Nurse Practitioner Programs in Michigan
Nurse practitioner is a nurse specialty certification, one of four recognized in Michigan. Diagnosing and treating illness, ordering and interpreting lab work, and prescribing medications and non-pharmaceutical interventions: For some Michigan nurse practitioners, this is a typical day on the job. In other words, a nurse practitioner can seem a lot like a primary care doctor. There are, however, some differences.
A nurse practitioner’s scope is defined by population to a greater extent than is a physician’s; this is central to concept of nurse practitioner training. Nurse practitioners are educated first as RNs and often, though not always, have a lot of experience before they train at the graduate level. Educational experiences are focused on the target population. The most common population focus is quite broad: family nurse practitioner. Other common population foci include adult-gerontology, pediatric, psychiatric/ mental health, and women’s health. Nurse practitioners who want to expand their options can do additional post-graduate certificates after their initial qualifying program.
Though they don’t have quite the level of education – or independence – that physicians do, there are some areas where they may be better prepared; the Citizen’s Research Council of Michigan cites nutrition among the areas where nurse practitioners may be especially well prepared. Health promotion is an important part of the job!
Nurse Practitioner Programs in Michigan
#1: The University of Michigan-Ann Arbor offers plenty of options. Nurses can pursue their nurse practitioner education in conjunction with either an MSN or DPN. They can opt for any of three primary care options (family, adult-gerontology, or pediatric) or either of two acute care options (pediatric or adult-gerontology). They can even opt to do a combined program: meshing family nurse practitioner or pediatric primary care with nurse midwife (another nursing specialty role). The University of Michigan-Ann Arbor nurse practitioner program is ranked #10 out of all family nurse practitioner programs in the nation by US News and World Report. The DNP program is ranked #18 out of all DNP programs.
#2: Michigan State University boasts 100% 2016 pass rates on family nurse practitioner and adult-gerontology examinations through both the ANCC and the AANP.
#3: The University of Michigan-Flint has a commitment to preparing nurse practitioners for rural and underserved populations. Master’s students are encouraged to pursue research interests. RNs who do not have BSN degrees can be considered for admission.
#4: Wayne State University offers yet another CCNE-accredited, nationally recognized DNP option.
Educational Standards
Prospective nurse practitioners earn graduate degrees. Michigan has multiple options. Most are CCNE-accredited; some are ACEN-accredited. Programs include clinical practice in real-life healthcare settings; the bulk of the program, though, may be online.
Though some stakeholders have pushed for the Doctor of Nursing Practice to become the standard, the MSN and DNP both remain viable options. In Michigan, it is not uncommon for the same school to offer both options. The University of Michigan-Flint has offered a side by side comparison of its two degrees; the MSN is 51 credits; the DNP 69 – 78, depending on the option selected. The University of Flint offers only the family nurse practitioner option at the MSN level; at the DNP level, one also has the option of adult-gerontology, acute care, or psychiatric-mental health. Some schools, though, do offer specialized options at the master’s level.
The program will prepare students to seek certification through a third party agency (another credentialing mandate). Michigan recognizes a number of nurse practitioner examinations. They are offered through the following organizations:
- The American Nurses Credentialing Center
- The Pediatric Nursing Certification Board
- The National Certification Corporation
- The American Academy of Nurse Practitioners
- The Oncology Nursing Certification Corporation
- The American Association of Critical Care Nurses Certification Corporation
The list of certifications is as of 2017. Most are standard, recognized in most, if not all, states. The oncology certification is an exception. It doesn’t meet what has become consensus about entry into NP practice, though it may be valued as an adjunct credential. Michigan is by no means the only state that references it in state code.
In a 2013 survey, approximately 2/3 (66%) of nurse practitioners responded that the had a DEA number.
(Additional Details: Nurse Practitioner requirements in Michigan)
Practice Settings
Nurse practitioners work in a variety of settings, the majority of which are walk-in, walk-out the same day. The Michigan Center for Nursing carried out a survey analysis in 2013 which included a question about work setting(s). Respondents were allowed to respond with multiple settings if they had them; thus, the total exceeded 100% (https://www.michigan.gov/healthcareworkforcecenter). The top three responses were physician’s office (30.6%), hospital inpatient (28.9%), and hospital outpatient (22.6%). Other common settings included the following:
- Federally qualified health center: 7.6%
- Nursing home or long-term care facility: 7.6%
- Non-hospital outpatient: 7%
- Hospice: 4.2%
- Public/ community health: 4.2%
- Nurse managed clinic: 3.6%
- Home health: 3.2%
- College health center: 3.2%
12.4% reported education.
Survey respondents also cited their practice area. Practice areas didn’t all correspond to the broad population area required for certification and licensing; they may in some cases reflect a specialty clinic, unit, or practice. Nurse practitioners are not, for example, certified in internal medicine, but it was included among the responses; this is one of several practice areas that could be considered primary care. The following were among the most commonly cited:
- Family practice: 18.4%
- Pediatrics: 11.2%
- Internal medicine: 9.5%
- Women’s health: 9.3%
- Cardiology/ cardiac care: 6.6%
- Oncology: 5.3%
A greater percentage of those who reported having made changes in the prior year reported having switched from an outpatient to an inpatient setting than the reverse. The percentage of those switching from general to specialized care was more evenly split.
Practice Issues
Michigan is classified as a restricted practice state by the AANP. Some activities require physician supervision. How much this will this affect an individual nurse practitioner depends on circumstances.
Healthcare providers often do work together, even when it’s not mandated. In some settings, for example, they work as part of large teams to manage complex care. According to the Center for Nursing 2013 report, 74.1% of Michigan nurse practitioners considered themselves to be part of patient care teams. Among the roles reported by a majority: clinical discussions or huddles.
On the other hand, restrictive laws can make it harder for nurse practitioners to set up shop in rural areas. The Citizen’s Research Council of Michigan is among the organizations that recommends change in scope of practice and in third party reimbursement practices.
Currently, average Nurse Practitioner salary is on a par with neighboring states: higher than any state with which Michigan shares a land border, though all are within $1,000 (or 1%) of each other. Minnesota salaries are very slightly higher. Michigan nurse practitioners averaged $102,250 in 2017. This is based on 40-hour weeks. BLS Data May, 2020
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