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??

Its not like it was a janitor with no medical experience.

My son was reviewed in our out of hours by a guy not wearing a badge. He turned out to be a paramedic. I thought it seemed really odd.
My (vaccinated) son had measles and he diagnosed a heat rash despite him clearly being very unwell. I’ve seen plenty of crap fully trained Drs though to be completely fair

Any medical professional should introduce themselves by name and role, so you are right to be annoyed about that. The Physician Associate role is relatively new in the UK and so many of the public might be unaware of it. They are well qualified, and fully trained in their role. It's highly competitive to get on the 2 year postgraduate course, and the course is demanding and rigorous.

I can understand only wanting to be diagnosed by a doctor if you didn't know anything about PAs buy why would you want to be diagnosed by a nurse?

That makes complete sense and of course the doctors and nurses will have many skills the PAs don’t have. My comment was in support of PAs and not meant to down-do anyone else, I’m sorry if I gave that impression. After everything the NHS did for my DD last year every single one of you has my complete admiration and gratitude.

She wasn’t questioning the medical treatment, she was questioning the provider giving it who was actually perfectly qualified and did a good job. Look at the title of the thread, the OP is saying she thinks she should be able to demand a nurse or doctor instead of a PA even though the PA was acting well within her role.

Absolutely this.

The NHS is in crisis and those in PA roles are providing vital support and keeping services going in many hospitals and GP surgery’s.

You may not know much about the role but if you are interested read a little more here. www.healthcareers.nhs.uk/explore-roles/medical-associate-professions/roles-medical-associate-professions/physician-associate PAs have to have a scientific based first degree and than in fiercely fought for places they do another 2 year course (which is actually the equivalent of 3 years Uni course fast tracked into 2 years).

They are fairly new to the U.K. having arrived just over 10 years ago I think but they are committed professionals who often suffer disrespect and snobbery from people not understanding their role.

Maybe she didn’t tell you what her job title was because she thought you might not understand the role and you might be one of those sort of people who may disrespect her and ask for the doctor.

Now you know a little more maybe the next time you are in hospital and a physician associate is involved in your care you might be able to drag out something nice to say to them.

^^ Agree with this. She should have told you before she started examining you.

I'd have expected them to introduce themselves by name and title butnto be perfectly honest I'd have more faith and confidence in a physician's associate than a nurse. Nurse practitioners can be OK.

I was pretty sure Physicians Assistants were more highly qualified than nurses and specialise in diagnosing patients.

If they are recognised professionals with a role they should also have a lanyard.

It sounds like she was doing her job but to not be recognisable to patients or have the nhs recognise or advertise her role is pretty bad imo.

Hope you feel better soon. Gallstones are the pits

@titchy

Hard to understand 🤨 okay.

Perhaps its why there are issues between the 2 groups of staff is all.

What about those in lower grade trust jobs?

A lot of paramedics are moving into hospitals and primary care now they can independently prescribe. It’s nice that more doors are opening for career progression. One paramedic I know is now an ACP in cardiology and they are fantastic.

They aren’t a “failed doctor” as one previous poster so rudely put it. They are simply expanding their own career now that the opportunities are there. It’s enriching their development and career pathway.

my cousin's girlf went to & finished medical school - am fairly sure she's working as a PA in USA. It's better money, nicer job & quality of life than if she fully qualified as 'medical doctor'.

Anyone in any healthcare setting should introduce themselves “Hi, I’m so and so and I’m the (job title)”

Bur yeah I do think YABU to say if you aren’t a doctor or nurse you shouldn’t put your hands on someone. A physicians associates literal job description is to support doctors with the diagnosing and management of patients, with one of their main roles to physically assess someone. They are far from uneducated HCP’s too, they have to complete a bioscience degree before hand which are usually 3 years and then 2 years training as a physician associate. Some physicians associates can already be qualified nurses, midwives, pharmacists etc who want to further their career. So maybe do a bit more research before jumping to the conclusion that they aren’t trained.

YANBU to have expected any healthcare professional to not only be wearing a security badge starting their name and job title, but also to have started the conversation with " hello , my name is Jo Bloggs. I am a physician's assistant( if a job patient unlikely to have heard of, followed by, that means I work alongside the doctors to help establish what is causing your symptoms etc etc) and finally to ask if patient consents to you assessing them.
I manage a team of Occupational therapists and they are expected to introduce themselves and gain consent for every intervention and have to document that this happened. It is very basic manners really.

However YABU to think a PA incapable of doing the job. They would , I hope, be liasing closely with a registrar or consultant. Maybe if they had explained their role you may have felt more comfortable and confident.

So much obsession by alleged doctors and lay people on this thread with hierarchy and who is more highly qualified than who.

And whoever the PP was who said ANP’s should do what they’re meant to do and relieve pressure off doctors by doing bloods and cannula’s 😂I’m assuming hasn’t worked in the NHS for a very long time or ever. That would be a massive underutilisation of skills. You can teach venepunture and cannulation in a day or two given enough opportunities, which begs the question on why they’re all doing a three year masters in Advanced Clinical Practice? Oh yeah, to practice in a clinically advanced role, not to do basic clinical skills which are obtained in the first six months as a newly qualified. The ACP’s/ANP’s in my trust work on the Middle Grade Doctors rota and their clinical supervisors are the Consultants rather than the Nurse in Charge. In most trusts the HCA’s/HCSW’s do the bloods, cannulae, ECG’s and catheterisations and they’re usually very bloody good at it.

This sounds very much like someone who works in the NHS - scope and role creep is a phrase being bandied about a lot at the moment. Usually by those very insecure in their own role...

Pyewhacket is a great example of the bullying and hierarchy that exists in the NHS.

I had a receptionist tell me my blood tests were all okay only to discovered yesterday they aren't. Then this week another receptionist told me my scan was okay then a few hours later I spoke to a doctor who said I needed referring. Not impressed.

YABU, Physician associates are qualified medical professionals and diagnosis is part of their job. No, they're not doctors, but neither are nurses or paramedics which presumably you don't have a problem with...

They're a new role in the UK (soon to be regulated by the GMC) but PAs have been working in the US for many years.

The PA who did my last lumbar puncture was excellent. Working full time in a neurological specialist diagnostic unit, she does around 20 LPs a day. She had a clear name badge and introduced herself correctly before asking for my consent. She was absolutely lovely and very skilled. Just the sort of person you need in a unit like that, everything organised and no waiting about. She had been a nurse practitioner and had undergone further training. There is definitely a place for this type of HCP IMO.

Some PAs probably did fail to get into medical school, but so what? Not everyone is capable of being a doctor. Doesn't mean that they're not capable of taking on any other responsible role. (I'm not a PA by the way!).

What has that got to do with PAs?

PAs should not be assisting in theatre as they are not qualified to do so. It should be an SCP or SFA assisting according to RCS guidelines.