WOMEN’S HEALTH NURSE PRACTITIONER 

“My journey as a women’s health nurse practitioner (WHNP) has led to opportunities that I could never have imagined when I began nursing school over 25 years ago. This has truly provided me with the best of all worlds, true autonomy and control over my own practice, the opportunity to collaborate with experts in all walks of women's health, and, most importantly, the opportunity to positively affect the lives of women and their families. The distinguishing factor about WHNP care is that it is provided in partnership with the woman, from a woman focused perspective, and with attention to woman- specific assessment and intervention strategies. Fulfillment, challenge, and variety are only part of this remarkable journey. And here's why …”

Susan Kendig, RNC, MSN, WHCNP


Background: 

Women comprise over one half of the U.S. population and are at the heart of family health care. Women's health is affected by all of the factors that touch a woman's life - her family, relationships, work environment, spiritual values, and community. Research over the last two decades has supported the fact that women respond differently to wellness and disease than do men, and that gender-focused health assessment, education, and interventions are necessary for women to be as healthy as possible. As women understand more about the factors affecting their health, the women’s health nurse practitioner is emerging as a key health care provider for women throughout the lifespan.

WHNPs are experts in woman-focused heath promotion and disease prevention, as well as managing chronic health conditions affecting women. Our case management blends health recommendations with the realities of women's lives, in order to ensure optimal health, while avoiding unnecessary health care costs. 

Nationwide, an estimated 12,000 to 15,000 nurses have completed the educational requirements to become a WHNP. Although certification is not a requirement for practice in about half of the states, more than 7,000 WHNPs have completed national certification. Opportunities for satisfying, rewarding, and innovative WHNP practices are growing as women seek health care providers who will partner with them in addressing their total women’s health needs.

Roles: 

A WHNP is a registered nurse who has advanced education and clinical experience in women's health care. As a specialist, the WHNP delivers comprehensive health care to women throughout the lifespan, with an emphasis on reproductive and gynecologic health needs. The WHNP is well-qualified to provide well-woman care, prenatal and postpartum care, care for women experiencing episodic acute or chronic illnesses, as well as care to men who have selected reproductive health needs or problems.

My story is only one example of the roles a WHNP can create. I became a WHNP in 1995, after almost 20 years of practice as a registered nurse in a variety of maternal-child, and women's-health-related positions. My certification as a WHNP has opened many exciting doors for me professionally, and has allowed me to build on my valuable RN experience.

As a WHNP, I am able to affect women's health in three major ways: providing women's health care directly to individuals in my own practice, educating new WHNPs through my faculty appointment, and by working with policymakers through a variety of community linkages to ensure that health policies affecting women are truly "woman- friendly." 

In clinical practice, I am co-owner and co-developer of Women's Healthcare Partnership, Inc., a unique multidisciplinary practice that combines mental health, advanced practice nursing, and health education to improve women's health outcomes and reduce unnecessary health care costs. My business partner is a women's health psychologist. In our practice, we collaborate with women's health care providers in addressing complex diagnoses, such as high-risk pregnancy, postpartum depression, disordered eating, pelvic pain, sexual dysfunction, and problems with menopause. As the WHNP, I provide assessment, health education, and counseling services to women individually, or as part of group classes. 

Typically, clients referred to me have seen several health care providers, have had several levels of testing and medication, and have multiple physical and emotional symptoms. As a WHNP, I provide the following services: 1) assess multiple health care records; 2) identify health problems affecting physical and emotional health; 3) teach patients about significant health issues; 4) develop a plan of care in collaboration with the client and her identified health care provider; and 5) follow up to ensure that patients have access to and use appropriate health services.

As an educator, I am a clinical assistant professor at Barnes College of Nursing at the University of Missouri-St. Louis, with responsibility for developing the WHNP curriculum I have had the opportunity to design innovative clinical components that broaden our students’ experiences beyond traditional women's health care. Currently, our nurse practitioner students, under faculty supervision, provide health education and assessment to pregnant and parenting teens in three school districts, as well as in a welfare-to-work program. We also work with a local clinic to provide traditional prenatal and family planning services, along with "house calls" to women who miss their prenatal appointments.

