Nursing Grad Essay

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Fairman’s Work In “The Visit: Nurse Practitioners and the Negotiation of Practice”, Julie A. Fairman (2011) illustrates how nurse practitioners have negotiated over time, using various methods, to collaborate and make a place for themselves in primary health care settings. She frames her discussion in the space of “the visit”. The visit serves as the context of “provider-patient interaction” (p. 190). It is defined not only by the environment in which providers and patient interact, but also the external factors that influence such interaction. Fairman (2011) claims that she used the visit as the unit of analysis because it is known to be “flexible” and exemplifies “how nurses’ clinical practice changes over time and location” (p. 190). Fairman shares personal stories from nurse practitioners to demonstrate how nurses and physicians learned to work collaboratively by first establishing trust. Those personal stories show progressive gain of independence. By collaboratively working with physicians, nurse practitioner supervision went from the physical presence of a physician to a virtual one with the use of technology such as the use of a phone. During the 1960s and 1970s there was an increasing need for primary healthcare providers. Primary care settings were less profitable, and over the years medical practices became more specialized. This resulted in significant physician shortages. With the increasing number of patients and decreasing numbers of providers this phenomenon made it possible for NPs to provide primary care to patients. The federal government directed the budget in favor of healthcare systems and education. The nurses and physicians acknowledged the fact that there are substantial advantages for physicians and nurse practitioners to work together. Since the primary health care setting is such a complex commodity it requires individual,

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