To expect to be examined and diagnosed by an actual nurse or doctor?

[Cravela]

Stomach pain came on suddenly and worsened over 24 hrs. Telephone appt with GP who advised hospital and sent me to the surgical assessment unit. So far so good

Staff member arrives in scrubs and takes all my details and then starts examining me. Tells me the plan (CT scan) and that she will give pain killers in the meantime.

Noticed she wasn’t wearing a lanyard/badge so I asked her her name Dr?. She says oh I’m not a doctor, ok so you’re a nurse? (No issues with that always choose to see an advance nurse practitioner when I go to the GP and I have a friend who is a consultant nurse). No she says she’s not a nurse. I was getting quite frustrated at this point because she was clearly avoiding just telling me her job role. So I straight out said can you tell me your job role please. She said she was a “physicians associate”.

I’ve never heard of one before so I googled after she left and literally anyone can be one after a 2 year course. They don’t come under the GMC or the nurses governing body and aren’t able to prescribe medicine or diagnose people??

I asked the nurse in charge if I could see a doctor or a surgical nurse and they came 10 mins later. Doctor was quite apologetic and re-examined me.

AIBU to think if you aren’t a doctor or a nurse you should tell people that before you put your hands on them??

I didn’t see her again after the first time, had CT and it is gall stones so home now.

I feel quite uncomfortable with what happened tbh

Triage?

These are a lot more common in other countries. My DPs overseas love their PA, and she is easier to access than their GP. Although I agree that the lack of training and professional recognition here is problematic. They may only do a two year course, but it is pretty comprehensive I think. I am a lot more worried about teachers and social workers that do six to eight week conversion courses then are given a whole class or a whole caseload of troubled families.

I think you should always introduce yourself and explain your role when you meet a patient.

AFAIK you do have to have a science degree before you do the training so they don't take just anybody and if the training is focused on initial assessment and triage etc, they are probably pretty good at it.

Happy to have details taken by anyone, would like a management plan by an actual nurse or doctor!

As a pp said anyone examining you should introduce themselves. That should be a standard! Why arnt they doing that?

I think on balance YABU. She may not be a nurse or doctor, but she was a trained health care provider. She did not diagnose you, she referred you for the appropriate test or scan given your symptoms which was a CT scan and was necessary for the doctor to then be able to diagnose you. She offered you pain relief, which a PA can do. I don’t think she did anything wrong.

* "I am a lot more worried about teachers and social workers that do six to eight week conversion courses then are given a whole class or a whole caseload of troubled families.*"

Huh? What country does that happen in then?
@Confrontayshunme

PAs often try to conceal their actual role because most of them failed to get a medical school place and are trying to become doctors through the back door. The ones like in the OP should be reported for misleading patients about their qualifications.

Only doctors should diagnose. ANPs, PAs etc. should be limited to the things they were created to do: lessen the pressure on doctors by doing bloods/cannulas/reviewing chronic stable conditions and very minor illnesses.

Scope and role creep is a huge safety issue in medicine. There is no such thing as a "consultant nurse", just a nurse trying to play doctor.

She should have been wearing her ID badge and introduced herself by name and job roll. Its very unprofessional that she didn’t.

It’s not unreasonable for her to examine you though - their roll is to triage patients depending on symptoms/test results/clinical findings and then report back to the medics who will examine again if needs be, plus diagnose and treat. It’s pretty standard practice these days. As someone mentioned up stream, it’s 2 years of focussed education off the back of a science degree, so they are hardly anyone off the street. In their narrow roll of practice, they will likely have a lot more clinical experience then say the foundation doctors or newly qualified nurses.

I have absolutely no problem with this.
They are most definitely part of the triage team. They are educated to degree level and beyond and arrange tests, scans, do administration in behalf of other medical staff.

www.healthcareers.nhs.uk/explore-roles/medical-associate-professions/roles-medical-associate-professions/physician-associate

This is wrong. Many PA courses will take graduates with non medically related degrees.

And as for PAs having more clinical experience than FY1s - what on earth? doctors have 2 pre clinical years and 3 clinical years.

They should have introduced themselves and been wearing an ID badge. But why is a physician associate with 2 years of training who is typically band 7 but can’t prescribe not acceptable but a nurse with 2 years of training (which is what many graduate courses are) who is band 5 and also can’t prescribe is? They weren’t diagnosing you at that point that argument is irrelevant anyway.

She did her job! My only concern would be the lack of a badge for ID, but she didn't diagnose you she just ordered the (correct) test!

A lot of snobbery on this thread.

She should have introduced herself but since she is just authorising tests sounds like people will get their tests sooner using her job role than waiting for a doctor. I think as long as the doctor reviews the test results I would prefer to see a less experienced person sooner to have my tests authorised.

The entry requirements and training for this role are pretty rigorous. She could have explained her role, but she sorted you out a scan. Given serious NHS staff shortages, I’m glad they are developing roles like this.

They have a 3 year BSc before their PA degree. That’s more years of education than a nurse. They were doing the job they are trained to do.

That is absolutely not true. I think you’re getting confused with the role.

An AP completes a 2 year foundation degree after already doing A levels/diploma’s/NVQ 3’s.

“literally anyone can be one after a 2 year course”

well literally anyone can be a nurse after a 3 year course!

Anyone examining you should introduce themselves but in terms of qualifications I don't think that should be an issue, a 2 years post graduate degree following a science honours degree is still a substantial amount of study.

I can see them becoming a bigger part of the NHS given the current pressures and I think that's a good thing.

But they can’t order CT scans?? Presumably because it needs a higher level of experience to decide if you need one. So was she just going to get a doctor to sign the request?

Would have no problem with this assuming after triage and the appropriate test, CT scan, she decided, then a Dr would be involved/consulted.

You are entirely miss quoting me. I didn’t say they generally have more clinical experience than an FY1. Take a surgical PA out of surgery and plonk them in medical admissions and they would struggle massively. But in their limited scope of practice, their experience is huge and that counts for a lot under the direction of a medic. I am a doctor so I’m hardly going to want to talk myself out of my own job!