DNPs will eventually have unlimited SOP

[SpecterGT260]

In psychiatry due to lack of access, the APNPs have been churned out.

I worked with one I refused to collaborate with, and I could not even cover for her bc I was so uncomfortable with the number and type of refills without reevaluating the pt. Some pts hadnt physically seen her in 8 or more months!

I was under the impression that many states have laws against this...... depending on the drug, I thought many require at least 6 month checkups and another good many cannot be rescripted more than 3 months out from last visit with no single Rx exceeding 1 month.

---

Members don't see this ad.

 

[SpecterGT260]

I just googled what APNP was

seriously.... I thought DNP was terminal and THEY are, in /manymost cases, unfit to write scripts... what exactly does one have to do to become an APNP

 

[xenotype]

I just googled what APNP was

seriously.... I thought DNP was terminal and THEY are, in /manymost cases, unfit to write scripts... what exactly does one have to do to become an APNP

I think this is rapidly becoming a more popular choice for them than primary care. It is better compensated because psych is an even bigger shortage than primary care. It is also perhaps the scariest, sending an army of DNPs out there prescribing psychotropic drugs that they do not in the slightest understand with none of the holistic patient evaluation skills psychiatrists are taught for years to use BEFORE resorting to these powerful drugs.

 

[SpecterGT260]

I think this is rapidly becoming a more popular choice for them than primary care. It is better compensated because psych is an even bigger shortage than primary care. It is also perhaps the scariest, sending an army of DNPs out there prescribing psychotropic drugs that they do not in the slightest understand with none of the holistic patient evaluation skills psychiatrists are taught for years to use BEFORE resorting to these powerful drugs.

Is it psych specific? The acronym doesn't necessarily suggest that.

 

[Bacchus]

I'm not sure. On my psych rotation my team had a DO and APNP. Hands down, the DO was much more fluent and better at what he did. I noticed a large amount of the "pattern recognition" going on for the APNP where as the DO was tailoring more custom treatments.

 

[xenotype]

Is it psych specific? The acronym doesn't necessarily suggest that.

Usually referred to as PMHNP DNPs. Psychiatric and Mental Health NP.

 

[SpecterGT260]

Usually referred to as PMHNP DNPs. Psychiatric and Mental Health NP.

 

[peteB]

Is it just me or do you guys also notice that many of these non-physician providers put a ton of letters after their names for every certification they got online? Why are they doing this? Are they once again trying to fool the patient into thinking they have more training than MDs because they have a huge slew of letters at the end of their names??

I think we should also start writing every single certification or test we passed after our names too

-Dr. Pete B, P-SAT, SAT, BS, MCAT, ACLS, BLS, MD, Step1, Step2CS, Step2CK, Step3

 

[greatnt249]

Is it just me or do you guys also notice that many of these non-physician providers put a ton of letters after their names for every certification they got online?

Yes. And to be quite honest, I don't get it. Reading John/Jane Doe, BSN/MSN, CRNA and so-on after your name doesn't convince me of your clinical competence.

 

[calvnandhobbs68]

Yes. And to be quite honest, I don't get it. Reading John/Jane Doe, BSN/MSN, CRNA and so-on after your name doesn't convince me of your clinical competence.

I love when people put BSN. I guess I should start putting BS Biology after my name.

 

[SpecterGT260]

I love when people put BSN. I guess I should start putting BS Biology after my name.

you dont? Hell... My CV ends with "Highschool Grad".

I list "pottytrained at 2.5" under lifetime accomplishments. Derm here I come!

 

[peteB]

I love when people put BSN. I guess I should start putting BS Biology after my name.

If any of us did that, we'd get laughed at-- hell if anyone in general put BS or BA in after their name it would seem odd-- but nurses get away with it... why?

Why is it they can flaunt every certification they have after their name, but if we so much as mention our Step 1 score, we're labeled as tools? There was even a thread on here with people arguing that we shouldn't be telling people we are in med school cause even THAT was toolish.

Why can't we add more letters to our name after we finish residency and fellowships, like they do after they finish various training programs?

