Collaboration: Foundation for a Successful Practice

Abstract

Barbara Resnick, PhD, CRNP, FAAN, FAANP, and Alice Bonner, APRN-BC Collaboration, by definition, is a joint and cooperative enterprise that integrates the individual perspectives and expertise of various team members. Some commonly identified themes of collaborative relationships include collegiality, teamwork, open communication, recognition of one another’s expertise, and a strong level of trust and respect. However, the development of an individual collaborative practice is unique to the practice, should optimize the skills of each party, and allow each participant to provide care within his or her scope of practice. Despite the potential benefits of a collaborative physician-nurse practitioner practice, several barriers also exist. Collaboration should be distinguished from supervision, which implies direct physician oversight of the nurse practitioner (NP) and is a requirement for nurse practitioner practice in some states. This article describes collaborative physician-nurse practitioner relationships in geriatric practice, and guidelines for implementation of a collaborative practice agreement. GERONTOLOGICAL NURSE PRACTITIONERS A gerontological NP is a registered nurse with advanced educational preparation and the skills to provide a full range of primary care services to older adults. Gerontological NPs practice under the rules and regulations of the Nurse Practice Act of the state in which they practice. In order to practice they must be nationally certified. Gerontological NPs are currently practicing in all of the 50 states, from rural communities to heavily populated areas such as major cities and retirement communities. In addition to gerontological NPs, adult and family NPs also practice in long-term care settings. ADVANTAGES OF COLLABORATIVE CARE The benefits of physician-NP collaborative practice are particularly evident in the field of geriatrics, because older adults commonly present with multiple physical as well as psychosocial needs. Moreover, physicians who participate in a collaborative practice have noted the positive aspects of this collaboration. Based on a survey of approximately 700 physi