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Advanced Practice Nurses: Should They Be Independent?-Reply
David R. Rudy, MD, MPH
Chicago Medical School North Chicago, Ill
Arch Fam Med. 1995;4(8):674.
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In reply
I appreciate Ruppert's measured response to my editorial' in the January issue of the ARCHIVES. At first blush, it is difficult to disagree with much of what she says. She writes that NPs do not wish to be independently practicing medicine. However, they do wish to be independently practicing nursing. To too many of her colleagues, that means making "nursing diagnoses" (as opposed to "medical diagnoses?"), prescribing nursing treatments, etc. Fine, one is tempted to suppose. However, I am not beguiled by the velvet touch. What is the difference between nursing and medical diagnoses? Some physician must be ultimately in charge because one correctly has the ultimate responsibility. The conversation she and I are having should be between the nurse and the physician in the practice, not in the press or in the legislatures. Collaborative practice requires mutual trust, but such trust must occur on site. The nurse's independence would
. . . [Full Text PDF of this Article]
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