Today, in the year 2012, there is a cry that sounds throughout all medical institutions that deliver critical care: it is a cry for knowledgeable individuals, regardless of rank (MD, DO, NP or PA) to bring their skills and dedication to the critical care units of their hospitals. When attending an American College of Surgeons (ACS) two hour presentation on this subject about ten years ago, I discovered that the physicians involved were double boarded and were most commonly supported by NPs and a fewer number of PAs. I had written an article in the last year of publication of the Physician Assistant Journal encouraging PAs to enter this specialty prior to the meeting with the ACS. Sometimes our cries fall on deaf ears or there is little interest, but the field has exploded and there are not nearly enough physicians to staff this area, and institutions throughout the United States are calling upon our professions.
I consider some of the administrators and directors of medical staffs took some heat for opening the doors for this larger group, but the fact remains that with open doors, hospitals are still short staffed and have hired some individuals who do not possess the training or experience to adequately fulfill this role. NPs have proven that they were up to this challenge and the rationale was that many were ICU/CCU nurses before they became NPs. PAs, likewise, have proven that they are adequately prepared for this responsibility as this is part of the daily responsibilities of Cardiothoracic PAs as well as Neuro-surgical PAs and many surgical PAs. We have been involved in this demanding and urgently needed specialty for more than ten years and many Chiefs of services state that “if you removed their name tags you would not be able to distinguish one profession from another.”
The name of the new book is “Integrating Nurse Practitioners and Physician Assistants Into The ICU: Strategies for Optimizing Contributions to Care.”
The editors are:
Ruth M. Kleinpell, Ph.D, RN, FCCM
Walter A. Boyle lll , MD, FCCM
Timothy G. Buchman. MD, Ph.D., MCCM
This book contains 11 chapters starting with 21st Century Challenges and then moves to Shaping the Next Critical Care workforce. Chapter 3 demonstrates the NP model at Sloane Kettering, followed by Billing, Reimbursement and Productivity. There will always be the need to train individuals who are prepared for this giant step upward, therefore the following chapter discusses the Orientation Programs. With the Joint Commission continually protecting the patients and their care, the next chapter deals with a very subjective matter: Credentialing and Privileging for NPs and PAs. We move forward in this text to Assessing Outcomes and then Integration of the NP and PA in the Pediatric ICU. The last three chapters focus on Forming Centers for Advanced Practice, Expanding the Role for NPs and PAs in the ICU and Beyond, and the Administrative Considerations for Maximizing the Integration of NPs and PAs Into the ICU. This represents a banquet for administrators, directors, service chiefs, and all medical staff, which includes the NP and PA.
The appendix of this book is worth the price alone as it focused on the nuisances of this type of specialty. This book is published by the Society of Critical Care Medicine and is available today by contacting them or Amazon. As I mentioned, there is no hospital library that should be without this volume and all senior staff members need to absorb the materials to fully appreciate that there is light at the end of their dark tunnels in staffing their critical care areas. I only wish I were 20 years younger so that I would have the opportunity to be involved in this valuable and rewarding service to our patients.
Robert M. Blumm has received national recognition as a distinguished fellow of the American Academy of Physician Assistants (AAPA). He is the past president of the Association of Plastic Surgery Physician Assistants, and was past-president of the American Association of Surgical Physician Assistants, past president of the American College of Clinicians and NYSSPA, as well as Chairman of the Surgical Congress of the AAPA. In addition, Bob received the John Kirklin MD Award for Professional Excellence from the American Association of Surgical Physician Assistants. Along with his associate, Dr. Acker, Bob was the first recipient of the AAPA PAragon Physician-PA Partnership Award. He has been a contributing author of three textbooks, written 300 plus articles and is a sought out conference speaker throughout the United States.
The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.
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