When it comes to EM...

[MexicanDr]

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Do you guys prefer to work along PAs or NPs in the ER Department? I am asking this question because so many NPs brag soo much on how they are much better than PAs, so I wanted to know your side of the story since PAs follow the Medical model unline the NPs.

Also, how much can the PA/NP Participate in Trauma calls?

 

[willow18]

I'm still a student, so take my advice with that grain of salt.

I have found midlevel providers to be a hit or miss. I've worked with some PA's that I came to respect and some that even myself, as a 3rd year student, found were overmatched and inadequate health care providers. The difference was of course experience. Since there's no residency, the on-the-job training is all that matters. And with that in mind, I don't see how NP's would differ from PA's.

Given that in the ED, most midlevels work the fast track, traumas are probably not going to be involved, but that probably depends on location. If you like gore, become a trauma surgeon (or work for the police/fire/EMS/sanitation dept who deal with on-scene excitement and gore). Emergency Medicine is called that because it's 90% medicine.

 

[southerndoc]

This is like the DO v. MD debate: it's a pointless discussion.

 

[gutonc]

This is like the DO v. MD debate: it's a pointless discussion.

Also, please stop asking the same, inflammatory and somewhat ridiculous question in multiple forums (fora?).

 

[southerndoc]

Also, please stop asking the same, inflammatory and somewhat ridiculous question in multiple forums (fora?).

I'm assuming that was directed at the original poster and not me (although you quoted my text when replying).

 

[gutonc]

I'm assuming that was directed at the original poster and not me (although you quoted my text when replying).

Yes...at the OP. Quoted you for truth.

 

[kungfufishing]

I'm assuming that was directed at the original poster and not me (although you quoted my text when replying).

Southern you are such a troll, always asking the same inflammatory question in every forum. I'm finally fed up with it after all these years.

(funny funny sarcasm)

 

[southerndoc]

Southern you are such a troll, always asking the same inflammatory question in every forum. I'm finally fed up with it after all these years.

(funny funny sarcasm)

Bite me! You, me, in the parking lot after school!

 

[deleted6669]

many pa's who work in trauma/critical care do a residency after graduation from pa school. see this site for links to pa residencies in all specialties:
www.appap.org

there are 4 critical care residencies for those who want to work in the icu and 5 others billed as trauma/critical care. also many surgical residencies. many surgical residency grads end up doing trauma/cc later on.

pa's with experience in trauma/critical care are on trauma teams throughout the country.

 

[Seaglass]

I prefer the experienced one that needs little supervision. Until then they all have pretty limited knowledge sets and require a lot of supervision. In practice there is no difference between them as far as ability to see patients or core fund of knowledge.

 

[Jeff698]

Never worked with either of them but if I did have one, I think I'd probably want to use them differently than in most places.

Lots of folks use them to see low acuity stuff. My problem with this is that I don't know its low acuity until I see them and make my own determination that there isn't an emergency hidden in their low acuity complaint. After all, that's the hallmark of our specialty.

I'd like to get ones who are good at procedures and use them for that. I'll see all the patients but they do the procedures. The vast majority of procedures that I do are monotonous, time consuming and don't require a physician. Suturing and splinting leap to mind. They bill well and are necessary but really slow me down.

I may not like back pains and migraines but I've found epidural abscesses and subarachnoids that were subtle and, I like to think, required the knowledge of a trained EP.

Take care,
Jeff

 

[Dwindlin]

Never worked with either of them but if I did have one, I think I'd probably want to use them differently than in most places.

Lots of folks use them to see low acuity stuff. My problem with this is that I don't know its low acuity until I see them and make my own determination that there isn't an emergency hidden in their low acuity complaint. After all, that's the hallmark of our specialty.

I'd like to get ones who are good at procedures and use them for that. I'll see all the patients but they do the procedures. The vast majority of procedures that I do are monotonous, time consuming and don't require a physician. Suturing and splinting leap to mind. They bill well and are necessary but really slow me down.

I may not like back pains and migraines but I've found epidural abscesses and subarachnoids that were subtle and, I like to think, required the knowledge of a trained EP.

Take care,
Jeff

I think this is a really neat idea. Anyone know if any ED's operate like this? I saw another thread somewhere that had talked about attempting something similar with RN's who had taken a class (or something) in suturing but it didn't work all too well it sounds.

 

[deleted6669]

there are places that use pa's on inpt services for vascular access and minor IR procedures but I have never seen this set up in an e.d.
anyone who went into em as a pa out of a love of the specialty (and not just someone looking for a job) wouldn't take a job like this as it wouldn't be very challenging in the long run. you could find new grad pa's to take this job but they wouldn't be em pa's with any kind of experience.

 

[deleted6669]

Delete

 

[KidDr]

I think this is a really neat idea. Anyone know if any ED's operate like this? I saw another thread somewhere that had talked about attempting something similar with RN's who had taken a class (or something) in suturing but it didn't work all too well it sounds.

We have a well-established RN suture program at my hospital. The RNs get good training and are directly supervised by the more experienced suture RNs for awhile after their initial suture course. I think it works great.

 

[Dwindlin]

We have a well-established RN suture program at my hospital. The RNs get good training and are directly supervised by the more experienced suture RNs for awhile after their initial suture course. I think it works great.

Sounds like this is the difference then between your program and the other I read about. It sounds as if it failed due to lack of good training.

 

[Peds2ER]

I prefer to work with competent, hard working people. I find it's pretty meaningless and unproductive to fixate on what letters are behind my colleagues' names.