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Nurse Practitioners - A Vital Partner of Physicians

­Nursing has come a long way since Florence Nightingale first stepped on the Crimean War battlefields of the 1850s. “The Lady With The Lamp” organized the nursing care of wounded soldiers and is credited with being the founder of modern nursing. She got her nickname for her habit of carrying a lamp while tending to her patients during the night.

One can only imagine what Florence would think if she could walk into the high-tech world of medical care today. Her lamp and that first field hospital have transformed into modern hospitals and specialized care facilities that use the latest technology available in diagnosing and treating the sick and wounded. Electronic monitors, diagnostic imaging equipment and medicine that was unimaginable in the nineteenth century is commonplace in the twenty-first century.

And just as the tools of medicine have evolved and expanded, so have the roles of nurses in the health care system today. Nurses still provide a lot of health care basics, including the special brand of TLC they regularly dispense, but they have gone from a supporting role to vital partner of the physicians they work with.

Advance Practice Registered Nurses (APRN) are registered nurses with advanced education and clinical experience. Each state has its own requirements, but Nurse Practitioners usually need a master’s or doctorate degree, plus extensive advanced clinical training in diagnosis and management of a wide range of illnesses and medical conditions. Some of their capabilities include:

  • Order blood tests, x-rays or other diagnostic tests
  • Interpret test results and make diagnoses
  • Prescribe medicine
  • Initiate treatment


APRNs include Certified Nurse Midwives, Nurse Practitioners, Certified Registered Nurse Anesthetists and Clinical Nurse Specialists. Among these four categories, there are many sub-specialties, like Acute Care, Family Medicine or Palliative Care. Some of these specialized nurses have chosen to focus on caring for people with chronic illness, the aging, those with memory loss, and those recovering from acute illness or injury. This may be in a nursing home, a rehabilitation facility, a memory care facility, or even a hospice, where they can fulfill their passion for caring for the weakest and most vulnerable.

APRNs are concerned with caring for the whole person and are an invaluable asset in any health care team, but especially in an extended care setting. Because of their extensive training and education, they become an active part of your health care team, able to respond immediately to changes in a patient’s condition or a medical crisis without having to wait for a physician to respond. Their quick response to even subtle changes in a patient’s condition can reduce potential setbacks in the recovery process. In the skilled nursing setting, this can mean a more focused approach to the individual patient’s goals which can translate into getting them home faster and with less risk of a return hospital visit.

A recent study by the University of Missouri for the Missouri Quality Initiative for Nursing Homes  found that when an APRN leads the health care team at a skilled nursing facility for older adults it improves basic care and communication. Using data from the participating facilities on care discussions, mobility, hydration and communication initiatives by the APRNs, the study showed that twelve of the sixteen facilities reported reductions in hospital rates and improvements in care overall.

HCR ManorCare has been a pioneer in recognizing and utilizing the special skills and dedication of APRNs in our MedBridge units within Heartland and ManorCare skilled nursing and rehab centers. Since they began, there has been a noticeable reduction of patient re-hospitalization. Patients already weak and ill can be put at great risk both emotionally and physically when sent back to the hospital for a complication. With the increased skill level of the APRNs and their comprehensive care plans, our patients have enjoyed a smoother recovery and less chance of problems leading to another hospital stay. That can help to keep health care costs down, and get patients home faster and healthier.

Nurse Practitioners also play a major role in Heartland Hospice and Advanced Disease Management services where they work with physicians, patients and families to help manage pain and help create a comfortable quality of life for those living with a terminal illness or chronic disease.



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