When Joan Foltz of Northfield goes to the doctor’s office, the person she typically sees is not an MD, but an NP.
Nurse Practitioner Christine Ablett sees patients at the AtlantiCare Physicians Group Primary Care Plus office in Pleasantville, where she works along side Dr. Jon Slotoroff, diagnosing and treating patients.
Nurse practitioners have worked in health care for more than 40 years, said Tay Kopanos, vice president of state government affairs for the American Association of Nurse Practitioners, who called them the best-kept secret in health care.
They may not be so secret for long. With a growing shortage of primary-care doctors and the Patient Protection and Affordable Care Act expanding access to medical care, nurse practitioners are emerging as a critical segment of modern medical care in America.
There are about 4,000 nurse practitioners, also called advanced practice nurses, in New Jersey, according to the state Board of Nursing website. The U.S. Bureau of Labor Statistics considers it a job with good growth potential and an average salary nationally of between $85,000 and $100,000, depending on location and years of experience.
In New Jersey nurse practitioners must be a licensed registered nurse, have an applicable master’s degree, pass a national exam and be certified by the state Board of Nursing.
“We have overlapping skills, knowledge and experience with doctors,” Kopanos said. “We are answering the question of how to provide the best access to health care.”
Ablett started her career as a registered nurse in 1994. She earned her master’s degree in nursing from Richard Stockton College in 2009.
“I always enjoyed caring for people, and I always wanted to keep learning,” she said. “This allows me to treat the whole patient.”
Locally, Stockton has offered a master’s degree in nursing since the late 1990s and added a post-master’s program in 2007. The program has a capped enrollment of 42 students and entrance is competitive, said program coordinator Edward Walton, who is also a nurse practitioner.
Walton said the master’s program is a logical step for working nurses looking to advance in the profession. Stockton’s program specializes in gerontology and primary care.
AtlantiCare currently has 75 advanced practice nurses AtlantiCare spokeswoman Jennifer Tornetta said with fewer doctors going into primary care, NPs fill the gap to assure quick access to care. She said AtlantiCare’s primary care model looks at patient needs, health care demand, and how to most effectively meet them.
“We are not trying to replace doctors,” Tornetta said. “But there is a shortage. Nurse practitioners fill that need.”
Nineteen of AltantiCare’s NPs work in primary care and specialty practices, 30 are in anesthesia and 26 are hospital-based. The company’s job listings include several nurse practitioner positions.
Foltz said her first experience with nurse practitioners was years ago when the doctor was not immediately available. She’s been seeing them ever since.
“They do seem to have more time to spend with you,” she said after an exam with Ablett. “And I know that if she sees a problem, she’ll ask the doctor about it.”
Kopanos said an American Association of Nurse Practitioners survey found that the main reason patients choose a nurse practitioner is because they partner with patients and spend more time with them on education and prevention. This is especially effective with primary-care and chronic-care patients. The AANP started an awareness campaign this year to promote their role in medical care.
“We want people to know that they are in good hands,” Kopanos said.
Local nurse practitioners said their training as nurses follows a different philosophy from a doctor’s medical training, focusing more on the total patient than just the disease. That can work to their advantage in patient interactions, especially with people reluctant to see an NP rather than a doctor.
“Some do come in and ask if they have to see the NP,” Ablett said. “Some are hesitant because they don’t know me. But they appreciate the help I give them. We are used to working one-on-one with patients and involving them in their care. It’s great when a patient thanks me and says they’d be happy to see me again.”
AtlantiCare Nurse Practitioner Theresa Rodino, of Egg Harbor Township, became a nurse after watching the care her daughter received when she had a stroke as a child. After 20 years of nursing she was ready to take her skills to the next level. She graduated from the Stockton program in May and started at AtlantiCare in June.
“As a nurse I was the eyes and ears of the doctor, monitoring the patient,” she said. “I worked for the doctor. As a nurse practitioner I diagnose and treat. I have nurses who report to me. I still collaborate with the physician, but I make the decisions.”
New Jersey does require that nurses have a collaborative agreement with a physician to write prescriptions. There is a bill in the state Legislature to remove that requirement, but Walton said collaboration among all medical professionals is still key to a complete package of successful patient care.
Tammie Brubaker, of Egg Harbor Township, has been a nurse with AtlantiCare for 14 years and respected the work done by nurse practitioners so much she decided to become one. She is in the master's program at Stockton and did a research project on patient satisfaction with nurse practitioners.
“Doctors treat the disease,” she said of her survey results. “Nurse practitioners treat the whole person. Patients like that.”
Contact Diane D'Amico: