I read sometime ago on a different site a ...

[Roland]

debate concerning if it was better to become a Physician's Assistant, or Advanced Practice Nurse. Those who advocated the PA path referenced the fact that many MD's preferred working with PA's who were trained in the "medical school" model of patient accessment rather than the "nursing school" model. What are the salient points of departure between these "models" of patient accessment? Furthermore, what are the supposed advantages and liabilities of each approach?I have been unable to find hardly any relevant information expanding upon this topic.

Sincere Thanks,

[Roland]

and state what they REALLY think. If I were a physician who held this viewpoint (the one alluded to above), I would simply state out right "physicians should be in control of all health care employees". Then I would procede to make my case as best I could, let my opponents make theirs, then let the chips fall where they would. Furthermore, if I was a senior PhD nurse pushing the theory line I would say essentially "look we view this theory stuff as a method of maintaining independence from physicians more than objective truth." Wouldn't the world be much simpler if everybody just openly argued their positions IN GOOD FAITH. In any case time to get back to reality since school starts tommorow. Thanks again to all for the input.

[loisane]

I applaud Kevin on his clear presentation of the points I was trying to make. His point that most physicians want all of health care to be "under them" is very well taken, and I believe central to many debates. It affects how we define nursing, and all of health care.

And I can agree with Roland that more honesty would make for a more straight forward world. But we live in times of media spin and perception becomes truth. Roland, it really worries me to see a new nurse define nursing in the way you propose. ("much of nursing can be defined as the implementation of medical care") Please continue to think about that, and I hope you end up changing your mind as you continue your studies.

I've heard all the arguments about the worthlessness of theory. I think what frustrates us comes from the fact that nursing theory is so young. We are working with the beta versions, they have yet to have all the bugs worked out.

And how do you improve theory. The same way you improve practice (as Roland has reminded us) ---with research.

So even those of you who have little use for theory, I am glad you mostly seem big believers in research. Roland is talking about outcomes research. This is a type of research that has only recently been done in great amounts. But we all know we are going to see more of it in the future.

To all of you, early or late in your nursing careers----------participate in research. It is the only way to advance theory to something that can be useful and understandable. It is the only way to justify our existence. It is the only way to prove the financial benefit of what we do. And for so many more reasons. Nurses have waited too long to get involved in research, we need to get caught up.

As to the answer to the straight forward question. No, there is no difference between a nursing assesment and a medical assesment. The difference is in the experience, education and theoretical/philosophical background of the health care provider.

As a CRNA I do the exact same pre-operative assesment as a MDA would in the same situation.

loisane