LC8150 Posted February 27, 2020 Share Posted February 27, 2020 I am wondering if PAs can "backtrack" and go to nursing school after becoming a licensed PA? I have become interested in OBGYN and would like to add midwife to my belt to make it a little easier for me to get a job in the field since obgyn PAs are not popular and PAs cannot deliver babies in most states. However There are only two programs that allow you to become a midwife without a nursing background and the certification you would receive is certified midwife which is only able to practice in 6 states. So I would like to become a certified nursing midwife which can practice in any state. Ideally I could find a midwifery program that would accept my advanced practice degree as education enough to become a certified nursing midwife without having to be a nurse first but its funny how being more educated has ultimately restricted my abilities to branch out. So anyways, are PAs eligible to go to nursing school? Quote Link to comment Share on other sites More sharing options...
MediMike Posted February 27, 2020 Share Posted February 27, 2020 There's no reason that I'm aware of that you couldn't, any more than you couldn't go become an engineer or rocket surgeon. Here's an...unfortunate...story of an unmatched Caribbean trained MD going back. The last line is my favorite... https://www.statnews.com/2016/11/28/residency-failed-to-match/ 1 Quote Link to comment Share on other sites More sharing options...
Reality Check 2 Posted February 27, 2020 Share Posted February 27, 2020 YIKES - online classes all night............................... stunned, just can't come up with exact words for how NOT OK that is. As for the OP - Yep, you can go to nursing school. Sounds like the path you desire most. Sad state of affairs.......................... Quote Link to comment Share on other sites More sharing options...
jmj11 Posted February 27, 2020 Share Posted February 27, 2020 I can't imagine getting credit for being a PA in a RN-based midwifery school, because of philosophical problems that nursing schools have with the PA profession. However, a PA who works with a GYN/OB could ending up doing virtually everything the physician does including deliveries. I've done deliveries during my OB/Gyn rotation. Maybe I'm missing something here, unless it is simply added the label "Midwife." 1 Quote Link to comment Share on other sites More sharing options...
Reality Check 2 Posted February 27, 2020 Share Posted February 27, 2020 http://www.paobgyn.org/ Have you talked to these folks? 2 Quote Link to comment Share on other sites More sharing options...
LC8150 Posted February 27, 2020 Author Share Posted February 27, 2020 12 minutes ago, jmj11 said: I can't imagine getting credit for being a PA in a RN-based midwifery school, because of philosophical problems that nursing schools have with the PA profession. However, a PA who works with a GYN/OB could ending up doing virtually everything the physician does including deliveries. I've done deliveries during my OB/Gyn rotation. Maybe I'm missing something here, unless it is simply added the label "Midwife." I know it is done during rotations but it doesn't seem like in actual practice, PAs assist with deliveries often. If I am even able to get a job in OBGYN, which appears to be a daunting task in and of itself, it sounds as if I would mostly be doing office visits (pap smears, colposcopies, contraception, etc) and would be relatively limited in anything more extensive. This information is from driving a few hours to shadow one of the very few women's health PAs I could find and talking to multiple professors, including an obgyn MD. I want to have the scope of practice I have as a PA but also have the education of CNM, who are able to deliver babies in many states without supervision. I'm not looking for a career change but a supplemental certification that will maybe make me a good candidate for a career in women's health. Right now I think NPs are far more common in women's health in the majority of states so I think adding some nursing background with a focus in delivery would help me be competitive in the field. I may be mistaken but my idea is to work as (office visits, carrying out simple procedures, prescribing contraception, etc) and have the job title of PA but with supplemental education in deliveries so that facilities that do not allow PAs to deliver or offices that do not typically hire PAs over NPs but do hire CNMs may find some extra value in me and I will be able to be involved with L&D more than I would otherwise. I don't want to be a CNM and solely do labor and delivery but I want to have the educational background to be involved in it more than I would be able to as a PA. Quote Link to comment Share on other sites More sharing options...
LC8150 Posted February 27, 2020 Author Share Posted February 27, 2020 6 minutes ago, Reality Check 2 said: http://www.paobgyn.org/ Have you talked to these folks? I have explored their website but have not yet joined. Looking at their job board, they only have one job listed for obgyn PAS and that's more than I could find on any other job board. I have looked at specific facilities in my home state and all of them hire only nurse practitioners. Even the large state hospitals only have a couple PAs and hundreds of NPs. I'm not sure if it's because PA is a newer field or if it's because we need supervision, but it's just not a welcoming field for PAs. Quote Link to comment Share on other sites More sharing options...
delco714 Posted February 27, 2020 Share Posted February 27, 2020 There's no reason that I'm aware of that you couldn't, any more than you couldn't go become an engineer or rocket surgeon. Here's an...unfortunate...story of an unmatched Caribbean trained MD going back. The last line is my favorite...https://www.statnews.com/2016/11/28/residency-failed-to-match/I don't want to speculate, but maybe it was meant to beThough she should make for a well informed NP i supposeSent from my SM-N975U1 using Tapatalk Quote Link to comment Share on other sites More sharing options...
