Doctor Nurse (NP). Does it matter?

[dry dre]

Can we just get a midlevel flogging sticky in this forum?

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[MD'05]

Nurses arent going to be taking over your practice and taking your responsibility, so they're not threatening your job either.

You are correct. They will not because we will crush them. I've been tortured enough.

 

[smkoepke]

Right. You don't know what pathophysiology is.

There might be nurses fat enough, but never smart enough.

that's uncalled for.

 

[toughlife]

I really don't care if your wife is a nurse. If you had actually read my posts before attacking me, you would know that I never claimed to have the same education as an MD. I don't want to be an MD. I don't want to compete with an MD. In fact, I believe I said that nursing and medicine have a different focus. Didn't I? I NEVER said what we do is the same as what they do. Read it again and then you can attack me. I am simply talking about evolving roles of nurses and respect for all health care professionals. period. Oh and until you know me personally, don't talk to me about struggle and sacrifice. I was NOT the one who said that a physician wasn't the "pinnacle" of medicine. Read it again.

Why don;t you tell us about your struggle since you keep bringing it up all the time? I would be happy to read what you have to say.

 

[MD'05]

that's uncalled for.

No it is not. I am sick of fat nurses. For chrissakess, we have patients that are 350 lbs with DM, HTN, COPD, venous insufficiency, and hemorrhoids and the nurses are just as bad. Instead of worrying about advanced degrees they should go mall walking.

 

[GeneGoddess]

No it is not. I am sick of fat nurses. For chrissakess, we have patients that are 350 lbs with DM, HTN, COPD, venous insufficiency, and hemorrhoids and the nurses are just as bad. Instead of worrying about advanced degrees they should go mall walking.

Well, I'm sick of overweight, out of shape MDs who smoke and ride motorcycles without helmets. You think with all that education, every MD would be in marathon ready shape, eat nothing but whole grains and lean protein, and never touch tobacco.

 

[Whisker Barrel Cortex]

Although I think smiley got offended way too easily and became rude earlier in this thread, I gotta say you guys have done a good job of proving her right later in this thread. Good job.

 

[red-rat]

You guys realize - just because nurses will be able to get a DNP doesnt mean they will. Not every nurse out there wants to become an advanced practitioner and spend 4 more years in school. There's not going to be a massive shift in nurses going back to school simply because they can get a doctoral level degree. Its just going to be more education, different title for the ones who do, and they'll likely have nearly the same responsibilities. Theres no reason for a huge huff. Everyone has clinical doctorates these days - pharmacists, dentists, optometrists, physical therapists - and these people work along side you, yet, they dont threaten your masculinity and "prestige". Nurses arent going to be taking over your practice and taking your responsibility, so they're not threatening your job either.

The current plan is to require this degree for becoming an entry level NP by 2015.

"AACN member institutions voted to move the current level of preparation necessary for advanced nursing practice roles from the master's degree to the doctorate level by the year 2015."

see reference on post 1

 

[USAF MD '05]

Well, I'm sick of overweight, out of shape MDs who smoke and ride motorcycles without helmets. You think with all that education, every MD would be in marathon ready shape, eat nothing but whole grains and lean protein, and never touch tobacco.

LOL Gene Goddess- I read your post, and I honestly thought you were making fun of me! I thought we must know each other or something! I have a little belly, I smoke Marlboro Lights and I ride my morcycle without a helmet most of the time!! Yeah, yeah- I know better, but what's life without a vice or two? I only do it so I can have more empathy for my patients...
I can't believe this thread still lives. It wore my butt out last night!

 

[USAF MD '05]

Although I think smiley got offended way too easily and became rude earlier in this thread, I gotta say you guys have done a good job of proving her right later in this thread. Good job.

Very true WBC.

 

[red-rat]

Various nursing books report that nursing is the "care and treatment of the bodies reaction to actual or percived illness." i.e. comfort them because they are anxious or in pain (bodies response to disease). There are around 100 or so "nursing diagnosises". i.e. pain, constipation, ineffective coping, risk for impaired skin integrity, Ect.

Notice that definition does not state that nursing is the treatment of disease. That would be considered the practice of medicine

Also, nurses have always performed medical orders.

A practitioner in health care is involved, at least partialy, in the medical treatment and diagnosis of disease.

Since NPs focus on diagnosis and treatment of disease then they would not be involved in the practice of nursing. It would follow that they are some kind of healthcare worker that performs certain medical duties.

