What does this mean?

They will pay the nurse less than they would have had to pay a doctor.

I read a job description for a nurse practitioner to serve as a clinical instructor for a well known school of medicine. Towards the end of the add it read, "The nurse practitioner, upon hiring, will be certified by the [state board of medicine] and [school of medicine] to perform advanced procedures such as bone marrow aspirations, scopies, biopsies, and other procedures as needed by the department of pediatric hemo oncology.

My question is this, why would a school of medicine and the state board of medicine certify a NP rather than hire a MD, DO, or even a PA? Why would the medical board certify a NURSE practitioner rather than the board of nursing?

Just a bit confused, please clear this up for me. Thanks.

The term "certified" by the BOM and SOM is what sounds a bit vague to me. There are states where the NP's practice is also regulated by the BOM in addition to the BON. But I have not heard of any state of jurisdiction where "certification" is granted to NP's for the performance of specific procedures.

There are states where the NP, in order to perform specific advanced functions (normally performed by physicians), are required to have a document describing the specifics of how the NP will perform certain procedures and the conditions upon which supervision and training will be provided by a physician. One such state is California where I practice. We, as NP's, are required by the state to have a Standardized Procedures document that details the "non-nursing" functions we perform as part of our NP role. My Standardized Procedures as a Critical Care NP do state that I can perform intubations, central line placements, arterial line placements, and provide conscious sedation in the ICU setting. But I would not necessarily call that as being "certified" by the State of California to perform the procedures.

I am also assuming that the SOM piece of this job description must have something to do with institutional priviledging or credentialing with the term "SOM" used as it relates to the medical school and the attached training hospital or healthcare institution as a whole. NP's, such as myself, who work in in-patient settings are also required to be credentialed to perfom specific tasks per the institutional policy on the practice of non-physician providers such as NP's and PA's (or Allied Health Providers as we call it in our institution, which incidentally, is attached to a school of medicine). Again, the term "certification" must have been used here loosely instead of accurately calling it credentialing.

I read a job description for a nurse practitioner to serve as a clinical instructor for a well known school of medicine. Towards the end of the add it read, "The nurse practitioner, upon hiring, will be certified by the [state board of medicine] and [school of medicine] to perform advanced procedures such as bone marrow aspirations, scopies, biopsies, and other procedures as needed by the department of pediatric hemo oncology.

My question is this, why would a school of medicine and the state board of medicine certify a NP rather than hire a MD, DO, or even a PA? Why would the medical board certify a NURSE practitioner rather than the board of nursing?

Just a bit confused, please clear this up for me. Thanks.

I think that I can help decipher this. First of all academic medical centers generally use one of two methods of organization. They either have the hospital and the medical school or they have the hospital, medical school and physician organization. In the first case the medical school also serves as the physician organization from a billing standpoint. In the second the medical school only does medical education and the physician specialty organization does the billing. For example with Mayo clinic there is the Mayo clinics which is the physician specialty organization and the Mayo clinic school of medicine which handles medical education. From the way this is worded I am guessing the job uses the first method. In this case in order to bill for your services you have to have an appointment with the SOM. The lowest rung on the SOM ladder is clinical instructor. Its the same term that we use for fellows in non-ACGME fellowships so that we can bill for their services.

For the rest I would agree Juan that there are few states where procedures have to be approved by the board. I there are a number of states where certain PA procedures have to be approved by the BOM. I am guessing they took a PA job description and put NP wherever it said PA. You would have to know if your state requires BOM interaction for NP practice. Some states require a delegation of authority which spells out specific procedures which the BOM must approve. This is not certification but neither does a SOM usually "certify" somebody. Instead they credential or grant privileges.

Overall this looks like a standard Peds Heme/onc job that was written by somebody in human resources (ie. someone who has no idea what an NP is or how the job works).

David Carpenter, PA-C

Hi Inspired:

It is common for NP working w transplant pts to infuse donor cells in a transplant recipient. I don't know about biopsies, etc but am thinking you will be getting specific training for that job just as other prior posts have indicated.

Good Luck!

Donor cells are just like a blood transfusion. There is no reason that an NP would be involved unless for some reason its also in your job description to hang blood. I was surprised but its remarkably un-dramatic.

David Carpenter, PA-C

I've known of quite a few advanced practice nurses over the years who taught in medical schools; usually as a joint appointment with a clinical position.