Physician Assistants

JANUARY 1996, VOL 63, NO 1 LETTERB

PHYSICIAN ASSISTANTS n response to the July 1995 “President’s Message” by Ellen K. Murphy, RN, JD, CNOR, FAAN, I must strongly object to the inclusion of physician assistants in the category of unlicensed assistive personnel (UAP). I agree that matching skills and qualifications to patient’s needs is the issue, but I believe your readers must understand the role of the physician assistant in patient management. AORN approved a position statement on UAP that emphasizes the following points. m Perioperative RNs demonstrate leadership by selecting nursing activities that may be safely and legally delegated to competent UAP. Perioperative RNs are accountable for patient outcomes resulting from the nursing care provided during the perioperative experience. rn Assistive personnel are individuals who are trained to assist RNs in providing patient care activities as delegated by RNs.’ Physician assistants provide physician services-not nursing careunder the supervision of physicians, not RNs. The 50 states, the District of Columbia, Guam, and h e r t o Rico refer to physician assistants as being licensed, registered, or certified. Physician assistants are subject to de facto licensure regardless of the terminology used by a state. Under licensure, which is considered to be the most restrictive method of regulation, an individual has no right to engage in a particular activity without first having been granted permission by the state to do so. Such permission generally is contingent on meeting stringent requirements

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(eg, passing an examination, meet- cian assistants who, like RNs, are ing educational qualifications). there to help patients. Physician assistants must meet NANCY HUGHES such standards and may not pracVICE PRESIDENT, INFORMATION AND tice without state approval. Thus, RESEARCH SERVICES licensure is the most appropriate AMERICANACADEMY way to describe the control exerOF PHYSICIAN ASSISTANTS cised by states over physician ALEXANDRIA, VA assistant practice. Physician assistants are licensed to practice mediAuthor‘s response. In my July cine with physician supervision in “President’s Message,” I refer 19 states, and they are certified to once to physician assistants when do so in 2 1 states and registered to I use them as an example of prodo so in 10 states. fessional, educated, highly skilled DANA R. GRAY, PA-C individuals who are not licensed PRESIDENT-ELECT in many states. It was not my AMERICAN ACADEMYOF intent to suggest that physician assistants are less skilled memPHYSICIAN ASSISTANTS ALEXANDRIA, VA bers of the health care team. ELLEN K. MURPHY n the July “President’s MesRN, JD, CNOR, FMN sage,’’ AORN President Ellen AORN PRESIDENT K. Murphy, RN, JD, CNOR, FAAN, writes that the term unliGLUTARALDEHYDE censed assistive personnel (UAP) read “Clinical Issues’’ in the may be used too loosely by some October Journal with exaspernurses. She refers to physician ation. I have observed that assistants as UAP, when, in fact, AORN has avoided addressing the physician assistants are licensed issue of the working temperature by state medical boards or state of activated glutaraldehyde. Now, AORN is directing members to physician assistant boards. use glutaraldehyde for 20 minutes Murphy points out that the for high-level disinfection. issue should not be one of licenAlthough I understand sure but rather the focus should be on appropriately matching qualifi- AORN’s stance and the Association for Professionals in Infection cations and skills to patients’ Control and Epidemiology’s needs. To include medically trained physician assistants in this (APIC’s) rationale, the legal issues involved are legion. I believe debate is to imply that physician assistants are not educated to meet APIC is reviewing its recommendations because they contradict the needs of their patients or that the recommendations of the US they place their patients at risk. Food and Drug Administration Physician assistants and RNs (FDA) and the Centers for Disease must work as a team to provide Control and Prevention. They quality care for their patients. also contradict the recommended A label such as UAP is only a practice of the Association for word, but labels may unjustly the Advancement of Medical characterize your fellow workers. Instrumentation: I urge all your readers to learn more about the education and Disinfecting solutions practice requirements for physi-

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