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'm really shocked at this thread. It's probably fairly similar to having an FYI , at least.

Anyway, I hope you all get used to PAs. They are cheaper than doctors and there will be many many more of them soon. There is a massive shortage of qualified doctors which is getting worse because the working conditions are so poor. But this is what the country voted for.

PAs will soon be regulated by the GMC (potentially from Summer 2023).

I work with a PA and she is a better clinician than some of the doctors at the practice. I was a naysayer not anymore.

There aren't enough doctors so I guess you will have to get used to PAs as they are the future.
I wouldn't have a problem, you get rubbish sea and nurses too so it is all about the individual and how competent they are.
I do think it's wrong they didn't introduce them self as pp have said.
All you drs looking down on PAs, count yourself fortune to have been able to attend medical school.

@Itwillkiiilllll

PAs assist in theatre where I have worked. They are training them to assist when there aren't enough junior doctors?! They even do procedures like abscesses observed. The trust pay for their training courses too (while the doctors have to self fund)

I think PAs probably have more medical knowledge than most nurses. Some (not all) nurses with two-year diplomas (from the pre-degree days) really don't know a lot. I'd much rather be assessed by someone with a 3+ year science degree + a 2 year physician's associate qualification; than someone with just a 2-year diploma and perhaps without the academic achievements needed to do a science degree.

@olympicsrock actually the new term is “central Doctor”.

I am in NHS

I would not mind being seen and assessed by a PA, ANP or nurse consultant, FY1, staff nurse or other. All add to the team - all are trained highly and professional.

Another great myth is the wage of doctors 😂
ANPs salary can be substantially higher than GPs

They probably should have introduced themselves though.

From your name or pseudonym, I can confidently say that you are an anaesthetic trainee. So, you feel that PAs are unsafe in your specialty but okay in others? I have seen anaesthetic consultants running double theatres in a tertiary hospitals with two AAs safely. Do you not think, you are “double standards “?

I strongly disagree. Nurses do have good knowledge and skills but they deskill themselves for unknown reasons by sticking to the routine like filling the forms, ticking the boxes on computer, routine care etc. Very few are willing to challenge the doctors; they prefer making anonymous complaints. The only nurses I have seen that stand up to the doctors of all grades are either infection control nurses or a few band 8 nurses. This is NHS culture. The same is not true in the US. I really don’t know why the nurses in the UK are so naïve? Please speak up. I am open for any criticism or comments.

QUICK QUESTION:🤔 So, if a PA is doing your hernia repair while the consultant is sipping his coffee and staring 🙄🙄at holly Willoughby or Lorraine Kelly on telly, do you expect this to be informed to you 😦in advance that a PA is doing your operation? Or you don’t give a toss 🤫so long as the job is down well?

@MallampatiCatty

Good QI project.

Some trust I have worked for have different colour lanyards for different grades and your grade on the lanyard 👍🏻

Let's be clear.

Whilst the PAs do not rotate and so are more familiar with the environment, they are not better at the role, at all, in my experience.

Believe me that when the shit hits the fan, no one will be calling the PA in, they'll be calling the junior doctor. When a difficult conversation is needed with family, again the junior doctor. When the radiologist refuses the scan, it'll be the junior doctor who sorts it.

Where I worked they were called 'Empty ward rounds'. Someone to write an entry to say that the patient has been 'reviewed' but the plan was never updated in any way.

And they get paid more than the junior doctor?

This is based on 4 PAs I have worked with: so not the biggest sample but not the smallest.

In contrast nearly every ANP/ACP I have worked with has been phenomenal. I think coming from a clinical background helps unendingly with clinical assessments.

We have a paramedic at the surgery I go to. He is very good, very experienced. His title is paramedic practitioner, don't know if that is an official thing or just what they use at the surgery. I'm pretty sure he can prescribe, he has a masters degree. We also have two ANP.

There is a real problem with replacing GPs when they retire and I don't think they could cope without them, the practice has 4 surgeries to cover with about a dozen doctors and some of them are part time.

Yes. Our politicians have managed to “create” a associate and assistant posts in every medical grade. I think if this current government continues, soon we will have to face HMTQ ASSOCIATE, MHTQ ASSISTANT, HMTQ PRACTITIONER.

This is disgusting.

Really? I got offered a place on a physicians associate course and I don’t have a bioscience degree? The course requirements just said a science degree. My only actual degree is a Bsc criminology degree, though I do have a midwifery diploma as well.

Look at the NHS careers website. Obviously your midwifery qualification was what got you the offer

@titchy i get that my midwifery qualification was probably a deciding factor in me getting a place but that does not change the fact that other people were getting interviewed the same day as me who had non bioscience Bsc degrees who were not nurses or midwives.

610 votes later you have a 50/50 split so you might never know whether you're being unreasonable or not 😂

Looking at a few different university websites looks like the previous degree entry requirements vary, some accept sports and exercise science. Guess they study some anatomy in sports science.

must be about 5 years ago I was offered a place, there weren’t course fees then and there was a 10k a year grant. Looks like students have to pay full course fees now.

You are clearly trolling now.

No. I’ve read the whole document. Central doctor is the new term for SHO and “post grad doctors” is the new term to use instead of junior doctor or trainee ie anyone from F1 to registrar.

Ah yes, doctors never confidently deliver a diagnosis and never misunderstand differential diagnosis and ambiguity. That’s why there are so rarely complaints and serious concerns raised about diagnostic errors. Now, I am not saying PAs should be considered experts or on the level of doctors but honestly, your arrogant attitude isn’t helping anyone.