I have a discussion that has not been addressed in this forum that is medically related and pretty relevent:
Why does the US. Army give PAs more autonomy than NPs ?
Background: I am working on my masters to be a Family Nurse Practitioner, I currently work in a medical ICU and I am also a member of the National Guard as a medic. I am in the clinical portion of my program. ( I am no expert by any means) PAs take the lead for many combat arms units as the primary provider, but yet NPs ( specifically family nurse practitioners or FNPs) are not allowed to work in the area.
FNPs work in ERs, Acute care clinics, primary care clinics and as hospitalists in every clinical setting as do some PAs. I do not see in practice a difference between the two professions in the clinical setting. I understand the academic differences.
My bias: I am an RN and a FNP student, I have worked with other FNPs and PAs, and in Indiana where I live and work at, NPs have far more autonomy as a mid level provider than a PA does, so why doesnt the Military expand the role of the FNP.
Just in case, the term family practice means that the NP can see infants to geriatrics..
I know the ANC.. army nurse corps is mostly female officers.. in some combat units they dont allow females in certain positions, I have never met a female PA in a infantry BN myself, so I wonder if that has anything to do with it ? I am a male by the way..
SO.. Any thoughts on the subject..?
There are female PAs in the infantry BNs. I am not sure why the Army does not use FNPs in the BN Surgeon role. Maybe because they still fall into the ANC and not the Army Medical Specialists Corps like the PAs. But, again, that is just speculation.
I have both trained with and worked along side FNPs in the civilian world and can tell you that they are just as competent as PAs. Sometimes their nursing background helps them out of situations that PA students can't reason through.
the reason that FNPs have more autonomy in the civilian world is that they have awesome representation in the state and federal legislatures. They are governed by the nursing board and practice "advanced practice nursing" versus "practicing medicine". The AMA does tie our hands a lot when it comes to our practice of medicine.
Good luck to you. I hope that ANG uses you in a way that you feel fulfilled.
Highly Experienced Member
Ex-Moderator, Fired For Cause
It's a bit like turning an aircraft carrier around while going full speed - takes a lot of time, effort and distance.
I think you'll see expanded roles for advance-practice nurses as both the medical and line establishments get used to the idea that nurses are not handmaidens. Examples: the commander of the Walter Reed Healthcare System is an ANC officer. The Acting Surgeon General is (was) an ANC officer (once attaining flag rank, branch becomes theoretically irrelevant).
It's not moving as quickly as I'd like to see it, or as quickly as many male RNs/NPs like to see it - such is the nature of the bureaucratic beast the the perceptions within.
Its funny you mention that.. the in the guard I am just a medic. In my former brigade, the 76th Infantry out of Indiana, they utilized me in a more independent role than other medics d/t my civilian education. It was pretty funny though, one time a NCO with higher rank than myself was hanging out at the aid station while I was out picking up picking up trash around our FOB on a detail. A patient came in that needed attention and it was beyond this medics capabilities. He called me in to help and then I went back to picking up trash. I understood that rank has its privleges... but i was being used as a mid level provider when needed and when not needed i would go out and do some dirty detail. This happened on more than one occasion, and I am glad that this NCO knew his limitations, as did I when it came to treatment on ground or calling in for a medevac. In the end of our combat tour , I was awarded a pretty a medal that I thought reflected the quality of medical work and the duties of being a soldier and that medal was higher than the medal that my NCO was awarded. Our brigade general pinned it on also, which to me meant alot. I know this has nothing to do with my original post, but made me think about it.
Not trying to be rude or anything, but there is no apostrophe s ('s) in Physician Assistant.
That used to irk me too. Now I don't care. Where are you going to PA school? I went to Kirksville College of Osteopathic Medicine. They have a small satellite campus in Arizona.
Sure I've got some quick thoughts on the subject, from the hip...
An NP and a PA are two different roles serving different functions. Oh, sure, sometimes there "may" seem to be similiarities but, they are two different roles. My guess is that the Army just didn't know what to do with NPs at first and are only using them as preventitive/community health. I've noticed a couple of research articles from Army nursing regarding the relatively new use of FNPs.
Do you think that could be it? Besides, if FNPs have been traditionally considered as preventative care and not recognized a trauma NP then no wonder they are not sent in FST, right?
I am still pre-PA. I am assembling an application to attend the IPAP. I was taking classes at a community college here in SW Michigan in order to transfer to Western Michigan University. I thought about this for a while, weighed the pros vs the cons, before deciding that the IPAP would be a better route for me at this point.
