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Nurse practitioners (NPs) are becoming a more common health partner for many Vermonters.

Choosing a Nurse Practitioner As Your Primary Care Provider

By Brenda Strysko, DNP, CNM, FNP-BCPrint Story | Email Story

Nurse practitioners (NPs) are becoming a more common health partner for many Vermonters.  According to a 2018 report by the American Association of Nurse Practitioners, Americans make more than 870 million visits to NPs every year.

Still, many patients are not aware that NPs can capably serve as a primary care provider. As clinicians that blend clinical skill in diagnosing and treating health conditions with consideration for disease prevention and health management, NPs provide comprehensive care to patients every day.

Vermont leads the way

Compared to other primary care providers, NPs are the most likely to practice in rural communities like Vermont. According to a 2011 survey from the American Association of Nurse Practitioners, the five states with the greatest reported percentage of NPs in rural areas are Vermont (56 percent), South Dakota (50 percent), Wyoming (43 percent), Montana (40 percent), and Maine (39 percent). With the challenge of rising health care costs, an aging population, and growing chronic disease, NPs bring strength to the healthcare workforce and provide a viable choice for your healthcare needs.

What kind of training does a nurse practitioner have?

All NPs must complete a master's or doctoral degree program and have advanced clinical training beyond their initial professional registered nurse preparation. This usually requires six to eight years of college preparation. Academic and clinical courses prepare nurses with specialized knowledge and clinical competency to practice in primary care, acute care and long-term health care settings.  Many NPs have years of clinical training and experience.

What can a NP do?

NPs provide a full range of primary, acute and specialty health care services, including:

* Ordering, performing, and interpreting diagnostic tests such as lab work and x-rays.

* Diagnosing and treating acute and chronic conditions such as diabetes, high blood pressure, infections, and injuries.

* Prescribing medications and other treatments.

* Managing patients' overall care.

* Counseling.

* Educating patients on disease prevention and positive health and lifestyle choices.

What about the quality of care a NP offers?

According to a 2010 publication by the Institute of Medicine, NPs undergo rigorous national certification, periodic peer review and clinical outcome evaluations, adhere to a code for ethical practices, and are recognized as health care providers capable of providing comprehensive, high-quality care. Self-directed continued learning and professional development is also essential to maintaining clinical competency.

Additionally, to promote quality health care and improve clinical outcomes, NPs lead and participate in both professional and lay health care forums, conduct research and apply findings to clinical practice. NPs are licensed in all states and the District of Columbia, and practice under the rules and regulations of the state in which they are licensed.

How are physicians and NPs similar?

Physicians and NPs are held to the same standards of care in terms of quality, safety, and patient outcomes. Like physicians, NPs will consult with their colleagues and/or specialists if a patient needs care that the NP cannot provide or has a problem outside the scope of the NPs experience and training.

Many physicians and NPs, in particular, often take pride in a holistic approach, emphasizing the health and well-being of the whole person and considering the effects that health problems will have on the patient, their loved ones, and their community. With a focus on health promotion, disease prevention, and health education and counseling, NPs can guide patients in making smart health and lifestyle choices, which can lower patients' out-of-pocket costs.

If you are looking for a primary care provider, I encourage you to consider both local NPs and physicians to find the provider who you feel will make the best health care partner for you. I hope that the provider you choose will be the perfect person to help you address your health care needs and reach optimal wellness.

Brenda Strysko, DNP, CNM, FNP-BC, provides care to patients at SVMC Deerfield Valley Campus in Wilmington, Vt.  For more information and to inquire about becoming a patient, call 802-464-5311.

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Protecting Children and Others During a Measles Outbreak

Dr. Marie George

Once a common childhood disease, measles was almost an expected part of growing up. But it wasn't without consequence. Worldwide, up to 2.6 million people died annually from measles every year up until a vaccine was introduced in 1963.

In recent years, some parents have refused to vaccinate their children based on misinformation about side effects of the vaccine.  As a result, the number of unvaccinated children, teens and adults in our communities is on the rise. While those making the choice to not vaccinate believe they're making this decision solely on behalf of themselves or their children, they're actually impacting the health of others. Sometimes with deadly consequences.

How is it spread? Who is at risk?

The measles virus is highly contagious and spreads easily. Spread by close personal contact, coughing, or sneezing, the virus can remain active in the air or on a surface for up to two hours after it has been transmitted.

That means that any unvaccinated individual — including infants and those with compromised immune systems — can get sick when entering a space where an infected person was even hours before. Infected individuals can then go on to spread the illness days before they show any signs of the disease.

How to protect those at risk

Measles vaccines are by far the best possible protection you can give your child. Two doses are 97 percent effective and the potential side effects are rare and not nearly as scary as suggested by a lot of popular media. If they appear at all, side effects are usually a sore arm, a rash, or maybe a slight fever. Claims that the vaccine causes autism have been undeniably proven to be false.

As for when to get your child vaccinated, the American Academy of Pediatrics, the Centers for Disease Control and Prevention and the American Academy of Family Physicians all recommend children receive the measles vaccine at age 12 to 15 months and again at 4 to 6 years old. Children can receive the second dose earlier as long as it is at least 28 days after the first dose.

How about adults?

Because the risk of death from measles is higher for adults than it is for children, teens and adults who have not been vaccinated should take steps to protect themselves. "The vaccine can be provided in two doses within 28 days of each other. This is particularly important for those planning travel overseas or to areas in the United States where outbreaks are occurring.

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