Guidelines for Nurse Practitioners in Ambulatory Obstetric Settings

2022 ◽  
Author(s):  
Kelly D. Rosenberger ◽  
Nancy J. Cibulka ◽  
Mary Lee Barron
Keyword(s):  
Nurse Practitioners

Fool’s Gold: Psychologists Using Disingenuous Reasoning to Mislead Legislatures into Granting Psychologists Prescriptive Authority

2003 ◽  
Vol 29 (4) ◽  
pp. 489-524
Author(s):  
Brent Pollitt
Keyword(s):  
Primary Care ◽  
Mental Illness ◽  
Nurse Practitioners ◽  
Primary Care Physicians ◽  
American Psychological Association ◽  
The United States ◽  
Psychotropic Medications ◽  
American Psychological ◽  
Training Requirements ◽  
Prescriptive Authority

Mental illness is a serious problem in the United States. Based on “current epidemiological estimates, at least one in five people has a diagnosable mental disorder during the course of a year.” Fortunately, many of these disorders respond positively to psychotropic medications. While psychiatrists write some of the prescriptions for psychotropic medications, primary care physicians write more of them. State legislatures, seeking to expand patient access to pharmacological treatment, granted physician assistants and nurse practitioners prescriptive authority for psychotropic medications. Over the past decade other groups have gained some form of prescriptive authority. Currently, psychologists comprise the primary group seeking prescriptive authority for psychotropic medications.The American Society for the Advancement of Pharmacotherapy (“ASAP”), a division of the American Psychological Association (“APA”), spearheads the drive for psychologists to gain prescriptive authority. The American Psychological Association offers five main reasons why legislatures should grant psychologists this privilege: 1) psychologists’ education and clinical training better qualify them to diagnose and treat mental illness in comparison with primary care physicians; 2) the Department of Defense Psychopharmacology Demonstration Project (“PDP”) demonstrated non-physician psychologists can prescribe psychotropic medications safely; 3) the recommended post-doctoral training requirements adequately prepare psychologists to prescribe safely psychotropic medications; 4) this privilege will increase availability of mental healthcare services, especially in rural areas; and 5) this privilege will result in an overall reduction in medical expenses, because patients will visit only one healthcare provider instead of two–one for psychotherapy and one for medication.

Care Work on the Front Lines

2020 ◽  
Vol 119 (820) ◽  
pp. 326-328
Author(s):  
Mary F. E. Ebeling
Keyword(s):  
Nurse Practitioners ◽  
Outpatient Care ◽  
Care Facility ◽  
Safety Net ◽  
Ethnographic Study ◽  
Care Work ◽  
Medical Professionals ◽  
Essential Work ◽  
Social Safety Net ◽  
The Us

An ethnographic study of the work of nurse practitioners at an outpatient care facility shows how these medical professionals must endlessly multitask to fill gaps in the US social safety net. In the context of the COVID-19 pandemic, a new focus on the essential work of nurses and the lack of resources with which they often contend is especially timely.

Small talk as work talk: Enacting the patient-centered approach in nurse-practitioner-patient visits

2018 ◽  
Vol 14 (2) ◽  
pp. 97-107 ◽  
Author(s):  
Staci Defibaugh
Keyword(s):  
Nurse Practitioners ◽  
Nurse Practitioner ◽  
Medical Visit ◽  
Patient Centered ◽  
Small Talk ◽  
Medical Visits ◽  
Relational Work ◽  
The Us ◽  
The Individual ◽  
Patient Relationships

Small talk in medical visits has received ample attention; however, small talk that occurs at the close of a medical visit has not been explored. Small talk, with its focus on relational work, is an important aspect of medical care, particularly so considering the current focus in the US on the patient-centered approach and the desire to construct positive provider– patient relationships, which have been shown to contribute to higher patient satisfaction and better health outcomes. Therefore, even small talk that is unrelated to the transactional aspect of the medical visit in fact serves an important function. In this article, I analyze small talk exchanges between nurse practitioners (NPs) and their patients which occur after the transactional work of the visit is completed. I focus on two exchanges which highlight different interactional goals. I argue that these examples illustrate a willingness on the part of all participants to extend the visit solely for the purpose of constructing positive provider–patient relationships. Furthermore, because exchanges occur after the ‘work’ of the visit has been completed, they have the potential to construct positive relationships that extend beyond the individual visit.

Introduction of Wireless Buzzer to Improve Efficiency in Gynecology Triage (Preprint)

2020 ◽  
Author(s):  
Nicholas Mark Stansbury ◽  
Erin Nelson
Keyword(s):  
Medical Students ◽  
Nurse Practitioners ◽  
Nursing Staff ◽  
Internal Control ◽  
Patient Flow ◽  
Low Cost ◽  
Work Flow ◽  
Optimal Time ◽  
Nursing Experience ◽  
Asking Questions

BACKGROUND Current workflow in GYN triage has medical students interviewing patients after triage by nursing staff. The optimal time to initiate patient contact is unclear. This confusion has led to duplication of questions to patients, interruptions for nurses and fewer patient encounters for students. OBJECTIVE Determine if a restaurant-style buzzer can streamline workflow in gynecology (GYN) triage. METHODS A Plan-Do-Study-Act approach was used. Stakeholders were medical students, nurses, Nurse Practitioners and physicians. Factors contributing to workflow slowdown: students re-asking questions of patients, interruption of nursing staff, confusion about optimal patient flow. The net result was fewer interviews completed by students. The project was introduced during clerkship orientation. Buzzers were provided on weeks 1, 3, 5 of the rotation. Weeks 2, 4, 6 no buzzers were provided as an internal control. After each clerkship, students received a survey assessing key areas of waste and workflow disruption. A focus group with ten nurses was also conducted. RESULTS From February-July 2019, 30/45 surveys were completed (66%) 1. Very difficult/difficult to know when to begin the encounter: 90% without; 21.4% with buzzer p<.001 2. Students re-asking questions: very often/often 96.7% without; 14.8% with buzzer p<.001 3. Nursing staff interruptions: 76.7% very often/often without; 18.5% with buzzer p<.001 4. The odds of interviewing 5 or more patients per shift are ~10X greater using the buzzer χ²=14.2; p<.001 CONCLUSIONS The 10 nurses interviewed unanimously favored the use of the buzzer. Introduction of a simple, low-cost restaurant-style buzzer improved triage work-flow, student and nursing experience.

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