An APRN’s scope of practice is “created and enforced at the state level”, which leads to differing scopes throughout the United States (Hansen-Turton, Wade, & McClellan, 2007). Depending on where you live, your scope could be vastly different. Traditionally, the majority of APRN’s are governed by their state board of nursing and physicians are governed by the American Medical Association. The dissimilarities in the governing bodies lead to a difference in the standard of care they are held accountable to. Physicians and APRN’s are trained under differing models, but provide parallel care utilizing their differing paradigms. To answer the question of whether the APRN and MD would be held to the medical standard of care, their collaboration
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Whether or not they had a collaboration agreement or protocols in place, when a patient comes into a clinic complaining of chest pain, an EKG and serial enzymes should have been performed. Although most patients who present with chest pain do not have a life threatening condition, health care providers must use common procedures and protocols to ensure that urgent management is obtained for those that do. Provider’s clinical judgment still remains an overriding factor, but basic clinical tools of history, physical examination, and EKG are key in the risk stratification of these patients. An initial EKG is the simplest most cost effective strategy, and should be considered a vital sign in a patient with chest pain (Kontos, Diercks, &Kirk, 2010). The AHA states that an initial EKG should be performed within 10 minutes of arrival to an ED, and also recommends that if the initial EKG is negative then serial EKGs be performed at 5-10 minute intervals as long as symptoms persist. They also make a statement regarding cardiac biomarkers expressing that if the patient presented within 6 hours of symptom onset the biomarkers should be repeated within 6-8 hours in those whose initial markers were negative (Antman et al., 2004). The clinic would be considered negligent if they did not have appropriate chest pain algorithms for providers to practice from or did not hold provides accountable for their disregard for protocols if they were in
Whether or not they had a collaboration agreement or protocols in place, when a patient comes into a clinic complaining of chest pain, an EKG and serial enzymes should have been performed. Although most patients who present with chest pain do not have a life threatening condition, health care providers must use common procedures and protocols to ensure that urgent management is obtained for those that do. Provider’s clinical judgment still remains an overriding factor, but basic clinical tools of history, physical examination, and EKG are key in the risk stratification of these patients. An initial EKG is the simplest most cost effective strategy, and should be considered a vital sign in a patient with chest pain (Kontos, Diercks, &Kirk, 2010). The AHA states that an initial EKG should be performed within 10 minutes of arrival to an ED, and also recommends that if the initial EKG is negative then serial EKGs be performed at 5-10 minute intervals as long as symptoms persist. They also make a statement regarding cardiac biomarkers expressing that if the patient presented within 6 hours of symptom onset the biomarkers should be repeated within 6-8 hours in those whose initial markers were negative (Antman et al., 2004). The clinic would be considered negligent if they did not have appropriate chest pain algorithms for providers to practice from or did not hold provides accountable for their disregard for protocols if they were in