Featured Legal Questions

I recently started a job as an NP (my first job, as I am a new grad). It is for a hospice company that is starting a palliative program. I am their first NP. Since they are starting the palliative program, they don't have palliative patients yet, so I am helping them as a case manager. I get my orders from the MD as an RN would. Should I be signing my notes as NP or RN? My job title is NP but I'm functioning as an RN. Also, upon hire I told them I needed a supervising MD and standardized procedures in place. I gave them a template and they said they would look into it but haven't done anything. Should I not function as an NP until those are in place? This has been so confusing to me as a new NP not having another NP coworker as a mentor.

I recommend signing your name as an RN for now for the following reason: You cannot work in the role of a NP until you have SPs in place and have a supervising physician. You need to stress to them that it is against the law for you to practice as an NP without SPs and a supervising physician and could be charged criminally for practicing medicine without a license as well as lose your license.

I was at the CANP conference and came to your lecture on the possibility of owning my own practice. I just wanted to get your thoughts on which corporation or setup (Nursing corporation, Management entity, or a Medical corporation) would be best if I wanted to open up a clinic for clinical trials. The facility would contract with pharmaceutical companies in running clinical trials and I would need physicians on board as prime investigators. I would be able to serve as a sub-investigator on the trials. Thanks for your insight.

If you are going to be utilizing MDs, you would need a Medical Corporation. If you are going to have an office to provide the clinical trials or any equipment, you may want your own management company of the Medical Corporation, so if your 51-percent physician owner left, he would not really own anything.

My administrator (who also happens to be an RN) and the collaborative physician for my new school-based health center have been working on editing draft NP Standardized Procedures and Patient Protocols without input from me. Is this legal? My administrator says it is legal because my clinic is not an organized health care system, and that only organized health care systems are required to have collaboration of nursing, medicine, and administration. I haven't even formally met the physician yet. Whether legal or not, this situation is definitely not best practice in my opinion.

Your administrator is wrong. It sounds like she is citing the Health & Safety Code. She needs to look at the Nurse Practice Act, which requires collaboration of the NP, Physician and Administration. My personal preference is to use process protocols. There is a book by Rebecca Zettler, “Process Protocols,” which has a CD with a template. Most of the NP Act is in the Business and Professions Code.

The ability to submit questions and receive responses from our team of experts is a free benefit of CANP membership.  Not a member?  Become one today!