judiewatkins
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This entry was posted on Sunday, November 8th, 2009 at 12:47 pm and is filed under Uncategorized. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.
Why did this conference not promote the Nurse practitioner/nurse clinician role. There are some of us out here, who are suitably qualified and more than adequately educated to the same level as these PA’s, but becuase we are nurses the role we undertake appears to get little or no support nationally. We are well recognised and supported by those with whom we work, but why add another job/role/title when people are already out here doing the same?
I agree with the previous posting, as far as I am concerned a PA is the same as a Nurse Practitioner, only the terminology is different (& as someone who promotes the use of English english not American Enlish as a language, I prefer NPs!!). In this video clip much emphasis was placed on PAs being ‘medically’ trained rather than trained in the vein of nurses, I am yet to be convinced. Also as we already have many capable nurses out there who can readily convert to NPs, WHY are we investing all this money in training PAs when that money could be more wisely spent elsewhere. AND for the record, Many Nurse Practitioners CAN prescribe!
Well; let’s look at the evidence shall we? In the USA PAs have been extremely helpful in supporting the medical team, often in groups with ANPs as well as doctors, and in teaching hospitals just as much as ‘out in the sticks’. And we don’t exactly have an excess of nurses do we? Also in the UK there is no national standard for ANPs whereas there is for PAs. PA courses are bringing new people into the health service (anyone feel underworked out there??). And PAs’ education and training is different from nursing, much more like the doctors’ approach, and in work PAs work to the doctors’ direction, under their supervision, and wil do what the doctor feels is needed.
Declaration of interest: I am a GP and the course director for the Birmimgham course. And yes, I was equally sceptical when I was first approached; but when I looked at the evidence it was clear that PAs can make a real contribution. As has been shown in the West Mids and Scotland pilot studies.
I am a 1st year PA student. I agree with Dr. Wheater that PAs and NPs can function very similarly–as I see it, the function of a PA is not to compete with NPs for jobs, but to be another front-line worker who can see patients, which should only improve patient care.
There are, however, a few differences between NPs and PAs–one is that PAs are trained with a general medical knowledge to train into any medical role (e.g. work for any doctor in any primary or secondary care role), whereas NPs usually will have had extensive experience within a single area of medicine, initially as a nurse, (e.g. in GP offices) and generally stay within that area. Another difference is the scope and depth of training–as a 1st year PA student, we are focusing on learning anatomy, physiology, pharmacology, microbiology, pathology, biochemistry, and are being trained to carry out differential diagnoses and to understand the biological mechanisms of drugs, and understand the pathology of diseases. As far as I am aware, both the scope and depth of the medical knowledge expected from us is different to NP courses. In addition, nearly everyone in my class has an undergraduate science degree (including biology, chemistry, immunology, physiology, and anatomy). There is also a foreign-trained doctor in my course who wants to pursue a career as a PA now rather than as a gynecologist for family reasons (more flexible schedule).
While I do not doubt that there are many qualified nurses who would make excellent NPs, the PA role does attract a different type of applicant, namely non-nurses. I am not interested in practicing nursing, so to me it makes a lot more sense to go to PA school rather than train as a nurse and then qualify as an NP. If I did not become a PA, I would have begun graduate-entry medicine (which I did strongly consider). I decided to apply to PA school rather than graduate-entry medicine mostly because the formal training time is shorter, and because of the flexibility in moving fields of medicine. This is important to me because I want to start a family in the next few years, and frankly, I’m not interested in formally training/moving around the UK for the next decade only to enter a job working part-time.
I think that many doctors are skeptical of the PA role because 2 years seems far too short to train someone to practice medicine. I think the key thing here is 2 years IS too short. While PA school is 2 years long, the whole point of the PA concept is that PAs train continuously over a career (as do doctors)–they train over decades on the job (under the supervision of a doctor), and each year they are able to take on more and more responsibility.
As I said before, however, I think that most PAs are not anti-NP, and most PAs are not trying to replace NPs, only to add another healthcare worker to the front lines of medicine. (Finally, Dr. Wheater need not worry that the NHS is “investing all this money in training PAs” because at the moment all PA students are self-funded!)
I wanted to add that although NPs can currently prescribe, they cannot prescribe the full range of meds that doctors can. The current aim of the PA profession is to gain prescribing rights for PAs to prescribe all the medications that their supervising doctors can prescribe (this is how it works in the USA).
I would just like to draw attention to the fact that NPs offer protocol based care i.e. a doctor draws up a protocol, using medical knowledge such as biochemistry, pharmacology and pathophysiology and determines what practical skills and parameters need to be considered to diagnose or manage a condition and a NP does this using the protocol (this doesnt have to be a written document but an agreed level of skill or accepted necessary investigation) whereas a PA has been trained in the medical science to have the knowledge to independently diagnose and treat in the same way as a doctor and does not rely on protocols but their own discretion, knowledge and skills. Their experience increases their autonomy over time as well. A NP does not have this as there is no formal universal qualification and they never will be the same as a PA. There are good examples of NPs out there with these skills and knowledge but they do not have a universally agreed competence level. We are being added to the team because we offer more support, patient continuity and skills to medical teams who invest in us by continuing to support our training and education. There is a huge defecit in medical team support out there… 4 hour waiting time targets and full waiting rooms anyone??