NP vs PA duties in critical care

[MowbrayRN]

Hello,

I have recently been hired in the Neuro ICU in Michigan, where the only mid-level providers are PAs. I am interested in going for the ACNP to be a critical care NP. At my father's hospital NPs and PAs have the same tasks, pay, etc. Although at my hospital I find PAs work more critical care and NPs are more primary care. I have also found the NPs do more of the paper work while PAs are in the fields putting lines in etc.

Is this a common finding in many hospitals in Michigan? If this is the case, I may consider going for PA.

Thank you for your time, I'm grateful for any responses.

Respectfully Yours,

MowbrayRN

[BostonFNP, APRN]

I'm in the midwest too and believe me guys my docs call us "physician extenders" which is far nastier then mid-level.

Pick you battles wisely....

Maybe we could call them "nurse extenders"...

[zmansc, ASN, RN]

This maybe just a local thing, but the physicians at the local hospital all love to use the term "midlevels", however the local community providers tend to talk call them.... Nurse Practitioners and Physician Assistants, go figure! I'm totally speculating, but in the hospital system the NP/PAs also tend to have to get their charts signed off, and often have to consult with the physician providers, where in the community clinics the providers do not have any "oversight" on the NP, and although the PAs have to have a supervising physician, their is no requirement for chart signoff, or other supervising activities. I'm not certain that the different ways in which these providers are utilized is affecting how they are referred to, but I found the correlation interesting.

As an aside, the hospital recently put out a RFP for a new provider group in the ER. One of the questions was something about how the group felt about and would utilize "midlevel" providers. One of the groups responses was perfect. They basically said, we find NP & PA providers to be extremely valuable and because we value them, we have moved on from using such a derogatory term as midlevels instead we refer to them as non-physician providers or to all our providers as simply providers. Hopefully, as we continue to gain ground in our fight to reduce restriction on practice we will simply be known as Nurse Practitioners.

OP, good luck in your endeavors!

[ryguyRN]

NPs and PAs are offended by the term mid-level because it implies that we are below MDs and nurses are below NPs and PAs. It really comes down to public perception, and the term is not helping improve the NP and PA perception. Of course many doctors are ok using the term, its a control thing I think.

[cruisin_woodward]

I guess it is a term used here for all APRNs and PAs, so I don't find it offensive. But I do see your point. As I said, I tell people that I am an advanced practice nurse. But they don't get it. They seem to understand what a PA is, but not what an NP is. Like I said, everyone uses the term here. It wasn't until I was working on my DNP (I went BSN to DNP), and was in a cohort with both BSN to DNPs and MSN to DNPs....that is where I found out that SOME people get offended by it.