DNP or Resident

[SDN9876]

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[Therapist4Chnge]

This is essentially the issue. Everyone wants to be a "Dr." when in fact I firmly still believe that only people who do a vigorous residency and go through medical training should be called Dr's.

That is all well and good, but the term "Dr." originated in academia and was later adopted by physicians, and not the other way around.

 

[wrx04silver]

It is unclear to me why this continues to even be a debatable subject. Nurses are not trained in the pathophysiology of disease, and as such, cannot be expected to function independently in a medical practice that requires this basic knowledge to make decisions safely and reasonably. One of the reason nurses get upset with physicians for ordering X test at Y hour, requesting X medicine at Y intervals, and not allowing them to give boat loads of ativan to the elderly (because the patient is agitated) illustrates the difference between the two professions; that is, they simply don't understand the thought process of the physician, best said in the words of my past chief resident: Doctor's fly the plane, nurses serve the coffee. Nurses are good at doing what they do, they just don't know why they do it. A young doctor, an intern for instance, may not know how to do something (often drawing the ire of seasoned nurses), but he/she knows why they they want something done, and why they don't want something done, and this is the difference between the two.

 

[core0]

Let's not forget that Registered Nurses are very protective of the title of "nurse" even though it's not a protected title. The RN's prevent the LPN's from using the "nurse" title even though the LPN's perform many of the traditional duties of nursing. In fact, at most places, LPN's can't wear the traditional all white nurse uniform.

So this claim that nursing is not about titles is rather stupid. We all know how important titles are to nurses and their inferiority complexes.

I don't think that any state prohibits an LPN/LVN from using the title nurse. The issue is protecting a title that at least in public perception means the one that takes care of them. Here is a summary of states where nurse is a protected title:
http://nursingworld.org/mainmenucat...tate/StateLegislativeAgenda/TitleNurse_1.aspx

This is the part I like:
"The intent of restricting use of the title "nurse" is to protect the public from individuals who are not licensed nurses, yet deceitfully lead the public to believe they are and able to provide services that only nurses are qualified to provide."

David Carpenter, PA-C

 

[Taurus]

"The intent of restricting use of the title "nurse" is to protect the public from individuals who are not licensed nurses, yet deceitfully lead the public to believe they are and able to provide services that only nurses are qualified to provide."

Yet, the nurses have no trouble wearing long white coats and calling themselves "doctor". In fact, they feel entitled to it. The level of hypocrisy from nursing is stunning.

 

[foreverLaur]

IMO, someone has an inferiority complex if they feel the NEED to be called doctor.

I did psych research for a few quarters and got reprimanded for almost 30 minutes because I referred to one of the researchers by her first name instead of Dr. XxxX. I was told I was being extremely rude by not acknowledging her title. She was the only one out of seven that REQUIRED you to call her by Dr. XxXX and nothing else and got very angry at any other title she deemed "sub par".

 

[fab4fan]

Let's not forget that Registered Nurses are very protective of the title of "nurse" even though it's not a protected title. The RN's prevent the LPN's from using the "nurse" title even though the LPN's perform many of the traditional duties of nursing. In fact, at most places, LPN's can't wear the traditional all white nurse uniform.

So this claim that nursing is not about titles is rather stupid. We all know how important titles are to nurses and their inferiority complexes.

RNs do not prevent LPNs from using the title "nurse." LPNs have a license to practice nursing. Medical assistants, CNAs, etc., do not; many doctors employ them in their offices and try to fob them off to unsuspecting patients as licensed nurses. RNs and LPNs object to this, just as physicians object to those who they see as "pretenders to the throne."

Get your facts straight, Taurus...please. I mean, I know you've got some "nurse hate" issues, but it's not that hard to get the basics right.

 

[fab4fan]

IMO, someone has an inferiority complex if they feel the NEED to be called doctor.

I did psych research for a few quarters and got reprimanded for almost 30 minutes because I referred to one of the researchers by her first name instead of Dr. XxxX. I was told I was being extremely rude by not acknowledging her title. She was the only one out of seven that REQUIRED you to call her by Dr. XxXX and nothing else and got very angry at any other title she deemed "sub par".

Your problem was that you assumed she would appreciated being on familiar terms with you. This is completely inappropriate, particularly with someone who is older and has more authority than you.

Learn that lesson now. Not everyone is going to want to be your BFF.

 

[Therapist4Chnge]

Maybe the problem is that you didn't use any title whatsoever, prefering instead to refer to her by her first name, which is completely inappropriate.

It is never appropriate for a student to refer to a professor or other superior/instructor by their first name. The error here was yours.

+1

It is one thing if a superior/mentor/professor tells you it is okay to call them by their first name, but for you to assume that it is okay is disrespectful.

 

[jbar]

+1

It is one thing if a superior/mentor/professor tells you it is okay to call them by their first name, but for you to assume that it is okay is disrespectful.

It kills me that the fellows I work with talk about the attendings by their first name. Not because it is inappropriate for them, but if they just spent 20 minutes talking about what "Jeff" wants it makes it too easy for me to say Jeff when I mean Dr. So and So, especially when I'm new on the rotation and don't know the last name of whomever they are talking about.

sigh.