I understand the concept of PAs. They assist and work with MD/DO to provide medical care. This makes since.

Should NPs be called former nurses that are midlevel practiotioners.
Are they nurses or practitioners but how are they both?

Does any of this follow? What do you think?

 

[smiley2]

OH OH OH! Smiley your so fiesty. It so much fun to sit back and wach you get hot headed. If you are 1/2 this fiesty in bed you would be a blast!!

I wish you worked at my hospital, you need to be tamed. Bad nurse! Bad, bad, bad (slap on butt)!

If you were at my hospital I would make sure that you wear a tight white skirt, top, and a nursing cap. This would remind you of your true purpose in health care.

By the way shouldnt you be doing you highly educated (equal to MD) work of wiping butt, taking vital signs, giving medications, and doing whatever the MD/DO tells you to do.





I respond to this post because, even though you were insulting, you made me laugh! And yeah, I'm fiesty pretty much anywhere.....including in bed. Bring on the tight white skirt......and the cap! Regardless of attire, I'd still be a damn good nurse. Carry on............

 

[briansmichaud]

I think part of what has driven nursing to seek out alternative roles is sheer frustration with being disrespected, by hospital admin., physicians, even the general public.

boo hoo hoo

 

[briansmichaud]

Right. You don't know what pathophysiology is.

There might be nurses fat enough, but never smart enough.

this is great...MD'05 i love your posts!

 

[briansmichaud]

Hello everyone. This has been a wonderful, enlightening experience. Good luck to all of you. Hopefully, med schools will begin to teach better reading and communication skills. I've had a great time though.
thanks for your posts. Oh, and to usaf md05, all of those quotes were in response to nasty posters. read it again.

you are being ridiculous

 

[briansmichaud]

Really? I first developed my disdain for nurses working several menial jobs in the hospital. That disdain was later reinforced while in medical school. Granted, there are a few nurses that are pleasant and hard working, but the majority I encounter are angry, unfulfilled, hateful, screaming, backstabbing, and gluttonous individuals. The "caring healthcare provider", right.

funny...very similar experience while working lower level healthcare jobs as well. guess that just adds support to your statement. i am sure we are not the only ones to experience poor nursing attitudes as MAs, etc...

sorry to say...but many nurses i have encountered do have BMIs in excess 30. it seems their struggle mimics the general publics'. i find this ironic...they should know better with all their schooling!!! MD'05 is right!

 

[briansmichaud]

No it is not. I am sick of fat nurses. For chrissakess, we have patients that are 350 lbs with DM, HTN, COPD, venous insufficiency, and hemorrhoids and the nurses are just as bad. Instead of worrying about advanced degrees they should go mall walking.

 

[MD'05]

Well, I'm sick of overweight, out of shape MDs who smoke and ride motorcycles without helmets. You think with all that education, every MD would be in marathon ready shape, eat nothing but whole grains and lean protein, and never touch tobacco.

At least we agree on something.

 

[GeneGoddess]

LOL Gene Goddess- I read your post, and I honestly thought you were making fun of me! I thought we must know each other or something! I have a little belly, I smoke Marlboro Lights and I ride my morcycle without a helmet most of the time!! Yeah, yeah- I know better, but what's life without a vice or two? I only do it so I can have more empathy for my patients...
I can't believe this thread still lives. It wore my butt out last night!

Nah...not making fun of you! But I have to groan every time I see this one surgeon. We park our motorcycles next to each other (yeah, I'm a biker-chick). I've got the leather jacket, gloves, full-face helmet, etc. He wears a do-rag. I asked him once (teasing) if he thought certain colors offered better protection than others... A great case of "do what I say, not what I do!"

 

[USAF MD '05]

Nah...not making fun of you! But I have to groan every time I see this one surgeon. We park our motorcycles next to each other (yeah, I'm a biker-chick). I've got the leather jacket, gloves, full-face helmet, etc. He wears a do-rag. I asked him once (teasing) if he thought certain colors offered better protection than others... A great case of "do what I say, not what I do!"

Gotta love the girls that ride. My justification for not wearing a helmet all the time is the number of times my wife has told me how thick headed I am. I figure that there has gfot to be at least 6 inces between skull and brain! Ride safe.

 

[GeneGoddess]

Gotta love the girls that ride. My justification for not wearing a helmet all the time is the number of times my wife has told me how thick headed I am. I figure that there has gfot to be at least 6 inces between skull and brain! Ride safe.

