Rekh

Paramedic and Physician Associate in Acute Medicine based in the UK. Views and opinions expressed my own.

[Rekh @RHND_19]

@drabdulhameed07 Spiro to help cut/look lean.

[Rekh @RHND_19]

@joshkimbre @rainie1410 @simontutt88 Best reply I’ve seen for a long time 😂

[Rekh @RHND_19]

@didsburygirl Don’t suppose it’s the same women who threatened to report me for not walking my very thick coated goldie in a heat wave? (I walked her late at night when cooler for her)

[Rekh @RHND_19]

@DEAWlts @ponteepon 🤯 why would they not at least discuss their plans with a consultant? That’s crazy.

[Rekh @RHND_19]

@DEAWlts @ponteepon I like to think that if a PA does a ward they would at the absolute bare minimum discuss and go through the notes of every patient they’ve seen with a consultant? If PAs aren’t doing that, then that’s clearly inappropriate and not for anyone else to do but the cons.

[Rekh @RHND_19]

@DEAWlts @ponteepon Guess it depends on the support needed I suppose. I would think it’s entirely appropriate to escalate say a difficult cannula to the SHO or something simple like a paracetamol px. Same as how a nurse would. If a PAs thinking of changing a plan etc. then that should go thru cons?

[Rekh @RHND_19]

@DEAWlts @ponteepon I’ve not experienced anywhere else I must say 🤷‍♂️. I know they’ve all come from different backgrounds. Once had MRCS and one MRCGP.

[Rekh @RHND_19]

@DEAWlts @ponteepon Kinda agree - but then you have rota mis-matches due to consultant SPA time, AL etc. I work with one dedicated CS, but my daily assigned consultant supervisor changes depending on who’s working where. Before they do, they are asked to make sure they are happy too.

[Rekh @RHND_19]

@DEAWlts @ponteepon Yeah I know what you meant. Of the 5 sprs currently in my team only three have completed the three parts of MRCP. Used to be 4/5 until very recently.

[Rekh @RHND_19]

@DEAWlts @ponteepon This is the big problem - if PAs stuck to reasonable roles we wouldn’t have this problems we’re in now.

Don’t forget that PAs are there to make consultants life easier, as opposed to residents. This is why you get some cons pushing the scope so much.

[Rekh @RHND_19]

@DEAWlts @ponteepon I don’t know where you’ve worked, however the majority of the med sprs I work with do not have MRCP. And I’ve certainlly worked with a lot of consultants not on the specialist register.

And yes of course I do. There’s clear limits for what PAs should be doing.

[Rekh @RHND_19]

@DEAWlts @ponteepon I take your point, but you don’t need to be on the specialist register to work as a consultant and you don’t need to MRCP to work as a med reg. These are all things worked on based on individual scope.

[Rekh @RHND_19]

@OTLHENAC @SaraTon08500527 @DrSharandeep @RCPhysicians Scope is an individual thing. Ceiling is the maximum scope for a professional group. It’s likely that a newly qualified clinicians scope is the well under the ceiling for their profession.

[Rekh @RHND_19]

@Microbedoc2 I’d agree if they did another referendum on rejoining rhe EU at the same time.

[Rekh @RHND_19]

@andymoz78 When about in the case of allergy to all neuromuscular blocking agents?

[Rekh @RHND_19]

@iDrSunny @gmcuk I’m certain there is massive variation - but my point is to choose PAs specifically doesnt address this issue. Certainly most the of ionising requests going on in secondary care by PAs I suspect will be off the back of a senior plan.

[Rekh @RHND_19]

@Ask_foradoctor True - but you could argue the same for nurses for example. When registered they legally can, but who can order what for a specific indication is governed by local scope.

[Rekh @RHND_19]

@Ask_foradoctor I don’t think the GMC has authorised anything with regards to ionising radiation. Just by virtue of being regulated, PAs then fulfil the IRMER requirements to be able to request.

[Rekh @RHND_19]

@doctor_dru_ 🤦‍♂️