PA-C's on L&D - page 2
Does anyone have any expeirence with physician assistants on labor and delivery? My wife is looking to hire a PA and is convinced that they can do just about anything their doc will let them, going... Read More
Feb 19, '04Joined: Sep '03; Posts: 1,214; Likes: 63Um sorry. You will NEVER convince me that a PA with 3 years of medical training is qualified to do a delivery. Correct that. Apply a bandage to a hangnail.
I don't care that they have a masters just as Np's do. 90% of the PA's I know never touched a patient before they entered their program. You don't learn everything in those three years.
Feb 19, '04Occupation: RN Case Manager Specialty: 18 year(s) of experience in Case Mgmt; Mat/Child, Critical Care ; From: US ; Joined: Apr '03; Posts: 861; Likes: 31PA's are not used in L&D here. We do about 400 deliveries/mo and only OB's or CNM's do those deliveries. Even in the teaching hospital there are not PA's in the L&D. There are Women's Health and FP NP's seeing pt's in the clinics, but they don't do deliveries.
There are PA's utilized in one of our large hospital sytems in several other areas however.
Feb 19, '04Joined: Apr '02; Posts: 38,762; Likes: 16,341Quote from CraigB-RNwould that be "FACTS" (not "fack")?Comments based on ignorance are one of the reasons that no one takes us seriously. I"m hearing comments based on emotion and not fack. Over the past 20+ years there are as many NP's and midwifes that I would let touch me or any family member of mine. For example, I picked up a mother and child from a scene (I work as a flight nurse part time) whose deliver had been totally botched by the Nurse Midwife.
On the other hand, some of the rural hospitals that I respond to have PA's that have probably delivered half the residents in town. And they've got more experience than the FP doc that is only 2 years out of residency.
Now EVERYONE has stories how deliveries were botched by all manner of providers, yanno???? So??? And who says "no one takes us seriously"? PUUUHLEEZE!
I have 7 years' L and D experience,and while that is not a ton as compared to some here, I have NEVER heard of or seen an PA in OB, even in the tiny rural hospital in Oklahoma where I first worked out of school. Yep, I have rural nursing experience, too. SO ----I am not ignorant, or uninformed, nor is anyone here. We are answering based upon EXPERIENCE. Take care now.Last edit by SmilingBluEyes on Feb 20, '04
Feb 19, '04Joined: Mar '02; Posts: 1,843; Likes: 1,237I worked in a hospital in Baltimore where PA's worked on the L/D unit. They did not do deliveries (at least not intentionally), but they rounded on some of the pt's, did ve's (nurses did not do VE's at that facility), wrote post-op orders and adm. orders for routine pt's., and assisted w/ C.sections. I also think some of them worked in the OB/GYN clinic, but I am not sure what they did there. They were employees of the hospital, not of private physicians' practices. CNM's took care of the "low risk" clinic patients and some private physicians had CNM's in their practices who did deliveries at the hospital. My GYN doc has 2 PA's in her practice. I saw one last week for a routine check-up. I thought she was thorough and I was pleased w/ the visit (if one can ever be pleased by A GYN visit). I would've had to wait 2 months to see the doc for my yearly, so I was willing to see her this year. The PA's that work in this practice do not have priviledges at the hospital. I went on a google search and here is a link about PA's in the OB/GYN setting http://www.paobgyn.orgLast edit by imenid37 on Feb 19, '04
Feb 20, '04Joined: Jul '00; Posts: 11,351; Likes: 388And people say that nurses get catty with one another because they are women? Then the second someone disagrees with me, I am ignorant and responsible for people not taking nurses seriously?
Craig, I have my own experience to draw on, and my opinion stands. Show me some real studies comparing the safety of PAs who do deliveries and the safety of CNMs and OBs or GPs and you'll get me to reconsider. Something tells me there aren't any.....Last edit by fergus51 on Feb 20, '04
Feb 20, '04Occupation: LDRP nurse, board certified lactation Consultant Joined: Sep '03; Posts: 1,385; Likes: 15Never use PA's in our hospital at all. I know one of the teaching facilities nearby uses them but NOT in L&D. Seems to me that would be out of their scope of practice. We only have MD's and CNM's.
Feb 21, '04Occupation: RN in L&D Joined: Nov '01; Posts: 720; Likes: 185I've never heard of it but I wouldn't be surprised.
I'd take a CNM, OB or even a competent Fp over a PA for delivery. Not because I have anything against PA's , heck I prefer my doc's PA over the doc.
Let's think about why people pick OB's, CNM's or FP's as care providers.
OB- extensive training and experience, this is a doctor that spent a good deal of their life training specifically to care for OB patients.
CNM- years of experience as a nurse then specific training to care for OB patients. Slap on a model of care that supports patient rights, holistic care, compassion and respect for the patient and CNM's have allot to offer.
FP- Someone who the patient has come to trust threw years of check ups, colds and other medical problems, They are familer with the patient and there family and had at least some training in OB during med school.
PA- ? I'm drawing a blank here....
I can see how it would benefit a Doc to have a PA do deliveries but what do they bring for the patient? I'm sure they could be trained to do deliveries but why not hire a CNM?
I would have to admit that I would be troubled by a PA doing deliveries at my hospital.
Feb 21, '04Joined: Mar '01; Posts: 1,012; Likes: 36No Ob/Gyn doctor in her right mind would ever allow a PA-C, under her supervision, to deliver babies in L&D. A Physician Assistant is expected to perform with similar skill and competency and to be evaluated by the same standards as the physician in the performance of assigned duties.
Your wife is correct in saying that "they can do just about anything their doc will let them do." But, if I were her I would check with her malpractice carrier to see what they say. It could cause her rates to go up dramatically.
Also, hospitals have a say in the scope of practice for PAs in their facility. No hospital, that I know of, would allow this - some still have problems with CNMs in the delivery room because it is such a high risk area.
It's a bad idea!Last edit by fiestynurse on Feb 21, '04
Feb 21, '04Joined: Sep '03; Posts: 1,214; Likes: 63Oh trust me, she's not going to let them DO much. But her rationale is this because some MD she talked to SAID that they could.
She agress that PA's are as useless as I do.
Feb 21, '04Joined: Mar '01; Posts: 1,012; Likes: 36I just checked-out the website that "imenid37" found on google search. The Association of Physician Assistants in Ob/Gyn. It looks like they do delivery babies at some rural hospitals. I am amazed!
Feb 22, '04Occupation: Lactation consultant, L&D RN, some postpartum Specialty: OB, lactation ; Joined: Oct '03; Posts: 1,951; Likes: 96nothing personal to PA's... but just what midwives need, another group of practitioner's encroaching on "their" territory (remembering that midwives were around before docs)... like they aren't having a hard enough time already...
Feb 22, '04Joined: Sep '03; Posts: 1,214; Likes: 63A midwife can barely get, let alone pay for insurance these days.
HOW ON EARTH is a PA-C getting it and paying for it?
Feb 23, '04Occupation: new grad Joined: Jun '03; Posts: 2,637; Likes: 18Never seen a PA do a delivery around my way. My OB had one in the office, she did rounds, etc, but did NOT do deliveries.
Scary thought, really.
I would prefer a CNM anyday.