Nurse practitioners overlooked???

allnurses Guide · Sep 6, 2007

Hi,
Just be interested to hear what you guys think about the UK using physician assistants, PA's. Training courses at 3 universities, including the university of birmingham are being developed for PA's. These PA's will be able to work under Dr's and to see, assess, diagnose, order tests such as xrays, and prescribe for patients, similar to what PA's do in the USA, but not as advanced, will be working in A&E or with GP's. Just seems to me to be an insult to NP's out there. We all know how good a job NP's do, just look in A&E, what would waiting times be like without NP's and I have seen many NP's better at diagnosing minor injuries than SHO's. Obviously nurses are not powerful enough, or listened to enough, why not expand the roles of NP's along the lines of the USA, with acute care NP's etc! Just seems nurses are getting a raw deal from the Gov at the moment.

Hiya, I am interested to hear your opinion. I am a NP in acute surgery and I see, assess, diagonse, order tests such as xrays and prescribe for patients. I have a team of nurse practitioners that I manage who all do the same. We have all done the NP MSC run by the local university and have been supported to advanced and develop our practice in line with the NMC and RCN guidelines. I also chair a local nurse practitioner forum and the experience is similar throughout the region.

I personally think that the NP's in my area have been well supported and are very appreciated by the local government and by our medical and nursing collegues.

As far as physicians assistants, the combination of the 2 roles seems to work fairly well in the US and I think the NMC requirements for advanced practice will push all NP's to advance thier practice.

karenG · Sep 9, 2007

ah yes..

this is something that the NP association is watching closely.

to be honest, if i am cynical its about control. NP's tend to be a bunch of nurse who are not easily controlled. Bev Malone called us the lunatic fringe of nursing.. :lol2: .

PA's can only work under the supervision of a doc.. I work unsupervised and am an independant practitioner ( at least thats how it works in general practice- not sure about hospitals!). My docs know what i do and we have clinical meetings weekly to discuss problems etc but other than that I am on my own.. I see and treat patients with an undifferenated diagnosis, my patients are all ages, and most of the time I manage quite happily without any problems. The role of the NP and that of the PA are similiar but different. mind you.. most NP's would like the money a PA is being paid and a few I know have said they wouldnt mind doing the job.. except I'm fairly sure they would end up disagreeing with the docs!

Karen

paris2 · Sep 12, 2007

Few years ago when this document

http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4123769 came out all our NP's were told to work towards to match up those MCP's competencies. Now the management has changed nothing has moved forward as yet.

Owain Glyndwr · Sep 13, 2007

mind you.. most NP's would like the money a PA is being paid and a few I know have said they wouldnt mind doing the job.. except I'm fairly sure they would end up disagreeing with the docs!
Karen

From the UoB website, the PA will earn a starting salary of £22,500 to £32,000 pa at current levels. Not great for the bottom figure but not bad for the top end of the scale. My guess is that it would be toward the lower end for most Trusts to save cash and make the PA a less expensive option than a NP or a doctor.

That's what it's all about. The cheapest/cheaper/most cost effective (depending on what wording you want to use) way of filling shortage posts/replacing staff. And of helping the medical profession out. Same in the US as the UK.

Cheers

OG

scattycarrot, BSN, RN · Sep 13, 2007

From the UoB website, the PA will earn a starting salary of £22,500 to £32,000 pa at current levels. Not great for the bottom figure but not bad for the top end of the scale. My guess is that it would be toward the lower end for most Trusts to save cash and make the PA a less expensive option than a NP or a doctor.
That's what it's all about. The cheapest/cheaper/most cost effective (depending on what wording you want to use) way of filling shortage posts/replacing staff. And of helping the medical profession out. Same in the US as the UK.
Cheers
OG

At least here in the US, PA's are well paid. The median salary here is $77,580, which makes a few years of hard schooling worthwhile. That pay scale in the UK is a joke. Newly qualified staff nurses don't make far off that bottom figure and they don't have nearly the same responsibilities as a PA would. Even 32,000pds is not alot....either for a PA or a NP. Ant they wonder why nurses don't stay in the HNS.

karenG · Sep 15, 2007

Few years ago when this document
http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4123769 came out all our NP's were told to work towards to match up those MCP's competencies. Now the management has changed nothing has moved forward as yet.

Why????????? the RCN NP competences are much wider ranging and an NP has much more autonomy!! mind you I'll happily work at a lower level for more money...... oh.. ok.. no I wont!!

Karen

karenG · Sep 15, 2007

From the UoB website, the PA will earn a starting salary of £22,500 to £32,000 pa at current levels. Not great for the bottom figure but not bad for the top end of the scale. My guess is that it would be toward the lower end for most Trusts to save cash and make the PA a less expensive option than a NP or a doctor.
That's what it's all about. The cheapest/cheaper/most cost effective (depending on what wording you want to use) way of filling shortage posts/replacing staff. And of helping the medical profession out. Same in the US as the UK.
Cheers
OG

last I heard the PA's were being offered 80k to come here from the states...now that was on the NP grapevine and so may be totally inaccurate.....

dont want to be a PA.. I'm way too assertive! I'll stick with being a NP!

Karen

ZippyGBR, BSN, RN · Sep 18, 2007

At least here in the US, PA's are well paid. The median salary here is $77,580, which makes a few years of hard schooling worthwhile. That pay scale in the UK is a joke. Newly qualified staff nurses don't make far off that bottom figure and they don't have nearly the same responsibilities as a PA would. Even 32,000pds is not alot....either for a PA or a NP. Ant they wonder why nurses don't stay in the HNS.

that's band 6 BASIC

- excludes high cost of living supplements

- excludes unsocial hours (which can easily add a quarter to your wage working rotating shifts and a third to a half if you work mainly unsocial hours) e.g. my headline salary is about 21k and my p60 had just short of 27 k on it without overtime

- doesn't account for the NHS pension scheme - how many US employers offer final salary pension schemes ? (in 80ths with max pension of 40/80ths)

- forgets that people aren't paying for health insurance beyond the 150 -200 gbp NI contribution that also covers contributory Social Security benefits

- how much are people in the US playing in union dues and malpractice insurance? my RCN membership comes to something like 15 gbp /month and covers in effect both

the other thing to consider is the salaries paid to Foundation and ST1/ST2 doctors which aren't all that more if they are working a full shift with none onerous unsocials ... which more and more of them are in the light of the EU working time directive

the other thing to consider is that Uk Pre-registration education is funded fully through the DoH no students pay fees and diploma students in England and all students in Wales get a full bursary, Degree students get a means tested bursary in England - so UK students aren't carrying the same debt burden as other Students in the Uk ... diploma to degree will be paid for by the WDC ans will NP programmes and in some cases mAsters