“The differences in roles related to a CRNP, a CNM, and a PA and how each of these roles might impact how you practice as a FNP. Be specific and provide examples.”

  • Write a minimum of 2 paragraph response to EACH of the below two scenarios andprovide additional insight to them separately related to issues and topics we may want to also consider.
  • Use the best available evidence/references from current (Btwn 2017 -2021) literature to support your explanation.

1st Scenario:

There are different roles in the management of obstetrics and gynecological health care. Certified Registered Nurse Practitioners (CRNP), Certified Nurse-Midwives (CNM) and Physician Assistants (PA) can all assist in care for these patients. These providers function in different ways to provide quality care to their patient population. As an FNP we will likely interact with these providers during care of certain patients. They can impact the practice of an FNP and require collaboration. A professional relationship with providers and their attitude towards collaboration can affect the relationship between these specialties (Melkamu, Woldemarian & Haftu, 2020). 

CNM provide primary health care services for women from adolescence beyond menopause. They can provide holistic care to include primary care, gynecologic and family planning services. They cover obstetric care during conception, before during and after pregnancy as well as newborn during the first 28 days of life (ACNM, 2020). These professionals can collaborate with pharmacist in most states to prescribe medications and can collaborate with a specialist if needed. In many states they are consider advanced nursing providers like an FNP or CRNP.

PA work under a physician and depending on the state can have a collaborating physician that is not on site. They care for patients in many ways that are like CRNPs. They have similar practice specialties that include care to patients, managing their needs and performing procedures for them (AAPA, 2021). Many physicians consider the work of PAs and CRNPs as a similar scope of practice. However, in some states CRNPs can provide care independently, whereas this not likely in the PA model. This can lead to animosity between providers in some instances.

2nd Scenario:

A CRNP is a registered nurse who performs physical diagnosis, psycho-social assessment, and management of illness needs. A CNM is a registered nurse who can conduct deliveries and provides supervision, care, and advice for the optimal care of the mother and child. A PA is a state-licensed health professional who works in collaboration with physicians and other providers in tasks such as diagnosing illness, creating treatment plans, and prescribing medication. CRNPs, CNMs, and FNPs are graduate-level registered nurses who cover similar levels of care but hold different roles and scope of practice while PAs are Master’s prepared individual that works interdependently with physicians who are licensed to diagnose and treat illness and disease and to prescribe medication for patients. 

According to Schneider (2021), while CRNPs’ have varying responsibilities depending on the patient population they focus on and the healthcare setting they work in, CNMs often serve as women’s primary care by performing tasks such as delivering babies and handling emergency situations during labor and delivery. Regarding the differences between NPs and PA, according to Gaines (2021), NPs draw from the nursing tradition which includes a whole person and wellness approach while PAs draws from the tradition of medical models to diagnose and treat illnesses. With the overlapping roles of CRNPs, CNMs, PAs, and FNPs, interprofessional communication and collaboration is an essential competency as it improves patient outcomes and safety by discouraging a culture of avoidance and isolation which causes medical errors and decreases patient outcomes. (Martin, 2021)

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