So why even bother with getting an RN?

[netglow]

[h=2]Saw an ad for urgent care wanting to hire MAs. They want you to be able to provide compassionate nursing care, assessing patients & taking effective action. They also want you to be able to triage critically ill patients and prioritize patient care appropriately as well as have skills in assessing, prioritizing many requests by patients, families, physicians, staff. You have to have skill in their EMR & infection control. You gotta coordinate care between clinic and other facilities such as hospitals or physician offices & do telephone triage and call backs ...among many & assorted other requirements.[/h]

[hiddencatRN, BSN, RN]

Another question. Why on earth would any primary office want an NP? Too costly I'd think for not quite enough bang for your buck - a job (especially primary triage) that an RN could do and has for decades.

Hmmm.

The only NPs I know who "replace" RNs are actually working under their RN license because they cannot find mid level provider jobs or choose not to work at the NP level for whatever reason. And they make RN wages.

Do you actually have experience of NPs filling RN jobs at NP wages or are you just making that up to try to make a point? Because it would also be ridiculous to employ a physician as a secretary in a doctor's office at a physician's salary.

[lmccrn62, MSN, RN]

This thread is bizarre and not sure what the bottom line is.

A medical assistant is a medical assistant

A nurse is a nurse

A nurse practitioner is a nurse practitioner. A medical assistant should never identify themselves as a nurse just as a nurse practitioner should not identify themselves as a doctor.

Depending on the type if office should determine the staffing. There are offices that need RNs.

If someone isn't happy with there title then find another. One discipline is no more important than another.

[DizzyLizzyNurse]

$12/hour for an RN? My CNAs make more than that.

I made more than that when I quit my CNA job to be an LPN....8 years ago!

[Altra, BSN, RN]

Another question. Why on earth would any primary office want an NP? Too costly I'd think for not quite enough bang for your buck - a job (especially primary triage) that an RN could do and has for decades.

Hmmm.

In my experience, NPs in primary care are providers. I have not seen it suggested that NPs should function otherwise in an office setting.

[Guest343211]

You know, it's really no wonder this country is going to hell in a handbasket, with thinking like this. The solution to your problem is to sic the government on someone else, to take away their job by regulating it out of existence? Who else's job would you like to use the power of overbearing government to destroy?

IDK, you would be hardpressed to find someone that detests government overlording and excessive government intervention than me. At the same time, consider this. What happens if you are caught practicing medicine w/o a license? Why should it be any different with practicing something that falls within the legal and professional domain of nursing? Just saying. . .

[Guest343211]

No, our MAs do a great deal more than that. I'm very comfortable with their performance and scope. They do a great job and we could not operate without them. We also have one nurse. The only point of my post was the correct the misimpression that one must possess a MD degree to direct MA activities. It may be thus in some states, but not in mine.

I don't identify my location, but there are less than 20 states with completely independent NP practice, so that should narrow it down for you somewhat.

There is a long tradition of MA disdain on this website. My experience with them has been nothing but positive. However, I have only worked with 6 in my entire career, lol. Those 6 have been outstanding members of our team and I've never had any reason to want to replace them. There has never been anything in a primary care office that I have needed that made me wish my MA were a nurse. We don't need nurses in the office. The nurse we have is a wonderful person, but spends most of her time ordering doing inventory and ordering supplies and does very little actual nursing activity. She really is unnecessary, and when she graduates from her NP program and resigns, it has already been decided she will not be replaced, and her responsibilities will be assumed by the office manager.

All I can say is, WOW. So when your MA is listening to heart and lung sounds, what do they really know of it? Yes, in my physician's office, a RN takes VS, input information, and does a focused assessment, to include lungs and heart. Personally, when certain people, physicians, NPs, PAs, or RNs listen and assess heart sounds, I take it with a grain of salt. Most of the miss things. Sure, we could be talking functional murmurs, etc, but still. Many health professions, in general, IMHO, suck at heart sounds. And some of them aren't all that great with lung sounds either. Yes, OK. So, I'm a critical care nurse, and these things can be more of an issue is that setting.

What do I think? I think MAs are not only cheaper, it's the whole "less is more" mentality from the primary provider. Listen, most people don't want anyone to question them. If they miss something, it not only ****** them off (stupid pride and what not), but they feel it may put them in a legally precarious situation should something missed is or may become an issue. Nurses would be obliged to document their assessment findings. Now, if you have a strong RN, with strong experience and good judgment, it would behoove the primary provider to give heed and consider whatever difference or distinction is made. Sure the final word would still come down to the primary, but someone of real integrity, who put the patient first, would put aside any possible pride or excessive worries, and take a closer look at the findings of the experienced RN. Since visits won't be reimbursed, physicians and primaries may not include them in their practices. It would also mean that you would have to take more time to closely vet the RN. This takes time from primaries' practices, for which they are also struggling to optimize patient visits and compensation. In my practice, at least I'd try and I'd bite the bullet and use highly experienced RNs with sound clinical judgment. Systems of checks and balances are good things. There's a big difference in the functioning and thinking of most MAs to most experienced RNs. But very few practices are willing to pay about a third or so of a physician's income to an office RN. For NPs in similar situations, that would make up generally 50-70% of their income.

It seems to also depends on how big the practice is and how many primaries are in it.

[Guest343211]

In my experience, NPs in primary care are providers. I have not seen it suggested that NPs should function otherwise in an office setting.

Well, this is a whole separate discussion. :)

[Guest343211]

Here's a liberal position for you, tell everyone to kiss your rump. Whether they are so called " democrat or republican" they do not care. The top echelon that has the money pulls the strings.

Off topic, but I just have to say, this is so the truth. This is true for all government systems too. You just have to find the one that limits the controls as much as you can.

[BrandonLPN, LPN]

Stupid question, is NP an "add- on" to RN licensure, or completely separate? You can't be a NP without also being a RN, right?

[nurseprnRN, BSN, RN]

Stupid question, is NP an "add- on" to RN licensure, or completely separate? You can't be a NP without also being a RN, right?

Umm, yes. And far be it from me to disagree with your original assertion so late in the discussion.:) (walked right into that one, huh?)

[BrandonLPN, LPN]

Umm, yes. And far be it from me to disagree with your original assertion so late in the discussion.:) (walked right into that one, huh?)

Yes as is "yes thats right" or yes as in "Yes you can be a NP without first having been a RN"? Cause I was under the impression that one had to already be a RN to enter a NP program.

And my original assertion? That "specialist" UAPs will push nurses away from traditional bedside tasks? Already happening in LTC. And if (when) hospitals throw a couple medication aides and wound techs on the hospital floor, acute care will see it, too. But since some seem to associate the "tasky" side of nursing with mindless, menial labor, maybe this is a change that will be welcomed by some?

[nurseprnRN, BSN, RN]

"Yes," as in, "Yes, you have to have an RN license before you can pursue and obtain an APRN license." The original assertion: that it was really a pretty silly question when you think about it. :)