SUPERVISION, COLLABORATION, OR COOPERATION
This research paper will present an overview of the NP and MD with regard to their different roles and whether these roles involve supervision, collaboration, cooperation, or all three. Included in this discussion will be the following topics: health care delivery, history and current status of NP roles; NP and MD roles; NP and MD collaboration; NP independence and MD opposition; implications and future hopes for the NP; and conclusions.
Health Care Delivery, History & Current Status of NP Roles
Aiken, Clarke, Sloane, and Sochalski (2001) state that currently there is a nursing shortage, and hospital nurses are reporting job dissatisfaction. Nurses worldwide are reporting uneven quality of hospital care (U.S., Canada, England, Scotland, and Germany). The authors state that the competence of NPs and MDs and the relationships between the two appear to be satisfactory, however core problems are reported which must be resolved to preserve patient care and safety. The inadequate staffing of nurses and lack of care are being blamed on the growth of managed care and other problems such as hospital competition and reduced Medicare hospital payments.
The American health-care system has become a managed care
marketplace. Changes in health care can be found in the financial and organizational levels. Costs are escalating with annual health care spending in the United States increasing. Multi-institutional provider networks are causing organizational changes. Efforts to control costs are found in managed care and other environments (Girard, 1993). Within these changes, nurses have the primary goal of promoting and protecting health. They have firsthand knowledge of multiple aspects of the patient's plight as well as their own. Nurses are facing threats to quality of care. All managed care facilities limit ranges of providers available and monitor or restrict services to mem...