More Nurse Practitioners Now Pursue Residency Programs to Hone Skills

Kaiser Health News (07/03/18) Andrews, Michelle

More nurse practitioners (NPs) are turning to residency programs in an effort to develop the skills needed to serve patients who have complex health issues. The NPs tend to be registered nurses who have a master's degree in nursing, and they often spend their residencies at federally qualified health centers, Veterans Affairs medical centers or other facilities. A recent Health Affairs study found that NPs accounted for 25 percent of primary care providers (PCPs) in 2016, compared with 17.6 percent in 2008 and 24 percent of PCPs in non-rural areas, up from 15.9 percent. Regulations for NPs vary by state, with some practicing independently of physicians and other having various levels of oversight. Also known as fellowships, residency programs for nurse practitioners are voluntary, and residents generally receive just a fraction of a regular salary. The need for residency programs for NPs has been the subject of much debate, says Joyce Knestrick, president of the American Association of Nurse Practitioners. While supporters tout the programs as a way of preparing new NPs to handle patients with complicated health needs, critics say they receive sufficient instruction in a standard training program. "It's a very difficult transition to go from excellent nurse practitioner training to full scope-of-practice provider," notes Margaret Flinter, who launched the first NP residency program 11 years ago. "My experience was that too often, too many junior NPs found it a difficult transition, and we lost people, maybe forever, based on the intensity and readiness for seeing people" at our centers. According to Flinter, the senior vice president and clinical director of Community Health Center in Connecticut, there are more than 50 postgraduate primary care residency programs in the United States today.

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