Women’s Health Nurse Practitioner (WHNP)
A Women's Health Nurse Practitioner (WHNP) is an advanced-practice registered nurse (APRN) who specializes in the comprehensive care of women throughout the lifespan. They focus on reproductive, obstetric, and gynecological health. Not only do WHNPs provide diagnostic care and treatment, but they also focus on preventive health maintenance. WHNPs differ from Certified Nurse Midwives in that they follow women's health through the lifespan in a mostly primary-care environment. Depending on the state in which they practice, oversight by physicians may or may not be required.
Why Are Women's Health Nurse Practitioners So Important?
WHNPs differ from physicians in that their patient care approach is more integrated. Being nurses, they assess patient needs not only to include physical symptoms, but psychosocial and environmental needs as well. Additionally, their assessment is not only women's health-based. There is a strong primary care component due to the fact that they can address chronic health issues as well. Collaborating with physicians, WHNPs ensure that every aspect of a patient's health is addressed.
WHNPs are highly skilled in education and therefore can spend time teaching patients and family about disease processes, treatments, and healthcare prevention in addition to diagnosing acute health issues. They utilize the nurse's process to assess specific needs, analyze options, create a plan of care, and evaluate the effectiveness of the treatment plan while involving the patient's family to optimize care outcomes.
WHNPs are also critical in improving access to care. According to the American Association of Medical Colleges (AAMC), there will be a projected shortage of physicians by the year 2030 - between 40,800 and 104,900 physicians overall. Women's health nurse practitioners are already beginning to fill the gaps, as primary care physicians are expected to experience a deficit of between 7,300 and 43,100 physicians.
Nurses who enjoy practicing independently and who wish to diagnose and prescribe while still utilizing nursing skills make excellent nurse practitioners. Those seeking to pursue their NP should also value autonomy, integrity, and leadership. In the field of women's health, nurses should enjoy working with women from various backgrounds, enjoy educating patients, and promote preventive and holistic health. They should be skilled in building trusting relationships and should be able to remain unbiased as individual values and choices may differ from their own.
To advance to a master's degree or doctoral in nursing, a student must complete an accredited nursing program and obtain a bachelor's degree in nursing (BSN). Since the minimum requirement for graduate programs are a BSN, ADN-educated nurses are encouraged to find an RN to BSN program to earn a BSN. Bridge programs can take about two years to complete. After earning a BSN, it can take two to four years to earn an MSN or DNP.
There are both online and traditional classroom graduate programs available. Online programs offer more flexibility and self-directed learning, which can benefit nurses who must balance a home and work life. Each method of learning has its pros and cons, so nurses are encouraged to find a program that best fits their needs.
Depending on the graduate program, prior clinical experience as an RN may be required. Some programs allow RNs to work and therefore gain experience concurrently through the program. This is so nurses can build and refine skills in the field of women's health to better prepare them for advanced-practice nursing.
Master's degree programs require completion of general advanced-practice courses, as well as courses specific to the women's health nurse practitioner track. General advanced-practice courses include concepts such as:
- Health promotion and maintenance
- Advanced pathophysiology
- Advanced health assessment
- Pharmacology for advanced practice nurses
Depending on the school, the curriculum for WHNP can vary, but core concepts include:
- Primary care of adolescents
- Perinatal care
- Gender/women's health
- Women's health across the life span
Examination, Licensure, and Certification
Certification for women's health nurse practitioners can be obtained upon completion of the graduate program or through educational institutions such as the National Certification Corporation (NCC). Eligibility requirements include:
- Current RN/NP license
- Completion of an accredited graduate NP program
- Completion of the exam must occur within eight years of graduation
- Electronic submission of diploma and transcript
- Post-master's applicants must electronically submit their certificate of completion
Certification is valid for three years, and renewal is through continuing education and assessment.
Women's health nurse practitioners must also register with their state's board of registered nursing for licensure. Requirements may vary from state to state; nurse practitioners are encouraged to check their state board for requirements.
Male women's health nurse practitioners can face challenges in the healthcare setting. Choosing a specialty career track in women's health can add additional challenges as the patient population is female. While many men pursue their advanced-practice degree to be able to diagnose and treat as well as act as a primary care provider, many are also interested in the field of women's health and pregnancy/childbirth. Like any area of healthcare and nursing, it is calling for male as well as female providers.
One challenge that men may face is from old-school providers who were practicing when males typically did not work as nurses. The issue is not necessarily that the field of study is women’s health, as there were (and still are) many male OBGYNs, but that males historically did not become nurses. Luckily, the rate of males entering the field of nursing and advanced-practice nursing is on the rise, and the school of thought towards men in nursing is changing.
Another challenge is that many female patients prefer a female provider, especially for women’s health. Undergoing a well-woman exam and discussing things such as STDs, contraception, and sexual health can be uncomfortable in and of itself - and having a male provider may create more anxiety for some female patients. This preference may affect male WHNPs in the workplace as they may not have a large panel of patients, which leads to an unbalanced workload in partnership-style practices.