 

[Farmer Jane]

RNs do not prevent LPNs from using the title "nurse." LPNs have a license to practice nursing. Medical assistants, CNAs, etc., do not; many doctors employ them in their offices and try to fob them off to unsuspecting patients as licensed nurses. RNs and LPNs object to this, just as physicians object to those who they see as "pretenders to the throne."

Get your facts straight, Taurus...please. I mean, I know you've got some "nurse hate" issues, but it's not that hard to get the basics right.

Yes. I happen to agree with Taurus on many issues, but LPNs not being allowed to call themselves nurses or wear white? That's just bizarre.

 

[prairiedog]

Yes. I happen to agree with Taurus on many issues, but LPNs not being allowed to call themselves nurses or wear white? That's just bizarre.

For a nurse to agree with "Dr" taurus on many issues is scary. He is an expert in nurse agony and blame

 

[foreverLaur]

First off, there is a difference in calling a physician by their first name and a coworker by their first name. I came from the business sector and we referred to everyone employed by the same company by their first name. I worked with a partner of E&Y and we even called him by his first name.

Plus, the woman who gave me a tour said everyone is friendly and on a first name basis. After I got lit into about the Dr. Xxxx thing, she later came up and apologized for forgetting to tell me that particular person was very picky about her title. She won't even let you call her Mrs. Xxxx. It HAD TO BE Dr. Xxxx. Nothing else was acceptable.

And finally - it isn't about the first name. I am okay with first name, Miss whatever or Mrs whatever or Mr whatever... It is about being demanded to be called doctor. I don't care if I have 12 PhDs and I am a MD. My name is still Lauren. Just because I have attained a certain level of education doesn't mean I am going to force people to constantly acknolwedge it. IMO, that is an inferiority complex (we discussed it in a psych class and it was one of the few things I really believed). You don't have to agree... was just stating an opinon.

 

[jbar]

It is simply a matter of social norms. We live in a society where most doctors and most people expect that when addressing a physician you call them Dr. X unless they have said that you can call them Y. I think most doctors would be upset if you called them Ms./Mr. in a clinical setting, many would take it that as either a sign that 1) you didn't know they were a physician, or 2) you know and are choosing to violate that norm.
Different societies have different norms. In England surgeons expect to be called Mr., they would probably prefer not to be called Dr. I would also point out that you should generally call people by however they introduce themselves. If someone says my name is Joe call them Joe, if they say their are doctor Smith, well, they expect to be called doctor Smith.

You don't have to agree with it, but like any social norm you have to be ready to accept the consequences of violating it. Whether it be a bad eval, a nasty look, or an uncomfortable moment. Some people may not notice, some might just let it go. But that is a risk you take when violating a social norm.

Same goes for public nudity, obscene language, playing loud music, etc. You can do what you like, but others who don't like it are going to let you know in a hurry.

I would also point out that it is strange that people have latched on to the Dr. thing as evidence that physicians have some sort of complex. We live in a society full of titles. In court judges are "your honor," cops are "officer X," college teachers are "professor Y," etc. No ones says professors have a complex. And see what happens when you call a judge by their first name.

These titles have a purpose, they define people's roles and their relationships with other people. I may be friendly with my patients, but I don't consider them friends. I respect my patients, and either ask them how they prefer to be called or call them by their last name. Our relationship is defined by a set of professional boundaries. You don't ask your patients on dates, or invite them over to your house. Being called doctor is part of that professionalism because at the end of the day when you are consulting someone about surgery you aren't looking for a buddy, you are looking for a professional who you can trust.

Are there patients I would let call me by my first name? Sure. But I would be just as pissed if they did it without asking as I would expect them to be if I called them by their first name. That is a decision we make for ourselves. Calling someone Mr. Smith instead of Doctor Smith in a clinical setting is just going out of your way to be rude.

Now all that aside the question of how to refer to people outside of the hospital is a whole other matter. Should doctors expect to be called doctor when they are checking into a hotel? I think there is more room for debate on that one.

 

[fab4fan]

First off, there is a difference in calling a physician by their first name and a coworker by their first name. I came from the business sector and we referred to everyone employed by the same company by their first name. I worked with a partner of E&Y and we even called him by his first name.

Plus, the woman who gave me a tour said everyone is friendly and on a first name basis. After I got lit into about the Dr. Xxxx thing, she later came up and apologized for forgetting to tell me that particular person was very picky about her title. She won't even let you call her Mrs. Xxxx. It HAD TO BE Dr. Xxxx. Nothing else was acceptable.

And finally - it isn't about the first name. I am okay with first name, Miss whatever or Mrs whatever or Mr whatever... It is about being demanded to be called doctor. I don't care if I have 12 PhDs and I am a MD. My name is still Lauren. Just because I have attained a certain level of education doesn't mean I am going to force people to constantly acknolwedge it. IMO, that is an inferiority complex (we discussed it in a psych class and it was one of the few things I really believed). You don't have to agree... was just stating an opinon.

Why is it you can never accept that you could have been wrong in a particular situation?

 

[silas2642]

First off, there is a difference in calling a physician by their first name and a coworker by their first name. I came from the business sector and we referred to everyone employed by the same company by their first name. I worked with a partner of E&Y and we even called him by his first name.

Plus, the woman who gave me a tour said everyone is friendly and on a first name basis. After I got lit into about the Dr. Xxxx thing, she later came up and apologized for forgetting to tell me that particular person was very picky about her title. She won't even let you call her Mrs. Xxxx. It HAD TO BE Dr. Xxxx. Nothing else was acceptable.

