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I remember hearing about stuff like this back when I was in college! (Hint: Ford/Carter Administration).You guys know this has already been happening in the states for a long time, right?
Not saying it's right or wrong, but surgical PAs do minor procedures like skin excisions (which is all that article described) and other similar complexity procedures unsupervised.
You guys know this has already been happening in the states for a long time, right?
Not saying it's right or wrong, but surgical PAs do minor procedures like skin excisions (which is all that article described) and other similar complexity procedures unsupervised.
Saphenous harvests (including endoscopic), opening and closing a chest, harvesting internal mammary artery? Those complicated enough?
PAs have been doing that solo in cardiac for a long time.
I'm not arguing for this, I'm just saying what's out there. This isn't new
I dont think people are objecting to their technical competence in performing the procedures. We let residents do them, after all.I understand the slippery slope arguments, but does anyone really think an RN couldn't be trained to do basic skin lesion excisions and wound closure? That's all they seem to be talking about in the article.
I dont think people are objecting to their technical competence in performing the procedures. We let residents do them, after all.
I agree with that, for sure.Right, I just think it's kind of a sensationalized article. I'm not sure excising some skin lesions should be considered "performing surgery".
Saphenous harvests (including endoscopic), opening and closing a chest, harvesting internal mammary artery? Those complicated enough?
PAs have been doing that solo in cardiac for a long time.
I'm not arguing for this, I'm just saying what's out there. This isn't new
Wordead said:Basically as said below, those are harvested under a CT surgeon's supervision for their use so I don't necessarily have a problem with that if the CT attending is fine with his ass on the line.
As I recall, this article was about midlevels doing these procedures alone. And like I said, a simple skin ellipse in an area of redundant tissue is easy enough but the article was talking about her basically doing facial lesion excisions and recons solo. I mean most ENT/plastics residents aren't comfortable doing those alone. You can really **** those up and there's not a lot of redundancy most of the time and if you drag the eyelid down or disrupt nasal tip supports or something you probably just committed that patient to a huge procedure down the line.
Certified Nurse Midwives already deliver babies, repair perineal lacerations, place IUDs, and do colposcopy. Cutting an ellipse around a nevus or small basal cell isn't more difficult than fixing a jagged bleeding perineal laceration.
I know this is the surgery forums and not the OB/GYN forums, but I just want to point out that there are already nurses operating in other fields so the precedent is there. It's not like GYN has not set a precedent for all surgeons before (eg laparoscopy).
You also have to realize that article is in Europe where nurse midwives are more common than USA so the precedent may be stronger over there.
Certified Nurse Midwives already deliver babies, repair perineal lacerations, place IUDs, and do colposcopy. Cutting an ellipse around a nevus or small basal cell isn't more difficult than fixing a jagged bleeding perineal laceration.
I know this is the surgery forums and not the OB/GYN forums, but I just want to point out that there are already nurses operating in other fields so the precedent is there. It's not like GYN has not set a precedent for all surgeons before (eg laparoscopy).
You also have to realize that article is in Europe where nurse midwives are more common than USA so the precedent may be stronger over there.
Saphenous harvests (including endoscopic), opening and closing a chest, harvesting internal mammary artery? Those complicated enough?
PAs have been doing that solo in cardiac for a long time.
I'm not arguing for this, I'm just saying what's out there. This isn't new
Meet the nurse who will soon perform surgery on patients alonePatients may expect a surgeon to operate on them, but Dalby is one of a small group of nurses who have advanced to the role of surgical care practitioner (SCP).
Soon Dalby’s role will become even more special: come September, she will be able to carry out surgeries, such as facial skin cancer excisions, with possible skin grafts and flap reconstructions, without a consultant by her side.
Unlike other nursing roles in the surgical team, an SCP, as defined by the Royal College of Surgeons (RCS), is involved with the patient from the moment they set foot in the hospital until the moment they go home. Dalby’s nursing background has certainly helped her to this point. She says: “I have a wealth of knowledge from being a nurse that’s helped me take the next step into advanced practice.”
We can now have a situation where a patient is seen solo by a nurse practitioner in the clinic, who then refers the patient to a nurse who performs surgery solo, assisted by operating room nurses, while anesthesia is given by a nurse anesthetist. There is no need for an actual physician or surgeon except, perhaps, to absorb the liability in case things go awry. I value the nurses who are an integral part of our health care team, but I would not want to be the patient in this scenario.
I still wouldn’t trust a nurse to sew up my knee, let alone perineum. And as another poster mentioned, those procedures aren’t surgery.
PAs sew up knees all the time.
PAs are not nurses
Good luck on the malpractice insurance for these practitioners. These carriers are not stupid. They know the risks very well.