Delegated Authority for NPs

[guitarnurse]

I recently was admitted to MSN Psych NP program and I am wondering what the rules are for delegated authority under physician supervision. I am wondering if as a psych NP would I have to work under a psychiatrist physician or if I could work under a family medicine or internal medicine physician. I have family members who work in internal medicine and family medicine as physicians and I am wondering if I could join either of their practices or if I would be required to work under a psychiatrist. I live in Wisconsin.

[Corey Narry, MSN, RN, NP]

Per Wisconsin Administrative Code Chapter N8.10(7):

"Advanced practice nurse prescribers shall work in a collaborative relationship with a physician. The collaborative relationship is a process in which an advanced practice nurse prescriber is working with a physician, in each other's presence when necessary, to deliver health care services within the scope of the practitioner's professional expertise. The advanced practice nurse prescriber and the physician must document this relationship".

The law is quite vague and doesn't address your scenario but erring on the side of caution is always advisable. That said, it's probably best to maintain a collaborative agreement with a physician whose training is in the same field or specialty in case questions of competence and qualifications between the physician and the NP are brought up later.

[sailornurse]

Why don't you ask the faculty in your program? I would think you would need to work with providers in the same specialty. Family Practice is cradle to grave and while we can prescribe some psych meds, it is not to the extent of psych specialty. Internal medicine is also not what you need. As a new grad NP, recognize the learning curve of about 2 years, you should work with a psychiatrist if you are required in Wisconsin to have supervising/collaborating doc.