Curbside Consultation for the Nurse Practitioner: Qualitative Inquiry for Education, Policy, and Practice

Abstract

Background and PurposeCurbside consultation (CC), defined as pursuing information or recommendation regarding patient care, without request for formal consultation is a favored information source for nurse practitioners (NPs) when making clinical decisions in practice settings. Research and education concerning CC among NPs is lacking. The purpose of this study was to obtain an understanding of NP perceptions of interpersonal aspects of the CC process to inform NP clinical practice and education.MethodsQualitative descriptive design and inductive content analysis was used. Twenty primary care and specialty care NP were recruited using purposive sampling for conduct of individual interviews.ResultsContent analysis identified themes describing interpersonal components of the CC process. NP practiced in collaboration with physicians in variable roles within primary care and specialty care settings. These collaborations varied dependent upon supervisory relationships with physicians. Additional themes concerned NP professional experience and characteristics of experts desired for CC. These characteristics included NP perceptions of colleague experience and expertise, trust, and interpersonal relationship dynamics.Implications for PracticeCC processes for NPs are multidimensional, including interpersonal themes as components of this communication exchange. Given CC is a highly utilized resource for NPs, further inquiry is critical for understanding of its implications for NP practice, policy, and education internationally.

Nurse practitioners, physician assistants, and trust: A systematic review

“…Finally, three articles assessed communication styles between NPs/PAs and physicians or between other NPs and PAs. Open, effective communication and a collaborative mindset between the parties were keys to building trust (Beisel, 1998; Louwagie et al, 2022; Papermaster & Champion, 2020).…”

“…Some physicians thought NPs/PAs had more time available for patients than physicians (Cairo, 1996), which allowed all parties to bond. Five articles discussed the importance of physician mentorship of NPs/PAs (Louwagie et al, 2022; Papermaster & Champion, 2020), treating them with reciprocal respect (Hallas et al, 2004; Norful et al, 2021), or the value of a collegial relationship (Beisel, 1998). Also, younger physicians were more willing to trust the abilities of NPs/PAs than older physicians (Papermaster & Champion, 2020).…”

“…Five articles discussed the importance of physician mentorship of NPs/PAs (Louwagie et al, 2022; Papermaster & Champion, 2020), treating them with reciprocal respect (Hallas et al, 2004; Norful et al, 2021), or the value of a collegial relationship (Beisel, 1998). Also, younger physicians were more willing to trust the abilities of NPs/PAs than older physicians (Papermaster & Champion, 2020). A collaborative relationship was not always the case as Poghosyan et al (2013) found some physicians did not treat NP/PAs with respect.…”

“…Adhering to clinical standards. Nine studies discussed the importance of adherence to clinical standards, which included acknowledging the importance of clinical standards (Matteliano & Street, 2012;Thomas et al, 2005), following evidence-based protocols (Papermaster & Champion, 2020), and reinforcing how standards impacted patient care quality (Louwagie et al, 2022). Transparency through rigorous measurement and reporting standards was also shown to be important (Kurtzman & Greene, 2023).…”

“…This was critical to collaboration (Hallas et al, 2004). Papermaster and Champion (2020) found that primary care NPs were often given their own caseload and granted more autonomy than specialty care NPs, implying their supervising physician had a greater propensity to trust.…”