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25 Most Important Current Issues Facing Nurse Practitioners in 2023
Written By: Donna Reese MSN, RN, CSN
Although the job of a nurse practitioner is gratifying, issues and challenges have troubled our profession since its inception. The year 2023 is no exception, with more concerns than ever plaguing those working in the medical field, nurse practitioners included.
With everything going on in healthcare at present, it may be hard to discern what are the important current issues facing nurse practitioners? With the ongoing struggle for full practice authority to concerns about workplace violence, NPs certainly have difficulties to face daily as providers in various environments. This article, “25 most important current issues facing nurse practitioners in 2023”, will help you focus on what is most pressing in our profession to be on top of what matters most.
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WHAT ARE THE MOST IMPORTANT CURRENT ISSUES FACING NURSE PRACTITIONERS?
(The following are the 25 most important current issues facing nurse practitioners in 2023.)
ISSUE #1: Safety on the job
Workplace-induced injuries and illnesses have risen in the healthcare industry in the past few years. Thanks to the pandemic and inadequate staffing, healthcare workers, NPs included, are experiencing severe, even deadly, illnesses and injuries affecting their daily lives and livelihood. Shift work, long hours, anxiety related to the inability to get the job done, missed breaks, and rushing to accomplish tasks all can lead to “musculoskeletal and other injuries, infections, changes in mental health, and the longer term, cardiovascular, metabolic, and neoplastic diseases” according to an NIH research
ISSUE #2: Inadequate staffing
As one of the more urgent current issues facing nurse practitioners, inadequate staffing affects NPs on many levels. Even before the pandemic and the great resignation in healthcare, nurse practitioners were in demand
. The 2020 prediction for anticipated job growth for nurse practitioners was 54% through 2030. With NPs resigning early, shifting jobs, and leaving the profession due to high stress, the present staffing situation for NPs is only getting worse.
In addition, not enough nurses, techs, aides, and other ancillary help puts more of a burden on nurse practitioners and slows down all aspects of healthcare. Working in an overburdened system translates to increased stress for NPs.
ISSUE #3: Stress
Although working as a nurse practitioner has been ranked as the #1 healthcare job
of 2022, our profession still comes with many challenges.
Stress is one of the more prevalent current issues facing nurse practitioners that has reached a boiling point. Particularly, NPs who have jobs in hospital and inpatient environments feel the tension greater than perhaps ambulatory care (although there is plenty of stress in both environments). Anxiety and pressure due to understaffing, over-scheduling, workplace violence, patent demands and threats, and administrative expectations can make the job of an NP very stressful.
At times it seems impossible to keep all our balls up in the air with patients and our bosses asking us to do more than we can physically handle in one day. It is no wonder nurse practitioners are burning out
and suffering from emotional/psychological issues at a higher rate than in previous years.
ISSUE #4: Overscheduling
As we know, the bottom line in healthcare is profit. If the organization cannot pay its employees and expenses, then the system cannot function. Due to these financial reasons, many medical organizations push the providers to take on more patients than they can handle and enforce a timeframe for shorter visits, creating stress for NPs. Additionally, nurse practitioners who value the importance of health teaching and wellness assessment are forced to edge out this critical component of patient care due to time constraints.
Due to back-to-back appointments being the norm to keep up, NPs must work longer hours to catch up on phone calls, charting, and record reviews after patient hours.
ISSUE #5: Workplace Violence
A very hot topic at present, workplace violence is now front and center in healthcare. Who would have thought 10 years ago that healthcare providers would regularly be in harm’s way by working in a hospital? Yes, our brave emergency room and psychiatric staff have long dealt with unruly patients, but workplace violence has now permeated every area of healthcare.
Unfortunately, workplace violence is one of the current issues facing nurse practitioners that has been primarily ignored by hospital administration and the public until recently, when the media began to spotlight an increase in this disturbing trend.
ISSUE #6: Needing self-care
Thankfully, nurse practitioners are learning that self-care is the only way to preserve our sanity and keep returning to work daily. If we don’t give ourselves breaks when needed, it is doubtful that our employers will step up in this area. Looking out for #1 is not in the make-up of many nurses, but to survive our current environment, we have all learned (and hopefully are applying) the phrase work-life balance
This is one of the current issues facing nurse practitioners that some of our seasoned nurses and many others still need to work on to keep them going in the long haul.
ISSUE #7: Long hours
Many hospitals still require staff, NPs included, to work 12 hours shifts. Additionally, nurse practitioners in ambulatory settings often need to work beyond their 8-hour shift to finish up the administrative end of their jobs due to excessive and compressed patient schedules. With other types of jobs now offering flexible scheduling with work-at-home options, many NPs stuck in the rut of outdated hospital schedules and long work hours are feeling the sting.
NPs are increasingly seeking jobs
that are less stressful, and that includes positions that do not require long hours.
