2019). The role of a nurse practitioner can become a blur and difficult to understand especially for those not directly in the medical field. Nurses must clarify the confusion, answer questions, and make the profession more stabilized.
Giving clarity on what is expected is extremely important to be able to change the narrative of what they can and cannot do. Being able to explain the scope of practice to others is a great way to gear toward the acceptance of nurse practitioners. This will create a more valid understanding and eventually not need to further clarify the scope of practice. A great way to start breaking barriers is by introducing ourselves as nurses from the start. I believe this strategy can lessen the confusion as nurses have a respectable reputation for being the best advocates for patient care. Enlightening patients on our education and training will allow them to trust nurse practitioners and speak about any health-related issues they may have. Communication is key in any relationship, especially those of a nurse practitioner and a physician to promote a good patient outcome. Unfortunately, if a physician is unaware of a nurse practitioner’s scope of practice, a lot of challenges may arise such as miscommunication that can ultimately impact the patient. There needs to be a level of respect, open communication, and professionalism to provide the best patient care, after all, patient well-being is the focus.