Rolling the Dice: ‘Unprecedented’ Doubling of NP Workforce Seen in Recent Years

            This article (1) references a recent study (2) titled Implications Of The Rapid Growth Of The Nurse Practitioner Workforce In The US: An examination of recent changes in demographic, employment, and earnings characteristics of nurse practitioners and the implications of those changes. This blog, the article, and the study are not about bashing Nurse Practitioners (NPs) but rather how:

“The pronounced growth in the number of NPs has reduced the size of the registered nurse (RN) workforce by up to 80,000 nationwide (2).”

            This is a multifaceted problem as I see it (a) leaving a shortage in the RN workforce, (b) oversaturation of the NP workforce. It’s only a matter of time. Jobs will become scarce, NP salaries will drop, and there won’t be enough talented bedside RNs to do the job. Another example of my former profession shooting itself in the foot. While I do not agree with the notion of filling the physician shortage with mid-level providers, this notion is often touted as a justification for producing so many NP’s. The study reports that in the period 2010–17 the number of NPs in the US more than doubled from approximately 91,000 to 190,000. The result is too many NPs and a shortage of bedside RN’s. The article references Gary LeRoy, MD, president of the American Academy of Family Physicians, who says “NPs today work across fields and are not clustered in primary care,” contradicting the notion of NPs filling the primary care physician shortage. 

“LeRoy said that, while NPs are valuable members of medical teams, there is a need to recognize what physicians’ extra years of training and study bring to patients. “As talented as many of our nurse practitioners are, they are not interchangeable with doctors,” LeRoy said. “They are part of a team, a team that needs to be led by a knowledgeable physician who sees the big picture.”

            It is true, and speaking from experience, poor bedside nursing quality of work environment, chronic short-staffed units, and overall poor quality of life are problems and are often used by individuals as reasons to become an NP.  To escape the horrors of bedside nursing. The study concluded with “In the future, hospitals must innovate and test creative ideas to replace RNs who have left their positions to become NPs, and educators must be alert for signs of falling earnings that may signal the excess production of NPs.” I would also say that they need to look at the quality of life and work environments that are pushing bedside RNs away from the bedside.  But this is a nursing problem to solve, so I’ll stay in my lane. Just like I’ve professed in previous blogs, no matter how you roll the dice, the physician shortage is a physician problem to solve, and the bedside RN shortage is a nursing problem to solve.  

References:

1. https://www.medscape.com/viewarticle/924863?fbclid=IwAR3D3dyV_41pdzJgnXMNNi-eBJup8yUgbex1szIP1JmvQiOwRPyC9jXG918
2. https://www.healthaffairs.org/doi/abs/10.1377/hlthaff.2019.00686

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