@pitdakota The C in CRNP is Certified, so title is Certified Registered Nurse Practitioner.
Back when I was a graduate nurse, I worked on a monitored Thoracic Surgery Unit. We had a CRNP who, along with the Intern, managed the care of our patients. She was able to write orders for patient care and the nurses were allowed to carry out her orders. After she left our service for a steady hours job in the ER, a PA was hired.
We were NOT allowed to carry out her orders. At that time,everything she wrote had to be co-signed by a physician. It made patient care rough. It was almost pointless to have her there. Thank goodness Pennsylvania changed it's rules regarding who can write orders.
I've had the opportunity to work with both good and not so good CRNP's and PA's. I've also been under the care of good and average CRNP's and PA's. When I had major shoulder surgery, I was seen post operatively by the PA for the first 3 visits. She was very nice, but my complaints of continued pain were dismissed as part of the healing process and I was told to focus on how much my range of motion had improved. Yes, it had, but I knew something wasn't right.
When I finally saw my actual surgeon on the 4th visit, he came into the room and declared that, after reading her notes, I look, feel, and am doing amazingly well. The former RN in me decided to set the record straight. First, I told him to never come into a room and declare that someone is doing amazingly well if you haven't spoken to the patient or examined the patient. I said ask the patient how they think they are doing, vs just declaring his opinion. Then I informed him of my issues and told him that I wasn't leaving his office until I had a script for a new MRI because something wasn't right. I wasn't asking for pain meds, I just knew my recovery was "off". Turns out I developed bursitis in a different bursa than the one they removed. I received a steroid injection and my recovery progressed well afterwards.
In hindsight, I should have informed the PA that I wanted to see my surgeon by the second visit, not fourth. After having words with my surgeon, he informed that no one had ever told him not to speak like that to a patient. After that, we got along beautifully. During my shoulder recovery, I developed a knee effusion. He gave me the option to treat it or have an MRI. When we discussed everything, one of the residents was in the room. I voted for the MRI because I am a big fan of knowing what Is going on before haphazardly treating something. He told that resident, she is a nurse and an informed decision maker. Write her out the script for the MRI.
Sometimes it's the squeaky wheel that gets the grease. As a patient, you have to advocate for yourself. Sometimes people think doctors are gods and would never question them. I say, if it something doesn't feel right, speak up.
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