Nursing is among the most prevalent occupations in the U.S. health sector, employing more than 2 million people. Nurse practitioners provide 60 percent to 80 percent of primary and preventive health care services in the United States, according to a 2007 survey by the American Academy of Nurse Practitioners. Nurse practitioners provide a wide range of health care services under guidelines of the Center for Medicare and Medicaid Services, or CMS. A nurse assists in taking care of patients under a doctor's guidance, but a nurse practitioner is trained to diagnose and manage common medical illnesses.
Business and Medicare
All nurse practitioners are certified by the National Board on Certification of Hospice and Palliative Nurses, after which they enroll as nurses under the same board. If a nurse wants to be recognized as an advanced practice nurse, she must enroll as a clinical nurse specialist. To apply for a Medicare billing number and qualify to handle insurance claims for services rendered to patients, a nurse practitioner must be registered as a professional nurse, be certified by a recognized professional body, and have a master's-level degree in nursing.
Special Services
A nurse practitioner carries out some services that are also performed by physicians. Only a fully qualified nurse practitioner can do so, and she must perform her duties in collaboration with a medical doctor. Types of services that may be handled by nurse practitioners include minor surgeries, some physical examinations, and initial interpretation of x-rays. Nurse practitioners are not allowed to carry out services such as performing full physical exams or treating an injury or illness without supervision by a physician.
Collaboration
When a nurse practitioner works in partnership with physicians to deliver medical care, he must document the extent of his practice and elaborate on his relationship with the physicians. If the collaboration is close, the physician does not need to be present when the nurse practitioner is evaluating a patient.
Documentation
Nurse practitioners are required to document all medical information about patients in legible form. This includes a patient's medical history. Documentation requirements are different for each bodily organ, so documentation can differ in both focus and degree of detail.
Prescriptions
Nurse practitioners, in close collaboration with a physician, usually have the authority to prescribe medications to patients without a physician's being present. Specific rules on prescription of medications by nurse practitioners differ from state to state, however. In some states, nurse practitioners do not have the authority to prescribe medications.
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