Can Physician Assistant Give Orders to a Nurse?

A Physician Assitant (PA) is a highly important member of the health care team.

PAs has to complete training and get their licenses to be able to act as a physician’s agent or its extension.

The list of things that a PA is legally allowed to do is quite extensive.

For example, PA can evaluate, educate patients, assist during surgeries, perform minor procedures in clinics, work in ambulatory care and hospital, etc.

The American Academy of Physician Assistants states that PA can practice in all states and all clinical settings.

For example, PA can provide services such as taking a health history, establishing a diagnosis, responding to emergencies, performing physical examinations, ordering lab tests and X-rays
PAs can also create a treatment plan, administer injection and immunizations, and perform minor procedures.

There are specialized schools that have classrooms and clinical time for PAs.

The majority of them completed ADN or BSN programs before they started the PA training.

To enter some schools, students need to proof prior medical work experience.

Also, clinical requirements at those schools include a large number of hours in different clinical settings as part of the internship programs.

Those can include hours in family practice, pediatrics, surgery, emergency, neurosurgery, internal medicine, orthopedics, etc.

Usually, to get the PA license, students are required to complete around 2,000 clinical hours before taking the exam at the Physician Assistant Board.

Each state regulates the exam procedure.

PA scope of practice is extremely broad, almost as the scope of practice of a supervising physician.

It is required for PAs to have a written Delegation of Service Agreement signed by all supervising physicians working in the same clinical setting.

It means that a PA can only practice in the specialty of its supervising physician.

For example, if a PA has a supervising physician specialed in internal medicine, PA cannot provide care to pediatric patients.

In general, the scope of practice of PA is a mirror of the scope of practice of the supervising physician.

Because a PA acts as a physician’s agent, a nurse is required to follow the patient-specific order administered by PA.

But PA can online administer patient-specific orders, and therefore cannon sign the procedures for a nurse to follow.

In the majority of states, it is common that a supervising physician must co-sign a certain number of orders by PA.

Some other healthcare agencies, for example, Medicare, require a physician to co-sign all orders written by PA.

The co-signing procedure ensures that a physician is overseeing the PA patient care activities, including orders.

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