PA to NP

[bobuddy]

Paula,

 

I have been thinking about this bill and wonder if you have any insight as to why NP's were included in this bill in the first place?  Would it have a better chance at passing by leaving the NP's out of the bill?

[Guest Paula]

Paula,

 

I have been thinking about this bill and wonder if you have any insight as to why NP's were included in this bill in the first place?  Would it have a better chance at passing by leaving the NP's out of the bill?

I have pondered the same thing.  I was not even aware of the bill until it was submitted.  When I read it I immediately felt it would not pass since it included NPs.  The idea was to make PAs and NPs equal in status.  So I can only determine the "equality" was for NPs to not have full independent practice and to oust the PAs from supervision and delegation make us all collaborative.   The NPs have a bill that was submitted months before the PA bill and it is for complete autonomy and apparently has a lot of support.

 

I was told the Michigan Medical society and Osteopathic med society were in full support of the PA bill and may not have been in support of it if the requirement to work in patient care teams was not in the bill.   When I asked the lobby guy about support from NPs he kinda sorta said nursing was in support!  I am not sure what that means. 

 

It's all about politics and control of one profession over another.  I have a feeling NPs will get their bill passed and PAs will continue to languish in MI with no parity or equality.  

 

But THE GOOD NEWS IS the apostrophe s might be the only thing that survives and passes in the PA bill.  A huge leap forward. 

 

You do understand my last two statements are said totally tongue in cheek!!!!!

[bobuddy]

So, if the Michigan Medical Society and the Osteopathic Med Society were in favor of this PA bill - my next question would be - are the ACTIVELY supporting this bill by getting their clout behind it and lobbying for it?  

 

It looks like our PA bill in KY will pass this week in the House (already passed Senate) for reducing co-signatures down to 10% within thirty days - which is huge for us in KY.  Right now the laws read "must be 100% co-sig within a reasonable amount of time" which hospitals took to mean -no co-sig - no order.  Inpatient and ER care was/is a nightmare due to interpretations of the law. 

[DPAM]

So, if the Michigan Medical Society and the Osteopathic Med Society were in favor of this PA bill - my next question would be - are the ACTIVELY supporting this bill by getting their clout behind it and lobbying for it?  

 

It looks like our PA bill in KY will pass this week in the House (already passed Senate) for reducing co-signatures down to 10% within thirty days - which is huge for us in KY.  Right now the laws read "must be 100% co-sig within a reasonable amount of time" which hospitals took to mean -no co-sig - no order.  Inpatient and ER care was/is a nightmare due to interpretations of the law. 

to expect medical society and osteopathic med society to lobby for Pas is like expecting a billion dollar gift on Christmas. it aint going to happen.

When they said nursing is behind it that is basically saying it will pass because their lobbying is stronger than any medical lobby out there.  Its all about lobbying. this idea that we have to convince and literally kiss the medical association's behind for them to accept any policy that will let the pa profession grow is totally the wrong way of doing things. like mainer said we need a strong lobbying group and face the medical association and everyone else to allow our profession to grow.

[Guest Paula]

No, not to my knowledge.  It is hard to get detailed information and I do not expect the med and osteo societies would jump in to  advocate for us. It is as DPAM says. 

[UpRegulated]

Moved to http://www.physicianassistantforum.com/index.php?/topic/12314-pa-vs-np-hurts-pas/

[Guest Paula]

^^^^^^^ this is off topic UpRegulated and nowhere on this thread are we discussing the difference between PAs and NPs.  In fact I think most of us are writing our opinions that favor NP status and political savvy of the AANP. 

 

You could post your post on a separate thread and it will get lots of feedback I think.

[Guest Paula]

Paula,

 

I have been thinking about this bill and wonder if you have any insight as to why NP's were included in this bill in the first place?  Would it have a better chance at passing by leaving the NP's out of the bill?

It would have had a better chance of passing if they had asked me for my input!    LOL!!!   I would have vigorously defended the PAs to have complete autonomy and make MI the first state to allow  PAs to be a separate and fully recognized profession.  It would make NPs and PAs equal in the eyes of employers and then we would all need to prove ourselves and compete for jobs equally.  

[db_pavnp]

Seems like a waste of time and resources for a small group of people (PAs) to try to lobby for what a much larger group of people (NPs) already have (greater independence).  I am surrounded by schools offering post master's certificates for MSNs to become NP/DNPs for a handful of credit hours.  If PA school grants a Master of Medical Science, it hardly seems a stretch for those NP/DNP certificate programs to open their arms to MMS applicants.

