The changing landscape of nephrology physician assistants and nurse practitioners

Abstract

Background: Physician assistants (PAs) and nurse practitioners (NPs) have expanded roles in nephrology as both the patient load and acuity of care needed for this population have increased. Purpose: To evaluate workforce patterns of PAs and NPs working in nephrology over the past decade. Methods: Using the biannual survey from the National Kidney Foundation Council of Advanced Practitioners, data were collected and analyzed over the past decade. Results: Surveys of nephrology practitioners show the evolution of the dialysis-centralized practitioner to one encompassing all aspects of nephrology: hospital, intensive care unit, research, office, and all types of dialysis. Salaries and benefits have increased to compensate for the expansion of responsibilities. Implications for practice: Physician assistants and NPs in nephrology have the opportunity to use their skills and training in caring for this high-risk population.

Understanding the practice patterns of nephrology nurse practitioners in Australia

“…For patients in kidney failure, these are often some of the most complex people to manage as they are known to have multiple comorbidities and complex treatment regimens including being prescribed between 5 and 15 daily medications (J. Davis & Zuber, 2021). These patients do require advanced and specialised knowledge provided by renal services (Levin et al, 2013) which this survey identified NNP provide.…”

“…The potential loss of this senior experienced nursing workforce due to impending retirement is problematic given the growing burden of CKD in the Australian population. In the United States, the largest issue seen in nephrology is recruiting and retaining NNP (J. Davis & Zuber, 2021). Strategies are also urgently needed in Australia to delay the retirement of this workforce while at the same time developing robust succession plans such as direct mentorship of registered nurses to build the capacity and experience of these nurses to undertake nurse practitioner Master's programmes.…”

Promoting Independent Advanced Practice Nephrology Care

“…Studies project this group will number over 400,000 by 2023 and will continue to grow. 4 Nurse practitioners and physician assistants have practiced in nephrology for many years, 5 and collaborative practice has demonstrated increased access to care, improved patient satisfaction, and improved outcomes. 6 To meet the needs of our patients, avoid redundancy, improve efficiency, and further advance the field of nephrology, it is critical that we increase utilization of independent advanced practitioners.…”

The Challenge of Addressing the Rheumatology Workforce Shortage

“…Rapid growth in APP utilization has been demonstrated in the US, including within oncology, gastroenterology, and nephrology, all of which face similar workforce challenges. 16,17,18,19 Several publications have examined the effectiveness of APP care in rheumatology. Solomon et al found that patients seen in practices with nurse practitioners (NPs) or physician assistants (PAs) had lower rheumatoid arthritis disease activity compared to physician-only practices.…”