Nurses: Primary Care Professionals

By Sherwen, Laurie N. | The Exceptional Parent, March 1997 | Go to article overview

Nurses: Primary Care Professionals


Sherwen, Laurie N., The Exceptional Parent


Increasingly--especially in the managed care environment--Nurse Practitioners (NPs) are being recognized as alternative providers for some of the roles of primary care or family medicine physicians. Often, NPs are in practice with physicians, working together to meet the healthcare needs of children and families. Parents need not feel that, if their children are under an NP's care, the treatment is second-class.

Nurses have traditionally been front-line caregivers to children with special needs. The NP--relatively new on the professional scene--is usually either a Pediatric Nurse Practitioner (PNP) or a Family Nurse Practitioner (FNP). The PNP works specifically in a pediatric environment; the FNP, in family practice.

NPs can foster high-quality services to children with disabilities and their parents in the new managed care environment by acting as advocates, influencing health policy and decision-making processes, and by adapting care without sacrificing quality. Professional education is crucial to these roles, and most nursing-education programs are responding to new managed care demands.

General training

General nursing studies have traditionally included child development, nutrition, medical conditions affecting children, and the psychology of sick and well children. The tradition of a strong family focus gives students special insight for working with families of children with disabilities. New emphases are:

Community-delivered care. Managed care has meant a shift of practice sites from a hospital to a variety of community-based and ambulatory-care settings, including the home, neighborhood clinics, nurse-managed centers, wellness centers and schools. Each course in the nursing curriculum is adding community-based practice to reflect this shift, teaching how to deliver care with resources very different from those in hospitals, tailoring it to the child's and family's real needs and living situations.

Technology. An understanding of current information technology, essential for delivering care in a community setting, is being integrated into the nursing curriculum.

Managed-care concepts. The nursing curriculum has traditionally included advocacy training which requires a grasp of how health care delivery systems work. Students now learn about both the problems and the possibilities of managed care.

Health policy and advocacy. Students learn how to influence policy makers, serving as advocates for their clients. …

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