 

[Leonid Rogozov]

If any of us did that, we'd get laughed at-- hell if anyone in general put BS or BA in after their name it would seem odd-- but nurses get away with it... why?

Why is it they can flaunt every certification they have after their name, but if we so much as mention our Step 1 score, we're labeled as tools? There was even a thread on here with people arguing that we shouldn't be telling people we are in med school cause even THAT was toolish.

Why can't we add more letters to our name after we finish residency and fellowships, like they do after they finish various training programs?

I had to put 'BS' after my name when I signed off on things as a psych tech...

 

[peteB]

I had to put 'BS' after my name when I signed off on things as a psych tech...

That's unusual, but ok.. Would you do that if you didn't have to?

 

[SpecterGT260]

I had to put 'BS' after my name when I signed off on things as a psych tech...

Why?

 

[Leonid Rogozov]

The reason was mostly policy and somewhat legal. I was a Psych Tech II (read orderly with a degree). One of my job requirements was giving group counseling which essentially required that I signed off on notes with my credentials for doing so, my BS. I couldn't tell you exactly 'why' they made me do it but I have a few ideas, mostly legal.

To answer the previous question, no I wouldn't sign off with the credential if I didn't have to but I hear in California you actually have to register as an MHT (mental health technician) and you get that credential after your name... don't quote me on that though.

 

[VenusinFurs]

Ok, just reading this last page:

If you're a nurse, you'd have BSN listed after your name because this means you have a bachelor's in nursing. It's a specific profession. "Scientist" or "biologist" isn't. Having a bachelors in nursing makes you a nurse (if you've completed your required credentials etc). Having a bachelors in biology does not automatically make you a biologist.

And this is not necessarily something you have a choice about. Nurses hospital badges usually list if they are a BSN or an RN or whatever. When you all sign your notes, you probably put MS3 or MS4 or whatever. It's a question of letting people know what level of training you're at.

How is this any different than doctors saying that they are "Doogie Howser, MD, FACP" or whatever? Yeah, the FACP means you're an internist, but the general public isn't going to give one single turd about that.

 

[MiracleforMD]

Ok, just reading this last page:

If you're a nurse, you'd have BSN listed after your name because this means you have a bachelor's in nursing. It's a specific profession. "Scientist" or "biologist" isn't. Having a bachelors in nursing makes you a nurse (if you've completed your required credentials etc). Having a bachelors in biology does not automatically make you a biologist.

And this is not necessarily something you have a choice about. Nurses hospital badges usually list if they are a BSN or an RN or whatever. When you all sign your notes, you probably put MS3 or MS4 or whatever. It's a question of letting people know what level of training you're at.

How is this any different than doctors saying that they are "Doogie Howser, MD, FACP" or whatever? Yeah, the FACP means you're an internist, but the general public isn't going to give one single turd about that.

FACP doesn't necessarily mean you are an internist.

 

[peteB]

Ok, just reading this last page:

If you're a nurse, you'd have BSN listed after your name because this means you have a bachelor's in nursing. It's a specific profession. "Scientist" or "biologist" isn't. Having a bachelors in nursing makes you a nurse (if you've completed your required credentials etc). Having a bachelors in biology does not automatically make you a biologist.

And this is not necessarily something you have a choice about. Nurses hospital badges usually list if they are a BSN or an RN or whatever. When you all sign your notes, you probably put MS3 or MS4 or whatever. It's a question of letting people know what level of training you're at.

How is this any different than doctors saying that they are "Doogie Howser, MD, FACP" or whatever? Yeah, the FACP means you're an internist, but the general public isn't going to give one single turd about that.

Ok, I see your point.


However, according to the Department of Labor website, a bachelor of biology degree is enough to qualify one to be a 'biologist', which is a specific profession. Obviously it doesn't guarantee you a job as one but neither does a Bachelors of nursing. Most biologist positions would probably prefer a Masters or Ph.D., but you are still qualified to be a biologist with a bachelors alone.

Also, a Bachelors of Engineering does most definitely make you an Engineer, but I have never seen an engineer sign an email with B.Eng.

