Can nurses and PAs do everything?

[squee!]

I go to the hospital and am usually seen by a PA or a nurse practitioner and rarely a doctor. It makes me wonder, is there anything that a doctor can do that a nurse practitioner or a PA cannot do?

 

[archman]

All the hard stuff... I'd imagine.

 

[jiveturkey]

I go to the hospital and am usually seen by a PA or a nurse practitioner and rarely a doctor. It makes me wonder, is there anything that a doctor can do that a nurse practitioner or a PA cannot do?

Charge you more.

 

[Scubaguy62]

I go to the hospital and am usually seen by a PA or a nurse practitioner and rarely a doctor. It makes me wonder, is there anything that a doctor can do that a nurse practitioner or a PA cannot do?

The PA and the NP must have ok from the doctor to write an Rx. I don't believe a PA or an NP can suture a wound, nor can they perform any type of surgical procedure, regardless of how simple it may be.

 

[sapphire]

The PA and the NP must have ok from the doctor to write an Rx. I don't believe a PA or an NP can suture a wound, nor can they perform any type of surgical procedure, regardless of how simple it may be.

In California, PAs and NPs usually act under a delegation agreement under a supervising physician. It allows them to do whatever the agreement says, with the exception of major surgeries, and they should not be left alone to manage the long term care of a complicated long term illness. They do not need to get an MD's approval each time, but the delegation agreement may state that the MD will review all or a portion of the charts of the patients they treat.

Additionally, a Nurse Practioner can actually hang up a shingle and practice here, they do not HAVE to operate under a physician supervisor.

They are allowed to prescribe any medication, including controlled substances. They can perform all office procedures, including suturing, office surgeries, sigmoidoscopies, etc.

There are also PA and NP surgical and anesthesia specialties who perform assists and anesthesia in hospitals.

Jennifer

 

[Scubaguy62]

Thanks for the info Jennifer. I'm curious though, do they need their own malpractice carrier to perform these procedures, or are the covered by the institution's carrier?

 

[sapphire]

That would depend on how they are employed. If they are employees, as in our group, they are covered under shared limits under our entity liability policy. They do not have individual policies like the physicians do.

I imagine if they are working as independant contractors, or hanging out their own shingle, they could obtain their own liability policy.

Jennifer

 

[GoBlue!]

There are extraordinary differences in training. There clearly is a very beneficial role for NPs/PAs in the healthcare system, but all involved must know how to best utilize their services, and the NPs/PAs must realize their limitations (just as doctors must).

Jim

 

[dvrliz1]

I think the responsibilities regarding NPs are different state to state. Here in NJ NPs work under a supervising MD, basically meaning they have to hang their licence with an MD office or hospital, etc. They are allowed to diagnose (RNs and LPNs are not) and prescribe most meds with the exception of controlled drugs.

For general stuff I really prefer an NP. I am a nurse and can tell you from experience that NPs were RNs first. They are usually more intune to a patient, spend more time with a patient and listen a little better. Don't get me wrong there are a lot of fantastic MDs out there, but I have to give cudos to NPs and PAs.

Oh, and yes I do believe that some NPs and PAs do know more than some MDs. I'm in the business....you'd be surprised.

Liz

 

[down4fun]

I agree Liz. I think the NP's have not lost perspective of the patient like MD's do. Of course there are exceptions to every rule.