Nurse Practitioner Programs in Vermont
Nurse practitioners are highly educated nurses who can take on duties similar to those traditionally carried out by doctors. In Vermont, they are licensed as Advanced Practice Registered Nurses, or APRNs. Their scope of practice includes diagnosis, prescription, and management and evaluation of care; this is in addition to the standard RN scope of practice. Prescriptive authority is broad, encompassing medication and other therapeutic and corrective measures. Diagnosis-related duties include ordering and interpreting diagnostic tests. APRNs can give orders to other healthcare providers.
Nurse practitioners are credentialed to work with particular populations. The following population foci are referenced in state code: families and individuals across the life span, neonatal, pediatric, woman’s health/gender related, psychiatric/mental health, adult, and gerontology. Prospective nurse practitioners should be aware that national certification agencies, the standard setters on which licensure ultimately depends, have merged adult and gerontology into adult-gerontology, and educational institutions have followed suit.
Educational standards have increased in recent years, and so has the level of autonomy that is granted to nurse practitioners, at least in many jurisdictions. Vermont passed legislation in 2011 that changed the role of nurse practitioners. Vermont is classified as a full practice state by the American Academy of Nurse Practitioners.
In a 2017 healthcare workforce report prepared by IHS Markit for the State of Vermont Agency of Administration, APRNs are grouped with physicians, not LPNs and RNs when predicting future needs (http://healthcareinnovation.vermont.gov/sites/vhcip/files/documents/Vermont.pdf). APRNs are included in a separate primary care practitioner report, published by the Vermont Area Health Education Centers (https://nevahec.org/interior.php/pid/116/nid/83).
Both reports paint pictures of need. AHEC described a statewide shortage of primary care providers, and noted that APRNs and physician assistant were providing a counterbalancing effect to physician shortage in some counties. IHS predicted an increase in demand in the years to 2030, driven largely by increase in the population over 65. They noted that if the status quo were maintained, the need for APRNs would increase in concert with physicians. If APRNs take on a greater role — as will likely be the case — the demand will grow at a faster pace. (Vermont may be classified as a full practice state, but achieving that status isn’t the last word in how NPs are used.)
There were a lot of unknowns in the IHS long-term scenarios; this is the nature of healthcare prediction. An initiative focused on reducing the need for emergency department care through better health management could reduce the need for some types of healthcare professional but increase the demand for others, like APRNs, who can manage healthcare conditions in ambulatory settings.
Vermont nurse practitioners earned an average of $49.96 an hour ($103,920 a year) in 2017.
APRN Programs in Vermont
#1: The University of Vermont offers adult-gerontology and family nurse practitioner tracks with multiple entry options.
Becoming a Vermont Nurse Practitioner
Nurse practitioner licensing is granted on the basis of education and national certification. Independent practice can be authorized after a transition to practice period.
The prospective NP will need to complete a program that is accredited by an accepted national or state accrediting organization. Three courses are specifically referenced in state code: advanced pharmacotherapeutics, advanced patient assessment, and advanced pathophysiology. These courses are also referenced in standards documents at the national level. A nurse practitioner program will typically include multiple courses in primary care or clinical management of health conditions. Course content may be organized in different ways. A family nurse practitioner program might, for example, include discrete courses related to clinical management for different demographic groups (e.g. pediatric populations). Other common courses include health promotion, research, and professional roles and ethics.
Ultimately, the nurse practitioner will be prepared to test through one or more of the following organizations:
- American Association of Nurse Practitioners (AANP)
- American Nurses Credentialing Center (ANCC)
- American Association of Critical Care Nurses (AACN)
- National Certification Corporation (NCC)
- Pediatric Nursing Certification Board (PNCB)
Vermont has one nurse practitioner school. The minimum requirement for entry is a bachelor’s degree. It’s not necessary that the bachelor’s be in nursing, but if it’s not, the process will be longer. A direct entry master’s student will need to complete 36.5 credit hours of more basic coursework before he or she will be ready to train at the advanced practice level.
Nurse practitioner students may come away with a Doctor of Nursing practice (DNP) or a post-master certificate. In-state options are available in family and adult-gerontology population foci: two very ‘in-demand’ areas if one is to go by projected future demographics as well as current healthcare demand.
Students can expand their options if they consider schools located in other states. Many programs are online. Programs include at least 500 hours of clinical practice (1,000 hours if the nurse is starting with a BSN and progressing to DNP); the required hours can sometimes be arranged in the student’s own community. It may be necessary to go to the physical campus a few times over the course of several years. Nationwide, many programs have transitioned to the DNP, but many others still grant the MSN. Prospective students can check national accreditation status by visiting the websites of the Commission on Collegiate Nursing Education and the Accreditation Commission for Education in Nursing.
Programs can be competitive. Experience may be a factor.
A Vermont APRN must work under a formal collaborative agreement with a qualified provider for at least 24 months (2,400 hours). The collaborating provider may be either a physician or APRN. A professional who is already credentialed as an APRN but seeks an additional role/ population focus will need an additional period of collaboration, albeit a shorter one. (See: Nurse Practitioner requirements in Vermont)
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