And finally - it isn't about the first name. I am okay with first name, Miss whatever or Mrs whatever or Mr whatever... It is about being demanded to be called doctor. I don't care if I have 12 PhDs and I am a MD. My name is still Lauren. Just because I have attained a certain level of education doesn't mean I am going to force people to constantly acknolwedge it. IMO, that is an inferiority complex (we discussed it in a psych class and it was one of the few things I really believed). You don't have to agree... was just stating an opinon.

But she wasn't your colleague-- you were the student and she was your superior. It was inappropriate for you to refer to her by her first name. You need to refer to her as "Dr." or "Professor" unless she indicated that she preferred you to call her otherwise. If it was in a clinical setting with patients, I would have referred to her as "Professor," and if it was in a non-clinical setting, I probably would have referred to her as "Dr."

 

[foreverLaur]

This is not a matter of right or wrong. Just an opinion on something I have seen in a lot of cases and my opinion on the matter.

She was not my boss. She was a post-doctoral individual during research under the senior researchers, just as I was. She was clearly more educated than us, but she didn't need to rub that in our face. She even demanded that the senior researchers refer to her by Dr. Xxx ONLY. She'd even snap at her boss if they called her by her first name.

And this is a completely different situation than a physician. I'm talking about people in general who demand to be called Dr. Xxx in a regular every day setting (outside of the work environment).

 

[fab4fan]

But this wasn't a coworker, was it? You were a student doing research. The person in question was a senior researcher. You were in a subordinate relationship to this person, and you called her by your first name. You can't really think that was appropriate, can you?

Regardless of what you would do in a similar situation, appropriate manner of address is taught to children from the moment they learn to talk. You can't really have been ignorant of this social norm. I mean, if I were a hot chick, I would totally let every dude feel up on my boobs. But that doesn't mean I walk around grabbing tit without asking first.

When you come back from a post absence, you really do come back, don't you?

 

[fab4fan]

This is not a matter of right or wrong. Just an opinion on something I have seen in a lot of cases and my opinion on the matter.

She was not my boss. She was a post-doctoral individual during research under the senior researchers, just as I was. She was clearly more educated than us, but she didn't need to rub that in our face. She even demanded that the senior researchers refer to her by Dr. Xxx ONLY. She'd even snap at her boss if they called her by her first name.

And this is a completely different situation than a physician. I'm talking about people in general who demand to be called Dr. Xxx in a regular every day setting (outside of the work environment).

You see? Now here was an opportunity where you could have simply said, "You know, you've given me something to think about" and let it drop instead of continuing to try to justify your actions. This is going to get you in trouble in the clinical setting down the road.

 

[silas2642]

You see? Now here was an opportunity where you could have simply said, "You know, you've given me something to think about" and let it drop instead of continuing to try to justify your actions. This is going to get you in trouble in the clinical setting down the road.

I think she has a difficult time being wrong, eh?

 

[fab4fan]

This has been discussed at length before, but she just refuses to accept criticism without trying to explain her side. Part of getting through any medical training is learning how to say "Thanks, I never thought of it that way" even when you know you were right. You need to learn how to be a diplomat. You learn to accept others for where they are, quirks and all.

 

[zenman]

It is unclear to me why this continues to even be a debatable subject. Nurses are not trained in the pathophysiology of disease, and as such, cannot be expected to function independently in a medical practice that requires this basic knowledge to make decisions safely and reasonably.

Let's keep it honest. Any NP is going to study pathophysiology. I not only did that but also psychopathology. In fact I took two psychopathology courses because one also had a focus on treatment. Granted they are not as indepth as what a physician studies, but you can't say we don't crack the book. Right now I'm plowing through Stahl's Essential Psychopharmacology and guess what? I remember seeing lysosomes, mitochondrion, Golgi apparatus, and rough endoplasmic reticulum before. I do like all the cartoons and graphics in the book though as I'm a visual learning

When I become an np, I do not intend to step on anyones' toes by invading your knowledge realm. I hated chemistry and I'd puke if I had to open a biochem book. You can have it. I've already reached the epitome of healing anyway as a shaman. And, unlike Taurus, I don't care if you join me.

As a nurse, I don't care what Taurus does. He will someday learn that defending takes a lot less energy than fighting. He can do all he wants in his own little world, ie, not hire an np, but he is pissing in the wind if he thinks he can stop this train. Doctors lost it long ago when 75% or so of the population started going to alternative practitioners. Now, instead of killing the alternative guys, you need to figure out why your customers went elsewhere. Simple actually.

Personally I don't give a whit about the DNP. I do however, wish np programs had more appropriate course work...like the one I'm in

 

[fab4fan]

Yeah, I was extra proud of that last line.

Sad thing is that I gotta bail again in a few days, and won't be back until Winter. Oh well, c'est somethingsomething.

Well, you'll be missed. I was kind of worried about you. I even pm'd a mod. inquiring as to your whereabouts; I thought you were banned or something. Glad you're OK.

 

[fab4fan]

Nah, no ban yet (though you know it'll happen someday).

I was at a training exercise in the desert with no internet access for a month and a half, and now I gotta go deploy until late October. Doubt I'll be posting from there (I'm pretty paranoid about posting on here from a military network). But I'll be back.

