Interesting Physician Perspective On NPs - page 7

I am not an NP. I am a full time rapid response nurse at a teaching hospital. This morning I stopped in to residents office to update the night residents on what had happened with their patients and... Read More

  1. Visit  uRNmyway profile page
    0
    Well as far as salary restrictions go, its been my understanding that cost of living is much lower in the South compared to the North. Please correct me if I am wrong though!
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  3. Visit  SycamoreGuy profile page
    0
    Quote from Jeweles26
    Well as far as salary restrictions go, its been my understanding that cost of living is much lower in the South compared to the North. Please correct me if I am wrong though!
    It depends on the state and city. All things being equal I believe salary is lower even when cost of living is taken into account.
  4. Visit  PMFB-RN profile page
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    Quote from Jeweles26
    Well as far as salary restrictions go, its been my understanding that cost of living is much lower in the South compared to the North. Please correct me if I am wrong though!
    *** I never found that to be true. Where I live in rural Wisconsin is pretty darn low cost of living. After spending a lot of time looking into it I never found anyplace with the cost of living vs pay rate I found here. Living in Wisconsin and working across the river in Minnesota. We bough a 4 br, 2 ba 10 year old house on 43 acres in the country with woods, a stream, fiels and some farm land for well undr $100K. A very nice house in town can be bought in the $50-$60K range. Starter homes in the $30K range. New grad starting pay runs about $65K. With differentials a new Rn can be making $100K year without OT in 4 or 5 years.
    Last edit by PMFB-RN on Nov 15, '12
  5. Visit  VICEDRN profile page
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    I live in the south and I think the restrictions on nursing practice are just a reflection of broad social and cultural problems. Other New Yorkers tell me it's not really cheaper here. Instead of taxes, you pay for everything individually like garbage service and water.

    As for protocol, I basically look at the np job as chart auditing. Any real work is done by the md. The np just answer questions from RNs, does evaluations of issues and decides whether to pass them on to md or ignore them and makes sure all the right orders are in system such as foley, pain meds, etc. if you don't write protocols, you just auditing charts. I bet nurses used to just verbal this stuff to md before the joint commission started looking into it.
  6. Visit  marty6001 profile page
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    Great story... Except for using the term mid-level. While it's an accepted term in the medical community I remember reading a position statement from the ANA refusing to use the term... Personally it makes me cringe to hear it when anyone in my hospital uses it... A losing battle I know but I can fight the good fight right???
  7. Visit  SycamoreGuy profile page
    0
    Quote from marty6001
    Great story... Except for using the term mid-level. While it's an accepted term in the medical community I remember reading a position statement from the ANA refusing to use the term... Personally it makes me cringe to hear it when anyone in my hospital uses it... A losing battle I know but I can fight the good fight right???
    Physicians have to pad their egos somehow right? I'm not sure there is a good term for both NPs And PAs. On the other hand I'm not sure NPs and PAs should be lumped together.
  8. Visit  treejay profile page
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    Quote from SycamoreStudent
    On the other hand I'm not sure NPs and PAs should be lumped together.
    How come ?
  9. Visit  BlueDevil,DNP profile page
    5
    FWIW, I don't live in the NE.

    As my family's finances are secure and retirement assured irrespective of our present and future income, we are no longer motivated by salary or cost of living issues, per se. We would never choose to live in any state that didn't allow NPs full independent practice and legally provide parity to my physician colleagues. I would never opt to work alongside colleagues that did not treat me as an equal in every way.

    I do not use the term "midlevel." I always take the extra millisecond to say "nurse practitioners and PAs" when I want to make a statement intended to be inclusive of both professions. That said, I certainly do not object to NPs and PAs being "lumped together." I do feel somewhat badly for PAs; I think it is unfortunate for the group that they are precluded from practicing to the full extend of their education and training. I hope that changes in the future, and I think if there is anyway NPs can help PAs obtain any measure of autonomy we ought to do so. However, we have not yet even been able to free our own members from the chains in states in (ahem) certain parts of the country that I guess it is politically incorrect to specify, lol. Until we can get our own profession straightened out, we are in no position to assist out PA brethren!
  10. Visit  Psychcns profile page
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    I think there are only 13 states where a APRN can practice independently. So we are like PA's in most states regarding mandatory physician involvement. I bet the more restrictive states for NP's are also more restrictive for PA's...
  11. Visit  SycamoreGuy profile page
    0
    Quote from treejay
    How come ?
    For one, IMHO, NPs have more of a leg to stand on regarding Independent practice. NPs are advanced practice nurses whereas PA's are by design assistants. Beyond that and dispite the interchangeable roles (in most instances), I think there is some value in keeping NPs a separate breed.
  12. Visit  myelin profile page
    1
    Quote from Psychcns
    I think there are only 13 states where a APRN can practice independently. So we are like PA's in most states regarding mandatory physician involvement. I bet the more restrictive states for NP's are also more restrictive for PA's...
    It really depends on the state. Even in one of the states that isn't part of the 13 that grant complete independence, the NP rules can still be pretty darn loose (especially compared to PAs)... a significant number only require a "collaborative agreement" (whatever that is) between NPs and docs. It isn't independent practice completely, but it certainly is a lot freer than what many PAs must put up with.
    SycamoreGuy likes this.
  13. Visit  SycamoreGuy profile page
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    That's a good point. In some states a collaborative agreement just means that the Physician will answer the NPs call if he/she has a question.
  14. Visit  Psychcns profile page
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    Besides the states, the scope of practice of NP,s/PA's is likely also influenced by politics and the employer. I worked for a while as a staff nurse on a busy detox floor in a NY hospital. The hospital did not employ NP,s, only PA's.. On my unit, the PA,s wrote all the orders. They worked from detox protocols which they modified and they also treated concurrent medical conditions. There was an attending. He would come to the unit and sit in the nurses station for brief periods of time, one /day during the week and on weekends there was a moonlighter who did the same thing..I think the PA's called the attending sometimes... There was a range of competence with the PA's..the good ones were excellent...the not so good ones listened to the nurses!! The attending had three units.. He may have signed charts but I don't think he ever saw patients..


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