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Is there a nurse practitioner in the house?

Nurses with advanced degrees are playing a growing role in American health care

Published: Tuesday, Jan. 21, 2014 5:30 a.m. CDT
(Curtis Clegg -
Graduate nursing student Preety Upadhyay, left, and undergraduate nursing student Samantha Sadecki practice their nursing skills on a mannekin at NIU's college of nursing.

SYCAMORE – Chantal Manhart can write a traditional or compounded prescription, diagnose a patient and provide routine checkup services, like most primary care physicians.

But she is no doctor.

Manhart is one of more than 8,000 nurse practitioners in Illinois charged with many of the same responsibilities as a traditional doctor.

“I see annual visits, problem visits, and mid-life women because of my clinic experience,” said Manhart, who practices at Prairie Point Obstetrics and Gynecology in Sycamore with three physicians. She is qualified to practice in both women’s health and family health.

A former physician employer suggested Manhart investigate a career as a nurse practitioner, so that his practice could see more patients after their surgical recoveries. More than 450,000 patients received treatment from about 106,000 nurse practitioners in the U.S. last year.

Manhart normally sees 15 or 20 of her own patients each day, and said she believes she can spend more time with patients than a physician can.

“A lot of them just see me,” Manhart said.

The physicians refer patients to her for follow-up care after surgeries, childbirth or other major medical procedures, and many of her patients are middle-aged women in menopause and who are coping with a variety of life-altering symptoms and ailments.

“(Nurse practitioners) can do pretty much anything that their doctor feels comfortable making them do,” said Abe Chacko, executive director of KishHealth System Physicians Group.

Nurse practitioners can examine patients with acute conditions like colds and bronchitis, provide limited treatment for chronic conditions like hypertension, asthma, and diabetes, administer vaccines, perform physicals, screenings and tests, treat minor injuries and skin conditions, and provide follow-up visits for patients of coordinating physicians at the practice.

The numbers of both nurse practitioners and patients seeking their services are expected to grow as the Affordable Care Act continues to roll out. Walgreens and other national pharmacy chains employ nurse practitioners and similarly-trained physician’s assistants for their in-store clinics.

“Health care in the United States faces many obstacles, most notably rising costs and the shortage of available health care providers,” said Cathy Carlson, associate professor of nursing at Northern Illinois University. A registered nurse, Carlson is also pursuing a nurse practitioner certification.

“In the U.S., Illinois ranks fifth in the shortage of health care professionals,” she said. Carlson believes that the number of advance practice practical nurses (APPNs) “can be increased further to become the mainstay solution to the shortage of primary care professionals in Illinois.”

Sue Clark, a spokeswoman and lobbyist for the Illinois Society for Advanced Practice Nursing, said that it is imperative Illinois grant nurse practitioners the same scope of responsibilities other states allow. In Illinois, nurse practitioners are required to meet with a collaborating physician at least once a month.

The collaborating physician can review charts and discuss cases, but that is not required by law. Clark said doctors’ essentially supervisory role is onerous and not required in many other states. Nurse practitioners in some states are allowed to open their own practices, admit patients to hospitals and take on greater responsibilities.

“Countless studies have shown there is no difference in outcomes between (patients visiting doctors and those visiting nurse practitioners),” Clark said. “I think it will be harder for the state legislature to ignore removing the collaborative agreement as the demand for primary care goes up. It’s a burden on (doctors and nurses).”

Clark said a bill with early support would allow nurse practitioners to sign Physician Orders for Life-Sustaining Treatment forms – a form that details a patient’s end-of-life care plan.

Manhart joined Prairie Point last year after her husband’s job transferred them to Sycamore. Previously, she practiced in Iowa, where she received her master’s degree in nursing and nurse practitioner certification in 2006. She feels fortunate to have found another practice where she can do what she loves most.

“I like the independence, and I like being able to see patients and know that I’m making a difference in their life, and I can see a difference in what I do,” Manhart said.

Jeff Engelhardt of the Northwest Herald contribued to this article.

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