Women’s Health Nurse Practitioners are APRNs who specialize in the care of women throughout the lifespan. They focus on reproductive and gynecological health as well as preventive health maintenance. Additionally, some can address specific chronic health issues. Certified Nurse-Midwives also manage the reproductive health of women, but focus mainly on pregnancy, labor, and childbirth.
The education for both WHNPs and CNMs is similar. Both are advanced-practice nurses who complete either a master's degree or higher. However, students may choose either the Women's Health track or the Certified Nurse Midwife track. While the course of study is similar and may have overlap, the CNM track emphasizes labor, childbirth, and the immediate post-partum and neonatal period.
Both WHNPs and CNMs can work in clinic settings. WHNPs can act as a patient’s primary care provider. This means that they can care for patients from an early age through the aging years. They can work in the inpatient setting as well, such as in emergency rooms or rounding on patients who are admitted with women’s health-related conditions. They may even work alongside physicians as first-assist during surgical procedures.
In clinics, CNMs educate patients on family planning, prenatal health, and the labor process. CNMs spend a significant amount of time in hospitals and birth centers. They care for patients during the antepartum, intrapartum, and postpartum periods. Additionally, they assess and stabilize a newborn following birth. They may also intervene/refer during abnormal birth situations, or when a mother or fetus needs more intensive care.
Women’s Health Nurse Practitioners often act as a patient’s primary care provider for women’s health maintenance and reproductive health. As such, there are specific legal concerns that Women’s Health NPs need to be cognizant of.
One of the main concerns is scope of practice. Nurse practitioners need to be aware of the specific scope of practice laws in their state. Some can practice independently, while some require physician oversight. Acting outside of scope of practice sets an NP up for litigation and can risk losing their license.
WHNPs must be sure to educate patients thoroughly on issues as failure to do so can affect not only the patient's health but fetal health as well. For example, an expectant mother with gestational diabetes requires education on the disease process, diet and nutrition, blood glucose monitoring, and medications. Failure to provide this education can lead to complications at birth.
WHNPs may also face legal concerns when counseling patients on reproductive health, and birth control. Special care must be taken when counseling teenagers. Some states have privacy laws protecting teenagers; teens can be prescribed birth control without their parents’ knowledge. WHNPs should be aware of the privacy laws in their state.
Additionally, abortion counseling should be thorough and well documented as well. Many facilities have specific requirements for patients seeking abortions, for example, pregnancy options should be discussed along with future birth control counseling.
Since WHNPs care for women through the life span, they have a broad spectrum of responsibility. Duties may include:
- Conducting well-woman exams
- Reviewing preventive health needs
- Educating on available contraception, allowing patients to make informed choices
- Prescribing medication/ contraception
- Inserting long-acting reversible contraception such as
- Intrauterine devices
- Implanted devices
- Educating/counseling on unexpected pregnancies
- Ordering and interpreting blood and imaging tests
- Addressing infertility concerns
- Sexually transmitted disease diagnosis, treatment, and education
- Managing women through the perinatal period, to include:
- Confirming/dating pregnancy
- Educating on pregnancy health
- Performing ultrasounds
- Monitoring fetal activity
- Menopause education and counseling
- Intimacy and sexual health
- Screening for domestic violence, substance abuse, and high-risk behaviors
- Diagnosing female-related disease processes, for example:
- Breast, ovarian, cervical cancer
- Hormone changes/menopause
- Ovarian cysts
- Female infertility
- Urogynecological disorders
- May work alongside OBGYNs as a first assist during surgical procedures
Nurse practitioners are critical members of the health care team. Their patient and family-centered approach to patient care allows them to provide holistic care to their patients, which leads to improved patient outcomes and higher patient satisfaction.
Women's health nurse practitioners can work in the following areas:
- Primary care clinics
- Women's health clinics
- Student health centers
- Community health centers
The working conditions of WHNPs can have both positive and negative aspects. WHNPs can suffer from stress as they have heavy patient loads and sometimes difficult diagnoses to make. They must keep their own emotions in check, yet still express compassion when faced with the task of delivering unwelcome news to patients.
Additionally, there is no room for error, which can add to the daily stress level. Also, some WHNPs must work swing or graveyard shifts, weekends or holidays, and some may need to be on call.
The specialty of women's health can also be very rewarding. They often develop trusting and long-lasting relationships with their patients. They are the caregivers during the lifespan of women's health, providing care and information regarding family planning, perinatal health, and menopause. They may be involved with diagnosing life-changing diseases such as breast, cervical, or ovarian cancer, and are there to support patients through treatments.
Women's Health Nurse Practitioner Salary & Employment
According to PayScale, women's health nurse practitioners make an average salary of approximately $91,270 annually, with a range between $72,000 and $113,000 per year. Salary amounts can fluctuate due to things like location (city/state), the nurse's level of experience, any additional certifications held, and the employing organization.
According to the most recent data (May 2019) from the Bureau of Labor Statistics (BLS), the top-paying states for nurse practitioners, in general, are:
- New Jersey
While the Bureau of Labor Statistics does not list data specifically for women's health nurse practitioners, advanced-practice nurses, in general, have a promising career outlook. Because of the physician shortage, aging population, and healthcare legislation, demand for nurse practitioners is expected to rise 26 percent by 2028, which is faster than average.