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If you are not yet an NP, you may not even know that nurse practitioners and physician assistants are often referred to as “mid-levels”.  While some NP’s and PA’s are offended by this term as they mistake it to mean they provide a mediocre quality of care, at MidlevelU we have a much different take on the word.  Here at MidlevelU, we believe there is nothing degrading about the term at all.  In fact, it is very appropriate in the following major ways:

1. In the hospital or clinic setting when a patient more complicated than the NP feels comfortable handling comes in, the NP or PA asks a physician for help, or the patient just goes straight to the physician.  That said, an NP or PA performs far more functions than a nurse.  In other words, when it comes to acuity of work, NP’s and PA’s fall in the middle between the nurse’s level and the physician’s.
2. Personally, I considered going to medical school to become a physician , but considering the length of time in school and the cost, ended up deciding it was not for me.  That said, I wanted to do more than be a nurse.  I chose something in the middle.
The above is true not only for myself, but for the vast majority of the other nurse practitioners I know.  
When it comes to the quality of care I deliver, I believe I deliver an incredibly high level of care — within the scope of care that I have chosen to specialize in, which is that of a nurse practitioner.  I do not intend for the term “midlevel” to refer to the standard of care NP’s deliver.  

I think we should embrace the term as reflecting the schooling we chose to pursue (more than a nurse, less than a doctor), and our role in a clinical environment when it comes to dealing with varying levels of acuity (more than a nurse, less than a doctor).  These things are factual.  And, if we go ahead and own the term ourselves and embrace it, then we can define what it means and move on.

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One thought on “Should You Be Offended By the Term Midlevel?”

  • M. Pappas MS, APRN, FNP-BC says:

    Completely disagree. My licence says “advanced”, not “mid” anything. The term is completely confusing to the public, who should who we are specifically: nurse practitioners. I found this blog accidentally, and hope you reconsider the name, both for your profession, and for the sake of your patients.

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