The Miseducation of Nurse Practitioners: Controversy and Takeaways

What does healthcare look like when patients can’t trust their providers? Controversial claims over the potential miseducation of nurse practitioners (NPs) have forced this question onto the healthcare mainstage, prompting both news outlets and professional membership organizations to publicize their takes on the matter.

This issue is complicated by the rapidly growing need for additional providers to support healthcare service demands, accelerated by an aging U.S. population. NPs have long been viewed as a solution, helping improve access to high-quality care. So, claims that NPs are not sufficiently educated or trained can pose real threats to the functionality of today’s health facilities, which are increasingly staffed by NPs.

Here’s a look at both sides of the NP miseducation controversy, with key takeaways for facility leaders.

Why Is There Controversy Around Nurse Practitioner Education Standards?

The controversy stems from reports of substandard care being provided by NPs in clinical settings. In one instance, a man presented to the ER with critically high blood sugar and was discharged by an NP to later die at home. In another, a patient wasn’t made aware that the NP suspected an ectopic pregnancy. Some argue that these mistakes are repercussions from the miseducation of NP providers, and that insufficient academic and clinical preparation for NPs risks further adverse patient outcomes.

There’s no denying the tragedy of those patient stories. However, they’re unfortunately not unique. Medical errors are considered a leading cause of death and injury in the U.S., and the numbers are associated with different types of providers across many healthcare fields. Because the overall statistics don’t identify NPs as the leading contributors to these troubling figures, there has been significant pushback against singling them out.

Does the Potential Miseducation of Nurse Practitioners Pose Real Risks to Patient Safety?

The education and training for a physician could take as long as 12 years, whereas an NP may only need 6 years to complete professional requirements. The differences there may account for patient reports of increased trust in physicians due to their extensive qualifications. However, alternative studies show that many patients trust their NPs, with some preferring them because of increased accessibility and greater reports of post-visit wellness.

These reports matter. Patient-reported data is a crucial metric for deciding whether outcomes are positively met. If patients value the care provided by nurse practitioners, then it’s imperative that health systems honor their feedback as calls for improvements and modifications to the provider landscape take effect.

How Can Facilities Respond to the Nurse Practitioner Controversy?

Regardless of whether the miseducation of nurse practitioners is a real problem, it does highlight the responsibility of healthcare facilities to ensure their patients have access to safe, trustworthy care. Human error is possible at all provider levels. To protect patients and personnel, and prevent suboptimal care, here are a few strategies to consider.

1. Standardize Nurse Practitioner Onboarding Processes and Clinical Guidelines

Standardizing the onboarding processes and clinical guidelines for NPs can contribute to improved role clarity, confidence, and better understanding of organizational values. Incorporating other providers into these functions may also serve to improve organizational culture and cooperation.

Onboarding considerations:

• Role introduction and expectations
• Competency validations
• Progress tracking and evaluation standards
• Mentorship opportunities

2. Utilize Collaborative Practice Models

Collaboration between NPs, physicians, and other members of the health team helps to improve communication and awareness of each others’ strengths and knowledge, often leading to more informed decisions about patient care. Utilized effectively, collaborative models also have the ability to reduce medical errors.

Collaboration considerations:

• Use of a particular model, such as the Structured Collaborative Practice Core Model
• Goals and expectations
• Team structure and who might serve as mentors or leaders
• Format and times for routine meetings
• Quality assessment criteria for program review and refinement

3. Offer Ongoing Education Opportunities

For nurse practitioners to expand their knowledge and hone their skills beyond what some call their miseducation, nurse practitioners must engage in continuing education. By assisting NPs with access to these opportunities, facilities contribute to ensuring provider competency, enabling safer, more effective patient care.

Ongoing education considerations:

• Scope of educational material and types of content to use
• Format for learning (webinars versus in-person workshops)
• Availability of clinical simulation training opportunities
• Potential reimbursement programs for out-of-house continuing education

4. Monitor Credentialing and Performance

Ensuring that credentialing is up to date and helping NPs stay on top of licensure requirements prevents qualification confusion and accidental lapses. This can be implemented into a routine evaluation that also addresses quality of practice standards and metrics. Routine investigation of these measures helps to evolve an NP’s practice and adapt it to the specific needs of their patients.

Performance evaluation considerations:

• Patient satisfaction scores and reported outcomes
• Timeliness of care
• Quality indicators such as the patient safety indicator and inpatient quality indicators (where applicable)
• Expectations and methods for following-up on data trends and feedback

Interested in Other Ways to Improve Patient Safety?

The controversy around the supposed miseducation of nurse practitioners serves as an important reminder that the commitment to patient safety is an ongoing process. Find more ways to effectively navigate that process with up-to-date, actionable healthcare strategies and insights straight from the experts.