Physician'S Certification And Borrower'S Acknowledgment Of Obligatio: Fill & Download for Free

The following is a general flow of Medical Heirarchy.1. The Ground ForcesThe bedside workers start with Nursing Assistants, who have a variety of Job Titles including CNA, HA, NAC, etc. These workers generally report to a Registered Nurse (RN) or Nurse Manager. They help with general tasks like hygiene, meals, beds, transport, and other basic necessities.RNs are the ones who make it all work. On a typical unit, they administer meds, conduct physical assessments, insert IVs, educate patients, and often serve as the coordination, communication, and advocacy link between the patient and the larger hospital system. Oh, and they also document everything.2. The Interdisciplinary SpecialtiesThese professionals generally have some form of Master's - level education, and they include Occupational Therapy (OT), Physical Therapy (PT), Respiratory Therapy (RT), Nutrition, and Social Work. These can also be RN's who specialize in Wounds, IVs, Dialysis, and other things.3. Lower Medical TeamMembers of this group are generally Physician's Assistants (PA) or Nurse Practitioners (NP/ARNP/APRN), and almost all have an advanced degree such as a Master of Science in Nursing (MSN), a PA degree, or a Doctorate in Nursing Practice (DNP). In a hospital setting, most of these providers work directly alongside the MDs in providing and prescribing medical care for patients. PAs also often assist MDs in Surgery.In 20 of the 50 states, NPs are allowed full prescriptive authority, allowing them to essentially function as Family Doctors, even having their own independent practice. That said, they require a lower patient load, and are also restricted in a variable set of medications and procedures, depending upon specific state laws.I also know that PAs are allowed a similar authority as NPs in many situations, although I'm not as familiar with the regulations surrounding their practice.4. Upper Medical TeamWith a few exceptions, all members of this group are fully-fledged Medical Doctors (MD). In a teaching hospital, the lowest rank of physician is the Resident, who is a recent Medical School graduate, and is currently training to enter a certain specialty. Residency programs vary by specialty, but generally range from 2-4 years in length.Residents report to the Chief Resident or Fellow, who in turn reports to the Attending Physician.*"MDs feel free to correct me on this specific section - I am not an expert in this area.Common Misconceptions:"Nurses work for the Doctors, who tell them what to do."Uh, no. RNs report to their Charge RN and Nurse Managers. The Nurse Managers in turn report to the Patient Care Director (also a Nurse) for their unit, and these Directors report to the Chief Nursing Officer (CNO) for the hospital. This CNO is an equal member of the Senior Leadership Team. Nurses do not work for, nor can they be fired or hired by, Doctors."Doctors run the show."Physicians are certainly responsible for most of the really pivotal decisions that intimately affect the patient's physiological processes. However, it's important to remember that each specialty is mostly self-governing in its practice. Physical Therapists are not trained by MDs, and most MDs could not simply jump in and do the job of a PT. Obviously they would be better equipped than anyone else to learn how, but you don't see MDs telling the PTs how to do their jobs. The same sentiment applies for Nursing, RT, OT, Nutrition, and Social Work. It takes the whole team working together to make positive patient outcomes.A note on Healthcare overall:There has been a recent shift within the industry to move toward a model of care that focuses more on "Healing" than simple "Curing." Until now, MDs have specialized in the complex physiology implicated in the curing and treatment of disease, and the Nurses have focused on supporting the Person behind the disease. This separation exists for a variety of reasons, most of which are understandable and lack any ill intent. And, lucky for us all, it is beginning to change. Roles are becoming more blurry: Nurses are becoming more physiologically educated, and Physicians are becoming more Person-centered.Also note that this is only to dilineate an overall trend. There have always been personable Doctors who treat patients rather than diseases; and there have always been smart, critically-thinking nurses who provide excellent, evidence-based care.I hope this helps paint a clearer picture of what can often be a complicated and confusing conglomerate of professionals. Healthcare providers aren't perfect, but we're always striving to get better.*sentence edited to correct error