In Massachusetts, nurses practicing in an expanded role include: nurse midwives, nurse practitioners, psychiatric nurses, mental health clinical specialists, and nurse anesthetists.
Massachusetts is one of several states in which the Boards of Registration in Nursing and Medicine jointly govern the practice of nursing in the expanded role. Nurses practicing in the expanded role must practice in accordance with written guidelines which are developed in collaboration with and mutually acceptable to the individual physician or the appropriate medical and nursing administrative staff.
Important issues of concern in collaborative relationships include responsibility, quality of care, communication, scope of practice, delegation of authority, patient satisfaction, and conflict resolution. Nurses practicing in an expanded role are responsible for their own actions. If such actions result in a claim, the supervising physician may be named. The best protection is to formulate or adapt written guidelines and practices which address the questions on how best to serve patients under the combined care of physicians and nurses emphasizing a team approach. Regular review of these guidelines and a regular conference/chart review time to review clinical care is an important part of maintaining quality patient care in a collaborative practice.
Clinicians outside Massachusetts should check with their state medical boards regarding the rules for collaborative practice.
- Physicians and Nurse Practitioners in Collaborative Practice [PDF]