The Role, Training, and One-Year's Experience of a Medical Nurse Practitioner

THE MEDICAL NURSE PRACTITIONER (MNP) is one type of health worker who is pre- pared to assume some of the traditional patient- care responsibilities of the physician.Some of the published descriptions of the role of the medical nurse practitioner are hypothetical, and others are based on actual experience (1-6).The per- formance of the MNP, however, has been evaluated in only a small number of studies (1,2).Although suggestions have been made for training curriculums (3), most reports based on experience do not identify the specific training.In this report we describe the training, role, and 1-year's experience of a MNP at the Terrace Village Health Center in Pittsburgh, Pa.The cen- ter is a primary care facility that serves a low- income housing project of about 1,900 families and 5,000 persons.It provides episodic (patientinitiated) medical care, supervision of patients with chronic illnesses, multiphasic screening, counseling, health education, and social and psy- chological services.The performance of a pedia- tric nurse practitioner at the center has been evaluated and published (7). Nurse Practitioner ConceptAssumptions.The plans for training a medi- cal nurse practitioner at the Terrace Village cen- ter were based on four general assumptions.The first assumption was that the MNP would be re- sponsible for patient triage but would not perform all of it.While complex cases, such as the multi- problem family, would likely require triage by the MNP, routine triage for many persons could be done under her supervision by staff members with less training (for example, a nurse assistant or a receptionist).