Physical Exam by Nutritionist RN

Jolie, BSN · Nov 10, 2005

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.

Is she a Nurse Practitioner? Does she work in an established office or clinic? If so, then I don't see any problem. I have no idea what a "Nutritionist RN" is or where one would be employed.

Trauma Columnist · Nov 10, 2005

I too wonder about this "Nutritionist RN." I would want to know her credentials. You can't practice independently as an RN, unless you are an advanced practice RN.

Denisem · Nov 10, 2005

If I understand what my friend is saying she is a RN who has left the field to go into nutrition but she must still use the RN credentials when she advertises.

Jolie, BSN · Nov 10, 2005

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!

Editorial Team / Admin · Nov 10, 2005

If I understand what my friend is saying she is a RN who has left the field to go into nutrition but she must still use the RN credentials when she advertises.

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'.

Denisem · Nov 10, 2005

Thanks I was feeling much the same but thought I might be paranoid because he was a friend. Will try to convince it it's not a good idea.

Editorial Team / Admin · Nov 10, 2005

Thanks I was feeling much the same but thought I might be paranoid because he was a friend. Will try to convince it it's not a good idea.

No, not paranoia. Reality. Go with your gut feeling.:)

Home Health Columnist / Guide · Nov 10, 2005

. "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.

Pennsylvania now licenses nutritionist for this very reason under the nursing practice act

Section 3.1. Dietitian-Nutritionist License Required.--(a) It shall be unlawful for any individual to hold himself or herself forth as a licensed dietitian-nutritionist unless he or she shall first have obtained a license pursuant to this act. Only individuals who have received licenses as licensed dietitian-nutritionists pursuant to this act may use the letters "L.D.N." in connection with their names

http://www.dos.state.pa.us/bpoa/lib/bpoa/20/nurs_board/nurseact.pdf

Indy, LPN, LVN · Nov 10, 2005

I think having a dietician working with a doctor's office, say, a family practice office, would be a huge asset. Many long-term conditions can benefit from a change in diet, and I've seen exactly one doctor who will give more than 5 seconds of advice on the subject. (That's the one I go to. He has the same personality in the hospital as in his office too!)

The reason I wouldn't advocate seeing a "nutritionist" independently is that, precisely because they can't order lab work, nobody is getting a complete picture. Any RN can examine a person, as in, they can look at someone and be in the middle of a mental assessment, that's just a skill. I don't claim to do a complete physical on anyone, however. If I'm not mistaken, my personal doctor defines that as: you have the lab work sitting in front of you. You had your pap smear done. (by his nurse practitioner) You brought me 3 months worth of blood pressure readings, nice. Physical exam in office, taking all that stuff into account and handing out either recommendations or a diagnosis, or a "see me next year."

It seems to me this RN maybe is a NP, or maybe isn't, who's to say... but I'd recommend using a NP in conjunction with your physician, 'cause I'm spoiled on my family doctor and think people should just have it that good.

Dayray, RN · Nov 10, 2005

Rn's do assessmnet, so its possibel that she is is capable of doing a physical. mabey she worked as an office nurse, public health nurse or school nurse and did physicals.

It's just like an assessment you do at shift change except that assessments are specific to your unit. However I woudent be abel to do a general physical because my assessment skills are specific to my area.

The one thing she can't do is order labs or tests and that is part of a good physical. Another thing that makes this less then a good idea is that she can't know him as well as a practictioner that he has seen before. there is allot to be said for seeing the same practictioner year after year.

I'm not sure why he would prefer to have the physical done by her. If he likes her approach then he might seek out an NP. I know that I really like the approach that NP's take and choose them over MD's whenever I can.

Denisem · Nov 11, 2005

I had the opportunity to speak to the RN today. She sure has had a varied career. Told me she was a nurse in a military hospital, nurse in a clinic which served low income people and a school nurse. She said that while she was working as a nusre she took classes in nutrition. She told me she has given hundreds of complete physical exams over the years. She works out of a building which houses many health service providers. Her initial consultation last 1-2 hours and all patients get a minimal exam, vitals, but if she finds a patient has not had a physical in a while she offers to do it. The price is the same and it's completely their choice.She told me she is completely qualified to do what she does and it is fully ethical. Seemed like a sincere person. I do feel better after talking to her and I guess it sounds like she's legit.