As a women's health advocate, I work directly with community groups, policymakers, and organizations to address issues affecting women's health. This has led to my appointment to the Missouri Department of Health's Women's Health Council, vice-chairperson of the March of Dimes-Greater Missouri Chapter, and member of the expert advisory panel for a national Cardiovascular Health for Women initiative coordinated by the Association of Women’s Health, Obstetric and Neonatal Nurses and the American Nurses Foundation. This has allowed me the opportunity to be a founding board member of two important community initiatives, the Teen Pregnancy Prevention Partnership, a diverse coalition of agencies and individuals dedicated to addressing issues affecting teen pregnancy; and the Maternal-Child and Family Health Coalition. I have also had the opportunity to work with managed care organizations and physician groups, helping them to understand the benefits of working with Whaps. 

Specialties: 

Most WHNPs provide primary women's health care, which includes pre-conception health care, prenatal and postpartum care, family planning services, management of sexually transmitted diseases, well-woman care, care during perimenopause and menopause, as well as care for women experiencing episodic acute or chronic conditions. With additional education and clinical experience, WHNPS are also qualified to practice in a variety of subspecialty areas, such as infertility, cardiovascular health, oncology, geriatrics, endocrinology, urogynecology, bone health, and high-risk pregnancy, and to perform advanced technical procedures such as limited ultrasounds. 

Practice Settings:

WHNPs practice in a variety of outpatient care, long-term care, and community-based settings, as well as in hospitals. Examples of WHNP practice settings include primary care clinics, physician offices, community health centers, hospitals, antepartum triage units, school and college health clinics, health departments, business and employee health settings, and nursing homes ¾ essentially everywhere that women seek health care. Additionally, opportunities abound for WHNPs as innovative business entrepreneurs. 

Qualifications: 

In addition to strong critical-thinking, decision-making, and communication skills, WHNPs must also possess specialized knowledge of the intricacies of how simply being a woman can affect health and disease. Nursing experience in case management and incorporating the physical, social, emotional, and spiritual aspects of life into health assessment, education, and interventions is also critical in achieving optimal women's health. The WHNP learns to apply ethical and legal principles to complex health care situations and collaborate with women to develop health care plans that recognize the realities of their life situations. Typically, RNs entering a WHNP program are building on prior nursing experience in maternal-child or women's health.

Throughout my nursing career, I have focused on women's healthcare, practicing first as a staff nurse on an obstetrical unit, providing labor and delivery, postpartum, and newborn nursery care. As my career continued, I gained experience in outpatient care, specializing in prenatal care for high-risk populations, including pregnant and parenting teens, and women who are pregnant and chemically dependent. My experience also included development of professional and consumer-oriented programs focusing on maternal-child health, women's health, and nursing practice. Some of my most valuable experience was in community health, where I provided home visits for childbearing families. All of these experiences have enhanced my WHNP practice and allow me to provide a whole-health approach to women's health care.

I also maintain a traditional practice in a private physician's office. In addition, my academic appointment provides me the opportunity to maintain skills in developing curricula and other education programs, as well as supporting practice in a health department and home setting. 

Salary Range: 

In 1999, nurse practitioners nationally earned salaries ranging between $50,000 and $70,000 across a range of specialties, with an average of $60,000. Salary ranges for WHNPs vary depending upon region and practice site. WHNP salaries typically fall into the mid range of the spectrum. However, entrepreneurial activities or specialized programs may provide the opportunity for increased earnings. 

Education: 

Education of the WHNP includes advanced classroom and clinical preparation beyond that of the basic professional RN. WHNPs may have been prepared through a graduate program leading to a master's degree, or through a certificate program. The WHNP curriculum includes education in general health assessment, gynecology, obstetrics, common non-reproductive health problems, clinical therapeutics, health promotion and disease prevention, and the WHNP role. 

Graduate programs leading to practice as a WHNP include a minimum of two years of post-baccalaureate education, culminating in a Master of Science degree in nursing (MSN). Several universities also offer post-master's programs that allow MSN nurses to complete one or two years of specialty coursework in preparation for the WHNP role. 

In a certificate program, RNs may complete advanced coursework and clinical education specializing in women's health that prepares them for practice as WHNPs. Certificate courses do not culminate in a master's degree, but do prepare participants for certification and practice as WHNPs. 

Associations:

Association of Women's Health, Obstetric and Neonatal Nurses
2000 L Street, NW, Suite 740
Washington, DC 20036
(202) 261-2400
Fax: (202) 728-0575
Web site: www.awhonn.org