For many health-care providers, meeting the needs of patients is a daily, if not an hourly, challenge. Increasing regulation, a plethora of new technologies and information, an aging population, the needs of the disenfranchised, and greater consumer expectations and awareness exert unrelenting demands at every level of care. All of this is further complicated by a shortage of physicians, particularly in primary care. Fifty-five million Americans live in areas with a shortage of primary care providers.

Over the past 50 years, the role of advanced practice registered nurses (APRNs), which includes nurse practitioners (NPs), has evolved to increasingly meet patient needs in both the inpatient and outpatient settings. APRNs are registered nurses educated at a master’s or post-master’s level for a specific clinical role and patient population, with certification reflecting the specialized nature of the graduate program.

Currently, there are about 234,000 licensed APRNs in the United States, and nearly 87% are certified in an area of primary care. The four types of APRNs include the NP, nurse anesthetist (CRNA), clinical nurse specialist (CNS), and nurse midwife (CNM). Under the NP umbrella are specialties in adult/gerontology acute care and primary care, family care, pediatric care, and psychiatric care.

According to Philip Martinez, EdD, MSN, APRN-BC, director of the Yale School of Nursing (YSN) Graduate Entry Prespecialty in Nursing program, a YSN graduate and full-time acute care nurse practitioner, APRNs can assess patients, order and interpret diagnostic tests, make diagnoses, prescribe medications, and initiate and manage treatment plans across a spectrum of settings and specialties. All APRNs consult and collaborate with their physician colleagues, and many of them practice as part of a health-care team. For example, Martinez is a member of the pulmonary intensivist team for a 12-bed ICU where patients are seen by a multidisciplinary team that can include other APRNs, physicians, nurses, dieticians, pharmacists, clergy, and social workers.