What are those paramedic Professions about ?

[Alladin]

Hi everyone !

As I encountered this website, I have read about some paramedical professions that do not exist in other countries.

As far as I understand it,
RN are some kind of specially trained nurses, that are allowed to do medicine almost independently. And CRNAs may even perform anesthesia procedures on their own- (really ??).
I have even read a topic, claiming that PA may perform surgery in the US... ( is this trues ? A non-physician may perform surgery ???!!!).

Therefore I?d like to ask you:
what are RN,CRNAs, Optometrists, PA etc.
- What are their qualifications ?
- Are they allowed to practice without the supervision of a physician ?
- Can (some of them) even prescribe drugs ?

Your help would be appreciated !
Regards-

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[leorl]

Hi.
RN's and CRNA's are nurses (they are two of the different degrees nurses can earn, or the certifications that nurses can acquire). I am not sure that CRNAs are allowed to administer anaesthetics without the guide of a supervising anaesthesiologist...perhaps they are allowed to inject the patients, but not allowed to determine the dosage or the type of anaesthesia? I am not sure, but I'd be highly doubtful that they are allowed to administer anaesthesegics by themselves. A PA is a Physician's Assistant (the name is self-explanatory). And Optometrist is someone who looks at your eyes.

All of them are required to undergo training and receive licensure/certification or earn degrees. Optometry is a field within itself, they go to separate optometry school and are not within jurisdiction of physicians. However, nurses and PA's work with (or under) doctors and can't really practice medicine without supervision, but nurses can have autonomy in terms of caring for the patient (feeding patients medicines, administering IVs, etc etc etc).

The physician diagnoses and prescribes certain medications, and surgeons operate. That's what sets them apart from other medical fields. THe others can do everything else.

 

[BellKicker]

•••quote:•••Originally posted by leorl:
•I am not sure that CRNAs are allowed to administer anaesthetics without the guide of a supervising anaesthesiologist...perhaps they are allowed to inject the patients, but not allowed to determine the dosage or the type of anaesthesia? I am not sure, but I'd be highly doubtful that they are allowed to administer anaesthesegics by themselves. .•••••Hi Leorl.

You should ckeck out a thread called "CRNAs making 120000 to 180000 a year" in the rotations and residencies forum. The gist of it is that they can basically do everything just as good as MDA's (they say). Some rural hospitals, I guess, only have nurse anesthetists. It's a very hostile and interesting thread. Basically poor med students bitching at rich CRNA's.

Aladdin!

Welcome to the forum, man. Are you a med student down in Deutschland? Maybe even heading for the US? Anyway, it's cool to have more euro-trash on these boards. :wink:

 

[leorl]

Thanks Bellkicker. I guess I should try to find the thread. I don't see the problem in CRNAs earning 120-180k? Yes, that's as much as some doctors make...but so what? There always seems to be a superiority complex in doctor's treatment of nurses. I'm not sure why that exists. Conversely, nurses disrespect doctors (especially those interning) for their lack of knowledge in what is old-hat for nurses. *sigh*. Can't we all just get along?

 

[Bandit]

PA`s can perform some little out patient surgery. Remove lipomas, cysts ect... They also do more than first assist in major surgery. They harvest viens for graft while the surgeon works elsewhere and is often preferred to residents in certain surgeries and practices (probably because they dont need to be taught as they go). They practice under the supervision of a physician, but not necessarily directly in view of said Dr. Mine, for example, pulls maybe 5% of my charts per month and is rarely in the same hospital I am. That being said, (I always say this) not all PA`s are created equal and some are H&P/DRE techs.

 

[deleted6669]

LEORL- Just a point of order. PA is PHYSICIAN ASSISTANT. there is no " 's " after the N.
PA'S have DEA numbers in their own names in the majority of states(?49 I think), and can write for scheduled and nonscheduled medications. many areas allow pa's to perform minor surgery not involving general anesthesia without direct supervision. there is a pa surgical clinic in san diego that does all outpt surgeries less than 20 min requiring no general anesthesia. lots of carpal tunnel surgery, cysts, derm procedures, vasectomies, etc-e

 

[Bandit]

Emedpa, add to that anything procedure requiring conscious sedation. Actually all 50 states allow script writing now.

 

[deleted6669]

Bandit-when did louisianna grant rx rights? I thought that they were the last hold out.
did you mean we can or can't do conscious sedation? your reply was a little unclear.
I frequently use conscious sedation for orthopedic procedures. typically fentanyl and versed for shoulder dislocations for example. I have been following the recent midlevel threads and agree with your statement that there are 2 classes of PA, those who should be in practice and those who don't have the 1st clue. best wishes-e

 

[Bandit]

Yeah, I guess it was a bit unclear! Yes we can (as you know). I know there are certain PA`s on this site and others that agree with us about the 2 class` of PA`s, but try to bring that up at a confrence sometime and see the reply you get.

 

[Alladin]

Ok, thanks for the information !

I have done a little research on this topic, and as far as I understand it, the optometrists und PA etc. here (i.e. continental europe), are definitely NOT allowed to do the procedures mentioned above by several members-
Which is quite understandable, since "our" Optometrists und PA?s training is a vocational one- not a degree from a university or college (nurses and physiotherapists aren?t academic professions either).

But where does the resposibility of the paramedical professions for patient-care end? Or ist this subject federal or to local jurisdiction?

I assume, that MD /DO? may have the final decisions about the proceeding in a clinic, but what about the more rural areas? I mean, is it even imaginable, that Optometrists may perform LASIK or Phacos on their own (at least in some states ?)...quite scarry !

 

[Alladin]

@ Bell Kicker

1) Yes, I study in Deutschland... (and tomorrow our soccer team will probably be beaten up by the koreans- hopefully!! Go Korea team fghting !)
2) Well, perhaps I?ll go and spend a part of my "praktisches Jahr" doing some electives in the US... If I?ll like it, I?ll take the boards-
If not, I?m probably going to stay here and find myself a decent residency spot in Rads or ophto... :wink:

Are you danish dynamite? Or how did you get to Denmark ?

 

[BellKicker]

Hey Aladdin.

You WILL beat Korea. I DEMAND a Germany vs. Brazil final.

A whole praktisches Jahr? Cool. We have almost no option to do electives. It's all mapped out for us (which can be nice sometimes, too.)

I guess I am Danish Dynamite, although it kinda sounds like bad porn to me.

I'm 4th year at University of Copenhagen. Where are you at?

 

[Alladin]

@ Bellkicker

I?d prefer a korean victory. You know, they?ve fought so hard with real enthusiasm - if you look at our team... well there?s our excellent goalkeeper and ten overpaid buddies, that won?t bother to move their asses. Really a shame, that we got this far! So I?d be glad, if Korea sends us home today... :wink:

No, only a part of my PJ. It wouldn?t be wise to spend it completely outside Germany (you know, you?d risk the hometurf bonus to a certain extent...).

I?m studying in my 5th year (of the german six year degree curriculum) at Heinrich-Heine University Duesseldorf. I guess, you?ve never heard about that city or the school before... :wink: