Anybody else feel this way

[ACNPCOLO]

Brief Hx: I come from a strong applied science background, got into nursing specifically as a spring board for NP. Now I’m BC in both ACNP and FNP. I love my job as a hospitalist the pt population is primarily internal meds patients. My problem is other NPs not the MD’s as one would expect. There are a number of really sharp dedicated practitioners; however we are constantly being lessoned by the remainder. I feel that a number of the NPs out there are either poorly trained or can’t break the floor nurse mold. I feel that I’m constantly having to defend the profession. I just wonder if it is just me? The other issue is that there are some NPs that think they are MD’s! Finally, what is the point of specialty degrees if any NP will do (FNP in ER, FNPs in Hospital med, etc.)?

Thank for allowing me to vent, I just need to know if this is a global problem.

[traumaRUs, MSN, APRN]

My take on it is we (APNs) will do what the market demands. In my area, FNPs rule the roost: they can do everything. I know a PNP and GNP that have been looking for a long while and still haven't found a job. I also have an ACNP friend who had a hard time and she ended up taking the only job offered.

As to the individual attitudes: do you think experience needs to be factored in? I have two years exp as an APN and definitely feel more comfortable now but still have many questions. And just like in other professions, there are good and not so good APNs. Just like MDs.

I actually had a recent interview for an ER position with a physician whom I've known for 8 years and he asked me what the role of the APN could be and he loved my answer that we are there to supplement the MD, not replace them.

So....my take on things.

[christvs, DNP, RN, NP]

Brief Hx: I come from a strong applied science background, got into nursing specifically as a spring board for NP. Now I'm BC in both ACNP and FNP. I love my job as a hospitalist the pt population is primarily internal meds patients. My problem is other NPs not the MD's as one would expect. There are a number of really sharp dedicated practitioners; however we are constantly being lessoned by the remainder. I feel that a number of the NPs out there are either poorly trained or can't break the floor nurse mold. I feel that I'm constantly having to defend the profession. I just wonder if it is just me? The other issue is that there are some NPs that think they are MD's! Finally, what is the point of specialty degrees if any NP will do (FNP in ER, FNPs in Hospital med, etc.)?

Thank for allowing me to vent, I just need to know if this is a global problem.

Hi, I'm sorry there are some difficulties at your work. I am wondering if you can give some examples of how the NPs seem poorly trained, or how they don't seem to let go of the staff nurse mold. I'm asking because I am a brand new NP (ACNP-BC) and will be starting my first NP position in a few weeks in Hospital Medicine. I am starting to get worried a little about how I will do, and was wondering if you had any tips for me. Thanks so much.

[Corey Narry, MSN, RN, NP]

Brief Hx: I come from a strong applied science background, got into nursing specifically as a spring board for NP. Now I’m BC in both ACNP and FNP. I love my job as a hospitalist the pt population is primarily internal meds patients. My problem is other NPs not the MD’s as one would expect. There are a number of really sharp dedicated practitioners; however we are constantly being lessoned by the remainder. I feel that a number of the NPs out there are either poorly trained or can’t break the floor nurse mold. I feel that I’m constantly having to defend the profession. I just wonder if it is just me? The other issue is that there are some NPs that think they are MD’s! Finally, what is the point of specialty degrees if any NP will do (FNP in ER, FNPs in Hospital med, etc.)?

Thank for allowing me to vent, I just need to know if this is a global problem.

Believe me, as a nurse practitioner who works in a team of other NP's and in a hospital where NP's and PA's are utilized extensively, I can definitely relate to your frustrations. But you have to remember that unless patients are getting in harm's way, the one important thing you need to focus on is doing your job well. Worrying about others will not help your sanity unless you volunteer yourself to be a resource to the NP's you feel are lacking clinical competence. As far as NP's who think they know everything, I would steer clear of them and let them behave the way the do. Sooner or later, they will end up doing something that would hang themselves dry. NP's are just like any professionals, there's good and bad in all of us.

Regarding the last issue you mentioned, I think changes will happen sooner or later. The healthcare field is becoming more and more complex and proving one's competence through appropriate training will become a must in due time. There are geographical areas (mine included) that still don't get the fact that NP specializations must be recognized for the training they are intended for. However, I think we as NP's have become the biggest culprit in why this is not happening because not only do we allow crossing over specializations without question, we even promote it. But I think it's just a matter of time for the reality about different NP specializations to be widely accepted and standards implemented. For one, malpractice and risks of lawsuits are real and any hospital can relate to that regardless of how small or how remote it is. Sooner or later administrators will realize that the NP who is most qualified to assume a specific role is the one who had the appropriate training in their NP program.