Is anybody else tired of the nurse practitioner craze?

[WillRegNurse]

Hi all. I am a new graduate RN who is enjoying his first job as a med-surg nurse. I don't know about everyone else, but I am so tired of the nurse practitioner craze that seems to be overtaking the newest wave of graduate RNs. Half the people I know at my new job are part-timers in grad school for a master's degree as a family nurse practitioner or a psychiatric nurse practitioner. Good on them, but does anyone else think the idea of a mid-level practitioner has been taken a bit too far?

I don't know about all of you, but if I had a medical issue, I wouldn't bother seeing an NP. I'd go straight to an MD. The idea of an NP seems folly to me. Either you are a nurse or you aren't one. Or, either you practice medicine or you don't. A nurse practicing some form of low-level to mid-level medicine seems absurd.

The position also seems discredited by the variance in the scope of practice among different states and the fact that NPs can never do surgery. If NPs had limitless prescription power, and could be trained for some surgeries, we'd be looking at something real. But the NP's that I have seen "practicing" at my hospital just seem to be adjunct to the MDs who see their patients. The patients don't take the NPs seriously for just that reason. They seem roleless. I feel like the hospital hires them just as tokens. I don't see NP's as the future of nursing -- AT ALL. There is this one lady nurse practitioner at my hospital who goes into the patients' room and says "Hi, my name is Kristen and I'm the nurse practitioner," and begins some interview while I as the bedside nurse think to myself "You know that patient doesn't care right? You know they will just forget about you once they are seen by the actual MD?" Of course I never say that. But that's what is in my mind. I see no point in them.

I see pure bedside nursing as our future. Nursing education. Stuff more involved in social services.

I think NPs are suffering from an identity crisis. Let me know your thoughts too.

[GM2RN]

The thing about people's opinions? They don't have to be "substantiated" to please you. My opinion is mine, I don't have to substantiate it at all.

You seem to have a tremendous chip on your shoulder, which is sad.

Exactly! "Substantiated opinions" is an oxymoron. Seems the OP may have missed a thing or two in English class.

[N.Betty]

Im beginning to think you are not a new grad at all....but a frustrated MD trol with a dislike for NPs :)

[brandy1017, ASN, RN]

I wouldn't mind being one of the adjunct NP's helping the doctor at the bedside, but I don't have the time or money to go back to school and I don't want to be paying back student loans from my social security in retirement! Where I live there are many and even more new programs for NP now DNP plus a PA program as well. Where will all these people get jobs? I don't want to move to another city or rural area just to get a job, but I do understand the exodus of so many young people from the bedside due to poor working conditions, mandation, and danger of back injuries etc. Who can blame them! So many hospitals are so busy trying to control their nurses, micromanage and intimidate them and then refuse to spend the money on lift equipment etc no wonder so many nurses are doing anything they can to get out as soon as they can! The cost of NP and now DNP is so high and I know fellow workers in these programs who will have $100,000+ in student loans by the time they graduate! My God that is a mortgage without a house and will take a heck of a long time to pay back. You need to be young and healthy to take out large loans like that! I wonder how they sleep at night with all that student loan debt on their back! I'm glad I have just a mortgage with a house thank goodness and no massive student loan debt to pay back!

[donnacarol]

I am a new grad NP form an entry-level master's program and I honestly feel that the education cannot compare to that of the MD. The education prepares the NP to start practice with minimal and basic medical knowledge and does not require any type of "residency" which is where medical students put their extensive didactic knowledge into practice. There is no such required supervised, structured, cohesive training period for nurse practitioners and honestly it is terrifying to think that there are so many undereducated, untrained, green primary care practitioners entering the workforce in quasi-supervised clinical situations. My recommendation is that NP programs tighten up their curriculum and raise their academic and clinical standards. This does not mean pushing for the privalege to put Dr. in front of their name.

[sharpeimom]

I prefer to see the FNP at my MD's office almost every time. She treats me like a human being whereas my PCP usually treats me like Grandma Moses. She doesn't rush me or make me feel as though I'm wasting her time. The PCP is right out of residency and while he may be a summa cum laude graduate of an ivy league med school, he still has a heckuva lot to learn about not being offensively "I'm the boss here" and not making anyone over the ripe old age of forty feel ancient, or treating sniffly little kids like lepers. Give me a caring NP over many uncaring in-it-for-the-bucks-and-prestige generalist MDs who graduate today.

