Oh naw you didn’t! …
Sorry, you probably are asking this question very innocently but PAs get very disheartened by sentiments like this. No, we are not the same. PAs are educated and trained to diagnose and treat diseases. We are trained to take complete medical histories, do physical exams, order and interpret lab tests and imaging, write prescriptions, and know how and when to ask for further help from specialists, therapists, etc.
Could a good, proactive, experienced RN eventually figure out how to do many of these things? Probably, but it would be based mostly on protocol-type knowledge gained and algorithms vs well-rounded, organized medical training. This is why some RNs choose to become NPs, they want to expand on their on-the-job knowledge and fill it out more formally to fit the provider role.
Don’t get me wrong, RNs have an extremely important job. They are the ones who take care of all of the patient care orders I’ve requested, call me when I screw something up or when they know something is just not right with our patient, and deal with the real life poop, vomit, and tears situations in health care. In the inpatient world, they spend far more time with my patients than I do. I would want them to be the ones to insert your Foley catheter, start your IV and check for compatibilities, and know just how to give you your meds, because those are skills that RNs are much better trained on than I have been.
But the bottom line is that our roles and training are completely different.
I admire therunningpa so much for explaining things so well without ever being a jerk about anything. Thank you!
(Also, totally laughed out loud at that gif usage because it’s exactly how I was feeling when I read the question.)
Yes yes and yes.
Further, the role of the provider is to treat the medical diagnosis, and the role of the RN is to treat the human response.
I know the response to this anon wasn’t meant to offend, but I get frustrated with the sentiment that people (MD’s, PA’s, DO’s, and even NP’s alike) get offended when they are compared to an RN.
My background in my nursing education was solidly based on the hard sciences (loads of chemistry and biology), evidence-based practice (as in practice based on research), and sharp critical thinking skills. With that background, our role demands that we know how to anticipate a diagnosis- so while we don’t make a medical diagnosis, especially in the ER when they don’t have one, we are supposed to assess the condition of the patient and do so accurately. We take that information, formulate our own care plan, and make suggestions to inform the patient’s treatment. We anticipate what procedures, labs, tests, and diagnostics will be performed, and we are trained to interpret those results and understand them, as well as what those results mean for our patients. Most importantly, we are the patient’s advocate. Not that providers aren’t concerned for their patients, but we are the implementer and observer of the care plan, and when we see changes in a patient we need to be skilled enough to recognize that and address those changes accordingly.
That means we don’t just give medications and understand compatibility- we know what those medications do, how they interact on a chemical level in the body, what adverse reactions are, what therapeutic results we should anticipate, and how to titrate those medications according to the patient’s condition.
We have to think critically about implementing provider orders. We don’t just do tasks, we weigh the pros and cons of those tasks with consideration of our observation of the patient condition, and if we feel that the patient is unfit for any particular order set we will say so and ask for either clarification or a change.
We are also expected to be top-notch educators, and are tasked with taking the medical diagnosis and making it understandable to the patient. We teach the patient how to manage their diagnosis, their medications, and what lifestyle they should expect in relation to.
We hold hands, we clean up urine, and we wipe some ass. When I hold hands, I use myself therapeutically and I carefully consider the art of conversation and being with that patient-even empathy and emotional support have a significant amount of critical thinking involved. When I change the incontinent patient I assess the skin of breakdown, look for signs of irritation that could be potentially hazardous, take care to clean the skin, and work carefully to prevent skin tearing when I pull out the depends.
When I start IV’s, I weigh the considerations of what that patient needs- will they need a contrast CT? CT loves 20 gauge minimum in a big ass vein, but I have this little old woman with tiny veins and technically they should be able to do IV contrast on a 22 in the hand.
When I insert a foley, I first weigh the pros and cons - is it necessary to put in the foley? Why? Is this a critical patient that needs output monitoring? Is this for the sake of convenience? Are there better alternatives that have a lower chance of a urinary tract infections?
Even my simple tasks that I do regularly are done with great care and consideration, and I always, always look at my patient before I implement a single thing. In simple terms, as Florence Nightingale said, if you cannot assess you cannot be a nurse. Even the most experienced nurse can suck if he/she lacks the ability to critically analyze and assess his/hers patient’s care plan and response. What I listed above are skills and abilities required of even entry level nurses, and the demands for our critical thinking ability are like never before. Even though entry level can be obtained through an associates, we are seeing a shift in the curriculum nation wide where the standard in comparison between the requirements for the ADN and BSN degrees are virtually the same.
Nursing is a practice developed from unique theories that stands apart, but not separate from medicine. Bottom line is nurses could not survive without providers, nor providers without nurses (nor nurses and doctors without techs, CNAs, respiratory, imaging, lab, etc).
I am by no means suggesting the original post author is being condescending or discrediting towards nurses. I’m just merely making an observation of an attitude where people are offended by being compared to a nurse, and I felt some of the sentiment here. It feels to me just the same as when someone says “you throw like a girl!”