I didn't see a line through your name so I figured you weren't banned, but I wasn't absolutely certain.

Be careful out there, OK?

 

[fab4fan]

This one will be cake.

The next one will be a little more dangerous (and hopefully much more interesting).

As if the hospital world isn't dangerous enough!

 

[zenman]

You sure about that? Because having looked at a lot of curriculum, I don't see it.

You sure you're not the exception, rather than the rule?

No, I looked at 10 different FNP programs and they all have pathophysiology.

I am however, the exception to many rules

 

[foreverLaur]

Maybe you should try not instantly jumping to incorrect conclusions so I don't feel the need to further explain myself.

I find it quite amazing that you can make a judge of character off an Internet forum. I'm pretty sure you could spend an entire day working side by side with me and you'd never know it was me. I was volunteer of the month at the hospital I volunteer at and I'm loving all the learning I've been doing with my PCA orientation I just started.

I simply stated that I personally believe someone has an inferiority complex when they force people to call them by Dr. Xxxx ONLY in and out of the academic/clinical setting. In my particular case, she required this title of her coworkers and bosses. A few of the people in the lab had gone out with her for drinks after work and she introduces herself as Dr. Xxx and likes to be called by that name ONLY even when out in a casual after work setting. Found that weird, and I believe she must have some sort of inferiority complex to be that anal about her title. I'm pretty sure that isn't reflective on how I am doing in my medical training.

I'll admit I am relatively opinionated and stubborn. However, I love to learn and hear other people's opinions, stories, and thoughts. It doesn't mean I'll change my opinions, but it is still a great way to learn and I'm always willing to listen and absorb. Learning is a lifetime process.

 

[bradt9881]

Nah, no ban yet (though you know it'll happen someday).

I was at a training exercise in the desert with no internet access for a month and a half, and now I gotta go deploy until late October. Doubt I'll be posting from there (I'm pretty paranoid about posting on here from a military network). But I'll be back.

Be safe; its a lot rougher now than when I did my desert duty in Saudi in 1991, 1993, and Kuwait in 1995-1996.

 

[maceo]

This is not a matter of right or wrong. Just an opinion on something I have seen in a lot of cases and my opinion on the matter.

She was not my boss. She was a post-doctoral individual during research under the senior researchers, just as I was. She was clearly more educated than us, but she didn't need to rub that in our face. She even demanded that the senior researchers refer to her by Dr. Xxx ONLY. She'd even snap at her boss if they called her by her first name.

And this is a completely different situation than a physician. I'm talking about people in general who demand to be called Dr. Xxx in a regular every day setting (outside of the work environment).

call her doctor and move on. Whats the problem? you made an error. you may not have been wrong though. get over it. move on. you will face many more problems in your career. trust me.

 

[maceo]

Maybe you should try not instantly jumping to incorrect conclusions so I don't feel the need to further explain myself.

I find it quite amazing that you can make a judge of character off an Internet forum. I'm pretty sure you could spend an entire day working side by side with me and you'd never know it was me. I was volunteer of the month at the hospital I volunteer at and I'm loving all the learning I've been doing with my PCA orientation I just started.

I simply stated that I personally believe someone has an inferiority complex when they force people to call them by Dr. Xxxx ONLY in and out of the academic/clinical setting. In my particular case, she required this title of her coworkers and bosses. A few of the people in the lab had gone out with her for drinks after work and she introduces herself as Dr. Xxx and likes to be called by that name ONLY even when out in a casual after work setting. Found that weird, and I believe she must have some sort of inferiority complex to be that anal about her title. I'm pretty sure that isn't reflective on how I am doing in my medical training.

I'll admit I am relatively opinionated and stubborn. However, I love to learn and hear other people's opinions, stories, and thoughts. It doesn't mean I'll change my opinions, but it is still a great way to learn and I'm always willing to listen and absorb. Learning is a lifetime process.

Lauren, baby, are you going to try to diagnose every single person that ticks you off? If you are, you are going to go to the loonie bin yourself. because it will drive you crazy. LIsten, call her doctor and move on. If you dont like it, dont go out for beers with her and dont associate with her.

 

[foreverLaur]

Lauren, baby, are you going to try to diagnose every single person that ticks you off? If you are, you are going to go to the loonie bin yourself. because it will drive you crazy. LIsten, call her doctor and move on. If you dont like it, dont go out for beers with her and dont associate with her.

And yet you turn right back around and diagnose me. Ironic. It didn't tick me off that she demanded to be called doctor 24/7. I was just stating an opinion on the topic of the whole doctor title thing... about people who feel the need to rub their title in your face because they have earned a doctorate degree. It wasn't supposed to be anything... until people on this forum decided to make it something.

I no longer work there. I earned the max amount of research credit towards my degree and I don't particularly care for psych or psych research. I was just making personal assumptions as to why someone would feel the need to do that. They may be right or they may be wrong, but I don't particularly care because it doesn't matter. I'll call 'em whatever they feel like being called.

 

[Farmer Jane]

Take care, Tired.

 

[bradt9881]

No way. The insurgency is dead. We're going to sit on an AF base for seven months then head home. I'm going to be incredibly safe and ridiculously bored.

Saudi in '91 means you probably made the initial push on Kuwait for Desert Storm, right? I'd give my left *** to have zoomed across the desert after the Republican Guard back then.

Afghanistan better still be rolling when I hit my next cycle in a year or so . . .

I was Air Force too (1983-2003). As an Independent Duty Medical Technician, I was in the rear at Kobhar Towers assisting the flight surgeons with taking care of the troops. Very very safe other than the scud attack problem. Our pilots, however, did a fantastic job of battering the Iraqi postions in preparation for the ground assault....

 

[foreverLaur]

relatively? no. it's more like clearly, accurately, and precisely.

You're wrong, so there isn't a discussion or argument here.

I say relatively, because you have no idea what I am like in person. It is much easier to rant/rave and such when you are on an anonymous online forum. In person, I am relatively quiet, shy, reserved, and very easy going.

Oh and personal opinions aren't right or wrong. They are simply opinions and I am entitled to my own. She has every right to demand to be called doctor in any setting she desires and I will oblige. Doesn't mean I can't theorize as to why she feels the need to do so, especially out of the academic/clinical setting.

It would have been wrong if I would have addressed her as "Hey Jane*!" on my first day on the job to my boss or someone with a higher level of education. However, she was introduced as a coworker and I was told that everyone was on a casual first time basis. I wasn't expecting the backlash I had received. If I had known that she required Dr. Jane*, I would have addressed her as so from day 1.

 

[foreverLaur]

It's not an opinion where there can be different variations of right/wrong. It's a fact that you were in the wrong. Just accept it.

So I am wrong for thinking that someone might have an inferiority complex because they demand to be called Doctor by anyone and everyone in every single situation? I think I am entitled to that thought. That may or may not be why she does it, but we'll never know so therefore nobody can determine if my theory is right or wrong.

Yes, it is wrong to refer to your boss by a casual first name unless they have told you to do so. However, I was initially under the impression that everyone was on a first name basis and I did not know she had a doctorate degree and she was not my boss or superior. She was simply introduced to me as Jane* and I did not know her last name at the time nor did I know she had a doctorate degree. I did not report to her and I rarely personally worked with her. After being corrected, I always called her by the appropriate name, and continued referring to everyone else by their first name as that is how they asked to be referred to. So, if someone could tell me what I did wrong... ?

 

[Farmer Jane]

Side note: I know a guy who wants to be addressed as "Dr. Firstname" because he has a doctorate.











From an unaccredited bible school. Uh-huh.

 

[Therapist4Chnge]

Let this be a learning lesson for you. You should be thankful that she said something to you. It has nothing to do with a "complex". I've never called any superiors of mine by their first name EVER. Even now that I am their "colleague" I still called them Dr. xxxx because they are older than I am. This is something you need to learn if you want to prevent pissing people off and not showing them respect.

I completely agree with SDN9876. She definitely did you a favor by letting you know, as the alternative would be that people may view you as disrespectful and lacking insight into the dynamics of a workplace, which can often do more long-term harm career-wise.

My former career was in consulting and I evaluated people on a daily basis for project teams, placements, cuts, etc. At that level, everyone had the skillset, so the difference between a person getting hired and fired was how well they worked with their teams. If you get tagged as "that guy/girl", no one wanted to work with you and you were left with the tech. equivalent of scut work. Etiquette matters, and you could be great at your job, but never be given the opportunity because of how you interact with your colleagues.

We should probably get back on topic......DNP & such.

 

[foreverLaur]

The business sector is clearly different than the academic/clinical sector. In the business sector, EVERYONE is on a first name basis. I have worked for some pretty prestigious companies, including Ernst & Young and even the partners of E&Y wanted us to call them by their first name. I'm actually starting to regret turning down my full time offer.

Also, the lady that is the topic of the argument was young and unmarried. I had NO idea if she was an undergraduate research assistant (could have easily passed for being an undergraduate student) like myself or a Ph.D student or many other potential options. All I was told was "over there, that is Jane" and that everyone was very friendly and on a first name basis. I later went up to her and said "Hey Jane, my name is Lauren. It is nice to meet you" and I got chewed out. I was NEVER told she was a Ph.D graduate and I was never told her last name. If they had introduced her to me as Jane Lastname, a recent Ph.D graduate or Dr. Jane Lastname, I would have addrsesed her as Dr. Lastname. However, I was never told that she had a doctorate degree or what her last name was. So, I did the best thing I know how and introduced myself to her with the information I was given at the time. I immediately apologized to her and called her Dr. Lastname from that day forward.

Just because I don't agree with her need to be referred to by doctor in every possible setting doesn't mean I actually disrespected her title to her face nor did I talk bad about her as a person nor did I mention my opinions on her desires about her title to anyone I worked with.

It is an anonymous forum. I was just posting an opinion and venting. I don't need to be belittled for having a lack of information.

 

[foreverLaur]

Quotes from a nurse who has been practicing for 30 years whom I have known personally for over 20 years. She is a CCRN and a Critical Care CNS who works in a cardiac ICU in Southern California.

"I wanted to tell you - don't believe all you read about the DNP - that is not the real world. That quote about the DNP is really so "Ivory tower academic" sounding. The DNP is not going to replace Masters prepared NPs and CNSs any time soon. My first job at UH in Cleveland was the teaching hospital for Case Western and they were one of the most progressive nursing schools in the country at the time and in 1979 they were saying the doctorate should be the entry level for nursing! well you can see how far that idea has progressed."

"The AMA would fight the DNP big time, I'm not sure the public would embrace it and what kind of salary would they make? One of the biggest causes of the nursing shortage is the lack of nursing school professors and most are near retirement age. I do agree that nurses are ideal for primary prevention, risk reduction and coordinating care for people with chronic health problems but I still think that will be nurses prepared at the Masters level"

"Just yesterday I was looking at a magazine that listed the average RN salaries by state. CA was the highest at $42 or $44 can't remember which but Ohio was one of the lowest listed in the country at $26 and I was surprised at that. I know the cost of living is much higher here but that's a big difference in pay."

"Just last week I was talking to a supervisor where I work and she said at least in our area, NPs have a hard time finding work as an NP. She thinks doctors are hiring more PAs especially the surgical specialties that you seem to have such an interest in. We do have several at my hospital where I work that are both NP and CNS that work in cardiac surgery , heart failure program and stroke program. They see patients but they also have to do a lot of QI work (quality improvement) which involves making sure the physicians follow national practice guidelines. Different areas of the country probably vary though in which they have more of - NPs or PAs. I think some physicians see NPs as more of a threat and they have more control over PAs practice."

"I think in this economy a lot of programs are cropping up for students that already have a degree (in anything) to go for I think 12 months and get their RN. You can make a pretty good salary fairly quickly. This area of the country has the highest salaries for RNs and its pretty easy as a hospital staff nurse to make a 6 figure salary. Many of the nurses I work with work work 6,12 hour shifts every 2 weeks which is FT and then they pick up one extra shift a pay period. They make $600 for the extra shift. I don't know if the NPs even make as much as the staff nurses who work the extra shift."

I'm interested in hearing any thoughts and opinions.

 

[zenman]

Just yesterday I was looking at a magazine that listed the average RN salaries by state. CA was the highest at $42 or $44 can't remember which but Ohio was one of the lowest listed in the country at $26 and I was surprised at that. I know the cost of living is much higher here but that's a big difference in pay."

The big issue for me in not money but the fact I will never return to the bedside as a staff nurse...period. It's not worth the stress.

Just last week I was talking to a supervisor where I work and she said at least in our area, NPs have a hard time finding work as an NP.
I'm interested in hearing any thoughts and opinions.

I'm doing psych NP. The way the world is going I'll have no trouble working more hours than I want. Plus I'll have more hours in psych than PAs. I never worry about anyone else anyway...just do my own thing. FNPs will do well also.

 

[zenman]

Side note: I know a guy who wants to be addressed as "Dr. Firstname" because he has a doctorate.


From an unaccredited bible school. Uh-huh.

Did you make the mistake of calling him, "Brother?"

My son will graduate next year with a Masters of Divinity w/ Specialization in Christian Education. It's a 90 plus hour program! How do you do 90 hours based on a book?

 

[ChillyRN]

Let's not forget that Registered Nurses are very protective of the title of "nurse" even though it's not a protected title. The RN's prevent the LPN's from using the "nurse" title even though the LPN's perform many of the traditional duties of nursing. In fact, at most places, LPN's can't wear the traditional all white nurse uniform.

So this claim that nursing is not about titles is rather stupid. We all know how important titles are to nurses and their inferiority complexes.

Well, I guess I can only speak for myself. I have a host of certifications, and they do not appear on my badge, I don't sign my name with them. My badge says "Chilly, RN ED/CCU." I sign my name CSmith, RN, but the way my signature trails off, the only thing you can make out is the C and the S. I am not sure if people I work with even know I am Chillly Smith, RN, BSN, BC, CCRN, CEN, SANE. What difference would it make? People judge me by my performance, which is how I prefer it. If I am ever a DNP, I imagine the only place those letters would appear is on the diploma, lol.

IMO, the debate about the DNP ought to focus on how that degree does or does not advance the knowledge and skill of the APN. The issue re: the "doctor" title is so trivial, I just don't understand why anyone even cares, least of all someone who is not a member sof the nursing profession and/or culture.

 

[ChillyRN]

The big issue for me in not money but the fact I will never return to the bedside as a staff nurse...period. It's not worth the stress.



I'm doing psych NP. The way the world is going I'll have no trouble working more hours than I want. Plus I'll have more hours in psych than PAs. I never worry about anyone else anyway...just do my own thing. FNPs will do well also.

I expect to make about 10% more as a FNP. That is not enough of a difference to pay for the cost of the education unless there is some other reward, i.e. personal satisfaction, yda yada yada. My real motivation is to learn and grow as a professional. I have been doing the same things for so long, it doesn't excite me anymore. As a result, I have become somewhat complacent. I want to be challenged and interested in something again. And besides that, my back hurts.

I am not convinced that a practice doctorate would make me a better FNP. If I can be convinced at some later time, I may continue. Who knows. I'm old and wise enough to know better than to say "never." I am pragmatic by nature. I'll do what makes sense to me at the time. For now, I have the MSN to think about.

 

[ChillyRN]

I later went up to her and said "Hey Jane, my name is Lauren. It is nice to meet you" and I got chewed out. I was NEVER told she was a Ph.D graduate and I was never told her last name. If they had introduced her to me as Jane Lastname, a recent Ph.D graduate or Dr. Jane Lastname, I would have addrsesed her as Dr. Lastname. However, I was never told that she had a doctorate degree or what her last name was. So, I did the best thing I know how and introduced myself to her with the information I was given at the time. I immediately apologized to her and called her Dr. Lastname from that day forward.

