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Nurse Practitioner Elected Medical Staff President

Rebecca Hendren, for HealthLeaders Media, February 8, 2011

Bob Donaldson is clinical director of emergency medicine and president of the medical staff at Ellenville Regional Hospital in New York. His current projects sound much like any medical staff president's goals.

What might surprise you is that Donaldson is not a physician but a nurse practitioner. He was elected to this influential position by his physician colleagues and enjoys great support from the hospital's medical staff.

I interviewed Donaldson to find out how a nurse practitioner broke down physician hierarchy and found an innovative hospital that could be a model for provider collegiality and meeting a community's healthcare needs.

Donaldson has a long background in emergency nursing and came to Ellenville Regional in 2004 when he was approached by the owners of an emergency medicine group that staffed providers for the ER, which at the time was staffed by all physicians, and asked to be the first non-physician provider for the ER.

He interviewed with the new CEO, with whom he immediately hit it off. The CEO convinced him that despite the hospital's financial difficulties those things would change, so Donaldson came on board.

"I passed muster, if you will, as the first non-physician, full-time, sole provider here as an NP working in the ER alongside the docs," he says. "It was so successful that we ultimately eliminated all the docs here and replaced them all with nurse practitioners or physician assistants."

In 2004, the ER saw 8,000 visits per year. Now, it sees 12,500 per year, a number it has maintained for the last two years. Donaldson notes that the non-physicians provider arrangement is unusual but explains that his CEO conducted extensive research on nurse practitioners and their practice as part of his graduate work.

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5 comments on "Nurse Practitioner Elected Medical Staff President"


Lisa Sams MSN, RNC (3/25/2011 at 4:51 PM)
Congratulations, this is such an important step for patients and families. Care can only be improved by high functioning interdisciplinary teams and what many consumers feel when they spend time with an Advanced Practice Nurse is they are treated as a whole person. Nursing continues to research and enrich clinical care through this view.

VBA (3/19/2011 at 1:39 PM)
Regarding medical management, the individual makes more difference than whether they are a physician or a nurse or a tech or anyone. A leader is a leader. With respect to the management of the critically ill patient and performing intubations, central lines, cracking a chest, cardioversion, and performing many other tasks, I am very concerned about not having a trained emergency physician in the emergency department. A nurse practitioner or physician assistant can do an amazing job for 90% of the patients who come to the ED, but there is a difference in the training both in content and duration between the two specialties (NP, PA is definitely a specialty and are amazingly skilled positions). its similar to a computer programmer and a the hardware engineer; both very skilled, but different talents and knowledge sets. They are not substitutes of each other and can be very dangerous when someone comes to the ED with a true emergency to not have the right person there to help them.

Susan Johnson (3/18/2011 at 11:06 PM)
I'm sorry, but when I go to an emergency room I expect their to be a doctor on-site. Maybe a nurse can handle many/most of the things that go on in an ER, but its ridiculous that there's absolutely no ER doctors on staff and its all nurses and PAs. Thats extremely dangerous to let these folks practice solo without supervision. An ER doctor has more than 4 times the training that an emergency NP or PA gets. We are not talking about a clinic where people treat cough and runny nose. The name is EMERGENCY for a reason and we need the BEST trained people we can get in there. I will not be coming to that hospital anytime soon and I'd advise everyone else to steer clear of it.