[bobuddy]

Seems like a waste of time and resources for a small group of people (PAs) to try to lobby for what a much larger group of people (NPs) already have (greater independence).  I am surrounded by schools offering post master's certificates for MSNs to become NP/DNPs for a handful of credit hours.  If PA school grants a Master of Medical Science, it hardly seems a stretch for those NP/DNP certificate programs to open their arms to MMS applicants.

And if a NP/DNP school did this for PA's - I wonder how many PA's would make the jump?  I know I would. 

[EMEDPA]

And if a NP/DNP school did this for PA's - I wonder how many PA's would make the jump?  I know I would. 

if I could take 2-3 classes online, do no clinical time, and take a single test once that I never had to recert on I would get the acute care np cert but would keep up my pa and em caq so I could apply for both pa and np jobs.

[db_pavnp]

Might be 15-20 credit hours at 15-20k.  I bet there are a couple hundred post master's certificate programs out there.

[EMEDPA]

Might be 15-20 credit hours at 15-20k.  I bet there are a couple hundred post master's certificate programs out there.

should be maybe 9-10 credits and 2000-3000 dollars or so....we're talking about nursing theory and that's it. no science, no rotations.

[db_pavnp]

I agree that it "should be," however the programs in place are 15 and 15-ish.  They might also argue that the NP is specialized and you are not, so they want you to take their curriculum.  You could probably argue out of it with a CAQ in that spec.  But they are providing you a service, entry into their more powerful lobby.

[EMEDPA]

I agree that it "should be," however the programs in place are 15 and 15-ish.  They might also argue that the NP is specialized and you are not, so they want you to take their curriculum.  You could probably argue out of it with a CAQ in that spec.  But they are providing you a service, entry into their more powerful lobby.

their "specialization" requires a lot less hours than my basic program...I have enough rotation time to be a fnp, acnp, anp, and rnfa.....once again, just stating facts, not trying to make a value judgement. my single fp rotation ( one of 8) was as many clinical hours as an entire fnp program.

[db_pavnp]

Maybe they would bite.  I think they would be more inclined to train thousands of PA->DNPs if each student didn't bring a set of demands to the table, though.  The greater your demands for reduced coursework and expense, the less likely the option will be available.

[EMEDPA]

I would not want a pa to dnp bridge. in 2014 I would want a msn np as I would later be grandfathered if the requirement ever became dnp.

I will already have a doctorate at the end of next yr so don't need another, just the practice rights.

[DPAM]

we have a superior education to Nps but due to lack of lobbying power they get full autonomy and independence. Do you guys see any hope in the near future in terms of autonomy and independence?

[Mainer]

NPs are not specialized.  That is a self-defining term. 

 

They receive limited training in a specific area resulting in a 'limited scope of practice'. 

 

Because of this limited scope of practice, they have cleverly called it "specialized"

 

Smart, but annoying to those who are better trained and would never pretend to be specialized if they really weren't. 

[LIPPER]

Why stop at "Entry level doctorate"? Lets start seeking some other outside-the-box credentialing. Something that's not on the current radar of NP's. Lets seek military rank; Make ROTC mandatory in school.... Perhaps mandatory platform shoes, then we'll be taller then them too....The possibilities are endless

[Guest Paula]

Why stop at "Entry level doctorate"? Lets start seeking some other outside-the-box credentialing. Something that's not on the current radar of NP's. Lets seek military rank; Make ROTC mandatory in school.... Perhaps mandatory platform shoes, then we'll be taller then them too....The possibilities are endless

And a set of bell-bottoms with ABBA records in our armamentarium. 

[sillycibin]

An important thing to keep in mind when we talk about getting autonomy or independence for the PA profession is that CMS aka Medicare restricts a lot of things that can only be done by a "licensed independent practitioner."  Which NPs are in some states and fighting for it in other states.  PAs on the other hand are dependent by definition.  Why is this important?  Because Medicare has so much power they can dictate to hospitals essentially what our scope is.  For example, I can no longer order restraints, chemical or physical, at my hospital thanks to Medicare.

[EMEDPA]

An important thing to keep in mind when we talk about getting autonomy or independence for the PA profession is that CMS aka Medicare restricts a lot of things that can only be done by a "licensed independent practitioner."  Which NPs are in some states and fighting for it in other states.  PAs on the other hand are dependent by definition.  Why is this important?  Because Medicare has so much power they can dictate to hospitals essentially what our scope is.  For example, I can no longer order restraints, chemical or physical, at my hospital thanks to Medicare.

chances are you can still do it, you just can't be paid for it. I order restraints all the time. pretty hard to limit the scope of practice of someone covering an e.d. solo...

