Allied Professionals: Integral Part of EP Service Line
(Voice of a Nurse Practitioner)

Steve Jobs once said “Great things in business are never done by one person.” This could not be truer as it applies to healthcare. Specifically, 2019 pandemic highlighted the fragile balance of supply and demand of our stretched healthcare system.

Since the 1960s nurse practitioners have been collaborating with physicians to positively affect the outcomes of healthcare. The role of the nurse practitioner was initially created to allow access to the underserved and rural populations. Over the decades with population growth booming coupled with specialty care advancements the need for collaborative practices grew.

The advancements in care in regards to electrophysiology is no exception. Electrophysiology is a subspecialty within cardiology requiring years of education and training. The increase in technology and available treatment options often results in more training for the electrophysiologist and more time performing procedures in the electrophysiology lab. The physicians time is a limited resource and needs to be utilized to a maximum efficiency. Nurse practitioners working in collaboration allow the electrophysiologist more time to employ his/her high skill set in the lab.

The first step of this teamwork is understanding the scope of practice for the nurse practitioner. The majority of electrophysiology education for a nurse practitioner is via supplementary courses from governing bodies such as the American College of Cardiology, Heart Rhythm Society and directly from the supervising physician. As the physician plays an integral role in education there must be a high level of communication and mutual respect. A working relationship is built on trust learning, commitment and a strong team, keeping the patient at the center of the daily operations. The more the nurse practitioner and electrophysiologist collaboration is visible to the patient the more patients understand the team approach.

Figure 1. Overview of nurse practitioner and physician collaboration. 

The physician and nurse practitioner have independent but many overlapping roles, as illustrated above.1 In the clinic nurse practitioners provide support with follow-up care appointments, seeing urgent follow-ups which can minimize emergency room visits, ordering testing, relaying test results, overseeing remote monitor results, follow up on device checks, assisting in triage for the nurses as well as coordinating patient care. Nurse practitioners are often allotted more time with the patient to provide patient education. It is well supported by research that increased patient education improves patient compliance, patient's satisfaction and ultimately improves patient outcomes. 2 In the hospital the nurse practitioner can obtain the history and physical, develop a treatment plan, discuss treatment options and arrange for procedures in collaboration with the electrophysiologist.

Nurse practitioners have been utilized in healthcare for many years. A team or collaborative practice allows maximization of utilization of all provider types within their scope of practice.3. The advancements in nurse practitioner knowledge has allowed them to practice in fields previously limited to physicians. The electrophysiology nurse practitioner is an integral part of a successful and efficient electrophysiology practice, like my practice – Texas Cardiac Arrhythmia.

References:

1. Clarin OA. Strategies to overcome barriers to effective nurse practitioner and physician collaboration. J Nurs Pract. 2007; 3:538–48.
2. Chen L, Farwell W, Jha A, Primary Care Visit Duration and Quality: Does Good Care Take Longer? Arch Intern Med. 2009;169(20):1866-1872
3. Stanik-Hutt J, Newhouse R, White K, et al. The Quality and Effectiveness of Care Provided by Nurse Practitioners. . J Nurs Pract. 2013; 9(8):492-500.

Sarah Liles, NP
Texas Cardiac Arrhythmia
saliles@mac.com