Nurse practitioner-physician joint practice criteria

All nurse practitioners and physicians in Utah joint practice were studied to describe the joint practice criteria occurring in the state. No empirical studies on joint practice were available in the literature. An article by Brown (1977) titled "Nature and Scope of Services: Joint Practices" suggested criteria necessary for successful joint practice. A sense of nursing identity, delivery of primary health care by nurse practitioners, a collegial relationship and open and collegial communication were the areas specified for assessment in the article and formulated into research questions. The conceptual framework for this study was based on general systems theory. The focus of the study was the focal system of the collegial relationship between the nurse practitioner and physician subsystems. The sense of nursing identity was the boundary of the nurse practitioner permeable to health maintenance, minor acute and chronic illnesses and patient education. One of the products of the nurse practitioner subsystem was primary health care. Communication between the nurse practitioner and physician subsystem directed the interactive process by which referrals and consultation were made. The instruments used in this study were interviews and questionnaires designed by the investigator. Each physician and nurse practitioner in a participating practice was interviewed and retuned a questionnaire to the investigator. Since most of the data was nominal and multiple responses were given to may of the questions, the principal analysis was through frequency distributions and percentages. The nurse practitioner's sense of nursing identity was found to be in transition between traditional and contemporary models. Primary health care was proven provided by all nurse practitioners in Utah joint practice. The collegial relationship of the nurse practitioner and physician was found to be in transition between traditional and contemporary models with some inequities in organizational structure and shared responsibilities. Finally communication abilities of the nurse practitioner were also demonstrated in transition between traditional and contemporary models regarding conflict resolution and communication of constructive criticism. Further study is recommended to empirically clarify joint practice criteria for future experiment research.