Monday Medical: Nurse practitioners — meeting the needs of patients |

Monday Medical: Nurse practitioners — meeting the needs of patients

Susan Cunningham//For Steamboat Today

Monday Medical

Don't be surprised if your next visit to the doctor's office or the hospital involves care provided by a nurse practitioner.

Nurse practitioners are a critical part of the health care team, providing many of the same services as doctors. In Colorado, that includes conducting well visits, seeing sick patients, ordering labs and diagnostics, interpreting results and more.

The first nurse practitioner program was developed in 1965 at the University of Colorado. Since then, nurse practitioners have grown in popularity: According to the American Association of Nurse Practitioners, there are now more than 220,000 nurse practitioners who provide more than 900 million patient visits a year.

The majority of nurse practitioners focus on primary care, which is especially helpful given the shortage of primary care providers nationally. But nurse practitioners can specialize in a range of fields, such as pediatrics, acute care, neonatal health, cardiovascular or emergency care.

"Nurse practitioners can work in a wide variety of settings, not just in a clinic," said Shannon Fonger, an orthopedic nurse practitioner with Yampa Valley Medical Center. "There are a lot of different areas that we serve in."

All nurse practitioners are certified nationally and practice according to regulations in the state in which they're licensed. Nurse practitioners must have a master's or doctoral degree and undergo clinical training beyond their preparation as a nurse. They must maintain their nursing license, as well as their advanced practice license, both of which require regular re-certifications.

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Nurse practitioners also bring a focus on the health and well-being of the whole person, spending time with patients to promote health and disease prevention, as well as working through the health problem at hand.

"The idea is that you're thinking of the entire patient, not just the organ system that's not working properly," Fonger said. "Treating one system really affects all of them, and you want to be sure you're not just treating the problem, but the whole person."

For instance, if Fonger is working with a patient who has a hip fracture, she might also check that the patient is up-to-date with cancer screenings, has had a bone mineral density test and is immunized.

"We can talk through all of those things, even if they're in the hospital for something unrelated," Fonger said. "It's helpful, because it can help diagnose and treat conditions before they become more of a problem."

Nurse practitioners work closely with physicians, as well as other health professionals, such as physical therapists, occupational therapists and nurses.

"We all work together for the patient to improve their outcomes," Fonger said.

Especially important in rural areas, where specialists may travel to see patients in other communities, nurse practitioners can provide continuity of care, even if the doctor is unavailable.

"After a treatment plan is set, we work with the physician to be sure the patient's needs are being addressed, whether a physician is in town or elsewhere," Fonger said. "Living in a place where a lot of our specialty providers commute or travel between a variety of locations, we can provide continuity when it's hard to get in for an appointment."

Nurse practitioners play a vital role in caring for our community.

Susan Cunningham writes for Yampa Valley Medical Center. She can be reached at

At a glance

Nurse practitioners:

• About 220,000 in the country

• Must first be a registered nurse, then complete graduate nursing education and national board certification

• Must recertify every two to five years

• Can treat patients, prescribe medications, order and interpret tests and more

• Visits are covered by insurance