Women’s health articles

Nurse practitioners — the vital role they play in women’s health

by Marcy Holmes, NP, Certified Menopause Clinician

• What are nurse practitioners?
• Nurse practitioner training
• NPs in primary care
• Benefits of nurse practitioners in health care

The idea of becoming a nurse practitioner was planted when I was just a teenager. I was greatly inspired by a friend’s mother who was a nurse practitioner, and I also went to a nurse practitioner for my own health care. I like being a nurse practitioner because it allows me to practice medicine in a way that is authentically centered on the patient — treating her when needed of course, but more important, also being able to provide the kind of proactive health care that will help her stay well and prevent illness.

At Women to Women, we sometimes get questions about the role and training process for nurse practitioners. Nurse practitioners (NPs) are part of a growing and deepening field of healthcare providers, and we want to explain more about the important roles they can play in women’s health care.

What are nurse practitioners?

There are so many different types of practitioners, with different letters indicating different degrees, that it can sometimes be confusing as to who does what, so let’s make it simple. Nurse practitioners are registered nurses with advanced education in many areas of specialty. They have a wealth of medical experience as well as access to extensive information sources. We use our experience and resources to create and deliver “customized” health care with a special focus on the patient. I’m proud to be an NP because we have the exceptional opportunity, and the time, to provide individualized attention to our patients, with the flexibility to practice as specialists or primary care providers.

For those of you who don’t know, NPs are nationally certified in their individual specialties and are licensed through their states’ nursing boards. Regulations in each state may vary, though fortunately here in Maine, we are recognized as independent providers. NPs work within their scope of practice either independently or under supervision of a physician, and that varies by state. We rely on our good relationships with physicians in order to send our patients for specialized care, such as surgery, whenever necessary.

I have been lucky to work with other skilled practitioners including physicians, and have always been considered a valuable part of the team. These sorts of peer relationships make being an NP even more rewarding than I ever could have imagined. It’s a rich and satisfying experience to team up with physicians and other types of providers in order to treat the patient in a comprehensive and compassionate way. In fact, many doctors often lean on NPs to help them provide the full service healthcare that every patient requires, and deserves.

How a nurse practitioner is trained

NPs are trained according to a unique combination of both nursing and medical models of care, which combines the multidimensional nursing approach to wellness with the medical model of diagnosis and treatment. Preparation to become an NP starts with the traditional educational requirements for registered nurses and usually includes years of patient care experience. [If you’ve ever been in the hospital, you’ll understand how important our “nurse” role is: nurses are the ones who provide the hands-on care that can help you feel better and put you on the path to physical healing.]

NP candidates then go on to complete additional education —a Masters degree is now required. Extensive amounts of advanced, clinical hands-on training follow, as well as certification examination. NPs often focus on one specialty at first, and then expand into other fields. In my case, after I completed training and preparation for my choice of women’s health care (I hold certification as a WHNP, a women’s health nurse practitioner), I added Menopause Clinician specialization. Other NPs choose broader areas, such as adult medicine or family practice.

NPs as primary care providers and specialists — evidence-based individualized care

These days, fewer and fewer people coming out of conventional medical schools and training choose to practice primary care, and instead opt for “more lucrative” specialty fields. Rather than being a problem, this shift creates a new space which can be filled by the growing number of NPs. Because NPs are nurses first, they are ideally suited for primary care and can focus on disease prevention, by paying close attention to nutrition, social interaction, and even their economic considerations.

One of the main reasons I like being a nurse practitioner, is the incredible variety of responsibilities we have and the many areas of practice we can be involved in. These include screening and diagnosis, treatment, annual physical exams and pap tests, birth control and IUD placement, STD testing, ordering and performing diagnostic studies, prescribing physical therapy, physical rehabilitation, performing or assisting during certain surgical procedures (biopsies, colposcopies, etc.), breast health evaluation, counseling, patient education, referral to other providers, and much more.

The rules and regulations for NPs vary from state to state, though in general the requirements to become an NP — and stay certified — are extremely rigorous, and they’re expanding all the time. Many US colleges and universities are adding doctorate programs for NPs (degrees are either PhDs or Doctors of Nursing Practice ). Even now, all NPs update their training regularly and the requirements for continuing education are increasing as well.

Nurse Practitioners deliver high quality women’s health care

As a women’s health nurse practitioner (WHNP) clinician at Women to Women, I specialize in meeting the unique needs of my female patients. The majority of NPs serving women deliver primary care though you might also see a nurse practitioner for obstetrics and gynecology, breast health, pre- or post-surgical care, screening and referral, health counseling, and management of chronic illnesses, such as diabetes.

And there’s more. NPs also provide services to women through specialties like psychology, family care, pediatrics, neonatology, gerontology, hospice and school nursing, and nursing home and residential care. Originally, NPs got their start delivering health care to patients in rural or remote locations, and those are still places you’ll find us on the front lines.

At Women to Women, our experience has shown us the many ways in which NPs are particularly effective at helping women during menopause — and this is my other certified NP specialty. NPs take the time to become experts at menopause, and make it a point to be extra sensitive to women’s needs during this transition, especially when it comes to managing the symptoms of hormonal imbalance. Women from around the world come to our clinic in Maine just to receive this sort of care.

More choices for the patient: NPs and freestanding clinics

Women across the country are starting to realize that NPs offer a uniquely positive kind of health care experience. In Maine, where the Women to Women Clinic is located, and in many other states too, nurse practitioners may operate their own clinics, and that’s a good thing. In each of these locations, the state’s board of nursing oversees NPs, and a physician isn’t required to oversee or supervise the practice.

This may seem unusual if you aren’t used to health care provided by NPs. But because, we focus on providing comprehensive health care to all our patients at the Women to Women Clinic, we consult with and refer out to physicians who can take treatment to the next level whenever necessary. This helps make sure that the patient gets the type of care she needs whenever she needs it. Again, this is due to the strength of partnerships we all create as practitioners working together.

The benefits of NP-provided health care

Even though it’s no surprise to me, recent studies show that, since entering the US healthcare workforce in 1967, NPs have always gotten high marks for patient satisfaction. Patients consider NPs to be dependable and reliable, just as MDs are. Patients also appreciate that NPs often deliver cost-effective care for all parties involved, and that becomes even more important when times are especially tough.

As our country slowly moves away from MD-centered primary care, the National Association of Nurse Practitioners in Women’s Health has sent out a reassuring message: there is an army of NPs ready to serve the needs of America. As our fields of practice expand, it’s widening the scope of the ways we bring health care to the patients we serve.

If you have a chance to see an NP for your health care, you’ll probably notice that we’re really there for you. We work hard to be patient advocates who devote lots of one-on-one time to the people we treat. It’s absolutely crucial to build relationships with our patients and their families. That’s why for me, health care is about building trust and focusing on you, the patient, and your wellness, rather than just treating an illness when you don’t feel well, but of course, we do that too!

When a practitioner sees a patient regularly, she knows firsthand what’s “normal” for that person, and it makes any practitioner more sensitive to changes that affect health and wellness. Sometimes even small shifts are important — that’s why you want a provider who is in tune with you and the way you live.

With an NP as your healthcare provider, you may find that you can create the kind of health care you want — a kind of medical care that takes your needs into account, and that is centered on the concept of helping you stay well. This sort of care is empowering and can help you become more invested in your own health.

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References & further reading on nurse practitioners

 

Last Modified Date: 06/02/2011
Principal Author: Marcy Holmes, NP, Certified Menopause Clinician