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Heart care team includes nurse practitioners and physician assistants

Thomas Antonini, MPA, RPA-C

Physician assistant Thomas Antonini.


One white coat can begin to look like the next, even with nametags that spell out NURSE PRACTITIONER or PHYSICIAN ASSISTANT. The health professionals who hold those positions at Upstate often explain themselves to patients.

“By the time they leave, they know who we are and what roles we play,” says Jennifer Helmer, the nurse practitioner who supervises the mid-level practitioners in the hospital‘s cardiovascular services.

She and her NP and physician assistant colleagues staff the floors around the clock, where patients await and recover from heart surgery. They provide pre-operative and post-operative care, conduct physical exams, obtain medical histories, diagnose and treat illness, order and interpret tests and manage medications. They also see patients who return for followup appointments in the offices at 550 Harrison St.

PAs assist the surgeons during operations, removing a vein from the patient‘s arm or leg that will be used for bypasses, or assisting in opening the chest to gain access to the heart.  “It‘s a team effort,” explains Thomas Antonini, a PA since 1984.

Gregory Fink MD, Upstate‘s chief of cardiac surgery, says the PAs and NPs collaborate well with the doctors and nurses and technicians. “They‘re very personable and know what they‘re doing. I get very good response from the patients about them.”

Helmer says the NPs teach patients what they need to know about their condition before they go home from the hospital – and they field phone calls at all hours.  “We‘re their point person.”


Both professions were born in the mid-1960s to answer the shortage of primary care physicians.

The first NP class started in 1965 at the University of Colorado, and the early curriculums focused on health promotion, disease prevention, and the health of children and families. Today the Nurse Practitioner Healthcare Foundation reports more than 147,000 NPs.

The first PA students – former Navy corpsmen – graduated in 1967 from Duke University, from a program modeled after the fast-track training of doctors during World War II. Today there are more than 81,000 PAs, according to the American Academy of Physician Assistants.

Both are licensed by New York State, NPs through the Department of Education and PAs through the Department of Health.  Upstate provides training in both professions.

The College of Nursing offers nurse practitioner training in the specialties of pediatrics, family practice and family psychiatric mental health. The College of Health Professions offers a physician assistant program that includes 15 months of classroom learning and 12 months of preceptorships.
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