Physical Exam by Nutritionist RN

[Denisem]

Hi

I have a family friend, male around 50, who does not like to go to the doctor's. Probably hasn't had a physical exam in 5-7 years. He does go, because I hound him, for blood pressure screenings and takes advantage of annual prostate exam at local clinic. I saw him recently and he told me that he was going to see a Nutritionist and when they were talking about his medical needs it came out that he hasn't had a physical exam and he told me she has offered to do it. She told him she can't order bloodwork but can give him a complete physical. There are some things that you should know:

1. She is an RN and my friend says that his prostate exam at the clinic has always been done by an RN so what's the big deal

2. She is not charging him extra for this but will be part of his initial consultation

3. She has told him if she finds anything that looks wrong she will strongly advise he see a doctor

He won't tell me her name thinks I will get involved. Has anyone ever heard of this. I wonder if it is ethical for her to perform a complete exam in her capacity. I guess I should be happy he is at least getting an exam but I am concerned.

Thanks for any feedback.

[MIA-RN1, RN]

This is an interesting thread!

I wonder tho, if she is doing the complete physical exam, does she sign papers attesting to that? I am thinking of employer-mandated physicals, school physicals, etc...those usually need to be signed by an NP or an MD or PA. Plus if she is doing a physical, and she finds something wrong, she can't diagnose it legally. So does it count as a physical exam?

Perhaps her complete physical exam is a good assessment, nurses do physical assessments all the time in the hospital from what I've learned in school, but is her exam a complete legal exam?

[suzanne4, RN]

Then it sounds questionable. "Nutritionist" is not a protected title as far as I know. Virtually anyone can hang out a shingle and call themselves a nutritionist in order to sell worthless and potentially harmful dietary supplements. I suspect that is what this woman is doing, using her RN licensure to lend credibility. Where in the world does she plan to "examine" her patient? In the backroom of her shop? That would certainly set off alarm bells in my mind!

Depends on the state, in some they actually have to be licensed by the state. And a physical exam is not considered part of a nutritionist's training as such. Any more than it is of a nurse in a clinic without having an Advance Practice Certification after his or her name.

Same thing as with a physical exam for school, etc. You will see it done by an NP or a PA, or physician, but not by an RN.

[Denisem]

I got the sense in speaking to her that she is doing them as a courtesy and there is no insurance billing or such for the service. I did ask her specifically what she does if she finds a problem. She said she strongly urges patients to see a doctor. I guess for someone like my friend who does not want to go to the doctor it will be better than what he has been doing.

[sjrn85]

Could it be that she doesn't bill insurance because she doesn't have the credentials to do so?

Nah...

[Denisem]

i wanted to find out more about this and while doing a search on the internet found this post on a medical forum board so i guess it is not unheard of.

cindymessage ] date posted: 07:26:08 11/15/05 tue

in reply to: steve 's message, "physical exam by nutritionist" on 13:34:02 11/09/05 wed

i am a nutritionist but not a nurse but my friend who lives in another state is both and does perform physicals, she calls it a physical assessment not a physical exam but it is complete.

[Tweety, BSN, RN]

Certainly no harm can come from getting a physical by this RN, if he's comfortable with that. RNs do head to toe physical assessments and do a good job. I think he's just trying to find a cheap and easy way of getting a physical.

I would encourage him to still see an MD or NP, that this exam is not to replace his recommended visits to the MD/NP.

Here, nurses don't learn how to do prostate exams until they are in NP school. I wouldn't let her go there unless she had that degree. :)

[RosesrReder, BSN, MSN, RN]

I think this woman is practicing either medicine or advanced practice nursing without the proper creds.

You might tell your friend to run, not walk, away from this 'RN'.

I suspect this too.

[tc104]

Hi

First time post here. I am not a Health Care professional but enjoy the site and have found a great deal of useful information. I felt compelled to register so I could respond to this thread which I have been following with interest.

About 3 years ago I made an appointment to see a nutritionist. I just wanted better eating habits and maybe lose 15-20 lbs. I was in my early 40's at the time. During the intial visit she asked all kinds of questions about my health, eating etc... She asked about my last physical exam and I told her my doctor had left the area 3 years earlier and have not seen a doctor since then mainly because I felt fine. She was very concerned about this and said at the very least I should have had a DRE done each year because I had a family history of prostate problems. She told me she was a Nurse and while it was not something she normally would do could give me a physical exam. I told her since I was already there why not. Since I needed to undress for the exam anyways she said she would also do a quick skin exam. When she was having me bend over for my DRE she noticed a mole up near my lower buttocks that she said looked funny to her and I should get it checked. I made an appointment with a Dermatologist and found that it needed to be removed and all seems ok but I do need to go for yearly skin exams. I don't want to debate with anyone about should she have done it or not but all I can say is she may have saved my life because where it was located I would never have seen it even if I knew what to look for.