Working with Physician Assistants

I’m working in an Emergency Department that is introducing physician assistants. What do I need to consider when working with physician assistants?

Physician assistants (PAs) are health professionals who provide medical services under the supervision of a physician. The supervising physician is defined in Nova Scotia Health policy as a physician working for Nova Scotia Health who is a legally qualified medical practitioner with good standing; one who has been designated as the physician who will oversee the physician assistant and allow them to practice under their license. PAs are accountable for their actions (which include inactions) and the decisions they make to their employer through a scope of employment, rather than a regulatory body. The PA’s scope of employment is defined by their role description, their competencies, the supervising physician’s area of practice, and the policies governing the practice setting. Examples of duties that a PA may perform include conducting patient interviews and taking medical histories, performing physical exams, documenting consults, helping to arrange other service consults, conducting or assisting in procedures and prescribing medication from a defined policy list.

Physician assistants are not authorized prescribers, rather they are granted the authority to prescribe a defined list of medications and interventions under the supervising physicians license under NSH policy.  

Nurses should consider the following when working with physician assistants;

  • Nurses should be knowledgeable of the PAs competencies and scope of employment as defined in policy so they are aware of what types of interventions and medications the PA is authorized to order.
  • Nurses can accept and implement an order from a PA for interventions or medication that is within the PAs competencies and scope of employment as defined in policy.
  • Nurses are required to have the knowledge, skills and judgment to;
    • Determine that each intervention or medication order is clear, accurate, current and complete; and take appropriate action if clarification is needed
    • Assess the appropriateness of an intervention or medication for a client
    • Discuss concerns about an intervention or medication orders with the appropriate interprofessional team member which could include the PA, the supervising physician or the unit manager.

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