[LadyFree28, BSN, LPN, RN]

I prefer to see the FNP at my MD's office almost every time. She treats me like a human being whereas my PCP usually treats me like Grandma Moses. She doesn't rush me or make me feel as though I'm wasting her time. The PCP is right out of residency and while he may be a summa cum laude graduate of an ivy league med school he still has a heckuva lot to learn about not being offensively "I'm the boss here" and not making anyone over the ripe old age of forty feel ancient, or treating sniffly little kids like lepers. Give me a caring NP over many uncaring in-it-for-the-bucks-and-prestige generalist MDs who graduate today. [/quote']

^^Agreed!!! The NP is NOT a craze...it's extending the RN into a holistic provider in nursing theory while expanding to a more independent level as a healthcare provider...at least in my area. I love that I get to see a nurse practitioner...They are hospitalists, run specialty and urgent clinics, they are really being utilized in a way that is appropriate, are competent, and IMHO are really shaping how healthcare can be efficient...Never fear future NPs...find your niche...some of you survived nursing school in the same conditions (I know I have!!)...you are a resourceful nurse! It will get better...survive and fix the system to make sure future NPs (I am considering this at least 5-10 years from now...leaning to probable to definite...still love bedside nursing) are in more supportive, favorable conditions. We need you in the field...I have worked closely with nurse practitioners in my career...I have experienced the POSITIVE of the roles of NPs in healthcare.

[NurseGuyBri]

I think it comes down to personal experience. For me, I like the nursing model over the medical model. Nurse Practitioners in my experience (both as a patient, colleague, and collaborated) have been more thorough and holistic vs. MD's. BOTH have a very important place, to me. I do think that to be an NP there should be a requirement of 5 years nursing or something similar. Just an opinion :)

[ceridwyn]

Australian NP's by the time qualified must have at least 7 years nursing experience before they are endorsed by the national board. An NP's education, after the nursing degree and grad diploma in their specialty then they go for the Master degree in NP.

An Advanced practitioner is not just advanced in theory and clinical experience during a course, but here experienced in a clinical care as an RN, is the seen the most important aspect of a NP in Australia and they are well prepared to hit the floor running in their new role.

No such thing as a graduate NP, they are already experienced in their field. That''s were the full faith comes into seeing an NP here. You know he/or she has plenty of experience as an RN, already behind them.

[joanna73, BSN, RN]

No matter how proficient a nurse you think you are, you don't know what you don't know. Learning occurs through education and experience at the bedside. IMO, too many inexperienced practitioners are simply looking to jump to the next level, without putting in their time, and far too many programs make this possible. I could enroll for an NP program now, but with only 2.5 years at the bedside, how proficient am I, really? If you want to be a half decent NP, you should have at least 4-5 years prior to entering any program.

[TraceyMarino]

Hi everyone: I recently graduated with my FNP and I am working 3 days with a terrific family practice MD, and one day a week iin the urgent care at the hospital. Just a few thoughts:

I became an NP because I love taking care of people. I love the autonomy, yet I always have back up from my MD, who I consider a mentor and friend.

He is male and I am female. He now gives all his female patients the option of having their annual exam with me---so far, all the female patients have opted for me doing their annual. I asked him about this, and he said, "you did 200 hours of women's health and OB, that's more than I did in medical school---you enjoy women's health, and having you here in my office gives my female patients a choice, and I am very glad for that". So are the female patients.

I don't feel like a second fiddle, and I know I am not a doctor. That is okay. It is important to not get your ego wrapped up in what you do for a living. I understand and accept the fact that there are patients who would rather see a doctor. That is fine with me.

Several of the doctors in our area bring their children to me for their care. I am honored and humbled that they have faith in my skills.

In the urgent care clinic, I have had patients ask me if they can come see me for all their care---I let them know that yes, they can come see me in the family practice office. I have also had patients get angry with me when they disagree with my plan of care, or diagnosis, and say right to my face--"you're not a doctor, you don't know anything". That's okay.

Medicine is a very subtle, very subjective process. I have known providers of all stripes who had terrible clinical skills but great bedside manner, and patients flocked to them. I have also known providers who had amazing skills, could save your life, but had terrible bedside manner and therefore patients hated them.

Go to who you like, trust, who you can talk to. Go to who you have easy access to. I agree with above posters that without NPs and PA's, access to care would be worse than it is now. Other countries have utilized NP's for years with excellent outcomes, and I believe that "mid-levels" are here to stay. I had 7 job offers before I even left school, at every location where I did clinicals. These offers came from physicians, not from administrators, all of whom loved having PA's and NP's working for them and with them. I am always shocked when these "anti-mid-level" comments come from nurses, who, after years of experience will finally appreciate that having an MD is no guarantee that you are gifted at caring for others!

[Iridescence]

From the JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION

Primary Care Outcomes in Patients Treated by Nurse Practitioners or Physicians

JAMA Network | JAMA | Primary Care Outcomes in Patients Treated by Nurse Practitioners or PhysiciansA Randomized Trial

[whoamibutme]

Sad comments from the OP. Sounds a bit catty and judgmental to me.

Completely disagree. Medicine is so individual... to say one would never see a particular clinician because they seem roleless and don't have MD behind their name... yikes. Guess what, lots of mediocre doctors out there too.

Of course, I don't entirely agree with the premise that to be a good NP means you have to have several years experience as an RN. The roles are profoundly different. The training, decision making, scope are all so different. Sure, it's probably good to have some type of experience under your belt. That's the argument PAs make as well. Yet, the true training and growth occurs after you graduate. One could even argue that for family practice, an MA brings better experience to the table than a hospital bedside nurse. They do a lot of delegated tasks in the clinics and are trained and mentored by family practice clinicians.