Physician assistants

[wembley1]

Hi guys,

Just seen some jobs advertised for physician assistants (PA's) paying 40k in the Midlands. What do you guys think of PA's, has anyone worked with PA's here in the UK? Think that it is a bit insulting that PA's are payed 40K plus whilst NP's are around 30-38 K, any reason PA's are paid more? Funny as PA's have to work under a physician unlike NP's. Seems to be that the health system is overlooking RN's/NP's in favour of these new roles, seems same thing going on for anaesthetic PA's, overlooking RN's. Love to hear your views, I think RN's really need to be proactive and protective of our roles and our advanced roles, seems to be more roles being created that will tell RN's what to do, and these PA's can be life science graduates with no health care experience...

[XB9S, BSN, MSN, EdD, RN, APN]

Wembely I completely agree with you, I think that there is a drive to make the NP programs out there MSc level, I know all of the universities in my area now only offer it at masters. The problem is that doing an advanced practice degree is not compulsory, although I think this may well change. Those that don't have the qualification will have to demonstrate advanced level practice to gain entry to the ANP bit of the register. This is how it should be.

We are quite a way off and you are right with roles such as Physicians Assistants being offered at such a huge salary there is no incentive for these NP's to push advanced practice, there needs to be parity across the roles.

Again my suspicion for the level of pay they recieve is that they are paid out of doctors money and under the control of the medics rather than falling into the agenda for change payscales. We need to get our doctors fighting for thier nurse practitioners as well.

It will be interesting to see how these new roles get around the prescribing laws, it has taken such a long time to get independent nurse prescribers will it be a case of just allowing them access to the prescribing course or will they never be able to prescribe, in which case are you not better off employing a prescribing NP who can fulfil the role required.

[karenG]

this is an interesting one...

I have been an NP long enough to remember the introduction of the first contact programme (and I wont tell you how hard we fought against that) and I remember the first PA's being introduced and trust me, the NP committee fought that too.

The NP committee at the RCN have been lobbying hard for years to get the role regulated. there is an agreed standard for education and JD etc on the NP website, which has been agreed with the RCN. NP education should be at masters level in the future. The NMC are ready to open a register for advanced level nurse practitioners- admission to the register will be controlled and you will have to be practicing at masters level and be able to demonstrate masters level education to gain admittance. this is currently sitting with the Privy council waiting for approval. once approved, the register will become active and you will only be able to use the title if you are on the register. This has been a long hard fight- I have been involved in this for 8 yrs now and finally we have light at the end of the tunnel!

the pay issue.. yes- NP's should get paid on at least an 8. but if you read the AfC stuff, we, as NP's lose out because most of us are primary care based (out of my training group only 1 was secondary care based) and dont manage teams. AfC is big on the higher grades having managerial responsiblilty. so until that changes, then the pay will be lower. There is no recognition in Afc for the fact that NP's (particulary in primary care) work alone, carry a case load and act independantly. I work withinn a team of docs but I see patients with an undiagnosed condition, take a history, make a diagnosis and treat or refer as appropriate. there is no recognstion of this in AfC.

as NP's we are still, as Bev Malone said, the lunatic fringe of nursing!