It's not only BSN or MSN that I'm talking about- nurses and non-physician providers often put many other combinations of letters after their names for various other certifications they have gotten. This is not something common in any other field that I know of. Computer programmers also have various certifications, but they never put them after their name.

I didn't think about FACP but it would also fall under this sort of thing.

 

[VenusinFurs]

FACP doesn't necessarily mean you are an internist.

Oh wait.

I actually wasn't aware what the fellowship title specifically meant until I looked it up.

*facepalm*

 

[VenusinFurs]

Ok, I see your point.


However, according to the Department of Labor website, a bachelor of biology degree is enough to qualify one to be a 'biologist', which is a specific profession. Obviously it doesn't guarantee you a job as one but neither does a Bachelors of nursing. Most biologist positions would probably prefer a Masters or Ph.D., but you are still qualified to be a biologist with a bachelors alone.

I have a bachelor's in biology. The notion that I could be called a biologist is hilarious to me.

 

[SpecterGT260]

I have a bachelor's in biology. The notion that I could be called a biologist is hilarious to me.

That is more of a job title than a degree. You don't need a PhD to be a biologist.....

 

[peteB]

I have a bachelor's in biology. The notion that I could be called a biologist is hilarious to me.

You could certainly call yourself a biologist if you wanted to. It just sounds ridiculous because most people who actually become biologists have a graduate degree too. But technically speaking you're qualified to be one. There's no license required, the degree's enough.

Usually you wouldn't do that unless you actually got a job as one though. Same goes for nurses. I think it would be odd for someone to call themselves a nurse if they have never worked as a nurse.

 

[Leonid Rogozov]

Usually you wouldn't do that unless you actually got a job as one though. Same goes for nurses. I think it would be odd for someone to call themselves a nurse if they have never worked as a nurse.

Hand-wavy.

You have to actually pass a board exam and be registered to be a nurse. If a certain level of care required a nurse, an unemployed nurse *should* be just as qualified as an employed one (competence may vary).

An MD fresh out of med school (assuming they pass their boards) is still a Doctor, even if she hasn't written her first script or given her first diagnosis yet.

 

[peteB]

An MD fresh out of med school (assuming they pass their boards) is still a Doctor, even if he hasn't written his first script or given his first diagnosis yet.

You don't think a license is necessary to be considered a doctor?

 

[Leonid Rogozov]

Hand-wavy.
An MD with a fresh new license to practice medicine is still a Doctor, even if she hasn't written her first script or given her first diagnosis yet.

You don't think a license is necessary to be considered a doctor?

fixt.

 

[PikminOC]

As far as I know APNP means advanced practice nurse prescriber. They are not isolated to psychiatry.

There are alot of people who are CNA"s who try to mislead and pass themselves off as nurses.

 

[peteB]

fixt.

Ok, but you can't get a license without doing at least 1 year of residency, which means you'd have made diagnoses and written prescriptions and actually worked as a doctor... Does a nurse actually have to work as a full fledged nurse to get a BSN + license?

 

[Leonid Rogozov]

Hand-wavy.

A person who passes their boards, and never writes a script, never does another surgery or makes another diagnosis again (for whatever silly reason) after their residency training and is still licensed to practice medicine is still a doctor, even if they are an unemployed doctor.

Ok, but you can't get a license without doing at least 1 year of residency, which means you'd have made diagnoses and written prescriptions and actually worked as a doctor... Does a nurse actually have to work as a nurse to get a BSN?

fixt 2.0

Let it be known that RN =/= MD and I'm not implying that.

So far as I am aware for nursing, you have to do a bunch of clinical practicums in school before you can even sit the RN licensing exam.

 

[Leonid Rogozov]

As far as I know APNP means advanced practice nurse prescriber. They are not isolated to psychiatry.

There are alot of people who are CNA"s who try to mislead and pass themselves off as nurses.

How is that possible to get away with?

