Super Nurses, to the Rescue

Published 9:56 am Tuesday, February 28, 2012

Mona Counts was a nurse practitioner before the title existed. For 40 years, she has served patients and taught other nurses in West Virginia and Pennsylvania. She’s been around the world and even to the White House to testify about barriers to healthcare in the community she serves and loves. But she’s most at home in the Appalachians.

As a nurse practitioner, or NP, Counts provides a higher level of care than the typical nurse. NPs are registered nurses who have completed advanced education – a master’s degree, at minimum. They care for patients in a manner similar to physicians, but emphasize care and cure. “I love being in a position to help others,” Counts said.

NPs see patients, diagnose illnesses, order lab tests and exams and prescribe medications or other treatments. They also counsel patients and help manage their overall care. NPs may work in a rural clinic, like Counts, or in an urban practice, nursing home, school, college or public health clinic.

Dixie Harms has spent the past eight years in a clinic in Urbandale, Iowa. “Since 2002, I’ve been employed in family practice and internal medicine and specialize in advanced diabetes management.” She also works with menopausal women to help them with hormone treatments.

NPs also may teach, another job Counts has in the Penn State School of Nursing. Some NPs are not employed but become entrepreneurs, starting their own practices. Add that to Counts’ list, too. She started the clinic in tiny Mount Morris, Pa., when she saw the need for healthcare.

There is a big need for NPs, especially in communities like Mount Morris. There’s a shortage of healthcare workers overall, and in under-served areas there’s a shortage of family practice physicians. “In the state of Iowa, we have many people living in rural areas who do not have access to healthcare,” Harms said. “Nurse practitioners are poised to help fill the void and provide high-quality care.”

The responsibility that comes with being an NP requires additional training beyond nursing school. NPs receive graduate training and most have a master’s, as already mentioned, or even a doctorate. The requirements may vary by state. “The key is to get a really good nurse practitioner education,” Counts said.

NPs can specialize in many areas, including family, gerontology, women’s or pediatric health. The American Academy of Nurse Practitioners (AANP) offers a certification program and NPs are licensed in all states.

Beyond the ability to handle nursing and science courses, people skills really matter for NPs. “I believe that one of my most important skills as a nurse practitioner is the ability to communicate with patients and listen carefully to their needs,” Harms said. Of course, it’s good to be caring and able to handle the emotional aspects of the job. It also helps to be good at managing projects and people when you get to the NP level.

Depending on work location and situation, the hours can be long. Most NPs find few other drawbacks to their work, except for frustration with the business and politics of healthcare. “One of the greatest challenges that healthcare providers experience is dealing with the restrictions placed on us by health insurance companies to provide the high-quality care we think our patients should receive,” Harms said.

But the rewards from helping patients outweigh these drawbacks. Counts added three other part-time NPs to her practice to “bring care and confidence to a very rural Appalachian area.”

The average annual pay for NPs working full-time is about $86,000, according to the 2009 American Medical Group Compensation and Financial Survey by the American Medical Group Association. But salaries vary by region and there’s some reward for experience.

This is not an overnight career move. Although NP education is shorter than that for an M.D., it’s not quick and easy. Aside from a great education, Counts says the best way there is to get involved in the profession. She’s been active in the AANP and says it helps all NPs to stay abreast of healthcare legislation. But to become an NP and be successful at it, her top tip is this: “Really be committed to making it work.”