Psychiatric Nurse Practitioner Susan Ouellette, CRNP, CSP, APRN-PMH, (www.sueouellettespeaks.com), says she gets this all the time from people who don't know any better. When she tells them, no, it's different from a doctor, they respond, "Are you going to go back to school so you can get promoted to be a doctor?"

Family nurse practitioner Peggy O'Donnell, ANP, BC, MS, RN, hears it too. "People ask me all the time, do you wish you were a doctor?" she recalls. "And I'm like, oh no, I am such a nurse! It's just who I am."

Since nurse practitioners have gradually taken on many responsibilities formerly reserved for physicians, it's an understandable misperception on the part of patients. Hopefully, Ouellette says, public awareness of the nurse practitioner role will increase. "I just look at people and say, I don't want to be a doctor, I can do anything I want. A nurse practitioner's a totally different thing."

A Unique Style of Care

One of the key differences between physicians and nurse practitioners lies in their caregiving style. The medical model of healthcare tends to focus on the diagnosis and treatment of disease. The nursing model of healthcare, on the other hand, incorporates the treatment of the human response to disease and emphasizes the prevention of disease.

Compared to the medical model of care, the nursing model of care tends to be more holistic. For example, with a patient who has chronic pain, a nurse practitioner is likely to assess sleep patterns, family relationships, and the patient's daily routine, in addition to trying to identify pathology.

Of course, each provider has his or her own style of care, and you can't generalize about a provider's style just from reading the letters after their name. However, nurse practitioners occupy a unique niche in the nursing profession because their training bridges the gap between the two healthcare models. "With nurse practitioning, it's great, because you can draw from either arena when you need to," explains O'Donnell."I feel that caretaking model coming out all the time, but I can pull out of the 'cure bucket' too. I know how to diagnose, I know how to treat--and if I don't, I certainly have specialists who can help me through an issue--but I can follow the medical model with the caretaking of nursing, which is really nice."

O'Donnell recalls one patient who came to her from a specialist. "The specialist was having trouble because [the patient] was very emotional and needy and difficult and so on. I soon found out, after meeting with her twice, that she was grieving her son's loss, that he had committed suicide, and she had just come to terms with it. And the next time I saw the specialist, he was like, I had no idea, no idea."

Although new nurse practitioners may initially focus on mastering the skills needed to properly diagnose and treat patients, with experience comes the realization that "giving a pill" is the easy part, continues O'Donnell. "And of course, people need pills for their high blood pressure, so they don't have a stroke," she clarifies, "but that's not the hard part. The hard part is finding out what's behind the blood pressure and what we can do for that."

Patients who have been to a nurse practitioner can usually spot the difference in style. "There are so many people who come up to me and say, 'Oh, I always see the nurse practitioner when I go to the office because she talks to me,'" reports Ouellette, who might see as many as 30 patients a day in addition to other responsibilities.

Differences in Compensation

According to May 2008 Department of Labor statistics, the median annual wages of registered nurses were $62,450 and the median annual wages forprimary care physicians were $186,044. Nurse practitioners don't earn as much as physicians, but they are in the upper tier of nursing salaries. One recent job posting for a nurse practitioner in a correctional facility offered $120,000, and a hospital job posting offered 92,000. There's a wide range of possible salaries for nurse practitioners, depending on your location and area of specialty.

Ouellette thinks that the healthcare system changes on the horizon may affect salaries positively. "Hopefully, nurse practitioner salaries are on the rise and will continue to rise, because they're going to need us. Nurse practitioners are worth a whole lot more money than they're getting paid." (See Family Practice Docs Upset That Some Nurses Earn More)

State-Regulated Scopes of Practice

The practice of nursing is independently regulated by states, and there is significant variation regarding nurse practitioners' scope of practice. In some states, nurse practitioners are blocked from prescribing controlled substances or can practice only under a "collaborative agreement" with a physician.

The collaborative agreement varies in scope. "Some states, like Massachusetts, do it through the institution and it's no big deal," Ouellette says. "And then some states like Maryland do it, and it's this big long laborious process that you have to go through."
(See Nurse Practitioners Protest State-Governed Limits on Practice)

Decreased Cost to Healthcare System

With millions of Americans about to flood the healthcare system, hospitals may not be able to afford to hire more doctors. As the number of patients continues to swell, healthcare settings will need to find affordable solutions. In many rural areas, nurse practitioners have been quietly providing primary care to under-served communities for years.

"We give good care, and we are cost-effective, so we can see the same amount of patients as doctors do," explains Ouellette. "We're going to be the goldmines, because unlike physician's assistants who have to practice on a doctor's license, right now, in certain states you don't need anything to practice. People are looking toward us because we do cost less than physicians. We're moneymakers for the institutions."
(See Do Nurse Practitioners Hold Key To Health Care Reform Success?)

