Nurses debunk myths every single day, the least of which is refuting stereotypes. So it’s safe to say that nurse practitioners (NPs) are well-versed in debunking myths. Even with the exponential growth of nurse practitioners recently, there are still a number of myths created by a misinformed public that still exists.
Let’s take a look at some of the more popular myths and see if we can clear the air:
1. NPs practice under a physician license
2. Nurses must practice 5 – 10 years before becoming an NP
3. NPs and PAs are the same
4. NPs cannot prescribe medications
5. All NPs are the same
6. A registered nurse delegates to an NP
Let’s go over 6 myths about working as a nurse practitioner.
#1 – NPs practice under a physician license
This is one of the many ways NPs differ from PAs. NPs practice under their own license, whereas a PA will practice under the physician’s license number.
NPs will have their own license number provided by their (respective) State Board of Nursing, which can only be issued if you possess an active registered nurse license.
A PA’s license is an extension of the (sponsoring) physician’s license number.
Where things probably get a little confusing is the prescriptive authority. NPs and PAs must have a collaborative agreement with a sponsoring physician in order to prescribe scheduled narcotic medications (regulated by the DEA due to their high risk of addiction). Every provider who administers or prescribes these medications, including physicians, nurse practitioners, and physician assistants, have to apply for a license through the DEA (Drug Enforcement Agency).
#2 – Nurses must practice 5 – 10 years before becoming an NP
The minimum requirements for a nurse to graduate from NP school and begin practicing as an NP would be approximately 5 years. This topic is currently a hot debate for many nurses and current nurse practitioners. Many NP programs do not have a minimum practice requirement to apply for entrance into a specific NP academic program.
This requirement has changed. In years past, nurses had to practice for two years at the bedside prior to submitting an application to an NP program. Many current programs do not have this requirement. Therefore, for argument’s sake, there is a possibility for a new nurse practitioner to start practicing at the bedside with as little as four years of total nursing experience. Let me explain.
Associate degree programs and diploma nursing programs are still in existence. These programs are approximately 2 years total before you sit for your licensure exam and began practicing as a registered nurse. If one of those nurses fresh out of graduation wanted to apply for NP school, they theoretically could. They could enroll in an accelerated bridge program (many variations of this exist) and attain their BSN in 18 months (or less).
This nurse applies, is accepted and begins there MSN nurse practitioner program (remember they have only been in the profession for 3.5 years so far). They graduate from the MSN program in as little as 2 years (or less if they were to take full-time credits). They then sit for their licensure exam and begin practicing within months from graduation. Theoretically, this particular nurse has practiced at the bedside barely 4 years (total) prior to working as a fully licensed nurse practitioner. (Keep in mind this nurse would most likely be working part-time or per diem, while attending school full-time)
Many points of this topic are up for debate, which I will gladly dive into in a separate post.
#3 – NPs and PAs are the same
Unfortunately, this myth probably is the basis for the term “mid-level”. In many facilities, the NP and PA role are lumped together in a single category. Many positions that are created within a hospital system can be fulfilled by a NP or PA because of their similar educational background and training.
While both can meet the needs of a specific position, there are some differences that set the two apart. As mentioned earlier, NPs practice under their own license whereas PAs practice underneath the medical license of a physician.
NPs learn through a nursing–based educational system. PAs learned through a medicine–based educational system. Within each of these specific programs, there are some mild differences. For instance, NP programs do not traditionally have a cadaver lab for anatomy and physiology. PA programs do.
Prescriptive authority differs between the two as well. Every state has a unique state practice act. As mentioned earlier, both must possess a DEA license in order to prescribe/administer scheduled narcotics. In many states, physician assistant prescriptive authority is more restricted. Which means there are some medications that physician assistants cannot prescribe.
Another important difference between the two professions is the specificity of training. PAs are trained as general practitioners. All PAs go through the same core educational program and then choose their specialty during their last year (approximately) of clinical rotations.
NPs are becoming more and more specialized. No two NP’s are the same. Everything from family nurse practitioner all the way down to neonatal nurse practitioner differs greatly. We touched on this a little bit in a previous post, I Want to Be a Nurse Practitioner, But What Program Do I Choose?
#4 – Nurse Practitioners Cannot Prescribe Medications
As previously discussed, NP can, prescribe and administer medications. NPs who have undergone the required education and training can possess a DEA license (they must apply and pay a recurring fee). NPs with a DEA license can prescribe and administer scheduled narcotic medications (in accordance with their state practice act). This DEA license is attached to the NPs collaborating physician’s medical license.
#5 – All Nurse Practitioners are the Same
As previously discussed earlier in this post, all NPs are not the same. There are a variety of specialty certifications within the nurse practitioner profession. Please refer to our previous post for more detail.
#6 – A Registered Nurse Delegates to an NP
For those familiar with the nursing profession, we all understand that the NP delegates to the registered nurse. I believe this myth and misinformation stems from individuals who are not familiar with the nursing profession as a whole. It’s also partly our fault because of the medical profession, in general, loves confusing acronyms. The NP role can be somewhat confusing because of the variety of acronyms that NP possess themselves as well as the confusing alphabet soup that defines different levels of nurses.
For instance, the unlicensed assistive personnel referred to as the nurse’s aide can possess a “certification”. If the nurse’s aide sits for the certification exam, they can possess the acronym CNA = Certified Nursing Assistant. To make things a little bit more confusing the RN = Registered Nurse delegates to the LPN = Licensed Practical Nurse and then the CRNP = Certified Registered Nurse Practitioner delegates to all of the aforementioned nurses.
Yes, it can be quite confusing.
As an advanced practice provider, it is the job of the NP to continually educate the public and our fellow professionals. While this list is not inclusive, it is some of the more popular myths that every NP has to continually debunk. Care to add to the list?
