The nurse is in

michelle mott

Michelle Mott, a certified family nurse practitioner, is associate chief nursing officer at The Emory Clinic. An NIH-funded researcher, she holds faculty appointments at Emory in both nursing and public health. Previously, Mott coordinated the Nurse Practitioner in Emergency Medicine program at Emory University Hospital and Grady Hospital.

By Michelle Mott

An advance nurse practitioner offers one solution for the health care crisis

There comes a time when we face a challenge that defines who we are; a time when meeting the demands of said challenge forces us to reexamine how we have been functioning. In health care, we are at one of those times now. Wherever we turn, the message is clear—improve quality, safety, and accessibility while making cost affordable.

Health care costs have risen to the forefront of national discussions as one of the economic factors contributing to the strain on American families, businesses, and health care providers. According to recent data from the Organization for Economic Cooperation and Development, health care costs comprise approximately 15% of the United States gross domestic product (GDP). By comparison, other major industrialized nations spend 8% to 10% of GDP on health care yet manage to make it available to a greater proportion of their citizens. Although the United States spends more on health care than other developed nations, we continually rank below peer countries when it comes to health care outcomes and patient satisfaction. Furthermore, we have a shortage of physicians, a rising number of people without insurance, and a financial crisis that may ultimately undermine efforts to address these issues.

As a nation, we are struggling to find answers. We need a solution whereby we have enough providers who can increase access to health services, provide quality care, and reduce costs. Enter the advanced practice nurse (APRN).

You may know the APRN as your nurse practitioner (NP), certified nurse midwife (CNM), certified registered nurse anesthetist (CRNA), or clinical nurse specialist (CNS). We may have worked with you or cared for you in the clinic, labor and delivery, the emergency department, or the inpatient setting.

All of these groups represent registered nurses who have masters or doctoral degrees, are nationally certified, and meet requirements for state licensure. NPs, CNMs, and CRNAs are licensed to assess, diagnose, treat, and prescribe medications for patients, and CNSs are the expert nurses in hospital units for evidence-based nursing care and interventions.

Regardless of the practice setting, our main goal is to address the patient’s condition while integrating a holistic model of care. Spiritual and emotional well-being are important factors as we address a patient’s concerns about disease or injury. We incorporate health promotion and health education for patients and their families in our care plan to empower them to make healthy lifestyle decisions.

In our practices, we work collaboratively with physician colleagues. The APRN-physician care model has been cited in economic, political, public health, medical, and nursing literature as a high-quality, cost-effective method to provide health care. APRNs often have lower administrative costs, and, through high-quality clinical skill and patient education, APRNs reduce costs to the health care system by assisting patients and families in making lifestyle changes that may ultimately reduce the need for costlier procedures and hospitalizations.

APRNs have a long history in the U.S. health care system, with nurse anesthetists and nurse midwives having practiced here since the early 20th century. The role of the CNS appeared as early as the late 1930s. The first NP practiced in 1965. All of these roles developed when our country needed providers with expertise to address issues ranging from improving safety and quality to increasing access to care for patients unable to afford or otherwise receive health care.

So, here we are, again, in one of those times. It is up to us as patients, providers, and administrators to funnel the frustration we feel over the state of the U.S. health care system to gain momentum. This momentum can help us reevaluate our mission, promote successful models, and create new methods of practice where others have stagnated or failed.

The APRN-physician practice model is one such model that has shown success. This dynamic approach is one of the more important ways to lower health care costs, improve quality, and foster more patient satisfaction.

Table of Contents

emory health fall