The rapid proliferation of nurse practitioners programs in the U.S. is spurring concerns about the quality of training for these advanced practice providers and potential consequences for patient safety, Bloomberg Businessweek reported July 24.
Nurse practitioners' presence in healthcare is rapidly growing as healthcare organizations look to increase patients' access to care and meet growing demands for healthcare professionals, particularly in rural areas. At present, more than 300,000 NPs are practicing nationwide. By 2032, this figure is expected to climb 45.7%, making it the nation's fastest-growing profession and far outpacing the growth of physicians.
Dozens of nursing students and professors told Bloomberg Businessweek that NP programs are rapidly sprouting up across the nation amid this increased demand, often graduating thousands of students who are not properly trained to care for patients.
Data from the U.S. Department of Education shows more than 600 schools offered advanced nursing degrees in 2022 — a figure three times higher than the number of medical schools nationwide. In total, 39,000 NPs graduated from programs in 2022, marking a 50% increase from 2017, according to data from the American Association of Nurse Practitioners.
NP training programs are not standardized, and many students complete coursework entirely online, according to the report. Bloomberg Businessweek reviewed data from the Department of Education and found institutions offering classroom trainings primarily online gave out the most advanced nursing degrees in 2022.
While NPs are required to log 500 hours in clinical training time, these hours are often unregulated and many online programs do not help students find appropriate clinical site opportunities, according to the report.
Historically, registered nurses primarily sought advanced degrees as a career advancement opportunity. However, as demand for the NP role has increased, many programs now offer direct entry programs, designed to bring in students who have a bachelor's degree but no healthcare experience. At present, the most accelerated programs available prepare these students for licensure exams in just three years.
Some professors voiced concerns that a lack of adequate training or extensive clinical hours could put new NPs at risk of making serious, potentially life-threatening medical errors, according to the report.
In a letter to the editor published by Bloomberg, AANP President Stephen Ferrara, DNP, defended the quality of care provided by NPs and accused the publication of "cherry picking negative information" about the profession.
"Millions of patients across the nation choose NPs as their health-care provider because of the exceptional care they deliver in more than 1 billion visits each year," he told Bloomberg Businessweek.
Multiple studies have demonstrated NPs' ability to provide high-quality care in primary, acute and specialty settings, Dr. Ferrara said. He also noted that leading healthcare experts and healthcare policy organizations have assessed evidence on NP care and recommended increasing patient access to these providers, including the National Academies of Science, Engineering and Medicine and The Brookings Institution.
Read Bloomberg Businessweek's full report here and AANP's full letter to the editor here.