 

[SpecterGT260]

Ok, but you can't get a license without doing at least 1 year of residency, which means you'd have made diagnoses and written prescriptions and actually worked as a doctor... Does a nurse actually have to work as a full fledged nurse to get a BSN + license?

you get your MD right at graduation. You are "Dr. _____" whether or not you can legally practice. Go call an intern in the hospital "Mr _____" I dare ya

 

[peteB]

you get your MD right at graduation. You are "Dr. _____" whether or not you can legally practice. Go call an intern in the hospital "Mr _____" I dare ya

Yeah, I get that The degree allows you to put Dr. in front of your name. But would you call someone who just graduated with an MD but has no license yet and hasn't started residency yet a "physician"? Or would that person need to be legally licensed to be called that (in your opinion)

 

[SpecterGT260]

Yeah, I get that The degree allows you to put Dr. in front of your name. But would you call someone who just graduated with an MD but has no license yet and hasn't started residency yet a "physician"?

No. But Dr is the degree. I dunno... id call an intern in the clinic "Dr x". There isn't much opportunity for me to interact with graduated med students outside of clinic who I couldn't call by first name anyways so that is a moot point. I dunno, it may just be a difference of opinion

 

[calvnandhobbs68]

Ok, just reading this last page:

If you're a nurse, you'd have BSN listed after your name because this means you have a bachelor's in nursing. It's a specific profession. "Scientist" or "biologist" isn't. Having a bachelors in nursing makes you a nurse (if you've completed your required credentials etc). Having a bachelors in biology does not automatically make you a biologist.

And this is not necessarily something you have a choice about. Nurses hospital badges usually list if they are a BSN or an RN or whatever. When you all sign your notes, you probably put MS3 or MS4 or whatever. It's a question of letting people know what level of training you're at.

How is this any different than doctors saying that they are "Doogie Howser, MD, FACP" or whatever? Yeah, the FACP means you're an internist, but the general public isn't going to give one single turd about that.

They sign their emails with this crap all the time. It's not just the nurses though...I've seen medical students have as part of their signature "BS 2009" or B.A. whatever. I've also seen administrators list 5 different abbreviations and acronyms after their names. It's just as dumb.

Don't mean to personally insult any students that do that but there is no utility to putting anything like that in your signature. If a person doesn't know you're a medical student and they need to, you should be addressing that in your email and if they do then it should be easily assumed you have an undergrad degree.

 

[PikminOC]

The credentialing hasn't gotten more rigerous and time consuming because the training has gotten more advanced. It's gotten more rigerous and time consuming because we allow medicine to function as a trust. The people who get to use us as better than free labor for the duration of our training are also allowed to vote on the length of our training, and unlike every other profession in America if you go outside their system its actually a felony. They get to charge patients as though they saw a board certified physician, but Medicaid reimburses the program for the physician's salary twice over, so they get at least part of the income from being a doctor without training to be one. There is nothing selfless going on when surgery decides that yet another year is the bare minimum to finish a gen surg residency, all for the privlidge of chucking 90% of that knowledge in the garbage and beginning three years of fellowship training.

Whether the field of medicine is actually harder than it was two generations ago is an interesting question. We certainly have a wider range of diagnoses and therapies, but we also have more algorithems, do fewer of our own procedures, and perhaps most importantly we focus on a drastically smaller portion of the field of Medicine as a whole. At the start of WWII a country physician, with four years medical school and an Intern year, could in an average week deliver a child, close reduce one fracture, ampute a limb, treat (and advise his town on) an outbreak of a diabling/fatal pediatric infecious disease like HiB, counsel the depressed, triage and turf the mildly ill, all while running his own labs and reading his own films. Does a modern Intensivist or Neonatologist really match that level of complexity when they have a dozen subspecialists supporting them? Does our version of General practice even come close? I'm not sure the NPs are wrong, I think they aer perfectly qualified to do at least a large subset of what we do. More importantly I think it should be their right to sell their product to whoever is willing to buy.

I realize this is from the first page of this discussion: any MD/DO who thinks NP's are good should have no problem collaborating with them and taking on their liability.

Also, in WW2, the physicians even made their own meds, cut their own histo slides etc.

But the standard of care is much higher now: and there are predatory lawyers as we all know.

Come on, Whipple's in 80 yo people?

