Confusion about "independently working"

Trauma Columnist · May 31, 2007

I'm an APN (CNS) in central IL and I work in nephrology. I see patients by myself and consult with various doctors at varying frequency. Sometimes I talk to two-three MDs a day, other days no MDs. I am very independent - I assess, come up with a plan of treatment, order meds, tests and also interpret them. My physicians (I work with 15) don't review my charts except for a random audit once per year. I am expected to know when I'm getting in too deep and consult with a physician.

whomi7 · May 31, 2007

I'm an APN (CNS) in central IL and I work in nephrology. I see patients by myself and consult with various doctors at varying frequency. Sometimes I talk to two-three MDs a day, other days no MDs. I am very independent - I assess, come up with a plan of treatment, order meds, tests and also interpret them. My physicians (I work with 15) don't review my charts except for a random audit once per year. I am expected to know when I'm getting in too deep and consult with a physician.

Thank you so much. I think I have better idea of what you are doing.

christvs, DNP, RN, NP · May 31, 2007

Hi. I am a RN on med-surg floor.Before I decide to go to NP school, can some NPs tell me about "independently working"?
For example, as a nurse, I have to get an order from doctors...even for Tyrenol. I would like to ask you who are working in ahospitaland (especally) a clinic about this question. Do you have to contact with doctors, everytime you see a patient? or Do you give them report at the end of the day? or Do they call you and tell you what to do a lot?
Some people say that doctors review pt's chart every month or so. some say 24hrs.
Can you please tell me how you work and how you spend your day.I would like to know details.
I really want to work independently instead of following orders.
How independant are you?

I'm still an NP student, but I know it also depends on which state you live in if you as an NP need "supervision" or "collaboration" with MDs. This should all be stated in the specific Boards of Nursing for each individual state. For instance, I live in MA, and I know NPs in MA need more collaboration from MDs than do NPs in NH, who have a little more independence and a little bit less of a legal need to have MD supervision (esp. with prescribing certain meds). So I'd check with the state you live in for more info.