First Paper Rough Draft

Writing as a Nurse Practitioner

            A nurse practitioner is an advanced registered practice nurse. This is “one step up” from a regular registered nurse, given the two extra years of graduate school taken to become a nurse practitioner. The difference in registered nurses and nurse practitioners are very big (Exploring Health Careers). Nurse practitioners are able to build their own practice, diagnose and treat common illness, prescribe medication and therapies, provide immunization, perform physical exams, order labs, analyze lab results, authorize treatments and much more that a registered nurse isn’t authorized to do (Nurse Practitioner).

In the field of nursing, writing is something done daily. Many writings for nurses include non-academic charting, case studies, and care plans. For nurse practitioners, this is not the case. Nurse practitioners do write non-academic charts, notes, and emails to patients, but they also make legal documents for patients, and write academic articles and journals on their practices (Research, 2012).

Non-Academic Writing

            I interviewed Jodi Best, a nurse practitioner who has gotten her BSN, MSN, Family Nurse Practitioner (FNP), and Family Psychiatric/Mental Health Nurse Practitioner. Nurse practitioners have a lot more writing and examining to do on their patients, than a nurse does. For example, when asked how after Jodi writes in a day, she explains:

“About 30-40% of my day.  I am always checking email throughout the day and answering it.  I see patients at different locations every day, and then I do a report /progress note on each patient.  They are longer then a basic note that a provider would write about a patient at the doctor office, for something like a sore throat.  If it’s the first time I see them it is a full Psychiatric evaluation, which often can be 4 pages long.”

            There are different types of nurse practitioners, such as pediatric, women’s health care, acute care, neonatal, adult, and family nurse practitioners. Jodi is a family nurse practitioner, so she mainly sees and treats children. Some of the non-academic writing she does for her adolescent patients include “letters to teachers, schools when I feel they need more help or specific accommodations for anxiety, ADHD, etc. during their school day. I am on a few committees here at work so have to write documents at times for those.”

            Another common way nurse practitioners and nurses use non-academic writing, is the progress note. This is an accurate and unbiased document of the patient’s medical history and newly found symptoms for diagnosis. When asking Jodi about this, she referred to it as a SOAP note.

 “S-subjective –what the patient tells me about their symptoms, response to medications I am prescribing, etc.   O-my objective observations such as vital signs, and a mental status exam.  On occasion I do a physical exam for inpatient crisis unit.  A-Assessment- what I see as the provider and I include the patient’s prognosis at that appointment.  P-plan- medications, recommendations for therapy or other services, community resources, and LOTS of patient education that I document I have done.”

            Evaluations are another form of non-academic writing that need to be carefully documented. This means documenting the patient’s symptoms, context of the symptoms, how long they have had them, and if the patient meets the criteria for a certain diagnosis. These evaluations are very important in the medical field and must be written carefully and precisely (Carryer, 2007).

Academic Writing

            There are many academic writings in the nurse practitioner field. One of the main topics in research articles by nurse practitioners and doctors right now is if nurse practitioners and physicians are becoming a growing competition towards each other.

“Across the country, nurse practitioners and family physicians work together in practices where their skills complement each other. At the same time, some doctors argue that, without ready access to supervising physicians, nurse practitioners are likely to order more tests and consultations and be quicker to admit patients to the hospital, thereby driving up health care costs.” (Flanagan, 1998)

            A randomized trial between August 1995 and October 1997 compared this thesis by sending patients to a nurse practitioner or physician to see whether care given by either was superior and more cost efficient. This included charts, prescriptions given, and outcomes patients had throughout. The research article concluded that only hypertension in patients given care by a nurse practitioner were rather lower than a physician’s (Mundinger, 2000).

            When asking Jodi her hardest academic writing she has had to do during her time as a nurse practitioner, she began to explain her work on a template for a patient being diagnosed in order to come up with a plan of care. “The template includes many of the different areas that must be documented for legal purposes or billing purposes so it helps all of us be very complete on our documentation.  I had each of the other providers look at them and agree with it before we put them into practice.”

Conclusion

            Being in the medical field requires a lot of writing every day, whether it be charting exact observations and emailing updates on patient care, to researching and writing academic research articles on medicine. Learning to write in a professional manner is so important in communication with other medical staff or providers. It is extremely important to be able to write concisely and accurately

Being able to articulate what you want to say to others or what they need to know is vital as a professional.  Especially in nursing field, when they often are documenting patient information.  But also as a team player in a hospital or clinic setting, communication skills via writing are a must.