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Mon Dec 17 22:23:18 GMT 2007

Our nurse practitioners primarly staff the telemetry/non telemerty patients and the step down ICU, however we used to see ICU patients also but stopped due to staffing limitations.  We cover 24 hours, 7 days week.  Of course the attending has to see the patient every day but it is expected that we can provide care for all of the trauma patients.  
---- "Bjorn wrote: 
> Our general/trauma extenders assist in the OR, round with the attendings
> on all inpatients (inc ICU), do a variety of procedures (chiefly wound
> care, tubes, and lines), and handle much of the day to day
> documentation.  Our trauma surgeons also staff a busy general surgery
> practice, so there's a wide variety of work to be done.
> 
> The PA's (there are no NP's in trauma at the moment, but our recruitment
> is non-discriminatory on that account) do not take call, and are not
> assigned to the trauma response team as such; however, when they're on
> site (weekdays mostly), at least one of them is usually accompanying the
> trauma attending, and thus tags along and acts as an extra set of hands,
> further freeing the surgeon to direct the resuscitation.
> 
> I don't think you'll find a Level I or II center which lists "management
> of ICU patients" in the PA/NP job description.  Functional realities
> notwithstanding, you've got to have a doctor (almost certainly a
> surgeon, and further, a boarded intensivist) directly responsible for
> ICU care.  It's part of the verification requirement.
> 
> In my observation, our PA's get more OR and procedure time than most.
> I'm aware of plenty of practices wherein the extenders are used for
> clinical and clerical infrastructure (i.e., scut work).  But then, ours
> were selected in large part for their surgical experience, and have
> enormous operative credibility.  We've been immensely fortunate in our
> hiring, and have a team of surgeons that admires and supports the unique
> surgical capacities of its assistants.  
> 
> All of which is to say that in a great many programs, and for any number
> of PA's and NP's, one person's scut work is another's indispensable role
> in a comprehensive system of patient care.  I have no doubt that the use
> of extenders in trauma centers will continue and increase; but I can't
> see there ever being a standardized job description across the
> profession.
> 
> Pret Bjorn, RN
> EMMC Trauma Program (ACS Level II)
> Bangor, ME USA
> 
> 
> 
> -----Original Message-----
> From: trauma-list-bounces at trauma.org
> [mailto:trauma-list-bounces at trauma.org] On Behalf Of
> czuehlke at frontiernet.net
> Sent: Friday, December 14, 2007 5:50 PM
> To: trauma-list at trauma.org; trauma-list-request at trauma.org
> Subject: Re: trauma-list Digest, Vol 54, Issue 16
> 
> 
> Greetings list members,
> 
> This is directed toward those that are in Level I and II centers (or
> other
> high volume centers).
> 
> How many of you use physician assistants on your service?
> 
> For those that have residents and fellows, what is the role of the PA
> during
> pt care? Does the PA take call? Do the PAs manage patients in the SICU?
> 
> Do you see a change in demand for PAs in trauma care?
> 
> Hi,
> In the one trauma centers I work in the PA sees just the mildly ill  
> patients and places sutures and or staples in patients. The PA is  
> never seen in the trauma rooms nor is he/she in a place where there  
> are serious medical conditions. NP's are treated exactly the same way.
> At the other hospital newly named trauma center level II for 2010. It  
> does not use NP's or PA's at all.
> Carol Eisenbrandt
> 
> 
> Quoting trauma-list-request at trauma.org:
> 
> > Send trauma-list mailing list submissions to
> > 	trauma-list at trauma.org
> >
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> > or, via email, send a message with subject or body 'help' to
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> >
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> > 	trauma-list-owner at trauma.org
> >
> > When replying, please edit your Subject line so it is more specific
> > than "Re: Contents of trauma-list digest..."
> >
> >
> > Today's Topics:
> >
> >    1. Nearly Famous! (tuganddawn at talktalk.net)
> >    2. Physician Assistants in Trauma (Michael Krowka)
> >    3. Re: Physician Assistants in Trauma (Ronald Gross)
> >    4. RE: Physician Assistants in Trauma (Brian E. Fletcher)
> >    5. Re: Nearly Famous! (Krin135 at aol.com)
> >
> >
> > ----------------------------------------------------------------------
> >
> > Message: 1
> > Date: Thu, 13 Dec 2007 20:56:15 -0000
> > From: <tuganddawn at talktalk.net>
> > Subject: Nearly Famous!
