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Nurse Practitioner Programs in Hawaii

Well-prepared Hawaii nurse practitioners can find a lot to do under the Hawaii sun. They may serve as primary care providers for pediatric, geriatric, or general populations. They may help people manage chronic health conditions in any of multiple settings.

Nurse practitioner is a graduate-level discipline. Hawaii’s NPs hold licensing as Advanced Practice Registered Nurses, or APRNs; APRN is a broader category that includes other types of advanced nurse, such as nurse midwives and nurse anesthetists. APRNs are, by state definition, nurses who may diagnose and order medical and corrective procedures. The NP scope of practice will vary by specialization but can include ordering diagnostic procedures, forming diagnoses, utilizing and ordering therapies, monitoring treatment effectiveness, and discharging patients from inpatient settings.

Hawaii is classified as a full practice state by the AANP. Nurse practitioners can work independently, carrying out the range of duties that their training prepares them for. The Hawaii State Center for Nursing Workforce notes in a 2017 workforce report that removal of legislative scope of practice barriers is among the factors that has contributed to a rapid rise in the number of APRNs (http://www.hawaiicenterfornursing.org/data-reports).

This rapid increase is very welcome in a time of high healthcare need.

At the time of the workforce report, a little over 5% of Hawaii's nursing licensees held the APRN credential. The workforce report provides a portrait of Hawaii's APRN workforce (as well as that of nurses credentialed at lower levels). 83% reported that they did indeed work to the extent of education/ practice. Some employers set additional stipulations.

The largest proportion of APRNs were employed by hospitals. Still, this comprised just 28%. Physicians’ offices were next at 17%; ambulatory care, third at 12%. Community health comprised 10%; academia, 6%; and nursing homes, 3%. 5% reported self-employment as their primary work setting. Work settings vary somewhat by geography.

The most common specialty was reported as family health, followed by acute care and mental health. Adult health, geriatrics, and pediatrics were also very commonly reported.

Top Nurse Practitioner Programs in Hawaii

#1: The University of Hawaii: Nurses can pursue a DNP at the University of Hawaii-Manoa or the University of Hawaii-Milo. The University of Hawaii—Manoa offers both family nurse practitioner and adult-gerontology tracks; it ranks #86 out of all DNP programs in the nation.

#2: Hawaii Pacific University provides master's level preparation for a much needed specialization: family nurse practitioner.

Becoming a Nurse Practitioner

Hawaii programs are available at the master’s and doctoral levels. Programs include core coursework such as advanced physiology and assessment and provision of care for particular patient populations. Students put in time applying their advanced skills in direct patient care.

Nurse practitioners do not all have identical competencies, nor are they all identified as competent by the same test. At the RN level, competency is assessed through the NCLEX. At the NP level, the candidate will take an examination that corresponds to his or her educational preparation. Family nurse practitioner is the most common program. Some specialties would require enrollment in an out-of-state program. The following certification agencies are noted in Hawaii state code:

  • The American Nurses Credentialing Center
  • The Pediatric Nurses Certification Board
  • The National Certification Corporation for Obstetric, Gynecologic and Neonatal Nursing Specialties
  • The American Academy of Nurse Practitioners

State code allows for the possibility of credentialing based on certification through other agencies that are ABNS- or NCCA-accredited and that appropriately assess NP competency.

Some nurse practitioners specialize in mental health. Continental Who's Who recently recognized a Honolulu NP who, well into a distinguished nursing career, operates a mental health clinic (https://www.prnewswire.com/news-releases/rebecca-lee-ross-phd-is-recognized-by-continental-whos-who-300658477.html).

Hawaii nurse practitioners can independently prescribe medication. However, they do need to apply separately for the APRN-RX credential. Those who seek it will document advanced pharmacology coursework that includes advanced pharmacotherapeutics. This is standard fare these days. Students who graduate from CCNE-accredited nurse practitioner programs will have a discrete course in advanced pharmacology. Would-be APRN-RXs who did not have a qualifying course in their original program have multiple options for making up the deficit; these are summarized in the application packet. (More: Nurse Practitioner requirements in Hawaii)

Geographic Distribution of APRNs

The Center for Nursing has provided information by county. Responses reflect APRNs in general, not just nurse practitioners, but nurse practitioners comprise the vast majority.

In Honolulu City/ County, acute care facilities are found in high concentration in a small downtown area, and not surprisingly, so are APRNs. However, APRNs are also found in moderate concentration in several other parts of the county; they may be employed at doctor’s offices, urgent care centers, or community health centers.

In Hawaii County, APRNs are most concentrated in Hilo, but also concentrated in Waimea. The Center for Nursing notes that there are several ambulatory care centers there, and that advanced practitioners may act as primary care providers. They are in moderate concentration in Ka’u; in the community clinics here, they serve as the main primary care providers.

In Maui County, just 4% of nursing licensees hold an APRN; this license category still shows the highest rate of increase over a 12-year period. The Center for Nursing notes that advanced practice nurses have the very important role of primary care provision in the more remote parts of the county. Wailuku and Kihei have the greatest concentration of APRNs, but they are found in moderate concentration in a variety of locations, including Lanai’i Island.

Kauai County: Lihu’e and Kapa’a have the greatest concentration of advanced practice nurses; Lihu’e, notably, is home to Kauai’s largest acute care facility. The Center for Nursing reports moderately high concentrations in the more remote areas to the North, noting that APRNs probably figure among the few primary care providers.

Having sufficient primary care providers in very rural areas is a concern not just in Hawaii but around the nation.

Hawaii APRN Salary

According to the Bureau of Labor Statistics, Hawaii’s nurse practitioners earned, on average, $58.93 an hour in 2017, the third highest pay rate in nation. This equates to $122,580 for a year of 40-hourweeks.

Hawaii APRN survey respondents reported, on average, a 41-hour work week, a little longer than that of LPNs and RNs.

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