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??

You can even have a Nurse Associate, god knows what they do. Also , depending on the trust, PA's can earn £50k, for doing what ?. Personally I won't have them on my shift. Go make everybody a coffee and check the supplies cabinet.

And you are right to demand to see a qualified doctor.

@Samiamnot there is no such thing as a conversion course for social work in the UK.
In England and Wales the options are a 3yr degree course, a two year MA course, a two year on the job training course (only available to people with a relevant degree at 2:1 and above) or a three year apprenticeship. After training social workers complete an assessed year in employment and as with any other profession, have to do ongoing CPD to maintain registration.

Please don't spout nonsense, it is scaremongering and unhelpful to vulnerable people who use those services.

I am worried for you. With this kind attitude, you will struggle as CMT/CST or GPVTS trainee and Registrar. No matter what your background is, you must always listen to others including your patients. Life experience is most important in health care. I have learnt lot from nurses and physios, who spent more time with a critically Ill patient on icu than me. Final decision is in your hands as a senior doctor. Until then, imbibe that knowledge, skills and attitude which makes you a good doctor, human being and colleague.

Shame on you to judge their experience or training on the basis of the original post. CT would have been appropriate if they wanted to also look at the pancreas. All depends on the op history and clinical findings.

@OssomMummy1

You have no idea what grade i currently am 🤦‍♀️

Its not about listening in a clinical setting that is completely different, its about the attitude to junior staff members. Be it possessive or to belittle them.

I have seen other senior clinicians treat juniors with such disrespect its untrue. To tell them to "bow down" to any staff group is simply inappropriate.

Your assumptions are shocking!

I get the same response when I say I'm a nursing associate. Am I qualified enough to look after the patient?
Yes I am . So was the associate physician. My difference is I can not do iv medication. In our trust a associate physician can not prescribe. They are used in a&e to examine, request tests etc in place of a 'proper doctor'
But yes , they should of introduced and explained role. Then get the same response we all get.

I can see Nursing Associates but not Nurse Associates, do you have a link other than this one?

www.healthcareers.nhs.uk/explore-roles/nursing/roles-nursing/nursing-associate/nursing-associate

The qualified Nursing Associates start at Band 4 and perform very useful tasks that free up nursing time.

The fact that a PA can earn £50K is no indicator of how many do earn that. Given so many have a nursing, HCP, or science graduate background then, with experience, I'd be pleased if they had at least a reasonable salary structure.

Yep. Most common answer from junior doctors is “ Not that I am aware of”. How helpful is that to another professional from whom you are seeking help? And when I get such answers, I ask the junior doctor to put the phone down, find out and call back. Come back to the real world. Accept that all that you know about your patient is what is typed on that handover sheet which, good only knows, when last updated!

We are resistant to change in the UK.

YANVVVVVU.

Can't believe anyone would say otherwise. What a precious human being you are that you can't have a qualified person assess you. PA's are qualified and ususally specialise in certain areas after graduation. Not just anyone can be a PA you need an undergrad degree in a science disapline an/or extensive work experience.

Quite simply put get over yourself and be grateful someone who was qualified assessed you.

Just because you don't understand medical roles you get your knickers in a twist over nothing. God help you when the very qualified paramedic triages you at you GP practice rather than a nurse. As yes paramedics are employed by GP practices now too.

@OssomMummy1

Im concerned about where you work. Juniors will only learn and be as good as their training and standards set. Thats on senior clinicians surely?

Yes once or twice they won't know. But they will learn they have to know.

Some people are just crap at their job in all fields. But the way you paint junior doctors is awful.

Most PA’s are already nurses or have degree in biomedical science before they become PAs. They are more qualified than nurses sometimes.

It occurred to me that folks using say BUPA SPIRE would be more open to new job titles

NO. You complained of Acute, out of the blues, severe tummy pain. It is a red flag for primary care where they have no access to immediate bloods. You don’t send such patients home with an outpatient ultrasound request. What if it was an ectopic? You would have bled to death at home. Your GP did the right thing.

Test

But as a doctor once you're at consultant level you'll be earning a damn sight more than a band 7 PA - why do you take such a short term view of your career?

they don't have the intelligence and broad based medical education to think laterally

Yep, that about sums up most of the doctors I've had the misfortune to come across. And PA's probably don't have a planet sized ego to deal with as well.

I'd rather see an ANP than the GP thanks.

Can’t believe how much snobbery there is on this thread - it’s sickening, in particular the OP who also seems ignorant

I would have a lot of respect for a PA and they are one of the solutions to dealing with our ongoing NHS crisis

they are highly qualified and experienced in their particular area - and undergo post graduate training - so more so than many other practitioners in the nhs

also what the PA did with the OP is exactly what she is meant to do

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

diagnosing certain illnesses being a key task

just because OP hasn’t heard of a PA doesn’t give her a right to judge

and for entry you do usually need a bioscience degree first - or you can apply if you are a nurse or midwife

so this lady may well have been a nurse already

snobbish OP has no idea of her background

Don't be pedandic, it's painful, or you are.

I work on an ICU unit and they just get in the way. Also the ones I met had no previous medical experience in emergency medicine so I had to double check everything she did. It just made more work. I'm glad to say we longer have them on our unit.

Pedantic

Very interesting thread.

Name changed due to job role but non-clinical NHS. We have huge issues within our service between juniors and PAs. Acute surgical specialty.

PA feels they don’t get respect for their job role. Juniors feel PAs are taking away training opportunities from them.

PA stays with our service so has more knowledge of how the ward round works, specialty specific tests and conditions. Juniors have more broad knowledge overall and they are there to learn (but rotate every 4 months).

Juniors resent being told what to do by the PA who then needs to come and ask them to sign a prescription or imaging request. PA is disappointed that the role isn’t what they thought it would be (ie they want to go to theatre/clinic etc but really they are doing the grunt work of an F1 without the prospect of advancing on).

I do nothing but referee arguments between them! Secretly I’m on the side of the juniors, PA portrays themselves as SHO level and wants to do the same thing they are doing but I’m not letting a PA take a spare slot in theatre over an SHO. They need to build their portfolio and need the training opportunities especially in competitive fields.

on top of that they have no regulatory body, no guidelines as to their scope of practice. It’s far too wooly for my liking.

With less time spent on wards and with patients, the life skills in both doctors and nurses have dropped in last 2 or 3 decades. The senior doctors can only do so much. Days of spoon feeding are over for all. When I am at work, I can recognise at an instant who is putting that little bit extra for the benefit of both themselves and patient. Your hard work never goes unrecognised and so is your bad attitude. Hard work gets you rewards and cocky attitude will take you nowhere!

@titchy

It was more of a sarcastic joke... i'm more senior. But for the lack of responsibility its a good pay packet. However, who would want to still be doing junior doctor type roles in their 50s 🧐 would be exhausting!

However, they work very well in primary care, would be happy to see one there. In an acute specialty service? No thanks, I’d be asking for a SHO or registrar at the least

wonder how many people would be happy with their children being diagnosed by a PA in an acute setting?