Nurse Practitioners Programs in West Virginia
West Virginia nurse practitioners are licensed as Advanced Practice Registered Nurses (APRNs). They have additional education well beyond the RN level; this qualifies them to carry out advanced duties.
West Virginia code specifically references nurse practitioners as being eligible for designation as primary care providers. In this role, they coordinate care and make referrals. This is not the only capacity in which nurse practitioners serve, however. Some are part of teams that include physicians and other healthcare professionals. Some have specialties which lend themselves to something other than a primary care role.
Nurse practitioner education is population-specific, at least relatively so. Many nurse practitioners are generalists with degrees in family practice. Some have a narrower demographic focus, such as women’s health or pediatrics.
Prescription of medications can be under a nurse practitioner’s scope. West Virginia requires a collaborative agreement with a physician for prescriptive authority, at least for the first three years. In providing a pathway for nurse practitioners to achieve independence, West Virginia is ahead of some other states in the region. Freedom from mandated supervision or collaborative requirements can make it easier for a provider to set up a practice in a rural, underserved area. (Higher regulatory burdens can mean fees as well as paper work.)
West Virginia nurse practitioners can sign some documents, including death certificates, provided they have the requisite training. This is one of many things that impacts how healthcare organizations choose to utilize nurse practitioners, how the workforce is distributed… and how much access residents have to good care.
Nurse Practitioner Programs in WV
#1: West Virginia University students complete their required coursework at the MSN level, then continue on for a DNP if they choose. The WVU program is primarily online. The WVU online master’s is ranked #51 in the nation by US News and World Report.
#2: Wheeling Jesuit University heralds from a different tradition but is also CCNE-accredited. It also allows students to complete their family nurse practitioner degree at the MSN level.
#3: Shepherd University is relative newcomer with regard to the DNP but has a track record for educating nurses. The DNP program is offered in a traditional setting in Shepherdstown.
#4: West Virginia Wesleyan College and Marshall University provide two more opportunities to enter the field as a nurse practitioner. West Virginia Wesleyan College is CCNE-accredited; Marshall University is ACEN-accredited.
One Credential: Multiple Options
Shepherd University lists the following among possible work settings: private medical offices, walk-in clinics, urgent care clinics, rural facilities, nurse-led clinics, employee clinics, hospitals and hospital-affiliated clinics, and health departments. It is among the schools that offer the Doctor of Nursing Practice (DNP), a longer graduate program which some stakeholders have pushed to make the standard but which is a long way from becoming an expectation. Many nurse practitioners in West Virginia and around the nation still enter practice with a Master of Science in Nursing (MSN). Some career options may be more feasible with a DNP. The extra clinical practice and in-depth inquiry into a practice-related issue (standard DNP features) can inform day-to-day practice. While national third party organizations have a role in articulating core doctoral competencies, there is some variation from program to program. Health behavior in vulnerable populations, statistical reasoning for evidence-based practice, and population health and emerging diseases are among the Shepherd offerings.
Becoming a Nurse Practitioner
West Virginia boasts a number of schools that offer family nurse practitioner programs. There are some other in-state options. A partnership between West Virginia Wesleyan College and Virginia’s Shenandoah University brings the neonatal nurse practitioner role within easier reach of West Virginians.
A nurse with a BSN can earn an MSN and nurse practitioner credentialing after about 50 credit hours; some programs are shorter.
There is an element of standardization to the credentialing process. Accreditation status is tied to certification. Most West Virginia programs are CCNE-accredited. One is ACEN-accredited.
Nurse practitioner programs are often online. This can make it easier for nurses to continue working in the field. Programs always include clinical practice. They often include minimal residency requirements. The student may need to come to campus one or more times a semester for simulations or other on-campus activity. Unlike the preceptorship requirement, this is not universal.
Opportunities and Challenges
A 2017 work force demand analysis (commissioned by the West Virginia Rural Health Association) shows that nurse practitioners are concentrated in some areas of the state (https://wvrha.org/wp-content/uploads/2017/06/2017-FINAL-WV-Workforce-8312017.pdf). The report captures subtleties beyond just the number of providers per county; it notes that some rural West Virginians rely on services provided by bordering states. Ultimately, though, it paints a picture of inequity. Of concern is the aging of the population and the aging of the workforce.
Some nurse practitioners carve out their own paths. The Campaign for Action recently profiled a dually certified family adult-gerontology nurse practitioner who opened a reverse-integrated practice in West Virginia more than two decades ago. The practice has an innovative design whereby primary care services are delivered in a behavioral health setting (https://campaignforaction.org/she-opened-the-first-nurse-led-care-practice-in-west-virginia/).
Innovation may get easier, thanks to multiple organizations in West Virginia and around the nation. The West Virginia Nurses Association has been involved in efforts to expand scope, and they have seen some major gains. The Legislative Auditor produced an 85 page document that included a review of states that had granted prescriptive authority. They stated that they did not see a need for experienced nurse practitioners to be tied to physicians for prescriptive authority and that the costs of this arrangement could outweigh any benefits. Advocacy efforts continue. The West Virginia Nurses Association had made multiple recommendations for scope of practice changes, including wide expansion of documents that nurse practitioners could sign. The state did not implement all scope of practice recommendations.
West Virginia nurse practitioners averaged $45.67 an hour or $95,000 a year in 2017.
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