Advanced Practice Provider Roles

Physician assistant

A Physician Assistant (PA) is a health care professional who is licensed to practice medicine in collaboration with their supervising physician. Physician assistants are committed to personalized, high quality health care and are held to the same legal and ethical standards of care as physicians.

Stanford Hospital & Clinics (SHC), PAs serve adults and families in an extensive range of practice settings throughout the medical center. They are involved as adult healthcare providers for acute, chronic and critically ill adults in both primary care and specialty settings. Physicians delegate duties to PAs, and within those range of duties, PAs use autonomous decision-making for patient care.

This team model is an efficient way to provide high-quality medical care.

Physician assistants may:

  • Obtain health history and conducts physical exams.
  • Diagnose and treat medical problems.
  • Dispense and manage medications and other treatments (e.g. physical therapy).
  • Order and interpret diagnostic (e.g. X-rays, CT scans) and laboratory tests.
  • Educate and counsel individuals, families and groups on health behaviors, self-care skills, and treatment options.
  • Refer patients to other health professionals as needed.
  • Work collaboratively with primary care and specialty practice physicians.
  • Provide primary and specialty care services.
  • Provide care for patients in acute and critical care settings.
  • Assist with surgery.
  • Perform minor surgeries and procedures (e.g., dermatological biopsies, suturing, casting, lumbar puncture, bone marrow biopsy, paracentesis).

Nurse practitioner (NP)

A Nurse Practitioner (NP) is a health care professional who is licensed to practice medicine in collaboration with a supervising physician. Nurse practitioners are committed to personalized, high quality health care and are held to the same legal and ethical standards of care as physicians.

Stanford Hospital & Clinics (SHC), NPs serve adults and families in an extensive range of practice settings throughout the medical center. They are adult healthcare providers for acute, chronic and critically ill adults in both primary care and specialty settings. Physicians delegate duties to nurse practitioners, and within those range of duties, NPs use autonomous decision making for patient care.

This team model is an efficient way to provide high-quality medical care.

Nurse practitioners may:

  • Obtain health history and conduct physical exams.
  • Diagnose and treat medical problems.
  • Prescribe medications and other treatments (e.g. physical therapy).
  • Order and interpret diagnostic (e.g. X-rays, CT scans) and laboratory tests.
  • Educate and counsel individuals, families and groups on health behaviors, and treatment options.
  • Refer patients to other health professionals as needed.
  • Work collaboratively with primary care and specialty practice physicians.
  • Provide primary and specialty care services.
  • Provide care for patients in acute and critical care settings.
  • Assist with surgery.
  • Perform minor surgeries and procedures (e.g., dermatological biopsies, suturing, casting, lumbar puncture, bone marrow biopsy, paracentesis).

Certified Registered Nurse Anesthetist (CRNA)

Certified Registered Nurse Anesthetists (CRNAs) are Advanced Practice Nurses who safely provide more than 32 million anesthetics for surgical, obstetrical and trauma care each year in the United States. They administer every type of anesthetic to patients, work in every type of practice setting, and provide care for every type of operation or procedure – from open heart surgery to pain management programs.

At Stanford Hospital & Clinics (SHC), CRNAs provide anesthesia and anesthesia-related care services upon request, assignment, and referral by the patient’s physician most often to facilitate diagnostic, therapeutic and surgical procedures. The scope of practice includes, but is not limited to, the following:

Pre-anesthetic preparation and evaluation of the patient:

  • Obtaining an appropriate health history.
  • Conducting an appropriate physical screening assessment.
  • Recommending or requesting pertinent diagnostic studies and evaluating the results.
  • Selecting, obtaining, ordering, and administering pre-anesthetic medications.
  • Documenting the pre-anesthetic evaluation and obtaining a comprehensive informed consent for anesthesia and related services.

Intraoperative care

  • Obtaining, preparing, and using all equipment, monitors, supplies and drugs used for the administration of anesthesia and sedation techniques; performing and ordering safety checks as needed.
  • Selecting, obtaining or administering the anesthetics, adjuvant drugs, accessory drugs, fluids and blood products necessary to manage the anesthetic.
  • Performing all aspects of airway management, including fiber optic intubation.
  • Performing and managing regional anesthetic techniques including, but not limited to, subarachnoid, epidural and caudal blocks; plexus, major and peripheral nerve blocks; intra-venous regional anesthesia; transtracheal, topical and local infiltration blocks; intracapsular, intercostal and ocular blocks.
  • Providing appropriate invasive and noninvasive monitoring modalities using current standards and techniques.
  • Recognizing abnormal patient response during anesthesia, selecting and implementing corrective action and requesting consultation whenever necessary.
  • Evaluating patient response during emergence from anesthesia.

Clinical nurse specialist (CNS)

The Clinical Nurse Specialist (CNS) possesses specialty knowledge and experience in their area of expertise. Their focus is to collaborate with members of the health care team to enhance patient care by developing and supporting nursing staff and intervening with patients within an identified specialty.

Through the roles of expert clinician, interdisciplinary consultant, educator, researcher, and leadership, Clinical Nurse Specialists:

  • Direct specialty knowledge and skill acquisition.
  • Shape core competencies of clinical practice.
  • Promote evidence-based outcome-guided nursing care.
  • Integrate quality patient care across SHC practice sites.
  • Promote an environment of mentoring and system changes that empower the nurse to experience professional growth and development.