U.S. News and World Report ranked the NP role first on its 2022 Best Health Care Jobs list, so we chatted with April N. Kapu, DNP, APRN, ACNP-BC, FAANP, FCCM, FAAN, and the president of the American Association of Nurse Practitioners® (AANP), about where she sees the role of nurse practitioners going in 2023.
You’re the President of The American Association of Nurse Practitioners® (AANP). What does it mean to you to hold this role?
I’m an acute care nurse practitioner, so I have education and training in acute care. My practice was in critical care. Before stepping into this role as president, I was the associate chief nursing officer for advanced practice at Vanderbilt University Medical Center. I oversaw all of the advanced practice professional models of care across the health system. Then I moved into this role, and it is a full-time role. I also moved to our Vanderbilt School of Nursing, where I’m an associate dean for clinical community partnerships. I have supported nurse practitioners and NP practices throughout my career, so moving into the president’s role allowed me to do that more on a national level. I have thoroughly enjoyed every moment of meeting nurse practitioners everywhere, not just in the U.S. but across the globe, seeing more about what they do and hearing more about their concerns and needs. I’ve been humbled by how much impact they have made in increasing access to care.
U.S. News and World Report ranked the NP role as the best job in healthcare for 2023. With over 350k + licensed NPs in the U.S., what draws nurses to this career?
This is the second year in a row the U.S. News and World Report ranked the NP role as the best job in healthcare, and according to the ranking of healthcare positions, the growth is up to 355,000 NPs across the U.S. We’re expected to grow between 2021 and 2031 by 46%. So there are a lot of factors that go into it.
It’s rewarding to be a nurse practitioner and provide that much-needed care across all settings. But it’s also consumer demand. Over 1.6 billion patients saw nurse practitioners and 2022 alone. And we continue to see increased demand. I constantly hear from patients and consumers of care how much they appreciate their NP care and how much their NP listens to provide comprehensive healthcare and high-quality care.
The patients say that, but also it’s our evidence. And our data has demonstrated our continued patient care outcomes impact, high-quality care, and access to care. So yes, nurse practitioners and nurses in all categories are in high demand, nurse educators and all types of nurses, but many nurses go in and become nurse practitioners because they want to meet that need. They often want advanced education and training to provide much-needed care in their community. So that’s why you see nurse practitioners in urban and rural areas, community centers, community health, and telehealth. I see them in skilled nursing facilities in schools. They are committed to ensuring everybody has access to health and healthcare.
What specific characteristics set apart a nurse who wants to take that step to become a nurse practitioner?
The majority of nurse practitioners set out to be nurse practitioners. So everybody seeks different occupations and jobs for various reasons. And so we all think it’s a question about why you became an NP over an MD. That was never even a thought for me. I wanted to be a nurse practitioner because of the nursing philosophy, and we provide comprehensive, holistic care. We’re very focused on social determinants of health, ensuring that the patient is engaged in their care and actively engaged and that the patient has ownership over their healthcare plan. We’re very good at coordinating care. So if you need to see a specialist, we’ll help coordinate that care.
Most nurses had it in their long-term career plan to be nurse practitioners. However, during the last several years, nursing has continued to be very challenging as a role. And many nurses may have worked at the bedside or in the clinic and may have said, I need to change in my career. And so, they chose to go down a different path because nursing offers lots of opportunities in terms of career paths. Some have said, I want to do something different, I’m going to go back to school, and I’m going to pursue my advanced education and training to be a nurse practitioner with a particular patient population.
You’re quoted as saying, “The nurse practitioner role is more than a job — it’s a calling, and it is an honor.” Can you expand on this?
I knew I wanted to be a nurse practitioner. I worked with nurse practitioners, saw what they did, and was compelled to do that type of care. When I say the honor part, that comes with a lot of emotion because I have been honored to meet so many amazing nurse practitioners providing care that otherwise would not have been provided in that community. They’re connecting the dots. People are getting access to care like never before in our country, where nearly 100 million Americans lack access to primary care. Seeing so many nurses stepping up to meet that need is humbling.
Where do you see the role of nurse practitioners going in 2023?
We have workforce challenges overall in healthcare. We need more nurses overall. So a lot of effort is going towards educating students coming up through elementary, middle, and high schools about the different career paths in nursing. And nurse practitioners are definitely one of those pathways.
We continue to seek to diversify our workforce. We want to make sure people interested in being nurse practitioners can do that. What I love about the AANP is that we offer many resources and support to nurse practitioners. But we also provide grants, scholarships, and information for potential future students on what it means to be a nurse practitioner, just introducing them to the career.
