Quote from ILoveIceCream
I imagine this has been asked before, so I apologize for the redundancy. My question is about protocols for nurse practitioners. Can someone explain what they are/how they work/give an example? I've heard it referred to as "cookbook medicine." Is this an accurate description? Do all NPs follow protocols? Is it true that physician assistants aren't confined by protocols? Is "confined" the right word? (do NPs see protocols as limiting what they are able to do?)
There are a few states that require NP protocols. However, in reality this rule is so broad as to be useless. For example in Georgia NPs with prescriptive authority need a protocol for medications. The board uses the following protocol as an example:
APRN may refer to and use the following guidelines (in their latest, current edition)
when treating and managing patients pursuant to this Agreement:
i. Uphold and Graham, Clinical Guidelines in the Family Practice.
ii. Sanford, Gilbert and Sandle, Guide to Antimicrobial Therapy.
iii. Danbro, Williams & Wilkins, Griffith's 5 Minute Clinical Consult.
iv. Schwartz, The 5 Minute Pediatric Consult.
v. Colyar, Ehrardt, Ambulatory Care Procedures.
vi. Uphold and Graham, Clinical Guidelines in Child Health.
vii. Physician's Desk Reference.
So if its not in one of these references (unlikely) then you couldn't prescribe it. Theoretically you could get in trouble for off label use of a drug but again enforcement is unlikely (and to use it you would simply have to amend the protocol with a paper showing the off label use).
Other examples of protocols I've seen used are the Washington manual or Harrison's. Again so broad as to be meaningless. There are one or two states where PAs have to use protocols in a similar manner.
Basically protocols are mostly bureaucratic red tape that no one pays attention to once they are filed.
David Carpenter, PA-C