1. What is a Nurse Practitioner?
2. What is an ARNP?
3. What is the history of Nurse Practitioners?
4. What can Nurse Practitioners do?
5. Can Nurse Practitioners prescribe medications?
6. What services do Nurse Practitioners do?
7. Do all Nurse Practitioners offer similar services?
8. How is the quality of Nurse Practitioner care?
9. Are Nurse Practitioner services reimbursable?
10. Where do Nurse Practitioner work?

What is a Nurse Practitioner? is a site from the AANP (American Association of Nurse Practitioners) This page defines a Nurse Practitioner.

ARNP Legal Authority is a page that explains the current authority Nurse Practitioners have for providing medical care.

Creighton School of Nursing gives some requirement for Nurse Practitioners and reasons why Nurse Practitioners are gaining in popularity.

What is a Nurse Practitioner?

A Nurse Practitioner [NP] is a registered nurse [RN] with advanced education and training. You can't become a Nurse Practitioner until you have a degree in nursing, with all the medical training and experience that work requires.
   The governing board in Iowa for Nurse Practitioners is the Iowa Board of Nursing . [Top of Page]

What is an (ARNP)? Advanced Registered Nurse Practitioner

ARNP, or Advanced Registered Nurse Practitioner is a Nurse Practitioner who has taken training and passed national examination in one of four area. The legal authority from the State of Iowa is as follows:

• Legal Authority:   Code of Iowa, Chapters 17A, 147, 152, and 272C
• Job Description: Advanced registered nurse practitioners practice advanced nursing in one of four specialized areas, including: 1) certified registered nurse anesthetists, 2) certified nurse midwives, 3) certified nurse practitioners, and 4) clinical nurse specialists.
• Education & Experience Required: Advanced registered nurse practitioner applicants must be licensed as a registered nurse (see Registered Nurse) in Iowa, complete a 12 to 18-month program leading to certification in a specialty area or a 24-month master’s degree program, and pass a written national certification examination. Exam dates, fees, and the length of program vary depending on the area of specialization. The RN license is issued for three years, expiring on the 15th day of the birth month of the licensee. Registration as an advanced registered nurse practitioner is scheduled to coincide with the RN licensure cycle at a fee of $48 for the three-year cycle.
• Continuing Education: Thirty (30) contact hours or 3.0 continuing education units are required for renewal of a license issued for less than three years.
  Forty-five (45) contact hours or 4.5 continuing education units are required for renewal of a license issued for three years.
• Examination: The computerized exam, National Council Licensure Examination (NCLEX), is given year-round at approved Sylvan Technology Centers. [Top of Page]

What is the history of Nurse Practitioners?

The first NP program opened in 1965 at the University of Colorado. It was established to help improve childrens' access to health care. Today, over 200 university and college NP programs are educating RNs to provide direct patient care from newborns to the elderly. Now, over 70,000 NPs, have been trained. [Top of Page]

What can Nurse Practitioners do?

There are no legal restrictions on the scope of practice of NPs or ARNPs in Iowa. Unlike Physician Assistants, NPs are licensed to practice independently. At Hawarden Family Medical Clinic, our ARNPs have continuos contact with Dr. Harvey and are qualified to provide quality family medical care. They are not physicians, nor to they ascribe to be physicians. Nurse Practitioners provide a unique blend of health maintenance and health care. Nurse Practitioners can provide care in the following areas, among others:

• Obtain health histories
• Perform physical assessments and examinations
• Order & interpret diagnostic/labratory studies
• Diagnose & treat common illnesses and minor injuries
• Make referrals to specialists
• Counsel & teach health and nutrition
• Prescribe/manage medication therapy
• Provide continued/follow-up and coordinate care

Can Nurse Practitioners prescribe medications?

Yes! Nurse Practitioners have prescribing privileges in 43 states, including Iowa. Legislation is pending in the remaining. Nurse Practitioners may obtain state and federal controlled substance licenses. [Top of Page]

What services do Nurse Practitioners do?

• Well/sick baby care
• Well/sick child care
• Well/sick adult care
• Well/sick elder care
• Family Planning
• Health education
• Psychological counseling
• Screening for diseases
• Case management
• Prenatal care
• Minor surgery
• Diet counseling [Top of Page]

Do all Nurse Practitioners offer similar services?

While all NP's advocate health promotion and disease prevention the services offered are based upon their education. The types of NP education are:

• Adult Nurse Practitioner
• Family Nurse Practitioner (this is the training of Kim and Teri)
• Women's Health Nurse Practitioner
• Neonatal Nurse Practitioner
• Geriatric Nurse Practitioner
• Pediatric Nurse Practitioner
• Psych-Mental Health Nurse Practitioner
• Acute Care Nurse Practitioner

How is the quality of Nurse Practitioner care?

The care that NPs provide is very good according to numerous government and private studies. In fact, the U.S. Congress, Office of Technology Assessment says, "Nurse Practitioners provide care whose quality is equivalent to that of care provided by physicians". A recent article in JAMA (Journal of American Medical Association) also affirmed the quality of care of Nurse Practitioners, stating in the conclusion "In an ambulatory care situation in which patients were randomly assigned to either nurse practitioners or physicians, and where nurse practitioners had the same authority, responsibilities, productivity and administrative requirements, and patient population as primary care physicians, patients' outcomes were comparable."  [Top of Page]

Are Nurse Practitioner services reimbursable?

Though not by all, most insurers do cover NP services. As they learn about the high quality and cost-effective care NPs provide, insurers are including them as reimbursable providers.

Federal and State government insurers recognize the quality and cost-effectiveness of NP services:

• All federal employee health insurance policies pay for NP services.
• Medicare pays for NP services when delivered in designated rural settings. Legislation is pending to increase the reimbursable areas.
• The military's insurance program for retirees and dependents known as CHAMPUS pays for NP services.
• Medicaid reimburses for Family and Pediatric NP services- some states grant coverage to all NPs.

Where do Nurse Practitioner work?

Nurse Practitioners work in a variety of settings located in rural and urban communities. They work in private practices, ambulatory care clinics, HMOs, hospitals, public health departments, emergency rooms, nursing homes, free standing health clinics, womans' health clinics, school-based health clinics, rural health clinics and employee-health departments.

With the shortage of physicians willing to work in rural setting, the Nurse Practitioners provide a quality extension of medical care for many areas. Specialists in OB/GYN and Cardiology in Sioux City and Sioux Falls utilize Nurse Practitioners to facilitate the care they provide. Nurse Practitioners may be the most cost effective primary care provider, they are certainly now a very real presence in womans' health care.   [Top of Page]