I know that the U.S. News and World Report have a lot of things that go into the ranking. But nurse practitioners, just like healthcare, have been challenged over the last two or three years as we’ve gone through the pandemic because there have been a lot of other needs. Nurse practitioners have stepped up to meet those needs by providing a lot of community clinics to increase access to COVID-19 care, expanding ICUs to see patients in the home, and expanding telehealth. So there’s still challenges work with challenges, and they’re still challenges with burnout. So we need to work hard as an organization to focus on the health and well-being of the nurse practitioner so that they do see the work-life balance and know how important it is that they take care of themselves so that they can bring their very best selves to their patients to do what they love.
Do you see nurse practitioners as the solution to the nursing and doctor shortage?
We need everyone working in healthcare to the top of their education and training. Nurse practitioners have done a lot. They have really stepped up. Over the years, the profession has evolved. We have national education as national standards for accredited education training and national board certification for the patient population, and we have done a lot we’ve set up to meet the demand. You see the increase, working in all settings now, certainly over the pandemic, but we could do more. But unfortunately, 24 states still have outdated laws where nurse practitioners cannot practice to the full extent of their education and what they’ve been trained to do. And these are unnecessary barriers to care that limit NPs from providing much-needed access that is needed out there.
As full practice authority is gaining ground in many states, do you expect to see a rise in the number of NP-led practices?
Absolutely. And we’re going to see more states move to full practice authority as they continue to see the evidence of what happens when nurse practitioners can practice. We’ve seen a tremendous impact in the workforce and states that have moved to FPA, an immense effect on NPs working across all settings, including rural areas, and improving patient care outcomes. The healthiest states in the U.S. are also practice authority states. We’re now in 26 states and DC with full practice authority.
During the last two years, they updated their laws. They needed to make sure they could increase access to care, we saw what was happening in the pandemic, and Massachusetts, Delaware, and New York all moved into full practice authority just in the last few years. So the momentum is there. States need the workforce, the solution to the workforce, the answer to access to high-quality care, and solutions to healthier lives. And nurse practitioners are absolutely doing that.
Can full practice authority help communities of color address healthcare access disparities?
Yes, absolutely. This is part of this. In my own journey, I’ve met many nurse practitioners working in many different communities, whether taking a mobile clinic out to the community, setting up in a community center or church, or ensuring that healthcare access is affordable and accessible. They are establishing trust with the community so that people actually reach out for health care.
A recently published study shows NPs in full practice authority can increase care to all communities, particularly communities of color and historically underserved communities. Our focus and the mission of our organization is to provide high-quality, accessible equitable care, so we’re focused on the reduction of healthcare disparities.
Talk about becoming a nurse practitioner (MSN vs. DNP) and the specialties a nurse can explore.
A nurse practitioner is part of a category called advanced practice registered nurse. There are four different categories of APRN. Nurse practitioners are one of those. The others are certified nurses, nurse anesthetists, clinical nurse specialists, and midwives. NPs are one type of APRN.
So we are registered nurses who pursue advanced education at the master’s and, often, a doctorate level for the nurse practitioner, advanced clinical training. And we select the patient population that we will focus on.
My background is in acute care, but about 90% of the NPs today have their education and training in primary care, which is where we see our most significant needs. But we’re seeing nurse practitioners going into other specialties, acute care, women’s health, mental health care, and pediatric care. So we’re finally seeing nurse practitioners in all settings.
Many nurses know the type of patient population they want to work with. And so that might help them in determining their pathway as a nurse practitioner and the patient population feels cared for. However, some may not know, so I encourage nurses to shadow a nurse practitioner to ask questions. Learn more just standing there side by side, and learn more about what an NP does. We have a website called We Choose NPs, with videos to learn more about what it’s like to be a nurse practitioner and the type of care we provide. Nurse practitioners all have graduate degrees, and many pursue a doctorate. I certainly did that. Several years ago, I pursued my doctorate because I wanted additional skills at the doctoral level in leadership and understanding finances and macro systems management. And really, to better understand how what I did as a nurse practitioner, clinical care could be expanded more on a leadership level.
Is there anything else you’d like to share about the AANP and the nursing profession in 2023?
I think the horizon is so bright. I think if we continue the momentum to stay focused on access to high-quality care and watch the evidence and follow that data follow the evidence, there are excellent studies with hundreds of 1000s of participants in those studies that show that we continue to provide high-quality, accessible care. So I would continue to follow the evidence to meet the demand for access to care. The American Association of nurse practitioners is the largest NP Association, and are a member-driven association. So we’re committed to ongoing education. We’re committed to providing practice tools for NPs, and we’re committed to advocacy. So we spend a lot of time on the state and federal level to update laws focused on patient care, and NCAA working to the fullest extent of their educational training. We are also very engaged in research and continually growing that body of evidence in terms of diagnosis and disease management, and treatment. So the future is very bright. And I hope that we as a country will continue the momentum to solve some of those critical needs that we have in healthcare.
