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The Nurse Practitioner Role in the Physician Office

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The Nurse Practitioner Role in the Physician Office

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Patricia Goode RN, nurse practitioner, nurse practitioner in officeThe nurse practitioner is a masters or doctorally prepared nurse. Increasingly in the future, nurse practitioners will be educated at the doctoral level. In 2004, the American Academy of Nurse Practitioners recommended a shift in the education of advanced practice nurses (nurse midwives, nurse anesthetists, clinical nurse specialists and nurse practitioners) to the doctoral level by 2015. The degree awarded would be the Doctor of Nursing Practice (DNP).

The Patient Protection and Affordable Care Act of 29010, also known as healthcare reform, will extend medical coverage of millions of Americans. This presents an expanded opportunity for physicians to collaborate with nurse practitioners in offices and hospitals. Nurse practitioners work in many settings, including offices, nursing homes, clinics, and hospitals. Study after study shows that patients enjoy interacting with nurse practitioners and have a high level of satisfaction with their services.

The National Practitioner Data bank reports increasing numbers of claims against nurse practitioners, and we have seen that trend in our firm as well. Med League receives an increasing number of calls from attorneys requesting expert witness nurse practitioners for cases involving office-based nurse practitioners. It is common for our clients to tell us that they assumed the patient was seen by a physician, but when they examined the medical records in detail, they determined that the critical office visit was handled by a nurse practitioner.

Nurse practitioners are qualified to diagnose and treat most common illnesses either independently or under the supervision of a physician. Although nurse practitioners work under the supervision of the physicians in the practice, the degree of supervision is loosely defined and varies from setting to setting. They are held to the standard of care of the reasonably prudent nurse practitioner.

The issues that arise, in our experience, and result in liability center around failure to diagnose. The usual allegation is that the nurse practitioner missed some critical symptom that resulted in a delay in diagnosis. For example, we’ve supplied nurse practitioner expert witnesses for cases involving alleged failure to detect signs of an impending MI or stroke, or misdiagnosing a lesion.

The advanced practice role of the nurse practitioner brings increased liability. In a medical practice with a rapid throughput (large number of patients seen per hour), the risks are high.

Obtain more information about the liability of nurse practitioners by reading chapter, “Nurse Practitioner Liability Issues”, in the fourth edition of Nursing Malpractice.

Med League is a legal nurse consulting firm that assists attorneys handling cases involving medical negligence, personal injury and other litigation with medical issues at stake. Call us for assistance.

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