In Texas, they overturned the mandatory helmet law. You can ride without ONLY if you have proof of more than $10,000 in medical insurance. I figure that my head is worth more than $10,000! Besides, when I rode a bicycle, guys used to follow me, catcall, etc. Not fun and somewhat scary. With the helmet, people just assume I'm male. Unless, of course, I don't tuck my hair in my jacket. That tends to be a dead give-away!

 

[ORS]

In Texas, they overturned the mandatory helmet law. You can ride without ONLY if you have proof of more than $10,000 in medical insurance. I figure that my head is worth more than $10,000! Besides, when I rode a bicycle, guys used to follow me, catcall, etc. Not fun and somewhat scary. With the helmet, people just assume I'm male. Unless, of course, I don't tuck my hair in my jacket. That tends to be a dead give-away!

I hope your head is worth more than that. I love to ride but wear a helmet (otherwise I would be dead as my head smashed into a mercedes that cut me off!!!!). $10,000 is nothing, and TX should require $250,0000. 10K can be spent in the first 30 minutes in the hospital (transportation, life support, CT/MRI, films, staff (10 people wil be working on you). And god only knows how much it will cost you (oh, I mean the taxpayers) when the 10K runs out. Yeah, I used to ride w/o a helmet, but wised up just in time. Please remember to sign the organ donor card and have a living will/DNR...

 

[donnap86]

I think this sucks. If your a nurse and u want to be called doctor GO TO MEDICAL SCHOOL like the rest of us real doctors (to be).

 

[donnap86]

Do you guys really think that patients won't freak out when they find out their FP "doctor" isn't an actual doctor but a nurse? Trust me, while I'm all that freaking health insurance money I better be seeing a real MD/DO and not a F-ing NP or PA. The people won't stand for it!!!!!

 

[Acherona]

Do you guys really think that patients won't freak out when they find out their FP "doctor" isn't an actual doctor but a nurse? Trust me, while I'm all that freaking health insurance money I better be seeing a real MD/DO and not a F-ing NP or PA. The people won't stand for it!!!!!

I had to go to the doctor a couple weeks ago to look at some cuts and scrapes and because my doctor wasn't in they asked me if I was willing to see the NP instead. Unlike the doctor would have, the NP spent like 45 minutes with me and even did some research on her computer to find info about a treatment she was recommending for me. While I was annoyed at first that I had to pay the same amount to see the NP, I was very happy with the personal attention. A doctor's expertise is probably not necessary for 90% of cases so I really have no problem seeing the NP unless I have something more serious.

 

[waterski232002]

I think that everyone would agree that mid-level practicioner's are an effective means for basic health care and to supplement the work load of physicians (MDs/DOs) under direct supervision.

The problem is when NPs, PAs, etc start referring to themselves as doctors in a clinical setting. Although some of these people may have earned a doctorate degree, the word doctor in a clinical setting refers to "Medical Doctor" and NOT doctorate of nursing, doctorate of philosophy, doctorate of whatever...

There was a court case a couple years back of a similar incident of such confusion. There was a car accident on the highway and a podiatrist stopped to see if he could help. The podiatrist introduced himself at the scene as a "doctor" and started giving orders. EMS and the patient believed that he was a "medical doctor" and listened to him. After the fact, the patient did very well, but he found out that the "doctor" was actually NOT A MEDICAL DOCTOR, and sued. The patient won and the podiatrist faced criminal charges as well....

 

[EYESURG]

I'm not sure what the concern is, because there are lots of allied health professionals with doctorate level degrees but very few of them actually use the title "Dr" because it confuses patients and because it simply isn't accepted.

This is so not true because most of them use these titles. EXAMPLE: most optometrists call themselves doctors and they inlcude that "Dr." infront of their name. Some actually claim to be physicians! We should end this scope expansion into medicine in all specialties.

 

[EYESURG]

I think that everyone would agree that mid-level practicioner's are an effective means for basic health care and to supplement the work load of physicians (MDs/DOs) under direct supervision.

The problem is when NPs, PAs, etc start referring to themselves as doctors in a clinical setting. Although some of these people may have earned a doctorate degree, the word doctor in a clinical setting refers to "Medical Doctor" and NOT doctorate of nursing, doctorate of philosophy, doctorate of whatever...

