Hamric, Hanson, Tracy, and O’Grady (2014) define consultation as a professional with a specific expertise interacting with another professional or organization. The professional or the consultee would require the assistance of an expert in a specialized field to help resolve an issue. Advance practise nurses (APN) can use consultation to provide clinical expertise to other professionals or to improve the quality of patient care they provide. Whereas, supervision is the mechanism used by a physician and APN to ensure the APN is practising within their scope to provide the most favorable care to patients while meeting medical standard of care and as defined in their collaborative practice agreement (Journal of the American Medical Directors …show more content…
Association, 2011), or in our situation, an APN and a staff nurse. During consultation, the consultee retains responsibility of the patient and has the option to reject or accept the consultant advice (Hamric et al, 2014), whereas, in supervision, the supervisor is ultimately responsible for the patient’s overall care (Journal of the American Medical Directors Association, 2011).
Collaboration is an agreement between two individuals or professionals to interact constructively in problem solving to accomplish a determine goal, purpose or outcome(Hamric et al, 2014). Therefore, from these defination, consultation and collaboration is not synonymous but in order to have a successful professional relationship, and to achieve a patient centered goal, with every consultation, there should be a collaboration between professionals. As a Registered Nurse(RN) on a medical surgical unit, I have seen consultation between the Physicians, Physician Assistants (PA), Nurse Practitioners (NP) and other professionals. Example of these consultation is when a NP writes a consult to an endocrinologist for a newly diagnosed diabetic patient or a nephrologist for a patient with acute kidney injury. With these consultations, the NP who is the consultee and the consultant ( endocrinologist or nephrologist) are working together to reach an outcome that is mutually determine, thereby making this practice part of the graduate competency criteria.
References Collaborative and supervisory relationships between attending physicians and advanced practice nurses in long-term care facilities. (2011). Journal of the American Medical Directors Association, 12(1), 12-18. doi:10.1016/j.jamda.2010.08.003 Hamric, A. B., Hanson, C. M., Tracy, M., & O'Grady, E. T. (2014). Advanced practice nursing: An integrative approach (5th ed.). St. Louis, MO: Saunders/Elsevier
In the United States, depending upon the state in which they work, nurse practitioners may or may not be required to practice under the supervision of a physician, frequently referred to as a “collaborative practice agreement”. However, in consideration of the shortage of primary care/internal medicine physicians, many states are eliminating or lessening the restrictive authority which allows and nurse practitioners the ability to function more autonomously (AANP 2015).
I need further development in knowing what the scope of practice of an RPN is because at clinical I am unsure of the difference in roles of the RPN’s that are working on the units compared to the Registered Nurses (RN’s). I feel that knowing and understanding the scope of practice of an RPN is crucial, in order to ensure the safety of the patients, but also to protect your license as a nurse. Also, it is important to understand your role as a nurse to ensure the patients’ needs are being met, and to ensure you stay within your scope of practice while providing care. The CNO’s scope of practice statement is, “The practice of nursing is the promotion of health and the assessment of, the provision of, care for, and the treatment of, health conditions by supportive, preventive, therapeutic, palliative and rehabilitative means in order to attain or maintain optimal function” (College of Nurses of Ontario, 2015). The goal I set for myself is, I will learn and understand the scope of practice of an RPN in order to be accountable for all my actions as a future
Ignatavicius, D. D., & Workman, M. L. (2013). Medical-surgical nursing: patient-centered collaborative care (7th ed.). St. Louis: Elsevier Saunders.
In this event, the matter that is unusual can be the fact that I have experienced and witnessed the process for interprofessional collaboration between the community nurse and other professionals that I have never knew about before. This event made me realize that there are many aspects of community nursing that I have knew about before where in this situation it is the importance and accountability of interprofessional collaboration. From my nursing theory course I have learned that interprofessional collaboration is when the nurse forms relationships with other professionals that enable them to achieve a common goal to deliver care and strengthen the health system and clients involved in it. (Betker & Bewich, 2012, p.30) In this event, our mutual goal is to provide the appropriate care for the patients/residents so they can restore their health after their hip or knee surgery. In the nursing leadership and management textbook it stated “interprofessional practice removes the gatekeeper and allows client access to all caregivers based on expertise needed.” (Kelly & Crawford, 2013, p.35) In this event, my preceptor and I gained knowledge about Revera and will pass on this information to patients who are interested in staying at a retirement home after they discharge from the hospital. One literature talked about how according to the Institute of Medicine, it is critical to have the capacity to work together as part of the interdisciplinary team to assist in delivering high quality, patient-centered care. In addition, effective collaboration among health care professionals results in improved patient care and outcomes. (Wellmon, Gilin, Knauss & Linn, 2012) This indicates the importance of interprofessional collaboration to provide...
