The Nursing Shortage: The Role of NPs in the New Nursing Landscape

Bedside nurse tending to geriatric patient in hospital
Bedside nurse tending to geriatric patient in hospital

The nursing shortage and the increased demand for nurses in the coming years are leading many nurses to pursue advanced nursing education to navigate the new nursing landscape. The Bureau of Labor Statistics (BLS) estimates employment of registered nurses will grow 15 percent from 2016 to 2026 due to employment growth and the need to replace workers who retire over the coming decade. Employment as an advanced practice nurse (APRN) is projected to grow 31 percent from 2016 to 2026 according to the BLS.

Pursuing graduate studies at Spring Arbor University Online's Master of Science in Nursing program will prepare you for a role as a nurse practitioner (NP) in either the Family Nurse Practitioner or Adult-Gerontology, Primary Care Nurse Practitioner track.

A Physician Shortage is Partially Driving the Nursing Shortage

To understand the impact the 2018 nursing shortage will have on APRNs, you need to understand the looming physician shortage. Demand for healthcare services is projected to outpace the growth of physician supply.

The Health Resources and Services Administration (HRSA) projects a shortage of 20,400 primary care physicians (PCPs) in 2020. The Association of American Medical Colleges (AAMC) anticipates a projected total physician shortfall of 40,800 to 104,900 physicians by 2030. Projected shortfalls in primary care range from 7,300 to 43,100 physicians. HRSA anticipates a 30 percent increase in the supply of primary care NPs from 2010-2020.

If effectively integrated into the healthcare delivery system, nurse practitioners (NPs) and physician assistants (PAs) could somewhat alleviate the PCP shortage. HRSA estimates that projected increases in NPs and PAs could potentially reduce this shortage by approximately two-thirds.

The Aging Population, Population Growth and Expanded Health Insurance Causing Increased Demand for Primary Care

Growing demand for primary care is related to population growth and aging as well as expanded health insurance under the Affordable Care Act (ACA). Unfortunately, over 58 million Americans currently reside in locations or belong to population groups that are known officially as primary care Health Professional Shortage Areas (HPSAs). Here the supply of PCPs relative to the population falls below federally defined standards.

The proportion of Americans living in HPSAs varies widely by state, but in almost half the states, it’s at least 20 percent of the population are in an HPSA. These are areas where APRNs can make a real difference. Research has shown that primary care NPs are significantly more likely than PCPs to practice in urban and rural areas, provide care in a wider range of community settings and serve a high proportion of uninsured patients and other vulnerable populations.

Many Nurse Practitioners Are Practicing in Higher Need Communities

New research published in the Journal of General Internal Medicine has revealed that physicians, PAs and chiropractors tend to practice in more affluent areas with already high life expectancy, while NPs tend to treat patients in lower income areas with low life expectancy. Areas with the highest income – compared to the lowest – had 30 percent more physicians and 15 percent fewer NPs. The counties deemed the least healthy had approximately 50 percent more NPs than the healthiest counties.

According to study author Matthew Davis, this may imply that NPs are playing a role in communities that need their help. At the AAMC Health Workforce Research Conference, researchers reported that while recent surges in NP and PA workforces could alleviate much of the overall physician shortage, problems getting care in rural areas and treating certain conditions are still likely to persist. Projections still forecast shortages of primary care labor in rural areas and too few available provider hours to treat chronic conditions.  

Nurse Practitioners Are in High Demand

According to recruiting and staffing firm Merritt Hawkins, which works with facilities looking to hire health professionals, only family physicians, psychiatrists and internists are more in demand than NPs. Merritt’s annual analysis shows that NPs are rated ahead of more than 15 physician specialties. The company surmises this trend may only escalate as more states change their laws governing APRN practice authority, with APRNs being allowed to perform more services.

"The demand for nurse practitioners has never been higher,” American Association of Nurse Practitioners President Cindy Cooke reports. “With the rise of full practice authority in 22 states and the District of Columbia, more patients than ever have direct access to high-quality nurse practitioner care in every setting – including the veterans’ health system.”

NPs are becoming more widely recognized by the public as a source for primary healthcare.

Nurse Practitioners a Major Part of Healthcare Delivery Systems in Team-Based Care

As the public seeks out nurse practitioners, retail clinics like those found at CVS and Walgreens are staffed by NPs offering quick access to treat routine maladies. “Nurse practitioners and other allied health professionals are going to be a major part of our healthcare delivery systems, especially with population health and team-based care,” reports Travis Singleton, senior vice president of Merritt Hawkins.

In 2012, approximately 127,000 NPs were providing patient care in the U.S. with roughly half practicing in primary care settings. Studies show that NPs can manage 80-90 percent of care provided by primary care physicians. In addition, evidence from a substantial research literature shows that primary care outcomes and patient satisfaction are comparable between patients served by NPs and those served by physicians.

Rising demand for primary care is taxing an already strained healthcare system. NPs will be increasingly utilized in team-based models of care where they will be needed to provide preventive and primary care. They will be in high demand, especially in medically underserved rural and urban areas.

As pointed out by the HRSA Health Workforce, some communities will likely continue to have a supply of primary care physicians well above the national average while other areas will continue to be below the national average. Preparing yourself for a role as an NP will position you for a rewarding career providing primary care to populations most in need.

Contact us to find out more about Spring Arbor University Online’s MSN/NP program.