Many nurses complete advanced training in order to be able to provide more complex services. An Advanced Practice Registered Nurse (APRN) may have the training needed to treat most patients that come to a medical clinic, but some states have unique regulations that require APRNs to work under the direction of a licensed physician.
The easiest way to meet this requirement is to partner with a physician collaborator. Learn more about the characteristics of the APRN/collaborative physician relationship so that you will be prepared to enter into this type of partnership.
1. Collaborative Practice Agreement
States that limit what an APRN can do without supervision require that a written collaborative practice agreement be submitted. These agreements can be referred to by many names, including prescriptive authority agreements, collaborative care agreements, consult agreements, and standing protocols.
Regardless of the name that your state chooses to use, all collaborative practice agreements must outline the rights and responsibilities of each party.
Some of the areas that should be covered in your agreement include the types of conditions you can treat with or without a physician present, which procedures require direct or indirect supervision, and who will order, perform, and interpret lab results.
2. Chart Reviews
Once you begin treating patients in your own practice as an APRN, your collaborating physician will be required to complete chart reviews. The minimum standard for chart reviews is set forth by each state, but you can agree to a higher percentage if you so desire.
The collaborating physician will request a random sampling of your charts and medications prescribed to patients that meets the state's minimum percentage. The physician will then review these documents for accuracy and competency.
You will meet with the physician to go over any mistakes and discuss best practices for maintaining your charts in the future.
3. On-Site Supervision
Some states require collaborating physicians to spend a certain number of hours observing an APRN on-site each month. These on-site visits will consist of the physician sitting in on your appointments and taking time to review your charts and prescriptions.
If you do live in a state that requires on-site supervision, you will need a collaborative physician that is willing to travel to your clinic. You can expect to pay more for your collaborative services when on-site supervision is required.
If your state doesn't require on-site supervision, choosing to partner with an online physician collaborator can be a more affordable option. Reach out to online physician collaborator services to learn more.
Share12 December 2022
One day I was playing a game of basketball with a friend, and the friend I was playing ball with tripped and took a hard fall to the ground. He hit his head hard, but he insisted he was okay and just wanted to go home and take a nap. I knew in my heart that he was not thinking clearly, and I didn't feel right letting him go home. I talked him into letting me take him to the hospital, and after some tests, it was determined he had a bad concussion. The doctors told me that if I had let him go home and sleep, things could have taken a turn for the worse. I created this blog to remind everyone to look out for each other after injuries. Not everyone thinks clearly after a head injury, and just being a good friend could save a life.