Neonatology

[Farhatk]

Can anyone tell me what the difference in roles are between a MD and a PA in the NICU? Thank you! 

[leennp]

Well there are not too many neonatology PA's in the US, Neonatal nurse practitioners are much more common than PA, you would have find a neonatology PA residency program once you complete your PA.     As far as the difference in roles, it really depends on the unit you are working in.   Some smaller NICU's, physicians briefly come in for rounds and to examine patients, if there is an admission, or a planned high risk delivery with expected resuscitation or admission, the NNP or PA handles everything for unit when the MD is not there, usually MD will cosign all orders, notes and procedure notes.    PA and NNP can do pretty much all the same procedures the MD can do, however, sometimes MD will prefer to do certain higher risk and infrequent procedures such as pericardial taps or EXIT procedure deliveries.        In larger, busier NICU's MD and PA/NNP may split the patients up and complete rounds on individual patients, NNP/PA may be on a dedicated delivery, procedure, transport team for a shift and only do that while MD's round.      The only "rule" is that an NNP or PA may not pronounce a patient at death, that must be done by a physician, and physician is the only one who can decide on instituting a DNR order and usually only a physician can decided when enough is enough in order to end a code situation.      I am answering this from the standpoint of an NNP with 30 years NICU experience.             Just on this forum trolling for info for my daughter who is applying to PA school, but since no one else answered, figured I could at least give you some information.