Cole, F.L., Ramirez, L., & Luna-Gonzalez, H. (1999)
Scope of Practice for the Nurse Practitioner in the Emergency Care Setting.
Retrieved February 1, 2003 from http://www.ena.org/pdf/ScopeNP.PDF

• Reviewed by Dwight Corning

This 15-page article is broken out into 10 sections, as follows:

Introduction: Overview of nurse practitioner field with a listing of the benefits of a nurse practitioner.

Background: Discusses the different specialty areas of nurse practitioners and the numbers of nurse practitioners nationally.

Practice Environment: Describes the environment that a nurse practitioner in emergency care participates in, as well as identifying the key broad categories of their work.

Patient Population: Describes the very broad patient population nurse practitioners are involved with, including “the young and old, healthy and dying”.

Philosophy of Care: Includes information such as “...all patients are assumed to have a life-threatening illness or condition irrespective of the initial chief complaint or reason for seeking care...Differential diagnoses reflect this philosophy of care and are organized from most life threatening to least life threatening and are eliminated as potential diagnoses in this same order.”

Educational Preparation: Outlines that nurse practitioners “must be prepared at the Master’s degree level”, training must include “a breadth and depth of knowledge concerning clinical management strategies”, and “should be broad based encompassing care to newborns through elderly, covering acute as well as chronic illnesses.”

This section also states “the curriculum must provide sufficient clinical assessment skills to develop differential diagnoses” and also discusses advanced pathophysiology, advanced pharmacology, etc.
Practice Arrangements: Outline the various settings a nurse practitioner may work in, including physician offices, hospitals, etc.

Regulation: This section discusses “national standards...regulate the educational requirements”, and “certification...indicates that an individual has obtained a specific body of knowledge and services as a measure of competency.”

Ethics: Discusses a code of ethics that includes “maintaining his/her competence”.
Conclusion: A summation statement of the document.

I found that the article covered much of the same ground that we will be covering, and to be formatted in a way worthy of our review as an example of how to present a scope of practice document. Of the three articles I reviewed, this one clearly has the most to offer.