Guidelines for Nurse Practitioners in Gynecologic Settings

The Basics Apply Everywhere

Nurse practitioners have advanced training beyond that of the average RN, and typically have at least a master’s degree. Many NPs have a doctorate. In addition, an NP has an expanded scope of practice. She can order lab work and diagnostic tests, interpret the results and prescribe medications. NPs who work in gynecology typically perform pelvic exams and Pap tests, order contraceptives and may manage prenatal care. They might also help a woman in menopause deal with symptoms such as insomnia or hot flashes or prevent complications of aging such as osteoporosis.

Practice Makes Perfect

The first guideline a nurse practitioner must follow is her state’s nurse practice act. Each state regulates the practice of nursing and defines what a nurse can do in that state. Three major areas that affect an NP's practice are oversight requirements, practice authorities and prescriptive authorities, according to the Center for the Health Professions at the University of California at San Francisco. An NP in a gynecologic setting in Florida, for example, must work under a supervising physician and must have written practice protocols to perform her tasks. In Kentucky, however, NPs operate independently and don’t need written protocols.

It's a Nurses' World

Because nurses and physicians are educated differently and have a different approach to patient care, NPs in the gynecologic setting often turn to nursing textbooks for practice and patient care information. These textbooks and references are typically written by expert nurses in the field, such as “Guidelines for Nurse Practitioners in Gynecologic Settings,” a 2008 reference book. Clinical guidelines and recommendations encompass all facets of gynecologic care, from the frequency of physical exams to managing sexually transmitted diseases. In addition to physical issues, guidelines and references also address emotional issues such as abuse and more general issues such as weight management.

The Medical Model

NPs are nurses and must conform to nursing guidelines, but they must also practice in accordance with medical standards of care, as much of what they do is actually medical practice. The American Congress of Obstetricians and Gynecologists, for example, provides clinical guidelines on topics such as immunizations, conception, contraception and basic gynecological care. NPs in gynecologic settings are expected to follow these recommendations in patient care unless there is a medical reason why a particular practice is contraindicated.