Going to see your family doctor for basic needs may soon be a thing of the past.
Joan Shaver, a professor and dean at the University of Arizona’s College of Nursing, predicts most people will eventually rely on nurse practitioners for their primary care needs. They’ll assess for disease, treat common ailments and help people manage their stable chronic conditions.
The prediction is driven by two realities. The U.S. Department of Health and Human Services expects a shortage of 20,400 primary care physicians by 2020. Meanwhile, the federal government predicted in 2010 that the number of NPs would increase 30 percent by 2020.
Nurse practitioners are registered nurses who also have a Doctorate of Nursing Practice. They are licensed to evaluate and diagnose patients, order tests and prescribe medications. In Arizona and 22 other states, they can work without having to consult with a doctor.
At the UA, Shaver said students earn a Doctor of Nursing Practice degree in one or more specialties — family, pediatric, adult gerontology acute care and psychiatric mental health. They also have a certified registered nurse anesthetist program.
In December, 57 students graduated with a Doctor of Nursing Practice degree from the UA and there are currently three Sahuarita residents working toward their doctorate, Shaver said.
Sahuarita resident Candice Brown, 29, hopes to have her Family NP by December 2020. She also plans to take extra courses to obtain a certificate in rural health, too. She’s been a registered nurse since 2009, and cares for patients in an acute care setting at Banner University Medical Center. She is also raising a 2-year-old little boy.
She dreams one day of working in the clinic on the Flathead Indian Reservation near Missoula, Montana, where she worked while pursuing her undergraduate degrees at Salish Kootenai College.
“I miss working in the clinic because you really establish relationships with the tribal elders and you really get to know their families,” she said.
Part Navajo and part Salish, Brown said she has a connection with the community on the reservation and it pains her that doctors tend to come and go. Many participate in the Indian Health Services’ loan repayment program. If they make a two-year service commitment to practice in health facilities serving American Indian and Alaska Native communities they can repay up to $40,000 of their school loans.
“It has an effect on patient care because there’s a lack of continuity, which leads to diminished positive outcomes,” Brown said.
The people who live on the reservation suffer at a disproportionate rate from diabetes, depression and substance abuse, Brown said. The life expectancy of an American Native woman in Montana is 62, 20 years less than elsewhere in the U.S. The average American Native man dies at 56, she said.
“This kind of stuff is why I really want to work in my community, to fill these gaps,” Brown said.
If all goes as planned, Sahuarita Unified School District Governing Board President John Sparks will graduate in May 2019 with Doctor of Nursing Practice degrees in both family and psychiatric mental health.
He has bachelors' degrees in management information systems and entrepreneurship, but Sparks says he is happier when helping people on a more personal level.
He obtained his bachelor's in nursing from Northern Arizona University in 2015, and works as needed in the critical cardiac care unit at Tucson Medical Center and part time in an observation unit at St. Mary’s Hospital.
“I really do prescribe to the philosophy of nursing, which is whole-person centered,” Sparks said. “Nurses tend to focus on the person. It’s not just a disease they’re treating. It’s a person who has an illness that needs to be managed. Nurse practitioners help them figure out how they are going to live with the disease process, how they are going to live every day and be happy and healthy.”
Nurse practitioners tend to spend more time with their patients and are trained to listen to the wishes and desires of the patients, which really appeals to him, Sparks said.
“I think good medical providers, whether they are doctors or nurses, take time to see how people are feeling. It’s not just about giving them a pill, it’s about how they’re feeling,” he said.
A father of four, said he is pursuing dual doctorates because he wants to see to his patients’ psychiatric and physical needs. He also dreams of someday working in a rural setting treating underserved populations.
He believes that, overall, most Arizonans are already used to the idea of nurse practitioners so he doesn’t think people will complain much if they take the place of primary care doctors. He and his family have been seeing nurse practitioners for years.
Shaver, the UA dean, said she consistently hears positive things about NPs.
“Patients generally express high satisfaction with NP care. We attribute that to the strong health education and emotional support skills RNs learn for helping people cope with medical regimens and care for themselves outside of hospitals/clinics/offices,” Shaver said.
Kim Smith | 547-9740