Nurse Practitioners Are Here to Stay

One thing is for sure: nurse practitioners aren't going anywhere, so their roles can only expand. And with the rising demand for qualified primary care providers, patients won't be fussy about who they see, as long as they can get the care they need. As the healthcare system evolves and nurse practitioning gains more visibility, perhaps the question on the proverbial man-on-the-street's lips won't be, "Is that the next thing below a doctor?" but "Are you accepting new patients?

Become a Nurse Practitioner Online

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Georgetown University School of Nursing & Health Studies
Online

Founded in 1789, Georgetown University is the nation's oldest Catholic and Jesuit university. Today, Georgetown is a major international research university that embodies its founding principles in the diversity of our students, faculty, and staff, our commitment to justice and the common good, our intellectual openness, and our international character.

Programs:

Family Nurse Practitioner
Nurse Midwifery/Womens Health Nurse Practitioner

University of Phoenix
Campus

As the largest private university in North America, University of Phoenix has more than 200 locations, and is available online in most countries around the world. Whether you're seeking a college degree at an associate's, bachelor's, master's, or doctoral level, we can help you reach your academic goal—and sooner than you might think.

Programs:

MS in Nursing/Family Nurse Practitioner
MS in Nursing (RN Required)
M.S. in Nursing

Campus Locations:

Pasadena

Costa Mesa

Ontario

Sacramento

Los Angeles

San Francisco

Murrieta

Oakland

Rancho Cordova

Fairfield

Online

San Jose

Livermore

Lathrop

Woodland Hills

Elk Grove

Gardena

Lancaster

Fresno

Bakersfield

Roseville

Salida

Diamond Bar

Palm Desert

The College Network
Online

Start your nursing career with The College Network. Earn your NLNAC/CCNE Accredited nursing degree online from one of our partner universities: Regis University, Indiana State University, Angelo State University and more at 1/2 the cost and time of traditional universities with no campus attendance, no wait list and local clinicals.

Programs:

LPN/LVN to RN - AS in Nursing (Licensed LPN/LVNs only)
LPN/LVN to RN - BS in Nursing - Indiana St. - (Licensed LPN/LVNs only)
Paramedic to RN

Roseman University
Online

The USN accelerated online program offers accelerated nursing education that allows you to earn a BSN in just 14 months. This new program blends the personal convenience of online course study with enriching clinical learning in Henderson, Nevada.

Programs:

Accelerated BSN

Walden University
Online

Balance your personal and professional commitments while earning a respected Ph.D., master's degree, or bachelor's degree online at Walden University. Programs offered in management, education, psychology and health and human services.

Programs:

Post-Masters Certificates in Nursing - Nursing Education
Doctor of Nursing Practice (D.N.P.) - General
M.S. in Nursing (MSN) - BSN Track

California College San Diego
Campus

California College San Diego (CCSD)offers degree programs in Medical Specialties, Respiratory Therapy, Healthcare Administration, Business Management and Accounting, Computer Technology and Networking, Computer Programming, and Computer Science. Online programs are offered by our affiliated college, Stevens-Henager College, Salt Lake City/Murray.

Programs:

Bachelor of Science Completion in Nursing (Online)
Master of Science in Nursing Education (Online)
Bachelor of Science Completion in Nursing Administration

Campus Locations:

San Diego

National City

San Marcos

West Coast University
Campus

Achieve your educational and professional goals with help from West Coast University. We offer accelerated Health Care Administration degrees designed for working adults like you.

Programs:

Bachelor of Science in Nursing
LVN to BSN
RN to BSN

Campus Locations:

Ontario

Anaheim

Career Colleges of America
Campus

Get your career started with Career Colleges of America. We have four campuses in the Los Angeles area offering a wide variety of allied health training programs.

Programs:

Vocational Nurse
Nurse Assistant

Campus Locations:

Gardena

South Gate

San Bernardino

Los Angeles

Chamberlain College of Nursing
Campus

Take the first step toward advancing your nursing career. Chamberlain College of Nursing offers a highly respected degree coupled with clinical learning experience in your local area.

Programs:

Master of Science in Nursing
Bachelor of Science in Nursing (RN to BSN)

Campus Locations:

Addison

Carrington College California
Campus

Carrington College California offers the programs you need to begin a career in healthcare. Choose from Healthcare, Massage Therapy, Dental Assisting, Pharmacy Technology, or Veterinary Services.

Programs:

AS in Registered Nursing
AS in Vocational Nursing
Certificate in Vocational Nursing

Campus Locations:

Sacramento

Antioch

San Jose

San Leandro

University of St. Mary
Online

Give your career a boost with University of Saint Mary. We offer online degree programs at the undergraduate and graduate levels to help make your educational and professional goals a reality.