[polarbebe]

Posting for a PA position at the oldest public hospital in the country, Bellevue Medical Center in NYC. I've copied and pasted the "interesting" part below.

 

SENIOR physician assistant "under the supervision of the surgeon or Cardiothoracic Surgical Nurse Practitioner"

 

Common or uncommon in your region?

 

http://careers.nyumc.org/mobile/jobs/descriptions/senior-physician-assistant-ct-surgerybellevue-hospital-new-york-new-york-job-4359275

 

Senior Physician Assistant - CT Surgery/Bellevue Hospital

1019539_0014470

Allied Health,

Interested in this career opportunity? Type in your email address, and we’ll send you the application link. Subscribe to our email list and get info about future opportunities.

NYU Langone Medical Center, a world-class, patient-centered, integrated, academic medical center, is one of the nation's premier centers for excellence in clinical care, biomedical research and medical education. Located in the heart of Manhattan, NYU Langone is composed of four hospitals - Tisch Hospital, its flagship acute care facility; Rusk Rehabilitation; the Hospital for Joint Diseases, one of only five hospitals in the nation dedicated to orthopaedics and rheumatology; and Hassenfeld Pediatric Center, a comprehensive pediatric hospital supporting a full array of children's health services across the medical center - plus the NYU School of Medicine, which since 1841 has trained thousands of physicians and scientists who have helped to shape the course of medical history. The medical center's tri-fold mission to serve, teach and discover is achieved 365 days a year through the seamless integration of a culture devoted to excellence in patient care, education and research. For more information, go to www.NYULMC.org.

We have an exciting opportunity to join our team as a Senior Physician Assistant for the Cardiothoracic Surgery Department in Bellevue. To qualify you must have a Physician Assistant Bachelor's degree, current NYS Physician Assistant License with prescriptive privileges, NCCPA Board certification, with ACLS/BLS certification plus at least two years of clinical rotation in various medical, surgical or other specialty areas and previous experience as a Physician Assistant. The successful candidate will be responsible for assisting the supervising surgeon in the management of patients and performing diagnostic and therapeutic procedures under the supervision of the surgeon or Cardiothoracic Surgical Nurse Practitioner; working closely and assisting the surgeon in providing quality, efficient, continuous and cost-effective care during patient's hospitalization; leading and coordinating the daily activities of the Staff Physician Assistants; performing complete health histories, physical examinations and psychosocial assessments of patients within the designated practice or clinical unit; ordering customary laboratory, radiological and diagnostic studies per practice protocols, differentiating between normal/abnormal findings and following protocol for abnormal findings; formulating the plan of care, along with the attending physician, patient and family, based on expected goals of care and length of stay; prescribing in-patient and discharge medications according to NYS law, including controlled substances with DEA authorization; facilitating the continuity of care across a continuum of services, e.g. home care and other appointments; coordinating implementation of clinical research studies or clinical trials, including patient screening, enrollment and data collection; plus all other duties as assigned. Excellent communication skills are essential.

Membership in a pertinent professional organization and fluency in a second language are preferred.

NYU Langone Medical Center provides its staff with far more than just a place to work. Rather, we are an institution you can be proud of, an institution where you'll feel good about devoting your time and your talents. And just as our employees invest so much in us, we invest in our employees. We're pleased to have one of the most competitive compensation packages not only among New York's hospitals and healthcare institutions, but within the corporate sector as well.

We begin with exceptional medical, dental, and drug coverage. We enhance this basic coverage with comprehensive wellness programs, and supplement those with retirement investment and benefits plans, and generous paid time off allowances. Add to that a very attractive tuition program, and you'll see just some of the ways that NYU Langone Medical Center demonstrates our commitment to our employees.

NYU Langone Medical Center is an equal opportunity and affirmative action employer committed to diversity and inclusion in all aspects of recruiting and employment. All qualified individuals are encouraged to apply and will receive consideration without regard to race, color, gender, gender identity or expression, sexual orientation, national origin, age, religion, creed, disability, veteran status or any other factor which cannot lawfully be used as a basis for an employment decision.

We require applications to be completed online.

 

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[Timon]

I had no idea NPs can co-sign a PAs charts...