Expansion of the Nursing Practitioner Role


The objective of this study is to examine graduate level nursing. Towards this end, this study will review the literature relating to graduate level nursing.

According to the American Association of Colleges of Nursing the present health-care system is presently undergoing a transformation. The report states that when a child is brought into the clinic to receive treatment for such as an earache, rather than being seen by a physician, the nurse practitioner makes provision of care for the child. As well, when patients are being prepared for surgery there are various specialists moving about in the surgery room however, it is not a physician that has been trained for administration of the anesthesia but instead it is a certified nurse anesthetist. (paraphrased)

Expansion of the Nursing Practitioner Role

The role of the nurse practitioner has undergone great expansion in recent years enabled by the master’s degree in nursing. It is this degree that enables advanced practice nurses to work in the role of nurse practitioner, certified nurse midwife, certified clinical nurse specialists and certified nurse anesthetist. Nurse practitioner additionally conducts such as physical exams as well as diagnoses and treats common acute illnesses and injuries. In addition, nurse practitioners manage chronic problems including diabetes, high blood pressures as well as ordering lab services and x-rays. Nurse practitioners also provide care in the areas of prenatal care and gynecology and deliver babies in hospitals as well as in private settings. Nurse practitioner also provides follow-up and postpartum care.

II. Nursing Education

It is reported that there is a shortage of primary care physicians and that the answer to this is more advanced practice registered nurses who have specialty training. As a shortage of primary care physicians continues, local university officials say they see a need for more advanced practice registered nurses with specialty training. Recommendations stated by the Institute of Medicine and the American Association of Colleges of Nursing include that all advanced practice nurses by 2015 be educated at the doctoral level. Recommend that by 2015, all advanced practice nurses should be educated at the doctoral level. Education at the doctoral level for advanced practice nurses is offered online by some universities who understand that adult students are more than likely employed full time and are in need of such education accommodations. For example, reported is: “The University of Scranton offers traditional master’s degree programs in nursing for advanced practice nurses with specialization in either the family nurse practitioner program, adult health nursing program or nurse anesthesia program. It also offers other advanced certifications.” (Allabaugh, 2014, p. 1) Earning a Doctor of Nursing Practice is reported to make provision of a “a major avenue for employment in the future, with the need for advanced practice registered nurses popping up in places like urgent care centers, hospital clinics and physician offices, The average starting salary advanced practice registered nurses can expect is $85,000 to $95,000 a year while experienced ones can earn more than $100,000 a year…” (Allabaugh, 2014, p. 1) It is reported that the Affordable Care Act combined with the shortage of primary care physicians particularly in rural areas of the U.S. means that there will be a need for more advanced practice nurses in the future

III. Present Statistics on Nurses Entering the Workforce

The work of Kutney-Lee and Aiken (2013) published by the Leonard Davis Institute of Health Economics states as follows: “The nursing workforce plays a central role in our present health care system, and will likely have an even greater role in the future. Nurses already provide the vast majority of care to patients in hospitals, and so it should come as no surprise that the quality of nursing care affects patient outcomes. Over the past decade, studies have linked certain nursing characteristics — such as staffing levels, education, job satisfaction, and work environment — with better outcomes in hospitals.” (p. 1)Additionally reported is that the “educational pathway for entry into nursing varies: about 60% of new registered nurses graduate from associate’s degree programs, 36% from baccalaureate degree programs, and 3% from hospital-sponsored diploma programs. Overall, about 45% of nurses in the U.S. have earned a baccalaureate degree” (Kutney-Lee and Aiken, 2013, p. 1)

The evidence supporting higher education for nurses is clearly evident in the research. For example, it is reported that previous research has indicated that “hospitals with a higher proportion of nurses holding at least a baccalaureate degree had lower surgical patient mortality and failure-to-rescue (that is, death following the development of a complication).” (Kutney-Lee and Aiken, 2013, p. 1) While the specific reason this is so is not clear it is reported that it is possibly “linked to the nurses’ role as the surveillance system for early detection of complications and problems in care. As part of their practice, registered nurses continually assess and monitor a patient’s condition, identifying changes that could indicate clinical deterioration, and intervening when necessary.” (Kutney-Lee and Aiken, 2013, p. 1)

The Institute of Medicine in 2010 is reported to have made recommendations that nurses in the U.S. holding a nursing degree be increased to 80% of all nurses by 2020 and stated recommendations that nurses who hold associate’s degrees enter into baccalaureate programs within five years of their graduation. (Kutney-Lee and Aiken, 2013, paraphrased)

The Guardian reports that current training of graduate level nurses is inclusive of ” a combination of theoretical and practical work. But the new standards, which are open to consultation, will include a focus on students gaining experience within community health teams. Trainees will also shadow school health nurses and district nurses who work with people in their own homes.” (2009, p. 1) According to UK Health Minister Keen “Nurses are the largest single profession within the health service, and are critical to the delivery of high-quality healthcare. By bringing in degree-level registrations we can ensure new nurses have the best possible start to meet the challenges of tomorrow.” (The Guardian, 2009, p.1) Graduate level nursing degrees will make provision of decision-making skills that new nurses require to make sound judgments and ultimately to provide care that is of higher quality. The Guardian report states that Christine Beasley, chief nursing officer reports “More young people than ever are studying for a degree and this will make nursing more attractive to them. Degree-level nurse education will be supported by a national framework for preceptorship [instructors] which will ensure that new nurses have the support they need to make the transition to confident practitioner.” (The Guardian, 2009, p.1) The chief executive of the Royal College of Nursing, Dr. Peter Carter is reported as stating that nurses are in need of knowledge that is extensive in nature and skills for analyzing situations and experiences that enables them to work in various settings.

Dr Peter Carter, the chief executive of the Royal College of Nursing, said: “This is an important and historic development, which the RCN has been in support of for many years. All nurses need to put quality care at the centre of what they do, and they also need extensive knowledge, analytical skills and experience to work in a range of settings. (The Guardian, 2009, paraphrased)

Summary and Conclusion

Graduate level nursing is going to enable the advanced nurse practitioner role to expand and to entail more responsibility, higher levels of decision-making and analysis as well as enabling nurses to earn a much higher salary while providing higher levels of quality care to patients. Graduate level nursing degrees will enable the field of healthcare to come much closer to meeting the needs of the population both in the urban and rural setting and will enable a higher volume of patients to receive treatment in a more timely and efficient manner than ever before in history.


Accelerated Nursing Programs (2014) American Association of Colleges of Nursing. Retrieved from: http://www.aacn.nche.edu/students/accelerated-nursing-programs

Allabaugh, D. (2014) Growth Expected in Graduate Level Nurses. The Times Tribune. Retrieved from: http://thetimes-tribune.com/news/business/growth-expected-in-graduate-level-nurses-1.1663223

Kutney-Lee, A. And Aiken, LH (2013) The Case of Baccalaureate-Prepared Nurses. LDI Issue Brief. Vol. 18, Issue 6. May/June 2013. Retrieved from: http://ldihealtheconomist.com/media/the_case_for_baccalaureate-prepared_nurses.pdf

Nursing to Become Graduate-Level Job (2009) The Guardian. Retrieved from: http://www.theguardian.com/education/2009/nov/12/nursing-to-become-graduate-profession

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