rate out nurse practitioners in its table of Occupational Employment Statistics, it does project health care workers as among the fastest growing fields in the next eight years.
Nurse practitioners function within their area of specialization to perform physical examinations, make nursing diagnoses based on the data they gather, provide nursing services to patients, and refer them to physicians when necessary. The profession emphasizes accountability, responsibility, and independent judgment. Rita E. Lavedier (1976) sums up the changes this has meant for the health care profession:
As medical science has progressed and consequently expanded the role of the physician, nurses have been in the forefront in filling the gaps created. They have willingly and effectively assumed health care functions previously considered to belong to the physician (p. 5).
Christina Sponselli (1997) observes, "The increasing acuity of hospitalized patients has created a need for nurses experienced in high-tech critical care" (p. 22). A pilot project at a hospital in New York allows patient to choose an NP to be the primary care provider. NPs in this program can admit patients to the hospital and write prescriptions for most drugs. They are also paid at physician rates ("Fairing Well, 1997, June, p. 12). This program is similar to others being tested across the country, in an attempt to deliver health care in new and more innovative ways to patients.
During the time that nurse practitioners have increased in numbers and stature, the health care field has been undergoing a dramatic change. Increasing numbers of Americans are enrolled in HMOs; between 18 and 21 percent are enrolled nationally, with the highest concentrations in Massachusetts (where 42 percent are enrolled) and California (where 38 percent are enrolled) (Sponselli, 1997, p. 21); managed care programs in some form are offered in 48 states throughout the country.
Changes...