Hospitalist "midlevel" service

Specialties NP

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Specializes in Psych, ER, OB, M/S, teaching, FNP.

Hi,

I am currently working in an in patient psych unit and we are looking at creating a "midlevel service". I work with another NP and a PA. We have a hospitalist psychiatrist and the administrators are looking at ways to improve. Currrently the doc has responsibility for all the pts and we see the ones he requests us to, do some discharges and other things like all the admission physical exams.

Has anyone been on a midlevel in pt service and have any suggestions? They are asking for input from us and none of us have any experience with this type of thing. Are you part of a service and see things you don't like? Things you wish they would change? This is an opportunity for us 3 to have some "say" into the creation of this and would like some thoughts if anyone has any.

Thanks!

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I don't know if this helps, but I work in surgical oncology and we have PAs and I LOVE them. They function essentially as senior residents/fellows and spend most of their time on the floor. They provide a great consistency as they know the unit and nurses and patient populations vs. the residents who switch all the time and are often overwhelmed. We used to have 2 PAs and they would work like 6a-2p and 2p-10p or something of the like. Medicine units have NPs I believe who function similarly, and units with midlevels have a lower rate of rapid responses.

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Specializes in Psych, ER, OB, M/S, teaching, FNP.

CharmedJ7,

Thanks for the response. It looks as if we are going to have a service where we will be given between 4 and 6 pts to be responsible for. We will still do rounds for some of the other pts and have responsibility for all the admision H&Ps. I think it will be pretty easy. I know there will be some tough pts but I don't think managing even 6 pts with a few H&Ps will be too much.

It is a bit hard as the main physician is new (but amazing) and he has never worked with any midlevels. So it has been hard for him to relinquish control. He is pretty protective of the pts but I am Ok with that. He is a great doc and eventually he will see that we are a help to him.

Ruralnurs

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Specializes in ICU, ER, OR, FNP.

please create the service, but don't call it "mid-level providers" that moniker chaps my butt when someone refers to me as such (they usually get one opportunity to do so). ask your patients if they would eat at an expensive restaurant that advertised "mediocre food inside".

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Specializes in Psych, ER, OB, M/S, teaching, FNP.

Yes I know that the term "midlevel" bothers many people. A CNM friend was once at a social gathering and introduced by a doc (that she felt she had a very good, respectful relationship with ) as a "physician extender". I think midlevel sounds better than physician extender.

I guess I don't connect the term "midlevel" with "mediocre". In this situation and with the docs we are working I feel very respected and supported. They call us "midlevels" but there is no disrespect intended. Any suggestions on what type of service to call it? We will have one PA and two NPs.

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