A nurse practitioner (NP) is a type of advance practice registered nurse with a specialized master’s or doctoral degree that allows them to practice like a doctor with certain limitations. A physician’s formal education and training is longer and focuses on disease and medicine. A nurse practitioner’s formal education is shorter and focuses on the care of the sick with advanced education and training in diagnosing, treatment, and management of chronic illnesses. Many NPs have been skilled and experienced registered nurses for years before going on for advanced education and training.

Advance practice registered nurses have been around since the 1940’s. These advanced practice roles were first utilized to address the shortage of primary care physicians in underserved areas. The first formal nurse practitioner program was founded in 1965 at the University of Colorado’s School of Medicine and Nursing. Today nurse practitioners can specialize in a variety of areas including pediatrics, geriatrics, mental health, family, acute care, or nurse anesthetist.

In 2008, there were over 86,000 nurse practitioners with a projected growth up to 198,000 in 2025. There are nurse practitioners in over fifty countries worldwide. Although credentials vary by country, most NPs hold at minimal a master’s degree worldwide. In the United States, depending upon the state in which they work, nurse practitioners may be required to practice under the supervision of a physician, although many states are eliminating “collaborative practice” agreements and nurse practitioners practice independently.

To become a nurse practitioner one must first complete their basic nursing education and pass the exam to be a licensed nurse. Once they complete their undergraduate education and have a year’s experience, they can apply to a graduate program to obtain a master’s degree in nursing. Admission into the master’s degree program requires letters of reference and a declaration of specialty. Upon successful completion of the program, a national certification exam is taken and must be passed to obtain a license to practice. The NP may further advance their education by earning a Doctorate of Nursing degree. The NP maintains their license by practicing a minimum number of clinical hours per year and completing ongoing continuing education hours.

Rules governing nurse practitioners vary by state but responsibilities typically include obtaining medical history, performing physical assessments, providing immunizations, diagnosing and management of acute and chronic medical conditions, (physical and mental), ordering and analyzing results of diagnostic tests and treatments and procedures, and managing overall patient care. NPs can prescribe medications (with some limitations depending on the state in which one practices), prescribe rehabilitation therapy, perform basic suturing, casting, cryotherapy and skin biopsies, refer to other health care providers, and perform other procedures for which they have received additional specialty training.

Within My Bariatric Solutions, there are three full-time nurse practitioners. They are Beryl, an Acute Care Nurse Practitioner, Steven an Adult/Geriatric Acute Care Nurse Practitioner, and Sharon a Family Nurse Practitioner. Beryl is responsible for patient care throughout the hospital stay which includes obtaining patient medical histories, evaluating patients after their procedures, reviewing labs and other diagnostic tests, ordering medications and adjusting home medications upon discharge, ordering out-patient equipment as needed (e.g. oxygen), and reiterating home diet and exercise. Patients meet her in the pre-operative class where she discusses expectations while in the hospital. She works closely with the surgeons assuring all in-hospital and immediate post-discharge medical needs are addressed.

Sharon and Steven see patients both pre and post-surgery. Sharon works from the Decatur and Ft. Worth offices while Steven practices from the mobile unit which divides its time between Abilene, Waco and Decatur. Sharon and Steven visit with patients to fulfill pre-surgery diet requirements and see patients for visits post-surgery at 3, 6, and 12 months. The NP assesses patient progress via labs and prescribes vitamins and/or suggests dietary and exercise changes, evaluates complications and orders any needed diagnostic test or labs, and they can make medication changes or prescribe new medications when needed. The NP may refer you back to your primary care physician dependent on the medication and the need for more frequent follow up visits.

Unique to the mobile unit, Steven can do limited upper GI studies and does all lap band adjustments under fluoroscopy. Sharon and Steven also work closely with the surgeons so that all patient medical needs are appropriately addressed.