Can healthcare's fastest growing job solve nurse shortages?

In just one year, the nurse practitioner profession has added 30,000 employees to the workforce, according to data released Nov. 13 by the American Association of Nurse Practitioners.

The role has already been dubbed one of the fastest growing professions in the U.S. by the  Bureau of Labor Statistics. The latest data revealing a nearly 9% year-over-year growth rate for the profession underscores that this will not slow down anytime soon. 

In fact, the BLS estimates that the nurse practitioner role will experience a 38% growth rate within the next decade, with around 30,000 annual openings for the role every year until 2032. 

The footprint of the profession's impact within patient care is also widening. Between 2013 and 2019, Harvard researchers found that 25% of health visits in the U.S. were conducted by a non-physician, such as a nurse practitioner or a physician assistant. 

NPs growth won't help overall nursing shortage

While the profession's growth is noteworthy and increasing numbers of nurse practitioners in the field will continue to mean additional clinicians to care for patients — especially in the context of a physician shortage where NPs often fill gaps in primary care — the overall growth is not expected to move the needle on the nursing shortage. 

"For nursing in general, it's a great opportunity for nurses to elevate their practice and participate in healthcare with more autonomy… But in the long run, it's not going to benefit bedside nurses. I think we're starting to see some of the bedside nurses who actually feel like they've been deserted by nurse practitioners," Ceonne Houston-Raasikh, DNP, RN, chief nursing officer for Keck Hospital of USC in Los Angeles, told Becker's. "But I think really we should be framing it as what most people do in their careers, which is, wanting to elevate and do more and aspire to achieve greater things in their career."

Making the decision to pursue an advanced degree in nursing makes room for more nurse leaders, but few who choose to do so remain at the bedside. This is what could lead fellow nurse colleagues to feel abandoned or like they carry a different work burden still at the bedside while others leave it to move up, she explained.

"It's definitely not going to help the nursing shortage in the long run, but it is not going to hurt it either," Dr. Houston-Raasikh said. "Most nurse practitioners start off working at the bedside, then they go back to school, and then they move on into their nurse practitioner roles. But I think what we should really be focused on in nursing is really looking at the number of educators that we have, because if we had more nursing educators, we would be able to educate more nurses and bring more nurses into the field."

A lack of nurse educators due to pay and scarcity has caused nursing programs to turn thousands of students away throughout the last several years. 

Where NP growth will matter most

As the profession continues to add more employees each year, nurse practitioners will be in more decision-making roles including hospital and health system leadership positions, C-suite positions, as voting members on boards, etc. All those things that can improve the experience of bedside nurses overall, according to Stephen Ferrara, DNP, president of the AANP.  

Still, he says, "more work needs to be done as outdated hierarchical models that fail patients and artificially constrain the full participation of all healthcare providers still dominate too many facets of healthcare."

Nurse practitioners are also critical to rural care, making up more than 25% of the rural primary care workforce, he explained. In 2018, nurse practitioners accounted for one third of all primary care clinicians who billed Medicare, according to a report from the Medicare Payment Advisory Commission.

"In my conversations with NPs around the country, I frequently hear they chose to become an NP because they were interested in providing services that improve patients' overall health and decrease the need for hospital services," Dr. Ferrara told Becker's. "Additionally, nurse practitioners — especially in states with full practice authority — frequently return to their communities to provide access to those in most need."

As such, primary care will likely be the area that sees the most benefit from the increasing addition of NP professionals throughout the workforce, Drs. Ferrara and Houston-Raasikh agree. 

"When you look at some of the statistics out there, we know that almost half of our physicians are going to be retiring — half of our primary care physicians," Dr. Houston-Raasikh said. "And in addition to that, we have more and more physicians who are choosing to specialize. So between the retiring primary care physician and physicians who are choosing to specialize, we will continue to see that space be available for nurse practitioners to function in that primary care role."

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