This seems perfectly reasonable. You made a mistake and apologized and corrected yourself. That is what mature adults do. Where the problem lies I am unsure.

We travel in the same social circle as some of the physicians I work with; at parties and picnics, they are Steve, Joe, JimBob, whatever. At work, I call them by their title. I respect the title, and use it in the professional enviornment. At the dinner party, if JoeBob double dips his chip, I would never say "Uh, excuse me, uh Dr. Jones? Uh, due respect, but please refrain from contaminating the food, sir." I'd say, "hey JoeBob, what the he!l do you think you are doing?"

 

[jbar]

The issue re: the "doctor" title is so trivial, I just don't understand why anyone even cares, least of all someone who is not a member sof the nursing profession and/or culture.

I think the reason why it matters is that the DNP is being sold as training that is equal to that of a physician. It should matter to many people outside of nursing. It matters to the hospital administration who has to figure how to utilize this person. It matters to the patients who have to weigh what this person who introduces themselves as doctor says. And it should matter to other healthcare professionals.
When someone tells me their assessment of a patient with chest pain, it matters if they are an EMT, a RN, or a board certified cardiologist. We have to use shortcuts to determine how much someone should be able to handle or what they know based on their certification because we don't have time to personally get to know everyone who works in the hospital. So when someone introduces themselves on the phone as doctor so and so, given what I know about the DNP as it stand now, it makes a big difference to me if they are a DNP or an MD/DO.

The use of "doctor" matters because it is shorthand for all the other stuff that really matters. Training, experience, testing, oversight. Right now the MD/DO means a certain level of competency, and the DNP.....well, see the rest of the thread.

 

[deleted6669]

My son will graduate next year with a Masters of Divinity w/ Specialization in Christian Education. It's a 90 plus hour program! How do you do 90 hours based on a book?

I have friends who have done this. lots of greek/latin translation/comparisons as well as study of works relevant to theology other than the bible.

 

[foreverLaur]

Interesting and relevant article.

"American College of Physicians Issues New Policy on Nurse Practitioners in Primary Care"

http://www.medscape.com/viewarticle/588914?src=mp&spon=24&uac=62477SK

I believe you have to be a member to read the article, but it is free to join. I can PM the full text to anyone who is interested. It is just REALLY long to post here.

 

[ChillyRN]

I think the reason why it matters is that the DNP is being sold as training that is equal to that of a physician. It should matter to many people outside of nursing. It matters to the hospital administration who has to figure how to utilize this person. It matters to the patients who have to weigh what this person who introduces themselves as doctor says. And it should matter to other healthcare professionals.
When someone tells me their assessment of a patient with chest pain, it matters if they are an EMT, a RN, or a board certified cardiologist. We have to use shortcuts to determine how much someone should be able to handle or what they know based on their certification because we don't have time to personally get to know everyone who works in the hospital. So when someone introduces themselves on the phone as doctor so and so, given what I know about the DNP as it stand now, it makes a big difference to me if they are a DNP or an MD/DO.

The use of "doctor" matters because it is shorthand for all the other stuff that really matters. Training, experience, testing, oversight. Right now the MD/DO means a certain level of competency, and the DNP.....well, see the rest of the thread.

Ah, I misunderstood the crux of the argument. I inferred that some were saying that it would be innappropriate for doctorate prepared persons to go by their title in a clinical enviornment under any circumstances because they are not medical doctors and only medical doctors should be called doctor. Since that is such a petty and foolish notion, I was genuinely perplexed by that opinion.

Now I understand you to be clarifying for me that the real concern is that some people would be so unethical as to try to deliberately mislead other staff, patients and the public as to their true role. I can see where that kind of subtrafuge would be dangerous and unethical, not to mention illegal. If people really do that, they should be held accountable. I personally don't think it is going to be a big problem, but I could be wrong.

I do not for one second believe a professional would try to pass themselves off as something they are not. I am dead certain the person on the phone, were they an APN with a doctorate degree would identify themselves to medial staff, the patient, and any other curious or concerned party, as an APN. If a few unethical individuals materilaize and go about impersonating physicians and become a genuine threat to public safety, I am sure it can be handled appropriately. So again, I think this part of the conflict is moot.

I do completely agree that the role of the APN needs to be crystal clear to all the stakeholders! I don't think that the role or scope of practice is defined by DNP vs. MS preparation, but I am not really savvy to all the ins and outs. The only time I have ever heard the argument that APNs are interchangable with physicians w/o any change in outcome statitics is in primary care. As the DNP is so new, I doubt those studies included DNPs, so again, the title the professionals represented used is irrelvent.

As for the ascertation that the APN training is equivilent to that of a physician, that too is completely ludicrious. I don't know any informed person who believes that. I have interpreted the argument to be that physicians are, in fact, overqualified for well child visits and the like, and that these primary care responsibilites can be safely left to adequately trained and educated persons other than a physician. This frees the highly trained expert physician to treat the complex cases, perform proceedures outside the scope of others, and generally focus on larger issues facing the acutely ill.