There was a court case a couple years back of a similar incident of such confusion. There was a car accident on the highway and a podiatrist stopped to see if he could help. The podiatrist introduced himself at the scene as a "doctor" and started giving orders. EMS and the patient believed that he was a "medical doctor" and listened to him. After the fact, the patient did very well, but he found out that the "doctor" was actually NOT A MEDICAL DOCTOR, and sued. The patient won and the podiatrist faced criminal charges as well....

Hi, do you know how can I find this lawsuit?

 

[waterski232002]

I actually saw it on a television expose... either MSNBC Investigates or something like that (dateline, 20/20, etc.).

 

[edinOH]

And WHEN they do?

I ask because a nurse colleague of mine is taking this route and swears that will be her title in the Urgent care in which she now works.

This is an incredibly long thread so forgive me if this point has already been made but...

A plantiff's attorney would crucify this person when he/she is sued for malpractice. The insurance carrier would need to make sure there is plenty of ink in their pen.

 

[Shah_Patel_PT]

Many dont know about the future plan to make all graduate prepared nurses recive a doctorate degree instead of masters degree. Thus earning the title doctor. Whether you think it is bad or not is up to you.

This is a press release

"Currently, advanced practice nurses (APNs), including Nurse Practitioners, Clinical Nurse Specialists, Nurse Mid-Wives, and Nurse Anesthetists, are prepared in master's degree programs that often carry a credit load equivalent to doctoral degrees in the other health professions. AACN's newly adopted Position Statement on the Practice Doctorate in Nursing calls for educating APNs and other nurses seeking top clinical roles in Doctor of Nursing Practice (DNP) programs."

Reference:
http://www.aacn.nche.edu/Media/NewsReleases/DNPRelease.htm

The fact is midlevels scope of practice (in some states) and number of practioners is increasing.The title of doctor is now something that NPs will gain. This could be confusing and misleading to patients.

What do you (residents & Med students) think about this? Does it matter?

If they really want to be called doc....I say the licensure prerequisites should be raised. Ex. raise the pass percentage on their exam by 10%

 

[impetigo]

Nice. 5 consecutive quality posts. Way to bring up that post count.

 

[bell412]

since you guys are not really doctors how about we call you woctors.

 

[adamdowannabe]

I have an odd "moral to the story"

I was a professional chef, and obviously even after graduating from a prestigious culinary school, you get a job as a "cook", even though you have a bunch of education you get the low man on the totem pole job. A residency in essence. All this school, you learn everything there is to know about the chemistry of food (yes chemistry of food) and now ya gotta be a little cook? Learning in school, doesn't teach you to actually apply the knowledge, so ya have to learn how to do it for real....for a number of years, then you get to be a sous chef.. a mix of running the kitchen (some autonomy), and still doing the cooking work (scut work), some responsibility, yet the ultimate "numbers game" is left to the chef, he gets the ulitmate call on the specials of the day (if anything goes wrong, it is ulitmately his mess to deal with), but if you have been working for a chef for a while your opinion is always accepted, except for gross errors...... He has to make sure all the food cost and labor cost is up to par, he gets the productivity bonus (if you're lucky, you get a cut for your hard work)


I followed this learning model, and had a great time as a sous chef, just enough decision making(Limited autonomy), a few people to teach stuff to (the line cooks) and I learned a lot of stuff from these fresh faces too, and even was learning spanish and some truely ethinic recipes from the prep cooks and dishwashers, they bust their ass......

Then I got a job as an executive chef.... I had finally made it, the pinnacle of the culinary world!

I had fun for a few months of being "the man", but the priorities shifted, now I was worried about "the bottom line" about always having to make the right decisions, or else PEOPLE DIE!!! (ok, or else food doesn't sell, and my numbers sucked) I spent more and more time on the phone yelling at purveyors, and such.... I pushed numbers, and did paperwork, sooo much paperwork, but I had arrived!!!!...... after a year, I decided it wasn't worth it to me, I prefered to be a sous chef, I missed the actually cooking, I missed having someone who knew more then me to ask questions to, I realized the Chef has the experience, more training, more understanding, I realized I didn't need to be that guy....... I wouldn't have ever known that, had I not become that!

So, what does this have to do with the price of chi in tina?

I am going to be a PA, a damm good one! Did I get into medical school, YES, did I have doctor friends tell me not to go, YES, but the PA/DO-MD is a similar dynamic, as the kitchen (kind of) The PA gets to be the eternal Sous Chef, the Dr. will always get the last say, the Dr. will always make the most important decisions (and although the oppurtunity to become the "doctor" involves more then a promotion, being the proverbial sous chef is a great place for a lot of us)

I applaud the MD's and the Do's (especially the Do's, because when I told my friends when I got into DO school, they joked with me how osteopathic is like witch doctory, then teased me about cows blood and chicken bones and spells)

You guys have decided to dedicate a long route to your goal, and that 6-8 years of residency and fellowships I wasn't ready to commit to, when I knew I wanted to be the "sous chef" all along. Plus, I thought getting into Med school was the final battle, only to find out, now I have to worry about tryin to get a residency match...... putting someone who squeeked into med school, in competition with the "best of best" all vying for a certain residency.... thats enough stress to make med school twice as miserable as just the education!

The Whole Dr.Nurse thing, and people wanting their own clinics, is pushing it, but insurance has screwed us as a nation, Maybe the pinncale of medicine is being the MD on an insurance company board, who gets bonuses based on how many excuses he can come up with why people don't need the treatment, so they won't reimburse for it.

As for the MD's who always say...." PA's?, I would never hire one", re-evaluate your thoughts........ you might find a PA who is really smart, and really good at playing the second fiddle, an extension of your hands, someone who becomse a trusted colleague, and always comes to you for your well earned expertise. Someone who got into the career, because they want to do all the things you don't want to do anymore, because you have more important things to do....... they might have something important share, regardless if they went through 6 years of residency or not.

So, I want to be a Sous Physician, because it's the perfect midlevel career in medicne, not a sneeky route to being a doctor, I just think the title physician assistant has too many syllables, it should be shorter...

like, Physant, (totally joking)

a PA gets taught medicine (not nursing) a PA appreciates there is a more experienced person around to double check with. A PA might even be able to catch something an overworked physician missed because of time issues..... Just please be kinder about your statements concerning the PA profession, and how it is a not quality medical care, please?

 

[bell412]

i'm a robot RN that was sent from another planet. this is just a secret so lets keep this between you and me ok. i'm secretly working for the american nurses association and i've been programed to know everything you do. shhhhhhhhhhhhhhhhhhhhhhhhhh top secret.

 

[Jeff698]

Adam...

Outstanding post. It shows some serious insight into what you want out of your professional life. It's very clear you've given serious consideration into your career.

I absolutely love the cook analogy and absolutely understand where you're coming from. I had the same thoughts when thinking about applying to medical school. I was all set to apply to PA school for the same reasons you mentioned until I realized I couldn't be an EMS director unless I was a physician.

Again, thanks for the great post.

Take care,
Jeff

 

[CircleTheDrain]

I think that everyone would agree that mid-level practicioner's are an effective means for basic health care and to supplement the work load of physicians (MDs/DOs) under direct supervision.

The problem is when NPs, PAs, etc start referring to themselves as doctors in a clinical setting. Although some of these people may have earned a doctorate degree, the word doctor in a clinical setting refers to "Medical Doctor" and NOT doctorate of nursing, doctorate of philosophy, doctorate of whatever...

Perhaps we need to come up with a title for those with Doctorates like "Doctoras " or "Doctorians"

 

[JudoKing01]

You overexaggerate! Most PAs make half and most CRNAs make about two-thirds of what you quoted! No matter how outrageous mid-levels get with lobbying for power, physicians will always be on top! Non-socialized healthcare is what allows limited license practitoners and mid-levels to thrive but it will also keep them in check. If more Ophthamologists were available, the general public would choose them over an Optometrist. How many people actually choose Nurse Practioners (outside of the psychiatry) or CRNAs? Next to none is the answer. Most nurse practitioners see patients in a physican's office. Most CRNAs anethetize patients in a hospital. If these mid-levels become independents then the media will likely inform the public of the "scary state of healthcare" with some over the top news report. In turn, the general public will check the credentials to the right of the healthcare provider's name.

I have yet to read the rest of this post, but I work with a number of CRNAs who cleared 200k last year, and that is NOT an exaggeration. These guys work non-stop and get paid $2000 for a 24-hr shift here. It's ridiculous.

By the way, I have a PhD and I was a nurse before I applied to medical school and I NEVER introduced myself as Dr. G to the patients. First of all, that is confusing as hell to the patients, and second of all, do you think I wanted them asking me medical questions that I probably didn't know the answer to as a friggin OR nurse? Hell no. Just let these new Doctor Nurses call themselves doctors to a few patients and when they get asked questions they have no idea how to answer, they'll wise up.

