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In the state of Arizona, a Nurse Practitioner can perform any task that a Registered Nurse is able to. In addition, a Nurse Practitioner who is certified by the Arizona State Board of Nursing can legally perform the following acts in collaboration with a physician:
1. Examine a patient and establish a medical diagnosis by client history, physical examination, and other criteria;
2. Admit a patient into a health care facility;
3. Order, perform, and interpret laboratory, radiographic, and other diagnostic tests;
4. Identify, develop, implement, and evaluate a plan of care for a patient to promote, maintain, and restore health;
5. If authorized under R4-19-507, prescribe and dispense medication; and
6. Refer to and consult with appropriate health care professionals.
In the State of Arizona, a Nurse Practitioner may also apply for, and obtain a DEA license for prescribing controlled substances.
There appears to be much confusion as to the type of collaboration that need is needed to fulfill state requirements. In all cases, Nurse Practitioners have a legal and ethical obligation to discuss a patients care with any qualified practitioner if there is any doubt about optimal and safe care in any situation.
The Board of Nursing in the past had required all Nurse Practitioners to send the name of a "collaborating physician" to the Board of Nursing. This is no longer required (as of 9/99).
The word collaboration is defined in Arizona Title 4 Chapter 19 of the Arizona Administrative Code, as: "Collaborate means to establish a relationship for consultation or referral with 1 or more physicians who have an active, unrestricted license."
Notice that this definition does not say any specifics. So, in theory, a Nurse Practitioner in the state of Arizona could practice independently and collaborate with consultants as needed for further assistance. A medical director could act as a collaborating physician.
If a patient is sent to a specialist for any reason, this is viewed as collaboration. Some independent providers will hire physicians part-time to review patient medical charts. Not only is this collaboration, but it acts also as a quality assurance tool.
Arizona Administrative Code Title 4, Chapter 19, Article I & V
Arizona Administrative Code Title 32, Chapter 15
