I read this and want to cry ! Reflections are personal as well as Professional. To use personal and self directed learning against a student is to my mind an amoral act ! Reflections should always be annonymised, and therefore not traceable to a patient/ care plan. We can't ditch the portfolio because this is the educational toy that all health care Professions are using. But we can be very careful how we write our reflections. How we demonstrate our learning and by careful wording we should be able to avoid this sort of event. So now not only do we need to write CMA (cover my ass) patient notes but also develope a CMA portfolio My heart goes out to the GP student. I hope,the out come was ok?
Well said, excellent review !
Both ANP and PA roles can add a great deal to general practice. The pay scales quoted are up for negotiation and as I understand it PAs will not be as well paid as much as£30k but obviously if they become a partner that will change.
I have to ask why PAs when we have ANPs ? I suppose the ANP role is also moving a nurse from one poorly resourced area to another, borrowing from Peter to pay Paul come to mind. Also, because our professional body the NMC has not regulated ANPs in a separate part of the register, the title can be used by any one who feels they can carry out the role. When in reality and for the safety of the public this is a specialist role and the title should be protected for appropriately qualified nurses as described by the NMC & RCN job descriptions.
The RCP needs to action professional regulation as a matter of urgency before the PA job is rolled out fully.
Indemnity also needs to be discussed. Urgently !
Anonymous salaried GP at 9.55 .. I do NOT consider myself equivalent to a GP. I have a similar but also completely different skill set. I am also paid less than GP. I offer a supportive role to a failing health service into which junior Drs are not attracted due to pressure and pay. But can you anonymous salaried GP justify why I should give up over one third of my salary to do my job, do you have to do that ?
You do mention qualifications... well I have over thirty years in health care, I have numerous academic and professional qualifications that I undertook for my own personal reasons and at my own expense for the majority of my studies.
Lengthy training .. together dr and nurses undertake continuous learning. My pre reg training was four yrs ! Can we be reasonable and work together on this rather than the confrontation and Dr Nurse game that is still being played. We are on the same side after all.
This made me laugh out loud, thank you ! I need one if those stress balls immediately xx
Chris makes some excellent points and handles the criticism levelled at PAs well. However, I am an ANP and I have to say @11.10 is correct, for those of us who have fought the system to develop our roles with yrs of university learning at graduate and post graduate level education, the most frustrating aspect of this discussion is the failure of NHSE to see that the NP and ANP role is already out there and can be harnessed effectively to add another dimension to patient care and aid inthe staffing crisis in general practice. May be it's is because NP and ANP are more expensive than the 20k alluded to in this forum. May it's because nurses are hopeless at projecting themselves as a Professional group.
Nurses are regulated by a professional body, we have yrs of experience to pull on, and a minimum of masters level education for the ANPs. We can order tests, we can prescribe. Chris alludes to the nursing and medical models being different, I am sorry Chris but they are not. We use a strategy for information gathering, assessment, planning and evaluation. Both models are essentially the same and the emphasis is on the patient is to improve their well being. Nursing models or medical model is weak argument to say that PAs are better. I have been educated to use both approaches and they do not differ greatly. All Qualified ANPs will be fully versent with the medical model.
ANPS, NPs or PAs these roles will help general practice, but they are NOT a replacement for a fully qualified and experienced GP. As I have said In other discussions, I add value to my practice because the GPs I work for are supportive of my role, my continued professional development and I am managed and supervised extremely effectively. You cannot just drop a nurse or PA into general practice without a good job description and a mutually agreed role. That is a recipe for failure.
Well said anonymous @ 8.16. I am also an ANP and I fail to see how PAs will add value. May be I am protecting my turf or may be I am protecting our patients. I love my job, value my colleagues and respect my GPs. I am not a GP in miniature or cheaper. I add a different dimension to patient care neither better nor cheaper just different. I have 30yrs of nursing experience and post grad qualifications. When I left uni with a my BSc I was in NO WAY prepared for life in general practice. I lacked the innate, expert and intrinsic knowledge that makes GPs, ANPs and practice nurses so good. How can two yrs of training prepare the persons for the vagaries of general practice.