Mayamom Posted February 28, 2020 Share Posted February 28, 2020 Good for you! I think it would be a great way to get to your desired field. Midwifery is a wonderful profession! Quote Link to comment Share on other sites More sharing options...
DiggySRNA Posted February 28, 2020 Share Posted February 28, 2020 Nothing stopping you TBH. If you can cough up the $$$, do an accelerated 11months-15months BSN...then fast track that to CNM. It will be costly but will grant what you want in a short amount of time. Quote Link to comment Share on other sites More sharing options...
dfw6er Posted February 29, 2020 Share Posted February 29, 2020 OP, another choice would be, if you're willing to put the time and money into it, LECOM's 3 year PA-to-DO bridge or their 3 year PCSP scholar program. Both will get your DO in 3 years and make you eligible to match into OBGYN residency. Then you can deliver all the babies you want without anyone restricting you to uncomplicated deliveries. 1 Quote Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted February 29, 2020 Moderator Share Posted February 29, 2020 1 hour ago, dfw6er said: OP, another choice would be, if you're willing to put the time and money into it, LECOM's 3 year PA-to-DO bridge or their 3 year PCSP scholar program. Both will get your DO in 3 years and make you eligible to match into OBGYN residency. Then you can deliver all the babies you want without anyone restricting you to uncomplicated deliveries. yup, great option. also consider a PA residency in OBGYN like the one at arrowhead in CA. One of my former students did it and is on the faculty now. Quote Link to comment Share on other sites More sharing options...
LC8150 Posted March 1, 2020 Author Share Posted March 1, 2020 4 hours ago, EMEDPA said: yup, great option. also consider a PA residency in OBGYN like the one at arrowhead in CA. One of my former students did it and is on the faculty now. I've thought about a residency but it seems that from the people I've talked to, facilities that don't typically use women's health PAs still won't even with the residency. I'm sure that's not true everywhere but with my personal connections, that's what I've heard. That makes me a bit nervous to go through the whole process to make myself competitive and get into a program that only accepts a few people a year for it to still not be respected. I absolutely would consider that first choice if I were willing to relocate permanently Quote Link to comment Share on other sites More sharing options...
dfw6er Posted March 1, 2020 Share Posted March 1, 2020 So, you'd have to see if hospital bylaws would allow a PA to be credentialed to deliver. The challenge is the nursing administration. Many places have them entrenched in committees that protect their own and they've made it policy to only credential nurse midwives or WHNPs for such a thing. Now if there's nothing expressly forbidding PAs from getting those privileges, you're OK as long as your sponsoring doctor and the credentialing committee agree. 1 Quote Link to comment Share on other sites More sharing options...
Cideous Posted March 1, 2020 Share Posted March 1, 2020 The real question is, when will PA's be able to sit for the NP boards and get some of that sweet legislative freedom....? 2 Quote Link to comment Share on other sites More sharing options...
Guest JMPA Posted March 1, 2020 Share Posted March 1, 2020 " but I want to have the educational background to be involved in it more than I would be able to as a PA. " <------this is obviously a nurse trolling the PA forum. Seriously, why would a PA need to go to nursing school? Its equivalent to saying a lawyer needs to go to paralegal school. Nurses take orders from PA's. Don't feed the troll Quote Link to comment Share on other sites More sharing options...
LC8150 Posted March 1, 2020 Author Share Posted March 1, 2020 1 hour ago, JMPA said: " but I want to have the educational background to be involved in it more than I would be able to as a PA. " <------this is obviously a nurse trolling the PA forum. Seriously, why would a PA need to go to nursing school? Its equivalent to saying a lawyer needs to go to paralegal school. Nurses take orders from PA's. Don't feed the troll No need to be so rude. If you've read my above posts you would see exactly why I am considering the need to go to nursing school. How many PAs do you know that deliver babies outside of clinical year because I don't know any and my professors don't seem to either. If you do, I'd love to know where they work to avoid extra schooling but in my area this is pretty much unheard of. Seeing as I have some specific areas in mind I would like to reside, I'm trying to explore my options. I wouldn't be going to nursing school and stopping there. I would be going to continue my education in a midwifery program so I would be more desirable in an OB field as a PA and I would be hired and working under the title of PA but have the certifications to deliver in facilities that don't allow PAs to. Quote Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted March 2, 2020 Moderator Share Posted March 2, 2020 There are facilities which allow PAs delivery privileges, but as you say they are not as common as CNM positions. I deliver babies in the ER, but that isn't what you have in mind obviously. If you are not wanting to do a PA OB residency in CA or NY and practice in those areas, RN to CNM is probably your best bet (or the Lecom DO accelerated program). 1 Quote Link to comment Share on other sites More sharing options...
