- Does a collaborative agreement ensure collaborative practice? Why or why not? Cite some evidence.
The collaborative agreement is for legal purposes but it doesn’t mean that collaborative practice happens efficiently if there is a collaborative agreement in place. According to research, one major barrier is that physicians don’t fully understand an APRNs scope of practice so they don’t allow the APRN to practice using their full capabilities. Another barrier is that of trust and mutual respect between the physician and APRN. If there are ideological differences in practice style, this can make effective collaboration difficult as well (Schadewaldt et al., 2013).
- What are some examples in the literature of good collaborative practice? Why are they exemplary?
One research study showed that attributes such as identifying patient issues, knowledge sharing, being open and transparent, listening to opinions, working as the hub of the group, and listening to opinions, lead to good collaborative practice (Hurlock-Chorostecki et al., 2016).
I spoke with an NP in my community who has practiced for over 30 years. She told of how she worked with a physician who was all about money and seeing more patients to gain more money which lead to lack of quality in patient care. The NP wanted to be in a practice that valued differences in patient acuity and planned appointments that allowed for more time if the patient had a higher acuity verses less time for patients with less acuity. She eventually started working with a physician who valued her as a professional and allowed her autonomy in scheduling her patients with the time she believed they required. He was about treating the patient as a whole and giving them the time they needed. They worked as a team and she loved working with him. Unfortunately, he retired and with it his practice had to close. Michigan is a state that doesn’t allow full practice authority for APRNs so the NP could not keep the practice going once the physician retired. Michigan’s strict collaborative agreement laws lead to my community losing a wonderful medical practice that kept the patient first and worked as team to provide better quality of care to each patient.
References
Hurlock-Chorostecki, C., van Soeren, M., MacMillan, K., Sidani, S., Donald, F., & Reeves, S XXXXXXXXXXA qualitative study of nurse practitioner promotion of interprofessional care across institutional settings: Perspectives from different healthcare professionals.International Journal of Nursing Sciences,3(1), 3–10. https://doi.org/10.1016/j.ijnss XXXXXXXXXX
Schadewaldt, V., McInnes, E., Hiller, J. E., & Gardner, A XXXXXXXXXXViews and experiences of nurse practitioners and medical practitioners with collaborative practice in primary health care – an integrative review.BMC Family Practice,14(1). https://doi.org/10.1186/ XXXXXXXXXX