Working with Protocols

Abstract

he need to develop, use, and justify departures from protocols is a demanding and sometimes confusing part of every nurse practitioner's work. In this article we'll examine exactly what NP protocols are (and what they aren't) and clarify some of the key issues surrounding them. NP protocols have evolved primarily as a means for physicians to delegate specific tasks of medical diagnosis and treatment. By codifying these medical acts into specific steps or standards, physicians have maintained control over NP practice. You can implement only those medical steps identified in the protocols and only when the required relationship with a physician has been established. Protocols provide parameters to limit the scope of NP practice and to define the responsibilities of the NP and the physician for the care of patients with specific diagnoses. Legislation advocated by many state medical societies for inclusion in medical or nurse practice acts often requires that you use protocols for practice that are jointly developed and implemented with a collaborating physician. Because of this, you can't practice independently of a physician in many states.