Dear Phil, get well, take your own advice and make sure you rest ! As for returning to work, your health is first and foremost. But what a huge and sad loss you and many thousand other GPS in similar situations represents to our health care provision. I am humbled everyday by the sacrifices made by my GP colleagues and fellow nurses. I mean it, you just take care now x
Well said Dr Drage ! So well argued and expertly put ! We have some amazing ANPs who add a whole level of holistic care to General Practice. As an ANP my role is varied and practical. I work across boundaries, I get a great of support from my GPs and the nursing team ! The PA role is new, expensive and unproven in the UK. Perhaps I am protecting my own turf here, but we do not necessarily need PAs when we have proven ANPs who are experienced, educated and competant.
You describe you day with vivid honesty. Your abilitybtomplace your role in context of home life and team work is inspiring.Thank you !
Gutted !!, why ? That a nurse should turn against her colleagues in general practice. That an academic has allowed her ivory towers to encroach upon simple reasoning and observation of practice. I am ashamed of her findings and comments, as I am sure are many of my fellow practice nurses and ANPs. My apologies for this trite unsubstantiated, passed off as academic diatribe!
Brilliant analysis ! Accurate ! Superb !
@noaleen fearin, I suspect you have worked with unqualified ANPs who are using the title without right or study simply because they can. The title & qualification & role is not protected due to huge failings by the NMC. A qualified ANP has yrs of experience at a senior level, has at least as a minimum a masters degree and has been supervised by a doctor who has assessed the ANP as competent. If those you have worked with were useless then they need investigation!
Oh dear the old chestnut of ANPs referring more and taking more time! Oh & how about the pay scale as suggested by the anonymous GP partner, (sadly you do not have the power of your conviction in you mistaken comments by telling us your name. However, I believe in and can proved what I write and Harvard reference it if need be! !) I am a well qualified and experienced ANP, I hold four masters degrees, I educate GPs, medical students, pharmacists and nurses in prescribing practice and therapeutics . I see the same number of patients as my GP colleagues, my referral rates are comparable as is proved by audit of my work load and neither do I rip off my employers by charging £50/hr but yes I am more expensive than the average practice nurse. ANPs and PA are not a complete solution, we need mixed teams of medics, nurses, pharmacists to assist our patients! We need an open minded approach to health care & not the narrow minded unsubstantiated rhetoric I have just had to read!
How terribly sad! General practice is also full of positives, full of job satisfaction and patient interaction! If medical students want respect, glamour, high power and dynamism then I suggest a role in the US drama greys anatomy or ER! I see none of these aspirations in primary or secondary care. I see hard graft, occasional sadness and periods of self doubt all paid for by working to a gold stand in health care and positive patient interaction. Respect was said to be earnt, sadly the negative spin by the Govt & media means no matter how good you are some people will not respect you! The old chestnut of 'not enough medicine or nursing from the education providers' raises it's head again. That hasn't changed in thirty yrs despite radical curriculum changes. I only hope the new graduates will have an open mind & see General practice as a dynamic, rewarding & fulling role. But I am not convinced !
As an experience Advanced Nurse Practitioner in primary care I can truly state that without the support and collaboration of my fantastic GP colleagues my career would be impossible to persue. GPs and ANPs really enhance each other's skills and abilities for the benefit of the patient. I would not wish to work under the terms as described Prof Thomas. As many previous comments point out "Professor come and walk I our shoes and sit in our seats for a little while" . I do hope his comments have been taken out of context but one can never be sure?
That should read I salute your strength of character !! Sorry
Well done ! I am so pleased for you, your family, your colleagues and your patients. Your win over the current media frenzy of creating negative stereotypes of our Professions, fuelled by a Government rhetoric is a great personal and Professional victory. I salute your strength of character?