When a same-day appointment with a doctor is out of the question because she is booked, there is a chance sick patients will be offered an appointment with a staff nurse practitioner instead.
The country is facing a doctor shortage, and Northwest Indiana is no exception.
If nothing changes, the projected primary care physician shortage by 2020 is 20,400, according to the National Center for Health Workforce Analysis. But, if primary care nurse practitioners and physician assistants are integrated into health care delivery, that shortage could be alleviated, it states.
With the shortage in mind, Indiana University Northwest in Gary developed a nurse practitioner program and hopes to admit the first class in fall 2015, said Linda Delunas, associate dean in the College of Health and Human Services.
"We knew there was and will continue to be a shortage of primary care practitioners," she said. "There was demand from our own baccalaureate graduates, and we knew the shortage would grow."
Having non-physicians fill in the gaps is no different than family practice medicine, in terms of health care providers knowing what they're qualified to do and knowing their limitations, she said.
"What's important is that they're knowledgeable and skilled and qualified," Delunas said.
The first class at IUN will be enrolled in a family nurse practitioner program.
"That's where we'll start, and then we'll perhaps offer some other specialty," she said.
The nursing field has other paths for those with a degree.
Registered nurses can earn a master's degree and work toward licensing and board certification to become an advanced practice nurse, or APRN.
Nurses who hold a bachelor's degree can spend class time and clinical time toward certification. Critical care, oncology, orthopedic and medical-surgical are examples of specialties, Delunas said.
Because of the volume of sexual assaults in Northwest Indiana, there is a growing need for nurses trained to treat those patients and to properly collect evidence, said Michelle Resendez, regional SANE coordinator for the northern Indiana region of Franciscan Alliance.
SANE stands for sexual assault nurse examiner, also known as a forensic nurse.
"We're specialized in forensics training," Resendez said. "We assess patients from head to toe."
The certified nurses know how to identify and select the appropriate evidence. In cases of sexual assault, the victim's body may be a crime scene, she said.
"We can physically document on physical assault and domestic battery," she said.
Patients are medically cleared in the emergency department. Once stable and consenting to a forensic component of swabbing and photography, the exam gets underway.
"We don't paraphrase in our charting," Resendez said. "It's very detail-oriented."
The exams and documentation can take hours. Resendez said one of her cases took eight hours.
The detail benefits law enforcement and prosecutors, helping with a conviction, she said.
The law allows evidence collection in Indiana up to five days after the crime, and, in Illinois, up to seven days after the crime.
The SANE specialization is becoming more known in nursing. Some may be better suited than others.
"It needs to be someone who is patient, someone who is actively listening, genuinely wants to take the time to help someone in need, someone that doesn't cut corners," Resendez said. "It's emotionally exhausting. The burn-out rate is pretty high. It's difficult to walk away and think it doesn't affect you. Because someone was victimized."
Some leave because the work is too much.
"They say it's too dark and it's exhausting mentally," Resendez said.