 

[mmmcdowe]

II looked up the rules around this a couple if years ago. It was actually pretty interesting. You can say you are dr. So adn so and that you have an md, but there are a lot of restrictions on the context of it. You cant say you are a medical doctor or physician, but you can do an ad of tv where it flashes your md title on the screen while you where a white coat and mislead patients, etc. It may have changed though, or i may be mis remembering.

 

[Rendar5]

II looked up the rules around this a couple if years ago. It was actually pretty interesting. You can say you are dr. So adn so and that you have an md, but there are a lot of restrictions on the context of it. You cant say you are a medical doctor or physician, but you can do an ad of tv where it flashes your md title on the screen while you where a white coat and mislead patients, etc. It may have changed though, or i may be mis remembering.

Not really true. Once you have an MD/DO, you are a doctor/physician. you may not be a licensed provider, but that doesn't mean you can't refer to yourself by your degree. Honestly, even many residents who work and take care of patients don't have their own licenses and work under the auspices of the hospital's license.

 

[PrideNeverDie]

just stating the obvious, but we only have ourselves to blame

i know keeping the doctor numbers down helps us stay in demand and keeps our salaries high, but by not training more doctors we have let other jobs get too close

we need to think longterm and train MDs to fill the MD shortage, not keep our salaries high right now and then watch our children's compensation be taken away by other careers

when DOs came on the scene, MDs should have told them that either they let us into their residencies or they would be banned from ours.

PAs and NPs should have been made to pass Step 3 and do an internship year for the field they got hired in. you want to work under a doctor you should know the treatment plans and put in some real time in that specialization.

if they want to work autonomously, they can go to med school. that's it.

where did the balls of our administrative leaders go?

 

[PharMed2016]

Sorry for going back to the whole initial thing but my main issue with using initials after individuals names would be when they are interacting with another in a non-official/practice capacity. For correspondence purposes like in education (as student) to a professor, I don't think that it's standard to put non-grad level degrees after ones name.

Example:
XXXX - ~~~~~
John Doe, LPN or RN or AS or EMT<-- Appropriate?

XXXX - ~~~~~
John Doe, BS or BSN <-- Appropriate?

XXXX - ~~~~~
John Doe, PhD or MS or MA or MPH <-- Appropriate? (I'm leaning towards more appropriate with this)

It is understood that one earned the right to the degree through education but to use it in everyday communications as described above? The reason I bring this up is throughout my undergraduate and graduate education, I have seen other individuals use these.

 

[peteB]

Sorry for going back to the whole initial thing but my main issue with using initials after individuals names would be when they are interacting with another in a non-official/practice capacity. For correspondence purposes like in education (as student) to a professor, I don't think that it's standard to put non-grad level degrees after ones name.

Example:
XXXX - ~~~~~
John Doe, LPN or RN or AS or EMT<-- Appropriate?

XXXX - ~~~~~
John Doe, BS or BSN <-- Appropriate?

XXXX - ~~~~~
John Doe, PhD or MS or MA or MPH <-- Appropriate? (I'm leaning towards more appropriate with this)

It is understood that one earned the right to the degree through education but to use it in everyday communications as described above? The reason I bring this up is throughout my undergraduate and graduate education, I have seen other individuals use these.

My opinion is that only grad degrees should be put after your name in communications, except for the sorts of official documentation that were mentioned above.

There is no need to sign your email with your bachelors degree or any certificates you have earned. I also don't see the point of things like FACP. Those things can be on your resume, but I don't think you need to sew them into your white coat.

Then again this is all a matter of taste and you can really do whatever you want. If having a slew of letters after your name helps your self-esteem, why not. I just think it's superfluous and only the most significant degrees belong there.

 

[Vigil]

I can give you guys some input on the whole initials thing, being a practicing RN right now. This is just my experience at my hospital, which is a rather large teaching hospital in a major metropolitan area.

Some of it is just plain old pretentiousness and seen with many nurses looking to protect their ego or show how much "stuff" they know and start an exorbitant and unnecessary amount of post-nominals (MSN, BSN, RN, EMT, CPR, ect...). Seen a lot in newer nurses I've noticed who got a chip on their shoulder who want to show off their shiny new degree or certification and feel that it's the best thing ever. They soon realize hardly anyone cares and it's tacky as hell.

As a clinician, obviously I attach "RN" to the end of my clinical documentation or charting for obvious reasons. I have my badge which states my name and designates me as RN. This is mainly for chart reviews and so people/patients can identify who I am and my role.

Administrators, supervisors, and non-clinicians usually have there name with their RN followed by the level of education, as further education has a lot to do with administrative procedure, healthcare management, and running units. They sign off on stuff with those postnominals as well.

There are certifying credentials like CCRN (critical care), CEN (emergency/trauma) and OCN (oncology) that I feel are appropriate as post-nominals because they are clinically relevant, although I generally hate word spaghetti. As a general understanding, they recognize that specific individual as being top of their game in that department and they have an advanced skill set. The examinations are usually taken after several years of exposure within that field. I think that is is most akin to physicians having fellowship training. Correct me if I'm wrong, I'm not too keen on it.

As an example my complete title is "Vigil, RN, OCN" so others know that I'm not only a registered nurse but also have chemotherapy infusion capabilities which you have to be certified to preform. It's nothing fancy, but an indicator if someone needs me to float to another unit to start chemo and monitor their nadirs, call the docs with critical values, ect... It means that I am the most qualified to do a rapid assessment of a cancer patient when the rest of the floor are normal RNs.

But again, the people who have Jane Doe, RN, MSN, BSN, ACLS, BLS are generally the obese administrators, patient advocates or educator nurses who haven't been on a floor in decades, preform sub-optimally in actual practice, and feel the validate their worth through a slew of redundant letters.

Or their newbs.

 

[Life Sucks]

I went to a DNP/NP and boy, NEVER AGAIN.....that trick was mean, while her and the doctor Iater both said I had a virus, the female doctor was way nicer than that bitch was.So those saying nurses have beadside manners can go suck it.

 

[SpecterGT260]

I can give you guys some input on the whole initials thing, being a practicing RN right now. This is just my experience at my hospital, which is a rather large teaching hospital in a major metropolitan area.

Some of it is just plain old pretentiousness and seen with many nurses looking to protect their ego or show how much "stuff" they know and start an exorbitant and unnecessary amount of post-nominals (MSN, BSN, RN, EMT, CPR, ect...). Seen a lot in newer nurses I've noticed who got a chip on their shoulder who want to show off their shiny new degree or certification and feel that it's the best thing ever. They soon realize hardly anyone cares and it's tacky as hell.

As a clinician, obviously I attach "RN" to the end of my clinical documentation or charting for obvious reasons. I have my badge which states my name and designates me as RN. This is mainly for chart reviews and so people/patients can identify who I am and my role.

Administrators, supervisors, and non-clinicians usually have there name with their RN followed by the level of education, as further education has a lot to do with administrative procedure, healthcare management, and running units. They sign off on stuff with those postnominals as well.

There are certifying credentials like CCRN (critical care), CEN (emergency/trauma) and OCN (oncology) that I feel are appropriate as post-nominals because they are clinically relevant, although I generally hate word spaghetti. As a general understanding, they recognize that specific individual as being top of their game in that department and they have an advanced skill set. The examinations are usually taken after several years of exposure within that field. I think that is is most akin to physicians having fellowship training. Correct me if I'm wrong, I'm not too keen on it.

As an example my complete title is "Vigil, RN, OCN" so others know that I'm not only a registered nurse but also have chemotherapy infusion capabilities which you have to be certified to preform. It's nothing fancy, but an indicator if someone needs me to float to another unit to start chemo and monitor their nadirs, call the docs with critical values, ect... It means that I am the most qualified to do a rapid assessment of a cancer patient when the rest of the floor are normal RNs.

But again, the people who have Jane Doe, RN, MSN, BSN, ACLS, BLS are generally the obese administrators, patient advocates or educator nurses who haven't been on a floor in decades, preform sub-optimally in actual practice, and feel the validate their worth through a slew of redundant letters.

Or their newbs.

I think the difference is whether it seems to be used to convey important clinical info or used for gaining personal recognition

 

[greatnt249]

I can give you guys some input on the whole initials thing, being a practicing RN right now. This is just my experience at my hospital, which is a rather large teaching hospital in a major metropolitan area.

Some of it is just plain old pretentiousness and seen with many nurses looking to protect their ego or show how much "stuff" they know and start an exorbitant and unnecessary amount of post-nominals (MSN, BSN, RN, EMT, CPR, ect...). Seen a lot in newer nurses I've noticed who got a chip on their shoulder who want to show off their shiny new degree or certification and feel that it's the best thing ever. They soon realize hardly anyone cares and it's tacky as hell.

As a clinician, obviously I attach "RN" to the end of my clinical documentation or charting for obvious reasons. I have my badge which states my name and designates me as RN. This is mainly for chart reviews and so people/patients can identify who I am and my role.

Administrators, supervisors, and non-clinicians usually have there name with their RN followed by the level of education, as further education has a lot to do with administrative procedure, healthcare management, and running units. They sign off on stuff with those postnominals as well.

There are certifying credentials like CCRN (critical care), CEN (emergency/trauma) and OCN (oncology) that I feel are appropriate as post-nominals because they are clinically relevant, although I generally hate word spaghetti. As a general understanding, they recognize that specific individual as being top of their game in that department and they have an advanced skill set. The examinations are usually taken after several years of exposure within that field. I think that is is most akin to physicians having fellowship training. Correct me if I'm wrong, I'm not too keen on it.

As an example my complete title is "Vigil, RN, OCN" so others know that I'm not only a registered nurse but also have chemotherapy infusion capabilities which you have to be certified to preform. It's nothing fancy, but an indicator if someone needs me to float to another unit to start chemo and monitor their nadirs, call the docs with critical values, ect... It means that I am the most qualified to do a rapid assessment of a cancer patient when the rest of the floor are normal RNs.

But again, the people who have Jane Doe, RN, MSN, BSN, ACLS, BLS are generally the obese administrators, patient advocates or educator nurses who haven't been on a floor in decades, preform sub-optimally in actual practice, and feel the validate their worth through a slew of redundant letters.

Or their newbs.

Fair enough; my point I guess was that all the titles are overkill. If you have an MSN, then it's redundant to say BSN/MSN. With any title, take the approach that you would to your résumé; only list your highest qualifications. If you have an MSN, it's implied that somewhere along the line, you earned your BSN. DPN, RN, LPN, or CNA should suffice unless you have special training qualifications in a particular field, such as the CRNA, CCRN, or OCN that you mentioned.

 

[VenusinFurs]

I went to a DNP/NP and boy, NEVER AGAIN.....that trick was mean, while her and the doctor Iater both said I had a virus, the female doctor was way nicer than that bitch was.So those saying nurses have beadside manners can go suck it.

n=1

Though I think a lot of NPs in outpatient primary care tend to be overcautious in comparison to MDs. To a ridiculous degree.

 

[PikminOC]

You would be surprised how little you have to do to earn some of those degrees.

 

[SpecterGT260]

You would be surprised how little you have to do to earn some of those degrees.

I looked up the washU DNP curriculum a bit ago. RN+ team building seminar. Not joking.

 

[jmadden]

Why do you think they get such 3rd party support for their education? Kaiser and other insurance companies
Cant remember the state but google it, they help lobby with their own strong RN union for more scope then they cut their reimbursement rates because they are not physicians.

Most nurses do not pursue apn or if they do many dont want to have more responsibility then mid level. Like many labor unions the leadership gets corrupted. Be it hoffa and teamsters with the mob or jane doe APN union leader rep with the trillion dollars that flow through government and other insurance companies.

And less reimbursement for them does not mean more for physicians for equal work, those savings just get churned to the profit margin for quarterly profits or back into the blackhole funds of state and fed governments

Why else would kaiser/fed and any other non-APN with the fervent desire to expand her SOP?

Because they can make a buck by using the current static-declining physician reimbursement as the ceiling, get APNs and others to do the same job, then cut their fees because they are not physicians despite having the same SOP and responsibility/liability.

