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The Role of a Family Nurse Practitioner in Internal Medicine and Pediatrics

Premier Primary Care Blog The Role of a Family Nurse Practitioner in Internal Medicine and Pediatrics

There are different types of providers that you might see when you go to your Primary Care office and it may leave you wondering, "What's the difference?" Commonly seen providers in a primary care office include Physicians, Nurse Practitioners, and Physician's Assistants. I often see patients astounded to learn that we can practice autonomously as your Primary Care Provider and pleasantly surprised once they learn just how much we can do for you! Here I will give you info related to our training and education, as well as specifics on my services provided to you. 

First, lets talk education. A Family Nurse Practitioner first completes 4 years of undergraduate nursing education and then goes on to work as a registered nurse. A Family Nurse Practitioner must then complete a graduate program, usually 3 to 3.5 years long depending on what they choose to specialize in, and then pass a rigourous board examination. Much like our physician counterparts, there are different board exams depending on what specialty area we have chosen. In the state of Indiana, A Nurse Practitioner cannot practice medicine unless they are board certified. During our graduate education we complete several rotations and residencies in different patient population areas to gain the knowledge and expertise to practice autonomously. Most Nurse Practitioners have been working for many years as a registered nurse prior to entering their graduate program. Education and Training does not stop once we are practicing medicine! In order to maintain our license to practice we must complete a certain number of hours every year in different trainings and classes geared towards the patients we treat and take tests to go along with this. We must also provide direct patient care for a certain amount of hours each year to keep our license active. Every 5 years, we must reapply for our board certification. This is done similarly to our annual license renewal, by proving we have trained, tested, and passed several hours worth of education. 

So, what can a nurse practitioner do for you? We can provide Primary Care Services to you equal to that of a physician. In Indiana, state law permits us to diagnose, order tests, interpret tests, initiate and manage treatment, and prescribe controlled and non-controlled medications along side our physician counterpart. I treat and manage chronic illness including but not limited to: Diabetes Mellitus, hypothyroidism, anemia, asthma, COPD, high blood pressure, high cholesterol, peripheral vascular disease, cardiac dysfunction, anticoagulation management, osteoporosis and osteoarthritis, autoimmune dysfunction, allergy, immunology, and skin concerns, anxiety and depression, obesity, fibromyalgia, memory deficits, migraines, motor and neurological deficits, erectile dysfunction, vitamin D deficiency, Testosterone deficiency, insomnia, IBS, acid reflux, and many more. Chances are, if you are dealing with or worried about a certain chronic condition, I can help you! If your disease or illness is something that is more fit for a specialist office, I can certaintly make sure to get you to the best specialist for you and walk alongside you in collaboration with your specialist. 

What about acute illness? We see that too! No one likes to sit at an urgent care and see a provider they are not familiar with. If you wake up sick or in need, call me first! Acute illnesses I can help with include but are not limited to: respiratory illness, viral and bacterial infections, skin lacerations or infections, acute pain, gout or other joint pain and inflammation, headaches, abdominal pain and/or pelvic and groin pain, nausea and vomiting, allergic reactions, COVID-19. We can provide point of care testing for COVID, flu, and strep. If you've got a new acute issue not on this list, I'm sure it is something I can help you with! 

Wellness and Prevention are key to achieving optimal health and as a Family Nurse Practitioner, this is a very important part of the care we provide! Wellness services include: Sports physicals, child wellness exams, adult wellness exams, medicare wellness exams, skin cancer screenings, smoking cessation, weight loss and management, and vaccinations. I perform women's wellness exams which include a breast exam and pap as well as discussion of birth control if desired. I can also help provide preconception counseling. We can work together to select the appropriate screenings for you including: colon cancer screening, prostate cancer screening, breast cancer screening, STD screening, cervical cancer screening, and lung cancer screening. We can also discuss screening early for signs of disease such as screening for diabetes, iron deficiency, hepatitis, HIV, thyroid dysfunction, and cognitive decline.  

Now lets talk procedures. Types of procedures that a Nurse Practitioner offers will vary widely depending on the provider as procedural work requires additional education and training in order to perform them safely and effectively. Here I will list procedures I do but this is not necessarily true for all Nurse Practitioners. Procedures include: Nexplanon (birth control implant) insertion and removal, joint injections, injections for pain and/or inflammation, Botox injections, removal of impacted ear wax, incision and drainage of cysts or abscesses, suture or staple removal, skin tag removal, wound irrigation, Depo-Provera injection, and Testosterone injections. If there is a procedure you are interested in or would like to see offered in primary care that is not on this list, I would love to hear any feedback. The best part of being your provider is the chance to always learn new things! If I hear enough feedback that a certain procedure or service is desired, I would love to obtain the proper training and certification to offer it to my patients. 

Thanks for sticking with me until the end! I hope this post has been helpful and informative. Please feel free to message with any questions you may have! I have listed some statistics below with the appropriate link to the scholarly article or study from which the statistic was pulled! 

Taylor C. Thomas, APRN, FNP-c

As a whole, these studies demonstrated that NPs in specialty settings perform as well as physicians terms of clinical safety and positive patient outcomes. Nurse practitioners matched or exceeded their physician counterparts in patient education and satisfaction.  

patients assigned to NPs were less likely to utilize specialty care and inpatient services; had no difference in costs; and experienced equal chronic disease management compared to MD-assigned patients.

 Lower cost and better quality of care was attributed to chronic care patient management by NPs

Quality of care for diabetes and CVD patients delivered in a primary care setting was comparable between APPs and physicians, noting no significant differences.

Research has found that patients under the care of NPs have fewer unnecessary hospital readmissions, fewer potentially preventable hospitalizations, higher patient satisfaction and fewer unnecessary emergency room visits than patients under the care of other providers. 

      Lutfiyya, M.L., Tomai, L., Frogner, B., Cerra, F., Zismer, D., & Parente, S. (2017). Does primary care diabetes management provided to Medicare patients differ between primary care physicians and nurse practitioners? Journal of Advanced Nursing, 73(1), 240–252.

 

 

 

 

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