To put that I don’t want to be treated by PAs in my ELCS birth plan?

[BPquestion]

I have recently been following the news, and ‘med Twitter’ about the growing problem of physicians’ associates. It seems there’s an issue with many of them performing outside of their limits of capability, expertise and knowledge. I also understand that they are not currently regulated by a professional body.

I recently read of a PA taking on an anaesthetic role, and another taking on a surgery role.

I am having an ELCS soon. Would I BU to put in the birth plan that I don’t want any PA to be involved in any part of the surgery itself?

yes but that is not what that poster was describing. I have supervised actual anaesthetic associates and they can play a useful role with limits.

the nhs jobs website is a good source. i am not an employment agency! if you do indeed know f2s desperate for a job, they will know where to look.

your previous post re uk "not prioritising uk graduates" etc is very confusing and I don't know what point you are trying to make. I won't be responding to any of your comments because frankly you are not making any sense and I have better things to do. ciao.

Well I don't disagree with that, last time I checked there were plenty of ELCS lists to go round.

Something has gone very wrong wrong.

@therealcookiemonster sorry but what doesn't make sense ? Australia gives priority when providing jobs to their own trained doctors (nothing to do with nationality, everything to do with where they trained). So UK doctors get the jobs that are left. Same in New Zealand, America, in fact every single other country except the UK. I totally agree that everyone should have the right do work and travel abroad, but why do we disadvantage our own graduates when no one had does. It's not racist (I am the child of immigrants), it's common sense. Everyone bangs on about how much it costs to train a doctor at medical school, surely we want to recoup that by letting them work in the NHS ?

No need to engage, but no need to be rude.

it's not rude to point out what you are saying is not based on any actual understanding of a very complex system. of course uk graduates get priority. I am someone who has been through the uk doctors training system. i have applied for training contracts from foundation to specialty training after graduating in the UK and am faced daily with the issues caused by lack of doctors and have worked with multiple PAs. you have read a couple of articles and had one bad experience with a PA and are trying to explain to me how the system I have been part of for most of my life works?!!! do you also go and speak to eskimos about how they have been building igloos wrong all these years?

I have tried to explain my point of view in a great deal of detail and you keep coming back with nonsensical responses. perhaps you should re read my answers.

clearly you have an issue with PAs, I have no beef with that.

are you sure that was an AA?...it sounds more like an ODP/anaesthetic nurse...which is a completely different role, has a very long history and is extremely important in the provision of safe anaesthesia.

delivering the placenta is a non-job right up until it isn't though...and then it can turn into a massive sh1tshow pretty quickly.

Well yes, that is true of any delivery really, that's why they happen in hospitals. Seriously ELCS is an incredibly safe and straightforward procedure, thats why women sometimes request them in preference to a vaginal birth. Now an EMCS is an entirely different matter.

FWIW I'm an obs anaesthetist and have seen enough 'exciting' electives to know they absolutely need to be treated with respect and a really good surgical skillset, including the ability to manage the unexpected at very short notice.

I don't disagree but if the PA was assisting/ delivering the placenta presumably the surgeon would be there too ?

This is the same as HCAs being brought in to be 'cheap' nurses. They have no training whatsoever and do things like take observations sometimes without even knowing what they are doing.

Don't get me wrong there's plenty of very experienced HCAs (who should be being paid more!) But the issue still remains. I know some hospitals don't allow HCAs to do observations anymore due to issues.

@Neurodiversitydoctor delivering the placenta is a non job until they pull it out so hard your entire womb follows 🙃

A nursing degree is also an intensive full time degree with no summer break - it doesn't mean you get to add on years - that's just muddying the waters!

Is that actually a thing ? I delivered placentas as a medical student....no one told me that could happen 😮

Ime, birthday plans are never read by HCPs. They just ask for consent in the middle of things when you're not in any frame of mind to remember what you wrote on your plan!

@therealcookiemonster I really do respect your experience and it's interesting to hear your take on things. BUT for the last 2 years UK graduates no longer have priority - was deemed illegal after we left the EU. Sad, but true. This is from Reddit

https://www.reddit.com/r/doctorsUK/comments/187dqu1/justaalittlereminderritwassourownnroyal/

I had a birth plan. Went out the window after 15 hours.

For anyone interested in the plight of some of our young doctors

www.bbc.com/news/health-68849847.amp

Highly unlikely a consultant obs/gyne would go “here’s the knife, I’ll watch!” To a PA 👀

That's terrible! Our wards are often understaffed but at least always a sister in charge!

twitter/X is really good for videos of dancing cats.

Thank you, this whole cutting through 8 layers of tissue and removing a person from inside the other with some organs involved doesn’t at all sound like a walk in the park to be blasé about with all the potential for shit to hit the fan that such a procedure would involve.

Another unlikely thing

Is that all they have to do - a MCQ exam? No practical exams or a Viva? Do they do assignments too?

What a B6 in charge??

@Neurodiversitydoctor yes, uterine inversion. Narrowly avoided a hysterectomy.