Programs:

Bachelor of Science in Nursing

Grand Canyon University
Campus

Don't Miss a Day of Your Future! Grand Canyon University is offering Bachelor and Master degrees through our College of Education, Ken Blanchard College of Business, College of Nursing & Health Sciences, College of Liberal Arts, and College of Entrepreneurship. Classes start soon!

Programs:

M.S. in Nursing: Health Care Informatics (Bridge)
M.S. in Nursing: Health Care Informatics
M.S. in Nursing: Public Health (Bridge)

Campus Locations:

Phoenix

Kaplan College - KHE
Campus

Don't wait another day to take the next step forward in your career. Kaplan College can give you the real-world knowledge and skills you need to succeed in your chosen field.

Programs:

Diploma: Vocational Nursing
Diploma: Nurse Assistant Training Program
Diploma: Patient Care Assistant/Technician

Campus Locations:

Vista

San Diego

American Career College
Campus

American Career College (ACC) offers hands-on training that will prepare students for careers in the healthcare industry at three campuses in Los Angeles, Ontario, and Orange County, California. ACC's programs combine classroom lectures and hands-on training to prepare students for a Diploma or Associate of Occupational Science degree.

Programs:

Vocational Nursing

Campus Locations:

Ontario

Los Angeles

Anaheim

Santa Barbara Business College
Campus

California is home to beautiful landscapes, a diverse population and countless things to do. Santa Barbara Business College is a California technical school that helps people just like you learn skills for their career. After all, without a good career, it can be difficult to enjoy all the wonderful things California has to offer.

SBBCollege is accredited by the Accrediting Council for Independent Colleges and Schools. For information on graduation rates, median debt of graduates who completed these programs and other important information, visit http://www.sbbcollege.edu/consumerinformation/disclosures.php. SBBCollege offers financial aid to those who qualify.

Programs:

Vocational Nursing

Campus Locations:

Rancho Mirage

Santa Maria

Intercoast Colleges
Campus

Get your career started with Intercoast Colleges. We offer a number of certificate programs in a variety of fields, including medical, allied health, massage therapy, nursing, and electrical training.

Programs:

Vocational Nursing

Campus Locations:

Fairfield

Institute of Technology
Campus

You can get started on a new career with Institute of Technology. We offer diploma and associate degree programs for careers in the culinary, technical, medical, business, and legal fields.

For more information about our graduation rates, the median debt of students who completed the program, and other important information, please visit our website at www.it-colleges.edu/disclosure

Programs:

Vocational Nursing-Diploma

Campus Locations:

Redding

Charter College
Campus

You can prepare for a new career with help from Charter College. Our accelerated Bachelors Degree, Associates Degree, and Certificate programs are designed to help you complete your education as quickly as possible. We offer year-round classes and flexible scheduling - study anytime from anywhere. We provide students not only with the technical skills necessary for success, but also job search and placement assistance so you can find new opportunities after graduation.

Programs:

Diploma - Vocational Nursing

Campus Locations:

Canyon Country

Summit College
Campus

Get your career started with an education from Summit College. We offer programs in legal office assisting, licensed vocational nursing, office administration, administrative and clinical medical assisting, medical billing and coding, dental assisting, and accounting assisting.

Programs:

Licensed Vocational Nurse

Campus Locations:

Anaheim

Colton

Keiser University
Campus

Keiser University eCampus Online offers degrees in fields that are in high demand and provides job placement assistance to all its students and alumni.

Programs:

Nursing, MS

Campus Locations:

Fort Lauderdale

Saint Peter's College
Online

Saint Peter's College has prepared its students for academic excellence and professional success for over one hundred years. Our dedicated faculty and staff are committed to providing each student with the opportunity for educational and spiritual enrichment. That same commitment to individual support is now available to learners everywhere via the new online degree programs offered by the College.

Programs:

RN to Bachelor of Science in Nursing

Stratford Career Institute
Online

Stratford Career Institute can help you earn your diploma from home in as little as six months, thanks to their proven study methods.

Programs:

Health Care Aide

Saint Xavier University
Campus

“Success with Purpose” is the hallmark of a Saint Xavier University education that is grounded in the tradition of liberal arts. SXU offers graduate and post-graduate programs that are recognized and respected by employers and delivered by professional faculty who are experts in their fields. Founded in 1846 by the Sisters of Mercy, SXU is Chicago's oldest Catholic University, and it is recognized as one of the top 40 comprehensive master's universities in the Midwest by U.S. News & World Report's America's Best Colleges 2010.

Programs:

MSN in Clinical Leadership
MSN in Executive Leadership
Nurse Educator Certificate

Campus Locations:

Chicago

CBD College
Campus

Get career training with CBD College. We offer an associate degree in vocational nursing, plus diploma programs for careers in the fields of medical massage therapy/physical therapy, pharmacy tech, surgical technology, and vocational nursing.

Programs: