An advanced nurse practitioner (ANP) is an experienced and highly educated Registered Nurse who manages the patient’s complete clinical care. According to the Missouri Division of Professional Registration. (2019), it is a competent person who has the freedom and power to act and take responsibility for these actions. This practice level is characterized by a high level of autonomous decision-making, including assessment, diagnosis, treatment, and prescription, for patients with complex multidimensional problems. Since Lydia is an adult nurse practitioner, she has the necessary knowledge to conduct examinations on women.
According to Nursing & Collaborative Practice. (n.d.), to be an ANP, a nurse must be licensed as a Registered Professional Nurse in Missouri and must have a “‘Document of Recognition” from the Missouri State Board of Nursing. A “Recognition Document” is not a separate license but a document indicating a specific title of an advanced nurse defining the legal framework of an advanced nurse. Moreover, in Missouri, a nurse must enter into a written Joint Practice Agreement with a doctor, which outlines the range of actions that the nurse can do. The ANP provides nurses with sufficient clinical practice. They have more training than a registered nurse, but they receive less training than a doctor. Thus, although Lydia can conduct pelvic exams, the doctor with whom the agreement is signed will re-examine the patient within two weeks.
Whether the patient is examined to see a doctor or a nurse practitioner, there is a subjective factor in any situation. Lavin (2018) notes that both physicians and nurse practitioners must carefully screen, test, monitor, and treat disease, as they are responsible for obtaining appropriate tests, advice, and referrals to meet the patient’s medical needs. With this in mind, nurse practitioners can apply essential risk management guidelines and resources to focus their efforts on successfully using the knowledge gained to patients. Thus, performing pelvic exams is within the scope of Lydia’s practice, as evidenced by Missouri’s legislation regarding adult nurse practitioners.
Lavin, R. (2018). Nurse practitioner scope of practice: Missouri regulations limiting healthcare access. [PDF document].
Missouri Division of Professional Registration. (2019). Missouri state board of nursing. [PDF document].
Nursing & Collaborative Practice. (n.d.) Web.