Current Issues & Challenges Facing Nurse Practitioners

Being a nurse practitioner has a number of advantages, including a chance to lead life-changing healthcare programs, specialize in a challenging practice area, and earn a competitive salary. Still, many advanced practice nursing issues and challenges can make the role particularly demanding.

A growing shortage of nurses is contributing to longer hours for those currently working in the field. Specifically, nurses often work 12-hour shifts, as well as varying hours and overnight shifts that prevent them from creating a stable work-life balance. The situation is so dire that the American Nurses Association (ANA) sent a letter to the Department of Health and Human Services in September 2021 urging the agency to recognize the shortage as a national crisis.

Nurses can also be subject to workplace hazards, such as exposure to viruses, pathogens, and dangerous objects such as needles. These hazards can cause serious and even life-threatening injuries.

Nurse practitioners often experience burnout due to the job’s stressful nature. Causes of burnout include compassion fatigue, physical fatigue, and the inability to decompress from and process work experiences. Burnout takes not only an emotional toll but also a financial one. According to a 2018 study by Press Ganey, nurse burnout costs the healthcare system $14 billion each year.

The COVID-19 pandemic has contributed to these issues, creating more dangerous workplace conditions and exhausted and overworked nurses. Healthcare providers have also been challenged to adapt to new treatment and vaccination protocols in attempts to stem the spread of this novel virus. A 2021 survey from Trusted Health found that 46% of nurses say their commitment to nursing has waned. Meanwhile, Mental Health America reported that nurses have higher exposure to COVID-19 and are more likely to feel tired than other healthcare professionals.

Significant changes in healthcare are affecting how the industry operates. Nurse practitioners have to keep up with frequent technological advancements, such as big data, artificial intelligence, and telehealth tools. Billing and payment processes have also shifted from fee-for-service to value-based care. And healthcare regulations continue to evolve, which can impact how patients pay for care and interact with their care providers.

One result is a growing demand for nurse practitioners to quickly adapt to these changes and help keep care costs low for medical facilities and insurers.

In 2019, Medicare proposed an executive order for expanding the scope of nurse practitioners’ practice that would allow advanced practice nurses to perform certain tasks without supervision from a physician, such as certifying when patients need home health care. Medicare proposed this order with the goal of improving access and removing barriers to patient care, especially among the elderly.

However, the American Medical Association (AMA), a physicians’ professional association and lobbying group, continues to oppose the expansion of nurse practitioner and physician assistant roles, arguing that such expansion poses a threat to patient safety. The association, for instance, has worked with state and federal lawmakers to keep nurse practitioners from practicing independently of physicians. The AMA has also awarded over $2 million in grants to advocates of this cause.

Nurse practitioners can approach and overcome these challenges with the right tools, strategies, and help from others in their field.

Nurse practitioners can advocate for safer and more sustainable workplace conditions to their colleagues and managers. In 2018, for example, the Massachusetts Nurses Association proposed a statewide ballot measure to set a nursing-to-patient staff ratio that could improve scheduling and work hours for advanced practice nurses. While the measure didn’t pass, it brought attention to staffing issues nurses are facing and set the stage for the proposal and consideration of future measures.

Nurses can avoid and recover from burnout by practicing self-care. This involves clearly communicating their work-life balance needs, saying “no” to tasks that are too emotionally taxing, and setting aside time for healthy activities such as yoga, meditation, exercise, and recreation.

Nurse practitioners have an opportunity to participate in studies about the impact of COVID-19 on future healthcare policies and procedures. A 2020 paper in the Wiley Public Health Emergency Collection, for instance, argues that nurse practitioners have been underutilized in the effort to deliver more accessible and higher-quality healthcare across the globe, especially in the wake of COVID-19. The paper concluded that further research and policy changes are needed to fully understand the scope of nurse practitioners, yet these professionals have the potential to be agents of change in healthcare practice and leadership.

PwC’s Health Research Institute survey of 2021 found that the pandemic has increased the need for telehealth services, particularly among mental health and family medicine patients. Nurse practitioners can better meet this need by training in virtual care tools and technologies, such as videoconferencing platforms, digital healthcare portals, and electronic health records (EHRs).

Many nurse practitioners and policymakers are advocating to expand their roles to reach vulnerable populations of patients with more affordable care. Delaware, for example, recently followed 23 other states passing legislation that allows nurse practitioners to practice on their own — without direct supervision from a physician.

Nurse practitioners will continue to be in high demand as the need for primary and preventive healthcare increases, especially among an aging baby boomer population. The U.S. Bureau of Labor Statistics (BLS) projects jobs for nurse practitioners will grow by 52% from 2020 to 2030, much faster than the average projected growth of 8% for all occupations. That equates to 114,900 new nurse practitioner jobs in that time.

The median annual salary for nurse practitioners in 2020 was $111,680, according to BLS, but that amount may increase if the nurse shortage persists and nurse practitioners are allowed to expand their services. In fact, healthcare organizations may also seek to hire more nurse practitioners because they can provide similar services to those provided by doctors but at a lower cost. Additionally, these nurse leaders can help deliver care to rural and low-income populations with physician shortages.

Future nurse practitioners can prepare for this demanding and rewarding career by gaining knowledge and experience through an advanced degree program. Maryville University’s online DNP programs can help nurses pursue leadership and specialized positions that can impact the lives of patients and the future of healthcare. With our DNP-NP track, students can also earn their doctorate while preparing for their NP exam and certification.

Learn more about how MVU’s online DNP and DNP-NP programs can help you take the next step in your healthcare career.

Academy Health, “Surge in Policies Expanding Nurse Practitioner Scope of Practice in Response to COVID-19 Provide an Important Research Opportunity”

American Association of Colleges of Nursing, Nursing Shortage

American Association of Nurse Practitioners, “Delaware Law Expands Health Care Access, Choice”

American Medical Association, “AMA Successfully Fights Scope of Practice Expansions That Threaten Patient Safety”

Association of American Medical Colleges, “Hospitals Innovate Amid Dire Nursing Shortages”

Becker’s Hospital Review, “5 of the Biggest Issues Nurses Face Today”

Healthcare Dive, “Burnout Hurts Nurses’ Ability to Meet Profession’s Demands”

Healthcare Finance, “Nurses Urge HHS to Declare the Staffing Shortage a National Crisis”

Industry Tech Insights, “The Major Issues Facing Healthcare in 2021”

Wiley Public Health Emergency Collection, “Leveraging Nurse Practitioner Capacities to Achieve Global Health for All: COVID‐19 and Beyond”

NP Hub, “The Biggest Challenges for New NPs (and How to Overcome Them)”

Press Ganey, “Performance Insights: Resilience for a Multigenerational Nursing Workforce”

The Regulatory Review, “Law Reforms Promote Nurse-Managed Care”

Trusted Health, “2021 Frontline Nurse Mental Health & Well-Being Survey”

U.S. Bureau of Labor Statistics, “Fastest Growing Occupations”

U.S. Bureau of Labor Statistics, “Nurse Anesthetists, Nurse Midwives, and Nurse Practitioners”

WBUR News, “Mass. Voters Say ‘No’ to Nurse Staffing Ballot Question”