Abstract:
The problem. The purpose of this study was to identify independently practicing nurse practitioners(NPs)in Iowa and to assess their educational preparation, geographical practice areas, clients served, services provided,
physician interactions, sources of reimbursement, and incomes.
Procedure. In November 1989, a nonexperimental,
descriptive survey developed by this researcher was sent to all 319 nurse practitioners residing in Iowa who were licensed by the Iowa Board of Nursing. A quantitative statistical analysis of data was conducted using percentages and frequency distributions.
Findings. Out of 227 respondents, 40 were in private practice. Of these, 73% were male and 27% were female, 88% were married, and 55% were between the ages of 35 and 44. Baccalaureate undergraduate degrees were held by 50% of NPs in private practice; 85% received NP education from
certificate granting programs over 18 months in length. Eighty percent of privately practicing NPs were certified registered nurse anesthetists, and 78% worked in institutions. Nearly 90% of WPs obtained institutional privileges and utilized protocols jointly written with physicians. Acutely ill clients aged 65 and over were seen in rural settings an both in- and outpatient basis.
NPs consulted surgeons and family practitioners and provided services associated with the provision of anesthesia. Client education and counseling were infrequently provided. Major sources of reimbursement were direct client payment and Medicare reimbursement. Seventy
percent of NPs in private practice earned over $50,000 annually.
Conclusions. The ability of nurse practitioners to
broaden the spectrum of professional choice for consumers and improve access to health care is being underutilized in Iowa. Only 19% of all licensed advanced registered nurse practitioners are in private practice.
Recommendations. Studies regarding the cost-effectiveness of NP versus MD care, as well as the climate of readiness for NPs in private practice, are recommended.
