Nurse Practitioners' and Physicians' Views of NPs as Providers of Primary Care to Veterans

Fletcher, Carol E.; Baker, Sally-Ann; Copeland, Laurel A.; Reeves, Pamela; Lowery, Julie C.

doi:10.1111/j.1547-5069.2007.00193.x

Cited by 29 publications

(51 citation statements)

References 17 publications

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“…Collaboration worked well where MPs noted that NPs took over some parts of their workload such as education and follow up care [60], ‘routine cases’ [67] or patients with minor illnesses and chronic diseases [63], so that MPs were able to focus on more complex cases [17]. However, not all MPs have experienced a decrease in workload because NPs would consult the MP for their patients [64] and supervision of NPs increased the workload of MPs [68]. …”

Section: Resultsmentioning

confidence: 99%

“…While some MPs agreed that collaboration can exist as true reciprocity they rather acknowledged that forms of collaboration range from an interdependent to hierarchical relationship [60]. Contrary to some of these findings, NPs and MPs rated their working relationships with each other as collegial [68] and their level of collaboration and communication as high [74] when measured on attitude scales.…”

Section: Resultsmentioning

confidence: 99%

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Views and experiences of nurse practitioners and medical practitioners with collaborative practice in primary health care – an integrative review

et al. 2013

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BackgroundThis integrative review synthesises research studies that have investigated the perceptions of nurse practitioners and medical practitioners working in primary health care. The aggregation of evidence on barriers and facilitators to working collaboratively and experiences about the processes of collaboration is of value to understand success factors and factors that impede collaborative working relationships.MethodsAn integrative review, which used systematic review processes, was undertaken to summarise qualitative and quantitative studies published between 1990 and 2012. Databases searched were the Cochrane Library, the Joanna Briggs Institute Library, PubMed, Medline, CINAHL, Informit and ProQuest. Studies that met the inclusion criteria were assessed for quality. Study findings were extracted relating to a) barriers and facilitators to collaborative working and b) views and experiences about the process of collaboration. The findings were narratively synthesised, supported by tabulation.Results27 studies conducted in seven different countries met the inclusion criteria. Content analysis identified a number of barriers and facilitators of collaboration between nurse practitioners and medical practitioners. By means of data comparison five themes were developed in relation to perceptions and understanding of collaboration. Nurse practitioners and medical practitioners have differing views on the essentials of collaboration and on supervision and autonomous nurse practitioner practice. Medical practitioners who have a working experience with NPs express more positive attitudes towards collaboration. Both professional groups report concerns and negative experiences with collaborative practice but also value certain advantages of collaboration.ConclusionsThe review shows that working in collaboration is a slow progression. Exposure to working together helps to overcome professional hurdles, dispel concerns and provide clarity around roles and the meaning of collaboration of NPs and MPs. Guidelines on liability and better funding strategies are necessary to facilitate collaborative practice whether barriers lie in individual behaviours or in broader policies.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Views and experiences of nurse practitioners and medical practitioners with collaborative practice in primary health care – an integrative review

et al. 2013

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“…These are described in greater detail as capacity constraints in Subsection 3.2.4. These issues are not limited to physicians; VA nurse practitioners have reported spending an increasing amount of time on administrative tasks over clinical tasks and not fully utilizing their training and expertise (Fletcher et al, 2007). Results from the Chief of Staff module of our 2015 Survey of VA Resources and Capabilities show that 84 per cent of respondents (94 out of 111 sites) identified providers performing administrative activities that could be performed by others as a key issue negatively impacting provider and system efficiency.…”

Section: Rationalementioning

confidence: 95%

Resources and Capabilities of the Department of Veterans Affairs to Provide Timely and Accessible Care to Veterans

Hussey¹,

Ringel²,

Ahluwalia³

et al. 2015

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“…Another Australian study, of nurse practitioner roles in rural and remote areas, demonstrates the gap between policy rhetoric and sustainability of the role in practice when powerful vested interests of the medical profession prevent an autonomous nurse practitioner role from surviving (Turner et al, 2007). A study in the USA Midwest reports acceptance by physicians of nurse practitioners, but only so long as the physicians perceive no threat to their professional territory (Fletcher et al, 2007). Caution is needed when making direct comparison between consultant nurses and nurse practitioners, but consultant nurse roles that advocate extension into medical tasks and substitution for doctors may be similarly threatened.…”

Section: Introductionmentioning

confidence: 95%

An exploration of personal initiative theory in the role of consultant nurses

Redfern

Coster

Evans

et al. 2010

Journal of Research in Nursing

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The aim in this paper is to investigate the contribution personal initiative theory makes in understanding the consultant nurse role. The role was introduced in the UK in 2000 to improve patient outcomes, clinical leadership and retention of experienced clinicians. A larger study used a multi-method approach to collect quantitative and qualitative data from focus groups, interviews and a questionnaire administered nationally at two time points. Findings from longitudinal telephone interviews with 30 consultant nurses are the focus of this paper.Three consultant nurses were selected as case studies to examine the potential of personal initiative theory when applied to new nursing roles. The activities of two of the three demonstrated a high level of personal initiative in the job. They persisted in overcoming problems faced in improving practice. The third scored lower: she emerged as a reactive conformist and less likely than the other two to pursue initiatives of her own.Personal initiative theory has potential as a framework for evaluating the consultant nurse role, although further research is needed to test it. The longitudinal analysis revealed a determination to stay in the job and overcome difficult challenges when consultants show initiative and are making progress in achieving change.

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Nurse Practitioners' and Physicians' Views of NPs as Providers of Primary Care to Veterans

Abstract: To facilitate the teamwork of NPs and MDs while improving utilization of NPs as primary care providers, VHA officials should routinely clarify roles, monitor quality of care of both MDs and NPs, and provide feedback to all concerned.

Cited by 29 publications

References 17 publications

Views and experiences of nurse practitioners and medical practitioners with collaborative practice in primary health care – an integrative review

Views and experiences of nurse practitioners and medical practitioners with collaborative practice in primary health care – an integrative review

Resources and Capabilities of the Department of Veterans Affairs to Provide Timely and Accessible Care to Veterans

An exploration of personal initiative theory in the role of consultant nurses

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