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Weekly Q&A: Defining independent, interdependent, and intradependent practice

HCPro's Weekly Update on the ANCC Magnet Recognition Program®*, September 20, 2005

This week, a reader asks for definitions and examples of independent, interdependent, and intradependent nursing practice. Read the response below from our advisor, Katherine Riley, BSN, RN, assistant vice president, operations, Southwestern Vermont Medical Center in Bennington.

Q: One of the sources of evidence under Force 9: Autonomy, relates to opportunities for "independent, interdependent, and intradependent" nursing practice. How do you interpret these three terms and can you provide examples of each?

A: To me, independent means little-to-no direct supervision. I define interdependent practice as that which occurs between departments, and intradependent as that which is within the same department, or area of practice.

Here are examples of these three forms of nursing practice, according to my interpretation:

• Independent practice: We have one RN in the radiology department who reports to a nonnursing director. She has defined her role based on practice standards, but functions very independently. The organizational policy, procedures, and outcome standards, along with the specialty-practice standards, set the framework-but the nurse defines the role and practice in that area.
• Interdependent practice: I see this as practice that crosses unit boundaries, such as the OR and Women's and Children's Services (WCS) establishing a cross-training program for the WCS nurses to develop competencies as OR nurses. They serve as the RN circulators, scrub technicians, and recovery nurses for C-section patients to provide better continuity of care.
• Intradependent practice: Consider nurses developing practice opportunities within their own work setting. For instance, several nurses on a WCS unit obtain certification as lactation consultants, and then develop a program to provide lactation consultation to breastfeeding moms on the unit as a specialty within their own specialty. Also, they are allowed to have a portion of their scheduled hours dedicated to this "intradependent" role.

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