Working with physician assistants
I’m a nurse who works in a doctor’s office in a small town. With the shortage of physicians in our rural area, we’re considering a physician assistant. What is the role of physician assistants in relation to nurses?
Physician assistants (PAs) are unregulated care providers (UCPs) who provide medical services under the supervision of a physician. The PA’s role is defined by the PA’s competencies, the supervising physician’s area of practice, and regulations governing the practice setting. Examples of duties that a PA may perform include conducting patient interviews and taking medical histories, performing physical exams, performing certain controlled acts as delegated by a physician and providing counselling on preventive health care.
Since PAs are UCPs, they do not have access to controlled acts. They can, however, perform controlled acts if they are delegated to them from a physician or anyone who is authorized to perform the controlled act. Since the PA has been delegated the authority to perform the controlled act, the PA cannot further delegate the act to nurses. Nurses cannot accept an order or delegation to perform a controlled act from a health care provider who does not have access to controlled acts.
If the procedure is not a controlled act, then whether a nurse may implement the order depends on the organization policy and legislation that is relevant to the practice setting. As always, nurses should use their judgment and ensure their practice is consistent with CNO standards.