CNA outlines seven basic principles which help facilitate in collaborating with other professionals, they are: client-centred care, evidence-informed decision-making for quality care, access, epidemiology, social justice and equity, ethics, and communication. Communication is a common theme that has repeatedly surfaced in my research. What makes communication an important aspect of interprofessional collaboration? Cottrell, Mellor, and Moran (2013), mentions how part of their findings with students who have participated in interprofessional education program was how their interactions and communicating with each other became valued. With knowing each other’s skills and profession, they were able to work well as a team to obtain the best care for the patient. By sharing expertise and perspectives provide a common goal which is, improving the patient’s
Medical-surgical nursing: patient-centered collaborative care (7th ed.). St. Louis: Elsevier University. Taylor, C. (2011). The 'Standard'. Introduction to Nursing -.
Intro- Collaboration with the interdisciplinary team plays a big part in the care of a patient.
Licensed practical nurses (LPN 's) fill an important role in modern health care practices. Their primary job duty is to provide routine care, observe patients’ health, assist doctors and registered nurses, and communicate instructions to patients regarding medication, home-based care, and preventative lifestyle changes (Hill). A Licensed Practical Nurse has various of roles that they have to manage on a day to day basis, such as being an advocate for their patients, an educator, being a counselor, a consultant, researcher, collaborator, and even a manager depending on what kind of work exactly that you do and where. It is the nursing process and critical thinking that separate the LPN from the unlicensed assistive personnel. Judgments are based
Nursing is a knowledge-based profession within the health care sector that focuses on the overall care of individuals. According to The American College of Nurse Practitioners (ACNP), “defines nurse practitioners as registered nursed who have received graduate-leveling nursing education and clinical training, which enables them to provide a wide range of preventative and acute health care services to individuals of all ages. They deliver high-quality, cost effective care, often performing physical examinations, ordering tests, making diagnoses, and prescribing and managing medication and therapies”. Nurse Practitioners are able to specialize in a particular area, such as family and adult practice, pediatrics, and women’s health; and refer patients to other specialist when necessary. Some Nurse practitioners work under the supervision of a physician; while others run their own practices.
Advanced practice registered nurses play a significant part in extending access to health care by providing primary care and specialty care services to clients. Advanced practices registered are mentors, educators, researchers, and administrators. According to Health Resources and Services Administration, “Ninety-six percent of the NP workforce reported being in clinical practice, providing direct patient care” (Health Resources and Services Administration 2016). Furthermore, “Nearly three percentages were in faculty positions and approximately one percent was in administrative positions”(Health Resources and Services Administration 2016).
Consultation and collaboration is used in working with others in the school. Community, and family to promote student personal-social, career, and academic development. One instance, would be through referrals to counseling or tutoring services that are given outside of the school, which is typically done when the counseling services is outside of the School Counselor’s scope in terms of typical and/or length of counseling services. The student’s information, assuming permission is given to share, will be shared with the community counselor and possibly progress information will be shared in return so that both parties can assist the student the best way possible. Consultation and collaboration will be used with parents as a way to provide
The necessary resources included technology and space for the Nursing Student to collect data and the expertise of the various stakeholders. The space for the student was readily available, and communication between the student and clinic staff was excellent throughout the duration of the project. The resources necessary to meet the long-term outcomes of the project include the extended clinic space and an increased number of providers to form healthcare teams and meet the increasing needs of the growing patient population.
In fact, there have been numerous studies supporting the clinical performance and outcomes of NPs. A systematic review covering the literature from 1990-2008 found that patient outcomes of care provided by APRNs in collaboration with physicians were similar to and in some manners, exceeded those of physicians alone (Newhouse et al., 2011) Newhouse, et al’s review added to the available evidence that APRNs provide safe, effective, quality care to specific populations (2011). In their review, they did not separate outcomes of NPs with full practice authority from those with reduced or restricted practice. Due to the patchwork of state regulation and restrictions on NP practice, it may be challenging to compare the outcomes of NPs with full independent practice from those with reduced or restricted practice. Furthermore, the AANP states “there are numerous studies that demonstrate nurse practitioners consistently provided high-quality and safe care” (n.d.). They go on to state “in the more than 100 studies on care provided by both nurse practitioners and physicians, not a single study has found that nurse practitioners provide inferior services” (AANP, n.d.). The Federal Trade Commission (FTC) has also reviewed the literature and determined there is not a significant difference in the outcome of NPs and physicians that would necessitate the anti-competitive nature of scope-of-practice regulations and restrictions on advanced practice nursing (Federal Trade Commission [FTC],
The medical community has changed since the 1980s, as positions and duties has changed. Each position contains specific duties to help with patient care and outcome. Just like a pyramid, each position holds a superior rank to the other. The doctors are at the peak and control the patient care. They make the decisions based on the information provided to them by the nurses. The registered nurse (RN) is at the next level and communicates between the doctors and the supporting staff. The supporting staff, the final level, assist the patients on a one on one basis. This pyramid of positions alters depending on the specialty or facility that an individual is employed, and condition of the patient. One without the other is an impossible task...
This becomes increasingly important when the nurse takes on an advanced practitioner role. Traditionally physicians have been responsible for diagnosing and prescribing and nurses have been the ones to carry out the bedside care. When combining both of these roles, there is an even greater influence on the care patients receive. With this kind of influence it is critical that the advanced care practitioner bring their knowledge of the designed environment, creative implementation, as well as the art of nursing, to the table when treating each