Dont be crabs in a barrel thinking pulling apns down somehow elevates you as your reimbursement has to be fought for like any other group of workers ever, broad collective bargaining, strikes, appeal to the public on issue.

There is zero savings to anyone. The less cost of an APN has never been passed down to the patient through insurance/gov hands. Those savings are just an increased margin of profit for either agent.

2.8 trillion healthcare gdp. Approx 6% is physician reimbursement the lowest of all modern healthcare societies. 8.7% was shown in an article a few years back, but gdp has risen and physician pay stagnant. I also believe they included all residents and fellows past pgy1 who are paid barely more then minimum wage in this gross calculation.

Its not just promotion of adp sop, these companies put out their own propaganda statistics with the intent of manipulating the public view. On kaisers website they have numerous economic figures of healthcare and in breaksdowns of healthcare expenses they leave hospitals in one group of 57% about and another of physicians and other services 26%. Within "other services" is the entire healthcare expenditure budget of va, military, dod and other gov self funded healthcare systems. All lab services as well like ginormous labcorp.

Also this physician expense includeds gross billable services of physicians employed by a hospital, which is not their own pay and is the gross cost of a persons entire hospital stay. To add insult to injury in the chart legend, the hospitals and not the physicians figure is adjusted for bad debt from these services or the many billed services that are not collected. To further inflate this billed does not equal insurance or medicare reimbursement.

So flagrantly manipulated it should be clear its no accident and there is an agenda.

Will post link

 

[PikminOC]

I looked up the washU DNP curriculum a bit ago. RN+ team building seminar. Not joking.

Have you seen the requirements for becoming an RN?

On some of SDN threads the nurses compare the classes they take as being similar to ours..

HAHAHAHAHAHA




(I wanted to use this emoticon even if it is not particularly relevant)

 

[jmadden]

http://www.statehealthfacts.org/comparebar.jsp?ind=593&cat=5

Legend with definitions of "hospital care" and "physicians and other clinical services" shows how flagrant this is

This is the latest 2009 data, the trend has been skewed even more since then.

Like you have to put serious effort into these types of data manipulation and just plain lying

And when APNs have same sop that means the basis for not allowing physicians to form labor unions is null. Its based on monopoly control of practice of medicine which is gone when half the states and the rest will follow for total APN authority or DNP so they can be called doctor in a clinical setting and a patient thinks they are a physician.
self identifying each other and selves as "physician" rather than "doctor" would help for this move, but in the end a physician labor union is the only thing to prevent this. Australia has a strong culture of labor unions and their physicians make twice our salary now a days .Residents 75-80k and fellows 115k. There dollar is also 5% stronger than ours currently.

Nothing intricate is needed as with subspecialization each board is better suited to serve the education and clinical goals of each other. But some basic terms with a strong voice when needed is the only thing to prevent getting squeezed further

And the AMA is not a labor union or even a union.

It has premed and med students mostly. In a real labor union u only have active laborers who need representation for current work terms as well as when retired. its just portrayed as a union. There is no power to negotiate with corporate greed and government corruption.

When an individual group of physicians allign in one particular hospital or group of hospitals the contract is kept confidential or the negotiations are. These are often just EM docs or IM or surgeons. Its better then nothing but a neurologist maybe one of 3 in a state and in separate hospital systems.

Reimbursement varies among services and specialties so alligning among specialty or board does little to prevent the squeeze as a whole.

Bc/be Physicians really arent that large a group where this should be a costly or treacherous endeavor as 2-3 million nurses or millions of teamsters.

And with payment coming from state and fed levels its the same issue as with just an "EM or IM" labor union. Your board is a separate thing and should stay that way. If there arose a physician labor group just in the state of michigan, it would be very easy for the fed/state to divert fed medicaid funds to another state with cutted reimbursement. Medicaid provider fees are not standardized and can change within and between states without changing the total budget. Medicare funding can be diverted through residency spots being transferred which transfers GME funding which is heavily relied upon besides the cheap labor of a resident.

Things are set up so fragmented and with so many level of admin to prevent any labor organization, even a healthy level.