> > To: <trauma-list at trauma.org>
> > Message-ID: <000a01c83dca$9b0826f0$4752f259 at 049682920380>
> > Content-Type: text/plain;	charset="iso-8859-1"
> >
> > Hello to everyone.
> >
> >   Before I begin may I wish all of you wherever you are and whatever  
> >  your beliefs a very Merry Christmas and a pleasant and event free   
> > New Year.
> >      I am a Paramedic/Firefighter working in the UK and have   
> > recently been asked to consider appearing in a  documentary series   
> > about the ambulance service speciffically dealing with concerns   
> > about the increase in calls, abuse of the service and out of hours   
> > GP service effects.
> >     A few months ago I would have been completely against this idea   
> > but recent reforms, behaviour of management and treatment by other   
> > health care professionals has made me consider the potential   
> > benefits of exposing certain ignored aspects of my service   
> > (including the appalling lack of professionalism, training and   
> > negligence by many Paramedics).
> >   I wonder if the list might offer any insights they have about the   
> > ethics and problems faced with this sort of media exposure   
> > especially when one considers the uncontrolable environment we work   
> > in. I would also appreciate any advice about how to deal with these   
> > "cutthroat" sensationalist media types!
> >    In any event, thanks for your time and trouble and I hope to hear  
> >  your responses.
> >
> >   Yours with kindest regards
> >
> >   Tug Crumpton
> >
> > ------------------------------
> >
> > Message: 2
> > Date: Thu, 13 Dec 2007 16:00:59 -0700
> > From: Michael Krowka <mkrowka at gmail.com>
> > Subject: Physician Assistants in Trauma
> > To: "Trauma &amp; Critical Care mailing list" <trauma-list at trauma.org>
> > Message-ID: <C38707BB.3C00%mkrowka at gmail.com>
> > Content-Type: text/plain;	charset="US-ASCII"
> >
> > Greetings list members,
> >
> > This is directed toward those that are in Level I and II centers (or
> other
> > high volume centers).
> >
> > How many of you use physician assistants on your service?
> >
> > For those that have residents and fellows, what is the role of the PA
> during
> > pt care? Does the PA take call? Do the PAs manage patients in the
> SICU?
> >
> > Do you see a change in demand for PAs in trauma care?
> >
> >
> >
> > Michael D. Krowka
> > EMT-P
> >
> >
> >
> >
> > ------------------------------
> >
> > Message: 3
> > Date: Thu, 13 Dec 2007 19:17:30 -0500
> > From: "Ronald Gross" <Rgross at harthosp.org>
> > Subject: Re: Physician Assistants in Trauma
> > To: "Trauma &amp; Critical Care mailing list" <trauma-list at trauma.org>
> > Message-ID: <47618535.7FF1.00B9.0 at harthosp.org>
> > Content-Type: text/plain; charset=US-ASCII
> >
> > Michael,
> >
> > We have 4 PAs and one APRN on service.  Contact me off-line and I   
> > would be happy to discuss.......
> >
> > Ron
> >
> >>>> Michael Krowka <mkrowka at gmail.com> 12/13/2007 6:00 PM >>>
> > Greetings list members,
> >
> > This is directed toward those that are in Level I and II centers (or
> other
> > high volume centers).
> >
> > How many of you use physician assistants on your service?
> >
> > For those that have residents and fellows, what is the role of the PA
> during
> > pt care? Does the PA take call? Do the PAs manage patients in the
> SICU?
> >
> > Do you see a change in demand for PAs in trauma care?
> >
> >
> >
> > Michael D. Krowka
> > EMT-P
> >
> >
> > --
> > trauma-list : TRAUMA.ORG
> > To change your settings or unsubscribe visit:
> > http://www.trauma.org/index.php?/community/
> >
> >
> >
> > ------------------------------
> >
> > Message: 4
> > Date: Thu, 13 Dec 2007 19:44:10 -0500
> > From: "Brian E. Fletcher" <bfletcher at columbus.rr.com>
> > Subject: RE: Physician Assistants in Trauma
> > To: "'Trauma &amp; Critical Care mailing list'"
> > 	<trauma-list at trauma.org>
> > Message-ID: <20071214004410.BJDP22267.hrndva-omta06.mail.rr.com at BRIAN>
> > Content-Type: text/plain;	charset="us-ascii"
> >
> > We have 10 Nurse practitioners.  We manage the step down ICU, floor
> > patients, and respond to traumas.  We essentially function like a
> resident,
> > performing primary/secondary assessment, FAST, central lines, Chest
> tubes, A
> > lines, suturing etc.  We also have an NP clinic and an attending
> clinic. The
> > NP clinic sees lower acuity patients and we also assist in the
> attending
> > clinic.  Hope this helps.
