NP vs PA duties in critical care

Advanced Practice Columnist / Guide · Jul 15, 2014

Where in Michigan is this? I am an ACNP (trained at an urban state university there) and worked as a Critical Care NP at a large tertiary medical center in Detroit (there are 3 major hospitals in that city and ours was the one built by a famous auto industry pioneer). I worked in this role from 2004 to 2009 and was a nurse in the same institution prior to becoming an NP.

Our ICU NP's and PA's there do the exact same things: insert lines, order vasopressors and everything else,

place chest tubes, intubate in some of the units, write notes, round, etc. There were more NP's than PA's in the critical care role when I was there. I learned a lot working there and it prepared me for moving across the US to California and finding a similar job here.

I'm not going to guarantee this would be the same set-up anywhere else in Michigan. I do know a few other NP's who work in a critical care setting in other hospitals there and their role is not the same as what I had.

MowbrayRN · Jul 15, 2014

I will be working in Detroit

allnurses Guide · Jul 16, 2014

Step one, stop using the term "mid-level".

MowbrayRN · Jul 16, 2014

http://en.m.wikipedia.org/wiki/Mid-level_practitioner

I've heard the term used by both PAs and NPs. Thanks for the "helpful" comment...

Advanced Practice Columnist / Guide · Jul 16, 2014

It's a Midwest thing MowbrayRN and I forgive you for that...Check your PM man.

PS - I never hear that term used here in California actually

ryguyRN · Jul 16, 2014

Second rule... don't use wikipedia as a referencing source.

cruisin_woodward · Jul 16, 2014

I am an ACNP in the Detroit area. NPs and PAs do the exact same job here. I work side by side with a PA, and we have the same duties. Absolutely no difference. I will say that I have been referred to as the PA's "girl", or the PA's "nurse". I am a nurse, but I respectfully correct the person, and tell them I am his colleague. I try not to let my blood boil over it. If you want to PM me, I am curious what hospital in Detroit? I can take a guess, because I know that some hospitals are more NP friendly than others.

As for "mid level", it is a commonly used term here. I am not really sure why it is offensive, but I know that other NPs cringe at the term. It's like a dirty word. I just use, "advanced practice", but I get looked at like I have three eyes. I think it would be helpful if RyguyRN could give some insight as to why it is offensive, and what terms are used in other areas?

fmAtoZ&backagain · Jul 16, 2014

http://en.m.wikipedia.org/wiki/Mid-level_practitioner
I've heard the term used by both PAs and NPs. Thanks for the "helpful" comment...

That's the problem... it could be anywhere, but the internet is not the best source anyways

fmAtoZ&backagain · Jul 16, 2014

As for "mid level", it is a commonly used term here. I am not really sure why it is offensive, but I know that other NPs cringe at the term. It's like a dirty word.

Mid level: Set you up below some other professional... we are not more or less than any MD, or PA, we are different, we are trained differently, our background is different. We work with everybody, PT, OT, RT, etc. (we are team oriented), and the patient is more than an illness to "heal", they are people, and they have family and other factors which makes a difference in how we assist them.

allnurses Guide · Jul 16, 2014

http://www.kevinmd.com/blog/2014/07/stop-calling-nurse-practitioners-mid-level-providers.html

The worst thing about "mid level" is what it implies about nurses and other vital member of the healthcare team.

Second, I provide the same care as my physician colleagues and I am held to the same standards as my physician colleagues, so what is "middle" about the care I provide?

Trauma Columnist · Jul 16, 2014

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....