To me, this all sounds like a win-win situation. I am not convinved that being Dr Chilly (as in a DNP prepared FNP) would make me a better primary care provider. However, if one day I am convinced that that level of education would be of benefit and complete it, I can't see myself actuallly asking people to call me that. I think it would be detrimental to the APN-patient relationship. If I attend some kind of conference,, I am not going to write Dr Chilly on my 'Hello my name is' badge. It would say, Chilly, DNP, FNP. (At least I think that is how it would properly be written). I think I would introduce myself to people as Chilly Smith, your nurse practitioner. Verbalizing the level ofmy education seems silly and unnecessary. After all, I didn't begin introducing myself: "Hi, I"m Chilly, your BSN, CCRN, CEN, SANE prepared nurse."

I do understand and completely agree that the DNP should be highly clinical in focus, and I think they ought to complete rigorous residency requirements in their area of specialty. Further, there definately needs to be standardization so that everone knows exactly how someone with that credential was trained and educated. I don't think APNs should be taking exams designed for physicians. It seems counterproductive and a waste of everyones time and money.

Nurse practitioners (and PAs) will be a part of the landscape from now on. Regardless of the titles they use in the workplace, their peers and adminstrative oversight people are going to know who they are and what they do. More importantly, they are going to have an opinion about how well the individuals providers do it. Reputations will be earned based on ones own merit, not assumed defacto by a title. In this sense, it is no different than physicians, They earn my admiration, respect and in some cases affection, based on who they are and the manner in which they perform their job. That is how it should be, don't you think?

 

[maceo]

Ah, I misunderstood the crux of the argument. I inferred that some were saying that it would be innappropriate for doctorate prepared persons to go by their title in a clinical enviornment under any circumstances because they are not medical doctors and only medical doctors should be called doctor. Since that is such a petty and foolish notion, I was genuinely perplexed by that opinion.

Now I understand you to be clarifying for me that the real concern is that some people would be so unethical as to try to deliberately mislead other staff, patients and the public as to their true role. I can see where that kind of subtrafuge would be dangerous and unethical, not to mention illegal. If people really do that, they should be held accountable. I personally don't think it is going to be a big problem, but I could be wrong.

I do not for one second believe a professional would try to pass themselves off as something they are not. I am dead certain the person on the phone, were they an APN with a doctorate degree would identify themselves to medial staff, the patient, and any other curious or concerned party, as an APN. If a few unethical individuals materilaize and go about impersonating physicians and become a genuine threat to public safety, I am sure it can be handled appropriately. So again, I think this part of the conflict is moot.

I do completely agree that the role of the APN needs to be crystal clear to all the stakeholders! I don't think that the role or scope of practice is defined by DNP vs. MS preparation, but I am not really savvy to all the ins and outs. The only time I have ever heard the argument that APNs are interchangable with physicians w/o any change in outcome statitics is in primary care. As the DNP is so new, I doubt those studies included DNPs, so again, the title the professionals represented used is irrelvent.

As for the ascertation that the APN training is equivilent to that of a physician, that too is completely ludicrious. I don't know any informed person who believes that. I have interpreted the argument to be that physicians are, in fact, overqualified for well child visits and the like, and that these primary care responsibilites can be safely left to adequately trained and educated persons other than a physician. This frees the highly trained expert physician to treat the complex cases, perform proceedures outside the scope of others, and generally focus on larger issues facing the acutely ill.

To me, this all sounds like a win-win situation. I am not convinved that being Dr Chilly (as in a DNP prepared FNP) would make me a better primary care provider. However, if one day I am convinced that that level of education would be of benefit and complete it, I can't see myself actuallly asking people to call me that. I think it would be detrimental to the APN-patient relationship. If I attend some kind of conference,, I am not going to write Dr Chilly on my 'Hello my name is' badge. It would say, Chilly, DNP, FNP. (At least I think that is how it would properly be written). I think I would introduce myself to people as Chilly Smith, your nurse practitioner. Verbalizing the level ofmy education seems silly and unnecessary. After all, I didn't begin introducing myself: "Hi, I"m Chilly, your BSN, CCRN, CEN, SANE prepared nurse."

I do understand and completely agree that the DNP should be highly clinical in focus, and I think they ought to complete rigorous residency requirements in their area of specialty. Further, there definately needs to be standardization so that everone knows exactly how someone with that credential was trained and educated. I don't think APNs should be taking exams designed for physicians. It seems counterproductive and a waste of everyones time and money.

Nurse practitioners (and PAs) will be a part of the landscape from now on. Regardless of the titles they use in the workplace, their peers and adminstrative oversight people are going to know who they are and what they do. More importantly, they are going to have an opinion about how well the individuals providers do it. Reputations will be earned based on ones own merit, not assumed defacto by a title. In this sense, it is no different than physicians, They earn my admiration, respect and in some cases affection, based on who they are and the manner in which they perform their job. That is how it should be, don't you think?

why dont you go to allnurses to spew your crap?

 

[ChillyRN]

why dont you go to allnurses to spew your crap?

Well that is an uncalled for response. I am not spewing crap, I am sharing my thoughts on a subject that appears to be of interest to several people. I thought we were enjoying a reasoned discussion. Reasonable people can disagree. I am very interested in the thoughts of other reasonable people, they give me pause, food for thought, illumination. I think discussion boards, (this particular forum being titled for RNs, NPs, PAs and others) are an interesting and occasionally educational past time. It isn't a war for heavens sake.

And my post was long enough in the first place, you didn't have to quote it in it's entirely.