ISSUE #8: Covering weekends and holidays
One of the ongoing current issues facing nurse practitioners that has long bothered our profession is the need to work on the days when the rest of the world is off. Having to work weekends, holidays and call can wear on us. Yes, we know that a career as a nurse practitioner may involve this type of schedule. Still, after many years of this grind or when our schedule interferes with family priorities, some NPs are just over it and begin to dream of life in a different profession or job with more regular hours and no need to work on the typical days of rest.
ISSUE #9: Job inflexibility
Besides having to work long hours, weekends, holidays, and call, the job of an NP can be inflexible in other ways. Although a career as an NP may offer increased flexibility compared to when you were a nurse, many of us still need to punch the clock at work and be available at any time while on duty.
Compared to many other non-medical careers where it is acceptable to come late to work, leave early as needed, and think nothing of extending their break, nurse practitioners are bound by the organization’s expectations that we are to be where we are required when we are scheduled. Leaving to get a cup at Starbucks in the middle of a busy day is unlikely, and calling off has a negative ripple effect on the entire staff, making us feel guilty.
ISSUE #10: Technology
One of the current emerging issues facing nurse practitioners is keeping up with evolving technology. Technological advances in the medical field will unlikely slow down, so it is essential that NPs stay abreast of what is new and upcoming in this field. Electronic medical record programs are frequently swapped for newer and better versions. Patient scheduling systems, SMART beds, new and improved patient lifts, GPS tracking of patients and equipment, wireless patient monitoring, and vests to monitor and collect physiological data are just a few examples of newer technology in the NP world. Technological education is always ongoing in our field.
ISSUE #11: Ongoing disrespect from physicians
The struggle between NPs and physicians has been an issue since the inception of nurse practitioners in 1965, when the first nurse practitioner training program began. Although this problem seems to be much better than in the past, physician resistance continues to this day, with some doctors advocating to keep NPs “in their place” by restricting and supervising those in our profession in certain states.
In general, with our exemplary dedication to patients and knowledgeable expertise, NPs are proving themselves in the healthcare arena, thus slowly gaining the respect of physicians in the process.
ISSUE #12: Patient demands
Do patients seem more demanding of late than in previous years? One of the more personal current issues facing nurse practitioners is trying to keep patients happy despite them being more demanding and choosier than in the past. The “patient experience” has become paramount in many institutions, with rewards and lectures given to staff regarding this topic.
For smaller practices, patients want to have a voice in their care, and there is an expectation that their provider caters to their needs. Shorter wait times and unhurried patient-centered care is expected just when we are being told to move faster with bigger patient loads within our practice. Balancing the two opposing expectations is highly frustrating for those in the field.
ISSUE #13: Salary
Although NP salary has taken a jump in recent years, compensation is still one of the current issues facing nurse practitioners. When surveyed
, only half (51%) of NPs stated that they are satisfied with their wages. Nurse practitioners are still in demand and are expected for years to come, thus, compensation needs to be enticing to draw NPs to jobs.
With the average nurse practitioner salary
at $118,040, you can expect the salary to increase due to the low supply and high demand for qualified NPs.
ISSUE #14: Gender wage discrimination
It is surprising to hear that there is still wage discrimination between male and female nurse practitioners. This may be primarily due to the fact that most NPs are women. Although the gap is closing, one crucial factor to note is that more men in our profession negotiate their salaries than women, who take what is offered. With more males becoming NPs, it is hoped that wages will increase all around for our profession, as male workers tend to drive up wages in general.
ISSUE #15: Restricted practice authority
Restrictions to our practice are one of the current issues facing nurse practitioners that have persisted since the inception of our profession. We are making gains as 29 states, and US territories have now been granted full practice authority
. However, in the remainder of the states still practicing in the dark ages due to these outdated restraints, NPs are not happy. Having our hands tied may be one of the most significant issues and stumbling blocks to our practice.
ISSUE #16: Current medical system is broken
Our healthcare system is in dire straits at present. We in the medical profession all predicted this problem coming for years, but the pandemic has propelled our broken system into one of the most urgent current issues facing nurse practitioners. Now that ERs have 8-12 hour (or longer) waiting times, prescription costs have sky-rocketed, and our medical staff is calling it quits; the rest of the US is sitting up and taking notice.
Whether those in charge of our tangled web of healthcare-related systems do something about this problem, time will tell. In the meantime, NPs are scrambling to try and make the system work for their patients and practice.
ISSUE #17: Increased litigation
According to Law360, not only is there a rise in medical malpractice lawsuits but the amounts awarded are increasing into the hundreds of millions of dollars. We can thank the pandemic and its aftereffects for much of this growth in litigation. With increased waiting time in ERs and for appointments and surgeries, we can expect more lawsuits to follow due to the negative consequences of these unsafe situations.
As providers, we are directly in the line of fire for costly litigation suits. This knowledge only adds more stress to this ever-present issue for NPs.