 

[toughlife]

I have yet to read the rest of this post, but I work with a number of CRNAs who cleared 200k last year, and that is NOT an exaggeration. These guys work non-stop and get paid $2000 for a 24-hr shift here. It's ridiculous.

By the way, I have a PhD and I was a nurse before I applied to medical school and I NEVER introduced myself as Dr. G to the patients. First of all, that is confusing as hell to the patients, and second of all, do you think I wanted them asking me medical questions that I probably didn't know the answer to as a friggin OR nurse? Hell no. Just let these new Doctor Nurses call themselves doctors to a few patients and when they get asked questions they have no idea how to answer, they'll wise up.

What makes you think you cannot compete with them? If you are willing to work for 200K, doing what they do, then you have nothing to worry about. We need more med students going into gas and just take this jobs back.

Here's a scenario, what would happen, if say, all anesthesiology jobs paid $175K across the board regardless and that med students continued to go into gas programs as they are now. Eventually, all the jobs CRNAs have would be taken over by MDAs, since I imagine, a hospital rather have an MDA than a CRNA if it costs them the same.

I for one, am not worried because in the end, I will still make a decent salary and I am willing to do what it takes to guarantee me a job. The most, I ever made in my life was 14K/yr so 200K is cool with me.

Besides, I am hispanic and we are known to work for cheap so CRNAs will not outcompete me in that regard

 

[Whodathunkit]

As for the MD's who always say...." PA's?, I would never hire one", re-evaluate your thoughts........ you might find a PA who is really smart, and really good at playing the second fiddle, an extension of your hands, someone who becomse a trusted colleague, and always comes to you for your well earned expertise. Someone who got into the career, because they want to do all the things you don't want to do anymore, because you have more important things to do....... they might have something important share, regardless if they went through 6 years of residency or not.

So, I want to be a Sous Physician, because it's the perfect midlevel career in medicne, not a sneeky route to being a doctor, I just think the title physician assistant has too many syllables, it should be shorter...

like, Physant, (totally joking)

a PA gets taught medicine (not nursing) a PA appreciates there is a more experienced person around to double check with. A PA might even be able to catch something an overworked physician missed because of time issues..... Just please be kinder about your statements concerning the PA profession, and how it is a not quality medical care, please?

Adam. In a move usually unheard of on SDN, I would like to say that after reading your post, my opinion of the role of a PA has changed. I would be happy to have a PA such as yourself by my side. Let's hope we have more teamwork relationships in medicine instead of everyone hating on "who wants to be what, without putting in the effort".

 

[JudoKing01]

What makes you think you cannot compete with them? If you are willing to work for 200K, doing what they do, then you have nothing to worry about. We need more med students going into gas and just take this jobs back.

Here's a scenario, what would happen, if say, all anesthesiology jobs paid $175K across the board regardless and that med students continued to go into gas programs as they are now. Eventually, all the jobs CRNAs have would be taken over by MDAs, since I imagine, a hospital rather have an MDA than a CRNA if it costs them the same.

I for one, am not worried because in the end, I will still make a decent salary and I am willing to do what it takes to guarantee me a job. The most, I ever made in my life was 14K/yr so 200K is cool with me.

Besides, I am hispanic and we are known to work for cheap so CRNAs will not outcompete me in that regard

woah, i never said i couldn't compete with them. i was just stating a fact, lol. i don't want to be in anesthesia, i want to be a butt scoping poop doctor. but as far as rather having an mda than a crna, i'm sure the hospital would, but if i was the patient - and this is nothing against ologists, just my experience - i'd rather have the crna take care of me. they know what they're doing way better than the ******* ologists i've been around.

 

[docB]

Besides, I am hispanic and we are known to work for cheap so CRNAs will not outcompete me in that regard

LOL Dude! Is this what Vincente Fox was talking about?

 

[toughlife]

LOL Dude! Is this what Vincente Fox was talking about?

I am not sure but I think he said something to the extent that mexicans take jobs that not even blacks want. I am not mexican but I would happily take a job that pays 200K from a CRNA. And if needed be, I will take less to get it.

 

[sunnyjohn]

Besides, I am hispanic and we are known to work for cheap so CRNAs will not outcompete me in that regard

 

[RNPhD]

Well, this is my first time visiting any of the message boards here. I am a nurse (go ahead, attack me). I was just speaking with another nurse about Dr. "behavior" and I actually defended the doctor in this conversation. My friend advised me to visit these boards to see if I felt the same way about "doctors" after reading a few posts. I am shocked and disappointed. I thought surely in the year 2005, we had made more progress than this!! This debate over who is the "Dr." is ridiculous. If everyone in the medical field would stop concentrating on who wears the white coat, maybe patients would be getting better care and Dr.s would be getting sued LESS. Nurses, Doctors, and anyone else involved in patient care should be focused on the patient....not on who has more power. Don't assume that all nurses want to be doctors. Some of us choose to be nurses because we enjoy caring for our patients and having more than 10 minutes to spend with them. That does not mean that we are less educated than doctors. We just choose to use our education in a different way! And.......many patients are choosing to see Nurse Practitioners because the NPs take the time to actually TALK to them. The patient feels like someone finally cares. Doctors can only blame themselves for that. There are great doctors and there are great advanced practice nurses. The patient doesn't care what title the person has or if they are wearing a white coat. The patient just wants the best care possible. If medical professionals would start respecting each other and stop behaving like children, maybe patients
WOULD get the best care possible.

I'm not sure if this forum is still active, so I don't know if my post will be read by anyone.........but, just in case someone else is still reading......
I came across this website by accident, but began reading....and laughing. I was particularly amused by the post where the writer "wasn't sure if the Board of Nursing regulates the practice of APN" Who else would regulate the practice? Nursing regulates nursing, just as medicine regulates medicine. Nurses would never let MDs regulate their practice, nor should they. Due to the state of health care today, the role of the nurse is expanding. Depending on what part of the country you are in, APNs don't need a collaborating MD (the word is COLLABORATING, not controlling) to prescribe or to admit to hospitals. They are totally independent. They are independently practicing nursing. In many parts of the country, an APN may be the only health care professional available. We are an important part of interdiciplinary health care. Instead of trying to understand the role of the APN and their scope of practice so that we can all work together to care for those in need of health care, many of the posts are negative and derogatory. The underlying message is that you feel threatened.
I have an earned PhD in nursing. A PhD is the highest academic degree given in this country. I am a doctor. I'm not a physician, and I don't want to be. I am a doctor and use the title both inside and outside of academia. When asked, I do explain that I am a doctor of nursing, not medicine. When was it decided that a medical doctor is the only dicipline allowed to use the title? Yes, the public may be confused, but it is our responsibility to make them informed. As far as the DNP, I'm not sure if I'm in favor of it. But--I will look at all the issues involved and make an educated decision.

 

[CatsandCradles]

Dear smiley2,

As a student that will soon enter medical school, I just want to say that you are very brave for posting and responding here.

I think that a lot of pre-med students are simply full of pride sometimes...and this can be our greatest downfall. Our pride gets so big that we have the tendency to look down on anything that could match that prestige.
It's true that many of us want to play the role of God and this is idolatry.

A lot of what the other posters have posted on are quite fair and articulate comments, however after carefully reading your post and other folks post, I clearly see that a number of posters were making false claims about you that you didn't even make.

I think evolutionarily, humans are all in a struggle to survive. It's in our genes. We, whether we are men or women, are all trying to get 'one up' on the other person. Resources (that is money) are limited, thus people will fight one another and do whatever it takes to climb up the social ladder.

The fights may take place on a forum such as this, or on Capital Hill before a Senate committee....but the bottom line is, it all boils down to a Thomas Malthausian theory on society.

1) Money
2) Prestige (the God complex)
3) Patients

In reality, it's just 1 and 2. Sure, most pre-meds will say they want to serve patients and society - well we're liars. If we really felt that way, we'd see waves of doctors trying to practice in third world nations were people need help. So you see, we doctors are not the saviors that the glossy media and television shows would like all of you to think.

Ever been to the doctor's office? What's the first question they ask you? "What insurance plan do you carry?"

So, as long as Money and Prestige are mixed together, it's no wonder that the doctors on this forum went into Blitzkrige mode and posted the way they did.

I guess it's that primitive brain stem that is located in all of us. We let our brain stem take control of the supposedly "higher" cerebral functions of our minds.

Well, your brave for posting all you did. And I admire you for doing that. You walked into a room full of angry dogs and came walked out a little bit shaken, but probably stronger for it.

