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Pediatric Orthopaedic Practitioners Society POPS

Question from POPS Member Jamie Cloyes

Posted over 1 year ago by Suzanne Hilt

Hi! I am a PNP who works with a doctor who does mostly peds spine. He also does a small amount of adult spine work as well, mainly deformity. I am interested in helping him with that patient population as well, but I don't know if I could do this. Do any of you have your PNP but still see a small number of adults?

Thanks!

Jamie Cloyes, Albuquerque, NM


Comments

Melisa Johnston about 1 year ago

I don't believe that PNP's can legally see adults. I would ask the credentialing folks at your institution or check with your state board of nursing. But I am pretty sure no.

Suzanne Hilt about 1 year ago

All states are different. You should definitely check with whichever state department oversees your licensure and scope of practice. In NYS our scope of practice allows up to see patients up to "around the age of 21".

Anne Stuedemann about 1 year ago

Great question Jamie. I reached out my Manager Advanced Practice Credentialing Office and she provided me with this great article our hospital references to help guide the scope of practice. The position statement can be found at www.jpedhc.org titled "NAPNAP Position Statement on Age
Parameters for Pediatric Nurse Practitioner Practice. It states as follows:
"The National Association of Pediatric Nurse Practitioners (NAPNAP)
broadly defines the pediatric population cared for by PNPs as all children from birth through 21 years of age and, in specific situations individuals older than 21 years until the appropriate transition to adult health care is successful (NAPNAP & Society of Pediatric Nurses [SPN], in press).
‘‘The purview of pediatrics includes the physical and psychosocial growth, development, and health of the individual. This commitment
begins prior to birth when conception is apparent and continues
throughout infancy, childhood, adolescence, and early adulthood, when the
growth and developmental processes are generally completed.
The responsibility of pediatrics may, therefore, begin with the fetus and continue through 21 years of age. There are special circumstances (e.g.,
a chronic illness and/or disability) in which, if mutually agreeable to the pediatric health care provider, the patient, and when appropriate the patient’s family, the services of the pediatric health care provider may continue to be the optimal source of health care past the age of 21 years’’.
I hope this information helps at a minimum explain the guidelines of a PNP's scope of practice. I also agree to check with your State Board of Nursing prior to making any changes to your practice.

Jamie Cloyes about 1 year ago

That is helpful, thank you all. I will contact our credentialing office, as well as our state board of nursing.

Jill Ariagno about 1 year ago

Hi Jamie, I would like to echo Anne's comments but remind you that not all states license nurse practitioners or have jurisdiction over them even though they are "recognized" by the state. This is the case where I work in Missouri. We are only "recognized" by the State Board of Nursing not actually licensed and in that vane they have no jurisdiction to discipline us as well. They can act on our RN license but not our APRN. So my point is this: It is our responsibility and duty as individual professionals to recognize and honor what our individual credentials allow us to do. We each chose a particular field in APRN practice for a reason and we specialized within that training only. So as Anne as pointed out above, if your are a CPNP, then your scope of practice is limited by that title. When push comes to shove, it will not matter what a state board has told you, nor a representative in your institution, all that will matter is what you are telling the judge about why you felt it was appropriate for you to practice outside your scope when something bad happens. They won't come after your collaborative MD, or your hospital......they will come to you. So the best advice I can offer after more than 25 years in practice is.......read over what Anne provided several times and decide.....is it worth risking my career? Best of Luck!!

Colleen Ditro about 1 year ago

I know I am late in responding but I manage patients up to the age of 35. I take care of patients that are in a "unique" situation-skeletal dysplasia. That is why I practice with this-There are special circumstances (e.g.,
a chronic illness and/or disability) in which, if mutually agreeable to the pediatric health care provider, the patient, and when appropriate the patient’s family, the services of the pediatric health care provider may continue to be the optimal source of health care past the age of 21 years’’

Today, of all days feel this is so important as one of our 27 year old Metatrophic patients died yesterday at another facility after a gallbladder surgery because they did not understand her underlying issues.

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