ISSUE #18: Need for more geriatric NPs
For those deciding which NP specialty to choose, knowing that there is a growing need for adult-gerontology nurse practitioners
may help sway your decision. With baby boomers now of retirement age, this large population of older adults will need medical care. Longevity in this age group is increasing, translating to many years of necessary doctor appointments, surgeries, and long-term care needs.
Many in this age group are determined to live at home in their golden years, necessitating the need for in-home provider services such as those offered through home health, mobile medical services, and telemed hospitals.
ISSUE #19: Telemed is here to stay
Telemedicine is one of the current issues facing nurse practitioners that has gained enormous popularity in the past few years. Staying abreast of the telehealth market and techniques has recently become a “basic” for providers. The more you are familiar with telehealth, the more marketable you are in your NP career, in addition to a boost to your current practice.
Telehealth is expanding in creative ways quicker than most can keep abreast with. With the current issue of overcrowded and understaffed ERs creating unheard-of long wait times, telemedicine may be the answer. A hospital in Rochester
, NY, is trying this avenue to lessen the burden of backed-up ERs in the area by offering virtual ER visits.
ISSUE #20: Continuous Updates and In-Service Education
To meet the demands of an ever-changing healthcare system, nurse practitioners must regularly attend in-service and educational sessions. In addition, most states require specific training and hours for NPs to practice according to their state’s guidelines. Classes pertaining to topics such as certain types of medication and Medicare guidelines are commonly necessary to work as an NP.
Now that Covid has settled down, some hot topics for continuing education about current issues facing nurse practitioners are:
• Substance abuse and addiction
• Prescribing opioids
• Medical Marijuana
• Health disparities
The American Association of Nurse Practitioners, along with the American Nurses Association, offers many options for necessary NP CEUS to meet state requirements.
ISSUE #21: Need for bilingual NPs
The need for bilingual NPs is one of the current issues facing nurse practitioners that is increasing in demand due to record numbers of immigrants and non-US-born people arriving in the US daily. According to the US Census Bureau
, about 8.3% of those in the US speak English “less than very well”. This means that NPs who speak more than one language can aid in effective communication with patients who otherwise may miss essential information about their condition or risk misinterpretation between the provider and patient.
NPs who are bilingual in Spanish are especially in demand as Spanish is the second most prevalent language in the US, with over 41 million speaking this language in their home.
ISSUE #22: Online education is gaining popularity
Most will agree that online education is a good thing. For prospective NP students, the flexibility afforded by online programs can only add to the appeal.
However, some NPs in the field can’t help but wonder if certain aspects of this trend will “water down” the hands-on experience gained in a brick-and-mortar NP program. With more and more nurse practitioner programs offering online classes
, will the next generation of NPs be as prepared as those going before them?
We can be assured that the quality of NP programs is rigorous and well-planned. However, time will tell how the new grad nurse practitioners
using online education will measure up to those who have chosen the traditional educational model for their training.
ISSUE #23: Shifting toward value-based care Value-based health care
(VBHC) models are being proposed as a solution to improve patient health and reduce overall costs to the patient and medical system.
With the Center for Medicare and Medicaid Services planning to fully adopt value-based care in the US by 2030, this is one of the more pressing current issues facing nurse practitioners. AANP
stresses that NPs, now more than ever, need education and support to develop new care management strategies to embrace value-based care effectively.
ISSUE #24: Reimbursement disparity
At present, there’s a gap in the reimbursement system between physicians and NPs from third-party payers/insurance companies. Medicare reimbursement for nurse practitioners is only dispersed at 85% of the physician rate. With NPs providing the same service at appointments as MDs, there is no logical reason why payment parity is unequal.
Incentives are needed for NPs to fill a shortage in primary care, and reimbursement disparity only intensifies the problem. Additionally, with more states granting full practice authority, NPs who practice independently deserve to be reimbursed for their services at the same rate as physicians for equal services.
ISSUE #25: Need to advocate role
All the current issues facing nurse practitioners named in this article (along with many more) require ongoing and diligent advocacy on the part of NPs. Nurse practitioners must continue to expand their role to reach our most vulnerable populations and push forward to offer affordable care options. In addition, we can advocate for safer conditions for both our patients and ourselves at work. The 2018 Massachusetts Nurses Association proposal to set reasonable nurse-to-patient ratios is an example of what we can do as a grassroots effort to be a catalyst for positive change in our healthcare system.
My Final Thoughts
This article, “25 most important current issues facing nurse practitioners in 2023,” will give you a glimpse of our most pressing career challenges. Over the years, our profession has had to overcome much inequity, ignorance, and at times, intolerance. But nurse practitioners are fighters. We are champions for our patients and do not back down when the going gets tough.
In 2023, times have changed, but in many ways, our obstacles remain. By having the answers to what are the important current issues facing nurse practitioners?, you will be better equipped to advance our profession and stay on top of your practice.
Donna Reese MSN, RN, CSN
Donna Reese is a freelance nurse health content writer with 37 years nursing experience. She has worked as a Family Nurse Practitioner in her local community clinic and as an RN in home health, rehabilitation, hospital, and school nursing.