sealPurdue News

February 1999

Nurses' roles, education expanding (Education version)

WEST LAFAYETTE, Ind. -- The continued streamlining of the American health care system is creating more demand for advanced practice nurses, and schools of nursing are answering the call by expanding graduate-level course offerings both on campus and via distance education technology.

"We're seeing more and more employers across the country requiring advanced degrees of their nursing candidates because of the way the health care industry is moving," explains Sharon Wilkerson, assistant head for graduate studies at Purdue University.

"Patients used to go to the hospital when they were sick, and they stayed until they were well. Now they are released from the hospital much earlier, and many require continued nursing care at home or rehabilitation at a clinic. Employers want advanced practice nurses who can monitor patients as they move in and out of different health care settings."

Wilkerson also notes that the skyrocketing cost of health care has changed the focus of medical practice to that of health promotion and wellness.

"That's where the advanced practice nurse -- specifically one trained as a nurse practitioner -- can really make a difference as a provider," Wilkerson says.

The American Nursing Association estimates that between 60 percent and 80 percent of primary and preventative care traditionally done by doctors can be handled less expensively by a nurse.

"It's not because the quality of care is different, but because of the basic economic factors involved," Wilkerson says. "Doctors have much higher overhead in terms of equipment and facilities, liability insurance, and the cost of their education."

There are four types of advanced practice nurses: certified nurse midwife, certified registered nurse anesthetist, clinical nurse specialist and nurse practitioner. All have advanced educational and clinical practice beyond the two to four years of basic nursing education required of all registered nurses.

Clinical nurse specialists usually concentrate on a general area of clinical practice such as mental health, cancer care, gerontology or neonatal health. Nurse practitioners are qualified to handle a wide range of health-related issues including the diagnosis of common minor illnesses and injuries. In many states they can prescribe medications, order and interpret laboratory tests and X-rays, and counsel and educate their patients.

Annual salaries vary according to the health care setting, but ranged from $43,386 in college health clinics to $60,000 in emergency departments and surgical facilities in 1997. The most recent national figures available list the average salary for an advanced practice nurse as $52,532 compared to $36,400 for an RN.

Wilkerson says the field has a number of rewards in addition to higher salaries.

"Advanced practice nurses have a lot more flexibility when it comes to the kind of work they do and when they do it," Wilkerson explains. "Many RNs work in the acute care setting of a hospital and only see a patient when there's a crisis. But a nurse practitioner, for example, can delivery primary health care across the life span of a patient, and usually during regular office hours."

The career field is expected to continue to grow, especially in the area of primary and preventative health care services. To help meet the demand, universities such as Purdue have broadened their graduate-level nursing curriculum and made it more accessible using distance education technology such as two-way videoconferencing and the Web.

But even with the additional courses, Wilkerson says there is still a waiting list.

"Because of the very intensive clinics involved, we can take only 15 to 20 students at a time in the traditional classes, and they fill up immediately," Wilkerson says.

Similarly, enrollment in a new distance education course in pharmacology is at capacity with 40 students. Plans call for a Web-based nursing research course to be launched this summer that will allow working nurses to take the class on their home computers.

"We're responding to what the industry is telling us it needs," Wilkerson says. "Advanced practice nurses have more versatility in terms of the kinds of care they can provide, and that benefits both the nurse and the employer."

Source: Sharon Wilkerson, (765) 494-4013; e-mail,

Writer: Sharon Bowker, (765) 494-2077; e-mail,

Purdue News Service: (765) 494-2096; e-mail,

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