> >
> > Brian
> >
> > -----Original Message-----
> > From: trauma-list-bounces at trauma.org
> [mailto:trauma-list-bounces at trauma.org]
> > On Behalf Of Michael Krowka
> > Sent: Thursday, December 13, 2007 6:01 PM
> > To: Trauma &amp; Critical Care mailing list
> > Subject: Physician Assistants in Trauma
> >
> > Greetings list members,
> >
> > This is directed toward those that are in Level I and II centers (or
> other
> > high volume centers).
> >
> > How many of you use physician assistants on your service?
> >
> > For those that have residents and fellows, what is the role of the PA
> during
> > pt care? Does the PA take call? Do the PAs manage patients in the
> SICU?
> >
> > Do you see a change in demand for PAs in trauma care?
> >
> >
> >
> > Michael D. Krowka
> > EMT-P
> >
> >
> > --
> > trauma-list : TRAUMA.ORG
> > To change your settings or unsubscribe visit:
> > http://www.trauma.org/index.php?/community/
> >
> >
> >
> > ------------------------------
> >
> > Message: 5
> > Date: Thu, 13 Dec 2007 20:39:34 EST
> > From: Krin135 at aol.com
> > Subject: Re: Nearly Famous!
> > To: trauma-list at trauma.org
> > Message-ID: <c73.2076a517.349338d6 at aol.com>
> > Content-Type: text/plain; charset="US-ASCII"
> >
> >
> > In a message dated 13-Dec-07 14:57:36 Central Standard Time,
> > tuganddawn at talktalk.net writes:
> >
> > I  wonder if the list might offer any insights they have about the
> ethics and
> >  problems faced with this sort of media exposure especially when one
> > considers  the uncontrolable environment we work in. I would also   
> > appreciate any
> > advice  about how to deal with these "cutthroat" sensationalist media
> types!
> > In any event, thanks for your time and trouble and I hope to  hear
> your
> > responses.
> >
> >
> >
> > Tug:
> >
> > good luck with your project.
> >
> > You might have better luck posting to the EMS-L using instructions
> found  at:
> >
> > List FAQ:      http://www.trauma.org/index.php/community/list/url/http:list.ftech.net/pipermail/trauma-list/2007-December/_HTTP://EMS-L.ORG_ (http://EMS-L.ORG)
> > Unsubscribe:   _EMS-L-UNSUBSCRIBE at EMS-L.ORG_
> > (mailto:EMS-L-UNSUBSCRIBE at EMS-L.ORG)
> > (subscribe should be _EMS-L-SUBSCRIBE at EMS-L.ORG_
> > (mailto:EMS-L-SUBSCRIBE at EMS-L.ORG) )
> > Manage:   http://www.trauma.org/index.php/community/list/url/http:list.ftech.net/pipermail/trauma-list/2007-December/_HTTP://EMS-L.ORG/MAN-EMS-L.HTM_
> (http://EMS-L.ORG/MAN-EMS-L.HTM)
> > Post to list:  _EMS-L at EMS-L.ORG_ (mailto:EMS-L at EMS-L.ORG)
> > List Manager:  _LISTADMIN at EMS-L.ORG_ (mailto:LISTADMIN at EMS-L.ORG)
> > Moderator:   _MODERATOR at EMS-L.ORG_ (mailto:MODERATOR at EMS-L.ORG)
> >
> > Or one of the various Yahoo Paramedic groups...
> >
> > ck
> > Charles S. Krin, DO FAAFP
> >
> >
> >
> > **************************************See AOL's top rated recipes
> > (http://food.aol.com/top-rated-recipes?NCID=aoltop00030000000004)
> >
> >
> > ------------------------------
> >
> > --
> > trauma-list : TRAUMA.ORG
> > To change your settings or unsubscribe visit:
> > http://www.trauma.org/index.php?/community/
> >
> > End of trauma-list Digest, Vol 54, Issue 16
> > *******************************************
> >
> 
> 
> 
> --
> trauma-list : TRAUMA.ORG
> To change your settings or unsubscribe visit:
> http://www.trauma.org/index.php?/community/
> 
> 
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