Unfortunately, I haven't been in class for the last three semesters due to other responsibilities that have precluded my attendance. I feel like I have forgotten so much already. I am also currently attempting to get a Ranger School slot for this spring, so if that works out for me, I won't be in college for the coming spring or summer semesters in 2008 either. Hopefully I can take (or retake) a few classes in the fall of 2008.
Funny though, on the civvy side, NPs are being utilized in a primary care role, acute care role, both in the trauma setting and primary care setting. Prevention is only aspect of being a NP, as prevention is a aspect that the PA should utilize.
I am curious, what is your medical background and I wish you luck in getting into the IPAP
Except for my EMT license, a position as the vice-chairman of the Medical Emergency Response Team at the Nuclear Plant I work at, and a bunch of pre-PA coursework, I do not have any medical experience. Oh, almost forgot, I am also working on finding some "shadowing" opportunities as well.This message has been edited. Last edited by: modernicarus,
The ACC states that FNP's and PA's are the same "mid-levels". FNP's are still Nurses, and so trained (no offense) but PA's are trained on the medical school module. PA's started after vietnam for the military trained medics. Medics trained so well that when they got out of the military most had done more in there short term than alot of MD's. As a Retired Army PA, I say PA's are a better fit to the military but NP's in certian jobs are a better fit. Military NP's are great folks as well but the PA training in just a better fit and FNP's are still ANC (Nurses)
As an Army FNP, the main difference to me is the training. As some have pointed out, PA's are trained along the medical line, with a lot of technical skills such as minor surgery, splinting, trauma care, etc. This is not to say NP's aren't, but the ones who do have these skills usually acquired them outside the FNP role. FNP's in the military are as the title implies, are trained to take care of families and their routine health care needs. We are slowly transferring over to more "battlefield" type medicine but it takes time and logistics. Recent changes including allowing FNPs to go to Flight Surgeon School, and allowing FNPs to replace PAs or FP Docs in units so long as certain criteria are met. On the down side, I see they are specifically requesting females (I'm a male) to fill certain positions in combat roles so they can go work with the women and children. That is right up there with saying it is OK for NPs to only practice autonomously in poor underserved areas. Either your qualified to do the job or not regardless of gender, nationality, or the location and income of your patients.
In that respect I have to disagree. I look at the 12 or so books I have for class right now and I say to myself. How is this being taught from a nursing perspective. I am doing the adult portion of my FNP program and you can read the rest of my experiences on my profile. This concept of being taught from a nursing concept or module is to me alot of propaganda.
The FNP and the CRNA do not function as a staff nurse anymore. You must have not liked the ANC. I was never in the ANC. I am still just a army medic in the guard, but anyway. thats my opinion.
The Army has to adapt and realize the value of the Nurse Practitioner. The Army cannot meet the demand for trained medical providers to go downrange now. With 15 month deployments and multiple combat tours by most PAs, a lot of them are opting to leave the Army. Even those with 10+ years in.
I foresee that they will allow nurse practitioners into the line units very soon if we continue to stay in Iraq and A'stan.
Agree to disagree. I do not have a thing aginst FNP's, I am saying the Army see's PA's a better fit for combat because we are trained under the medical school module. And yes I have worked with alot of FNP's and think they are well trained, but they are trained under the Nurseing therory. AS for ANC staff Nurses, that is a whole other topic. Most are great, as in every body of medicine, you have good and bad. I feel this way about FNP's in combat slots, Apply start a cause. If you dont apply for a PA slot you will never get it. If you are a guard Nurse, and going to FNP school, then speak with the command now about a slot.
Personally, I kind of like the PA model better. Since PA's follow the med school model, I think that many docs can relate more to their training.
When I think of docs, PAs and NPs I think along the lines of
Doctor=assessment diagnosis, treatment
NP's good with treatment and good in primary care clinic.
PAs assessment diagnosis (reliable) and supervised treatment very good They are outstanding in a variety of medical settings from surgical to clinical.
I just think that PA's think more like doctors due to their training and routinely participate in a broader range of procedures with more reliability. Maybe it is just my perception.
My opinion will probably make me unpopular with some, but so be it, it is just my opinion.This message has been edited. Last edited by: ffa211,
See NP Jobs for Veterans hotlink deletedThis message has been edited. Last edited by: IronErik,
|Powered by Social Strata|