You have a lot to be proud of and that should make you smile



C&C

 

[TNNP]

While a PhD in nursing or any other subject is worth discussion, Im hoping to gain feedback a the new degree that all graduate nursing stundents (particularly NPs) will be required for entry to their profession by 2015. They call this the Doctrate of Nursing Practice (DNP or DrNP).

This is the degree that they will get them
"Independant...Practice", "independent reimbursement", and "Admiting" privileges.

also
"The DrNP, or clinical doctorate, prepares the graduate to practice independently with the most complex patients"

Can you belive this! If not go to the reference listed above.

If you dont think they will expand their scope of practice, remember that in many states the board of nursing determines their scope of practice. Since nurses make up the largest group in helathcare they have the power to lobby hard.

I am an Acute Care Nurse Practitioner and frankly I am surprised at the aggression I am feeling on this thread. The NPs I talk with everyday have no interest in working solely independently. (maybe I've been niave) I for one see my role as a physician extender (and so do most of the ACNP's I communicate with). I have a certain amount of autonomy (protocol and knowing the personal preferences of the physicians I work with, of course)--I handle the uncomplicated things so that he can focus on the more complicated things. I'm glad the physicians I work with are clear about what they are comfortable with me handling on my own--I also know at what point they want to be notified--this is key.

I think that the role of the NP at least in TN is not clearly defined, even by our state board--so there is a lot of variation depending on the physician you work with. I also feel that NPs need physician supervision and clearly defined expectations--that can only come with physician collaboration. If the MDs won't work with us then we have to find a way to define ourselves--I'm saying we need your assistance.

To the question at hand about the DNP. I don't understand the push either--I don't think adding some extra letters will make me a better clinician and I certainly don't want anyone calling me Dr. If I wanted that I would go back to medical school, but as it is I don't want the liability that MDs have.

I think anyone who says that we have the same education as a physician is gravely mistaken. I am not trying to demean my profession, because I think there is a vital need for midlevel practitioners, I feel we are well-educated and we can be of great assistance to the physician we work for and the patients we care for--but we have to work together and clearly define our role as it pertains to each individual pratice setting.

For the most part, I think any NP who wants full physician privileges is biting off more that he/she can chew and setting up for a failure, although we are well educated there is no replacement, as many of you have said, for the intense education and training that you get.

I don't mind obtaining a DNP, but this is one NP who likes my clearly defined role, close physician collaboration, and just enough autonomy!

 

[silas2642]

I don't really give a crap what NP's want to call themselves, doctor, God, whatever-- it doesn't matter to me. The thing that drives me nuts is when nurses start thinking that they ARE doctors or know more than them. My philosophy is if you want to be a physician, then go to medical school like the rest of us have to.

 

[MacGyver]

I was particularly amused by the post where the writer "wasn't sure if the Board of Nursing regulates the practice of APN" Who else would regulate the practice? Nursing regulates nursing, just as medicine regulates medicine. Nurses would never let MDs regulate their practice, nor should they. Due to the state of health care today, the role of the nurse is expanding.

Come on now. WE all know that the nursing boards are playing semantics games. They know that NP practice is practicing MEDICINE, not nursing. Scripting drugs was NEVER considered part of "nursing" until the state nursing boards got together with their fancy lawyers to get a work around from the state medical boards.

Its a loophole that you guys are explointing, nothing more. That same loophole would allow nursing boards to declare that surgery is the practice of nursing, and therefore not under the purview of state medical boards.

If state medical boards wanted to, they could arbitarily declare that checking machines, administering IVs, changing bed pans, etc is the practice of MEDICINE and use their authority to regulate it. They have the same power to do to nursing what the nursing boards did to medicine. The difference is that **** flows downhill; nobody WANTS nursing's scope of practice, whereas everybody and their brother wants a piece of the "practice of medicine" pie.

The reason state nursing boards started playing these semantics games to encroach on doctors turf has NOTHING to do with improving patient care and EVERYTHING to do with $$$$$$. Ditto for this stupid DNP idea

 

[mysophobe]

This is so not true because most of them use these titles. EXAMPLE: most optometrists call themselves doctors and they inlcude that "Dr." infront of their name. Some actually claim to be physicians! We should end this scope expansion into medicine in all specialties.

I think she was referring to other professionals, i.e., people with PhDs or the like. I know there are some psychologists that do rounds in hospitals and see patients in hospitals, and many places actually have it written somewhere that people not possessing an MD or DO cannot call themselves doctor so that the patients are not confused.