DISCUSSION RESPONSES

The Mississippi Nursing Practice Law 73-15-20(3) states that a nurse practitioner is required to collaborate with a physician and guidelines must be made between the two. The protocol must include clinical guidelines and coverage that will occur for the patients if the nurse practitioner or collaborative physician is not available. This must be approved by the Board of Nursing (Mississippi Scope of Practice Policy, 2020). Another physician can be a backup for the initial collaborating physician. Chart audits of either 10% or 20 charts must be review at random every month by the physician and the nurse practitioner must meet with the physician once per quarter (Collaborating with Nurse Practitioners, 2016). A nurse practitioner can work in a free standing clinic, which is a clinic that is over 75 miles away from the collaborating physician, but the physician has to be available, and approved by the Mississippi Board of Nursing (Collaborating with Nurse Practitioners, 2016).

Two Physician Collaboration Issues

There are issues that can occur with physician collaboration. One issue is the nurse practitioner role is not clarified in a practice and what the expectations are. Another issue is the lack of time for collaboration; the physician does not have time to assist the nurse practitioner or review documents (Biezen at el., 2017).

Barriers of Practicing Independently

There can be barriers for the practicing nurse practitioner working independently. Barriers can be lack of education and training, lack of supervision, increased workload, lack of equipment, issues with staffing, treating patients outside the nursing scope of practice, policies and procedures restricting practice, and lack of trust with physicians (Torrens et al., 2020). This can also occur for the nurse practitioner not working independently. It is best to know exactly what the nurse practitioner role is, not only regarding the state laws but the facility working in as well.

Plan for Addressing Issues

Mississippi has policies in place that are simple to follow. If any questions or issues develop then the Mississippi Board of Nursing should be contacted. At any time the issue becomes a problem at the state legislature level then before addressing the issue, the problem should be researched fully. Once it is determined that further consideration is needed then local state representatives should be contacted to discuss the situation. As a graduate nurse practitioner it is essential to know policies that should be followed according to the state working in and with the Board of Nursing, so there is there is complete understanding of restrictions and guidelines. Before I begin working I will review the state guidelines and will discuss expectations and policies with my employer to gain a complete understanding of my role.

References

Biezen, M., Wensing, M., Poghosyan, L., Burgt, R., & Laurant, M. (2017). Collaboration in teams with nurse practitioners and general practitioners during out-of-hours and implications for patient care; a qualitative study. BMC Health Services Research. 17. 259. doi:10.1186/s.12913-017-2548-x

Collaboration with Nurse Practitioners. (2016). Retrieved from www.msbl.gov/sites/default/files/Documents/APRNCollaborationRules.pfd

Mississippi Scope of Practice Policy: State. (2020). Retrieved from www.scopeofpracticepolicy.org/state/MS

Torrens, C., Campbell, P., Hoskins, G., Strachan, H., Wells, M., Cunningham, M., Bottone, H., Polson, R. & Maxwell, M. (2020). Barriers and facilitators to the implementation of the advanced nurse practitioner role in primary care settings: A scoping review. International Journal of Nursing Studies. 104, 103443. doi:10.1016/j.ijnurstu.2019.103443