dfw6er Posted March 2, 2020 Share Posted March 2, 2020 2 hours ago, CLJ4349 said: No need to be so rude. If you've read my above posts you would see exactly why I am considering the need to go to nursing school. How many PAs do you know that deliver babies outside of clinical year because I don't know any and my professors don't seem to either. If you do, I'd love to know where they work to avoid extra schooling but in my area this is pretty much unheard of. Seeing as I have some specific areas in mind I would like to reside, I'm trying to explore my options. I wouldn't be going to nursing school and stopping there. I would be going to continue my education in a midwifery program so I would be more desirable in an OB field as a PA and I would be hired and working under the title of PA but have the certifications to deliver in facilities that don't allow PAs to. I seem to recall there being PAs delivering babies in Oklahoma.....Talihina or Tallequah or some such town. You might reach out to the Oklahoma Academy of Physician Assistants, as they could probably tell you the details. 1 Quote Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted March 2, 2020 Moderator Share Posted March 2, 2020 31 minutes ago, dfw6er said: I seem to recall there being PAs delivering babies in Oklahoma..... wouldn't surprise me. one of my former students ( an army medic before PA school) did a trauma thoracotomy his first week as a solo provider in a rural ER there.... Quote Link to comment Share on other sites More sharing options...
medic25 Posted March 2, 2020 Share Posted March 2, 2020 12 hours ago, EMEDPA said: wouldn't surprise me. one of my former students ( an army medic before PA school) did a trauma thoracotomy his first week as a solo provider in a rural ER there.... Off-topic, but wondering your thoughts on the risk/benefit of a thoracotomy in a resource-limited setting? Unless you have surgical backup arriving extremely quickly (I'm guessing a challenge in a solo provider rural ER), what are you gaining that can't be done with an ultrasound probe on the heart and a couple of chest tubes? Quote Link to comment Share on other sites More sharing options...
Moderator LT_Oneal_PAC Posted March 2, 2020 Moderator Share Posted March 2, 2020 6 hours ago, medic25 said: Off-topic, but wondering your thoughts on the risk/benefit of a thoracotomy in a resource-limited setting? Unless you have surgical backup arriving extremely quickly (I'm guessing a challenge in a solo provider rural ER), what are you gaining that can't be done with an ultrasound probe on the heart and a couple of chest tubes? further off topic. The thing I can think of is clamping the aorta, flipping the lung to minimize pulmonary bleeding in GSW to chest, suturing cardiac defects With GSW to chest, and more effective compressions. I’ve heard many say don’t do it if no one is there who can fix it, but there aren’t getting more dead. Problem is a lot of these small hospitals can’t afford the thoracotomy kit. I’ve often pondered what I would do in this situation. I think if I saw a GSW to the left-center chest and they went pulseless right in front of me, I would do it. @EMEDPA did this guy have a kit or did he macguyver it? Quote Link to comment Share on other sites More sharing options...
medic25 Posted March 3, 2020 Share Posted March 3, 2020 7 hours ago, LT_Oneal_PAC said: further off topic. The thing I can think of is clamping the aorta, flipping the lung to minimize pulmonary bleeding in GSW to chest, suturing cardiac defects With GSW to chest, and more effective compressions. I’ve heard many say don’t do it if no one is there who can fix it, but there aren’t getting more dead. Problem is a lot of these small hospitals can’t afford the thoracotomy kit. I’ve often pondered what I would do in this situation. I think if I saw a GSW to the left-center chest and they went pulseless right in front of me, I would do it. @EMEDPA did this guy have a kit or did he macguyver it? Always the big question I've heard; then what? Even if you clamp the aorta and stop the loss, are you putting them on a chopper with an open chest and no perfusion below the clamp? I could see an argument for it in a stab wound, tamponade on echo and lost pulses in front of you... maybe you get lucky and have a single puncture in the heart you can close. Besides the cost of equipment, I think it's also important to consider the risk of bloodborne pathogen exposure and the impact on the rest of the department if the odds of a successful resuscitation are close to zero. Quote Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted March 3, 2020 Moderator Share Posted March 3, 2020 he had a kit. He also put a foley directly into the hole in the heart, sutured it in, and ran O- through it. he did cross clamp the aorta. A general surgeon arrived 15-20 min later. guy died in the OR. Quote Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted March 3, 2020 Moderator Share Posted March 3, 2020 13 hours ago, medic25 said: Off-topic, but wondering your thoughts on the risk/benefit of a thoracotomy in a resource-limited setting? Unless you have surgical backup arriving extremely quickly (I'm guessing a challenge in a solo provider rural ER), what are you gaining that can't be done with an ultrasound probe on the heart and a couple of chest tubes? I probably wouldn't do it unless single stab wound or gunshot. I would do a perimortem c-section. Quote Link to comment Share on other sites More sharing options...
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