Scary reading doctor forums about NPs...

Specialties NP

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So as I've been winding my way through the decision-making process of NP/PA/MD/DO I found myself at a very active forum community of medical students/professionals/etc. across all parts of the field. I learned LOTS when i was specifically researching what was needed for the medical school process. (I removed the name of the forum due to an administrator PM I got)

I did a search of the term "nurse practitioner" within their forums to get a sense of the thoughts on the field from that angle...

:eek:

Wow! I was not prepared for the amount of negativity and vitriol I saw. Most of what I read was very damning of the NP field (specifically in regards to the progression of NPs to have scopes similar to MD/DOs and independent practice rights).

Is this the feeling everywhere? I'm excited about the opportunity to practice primary care medicine in a primary care clinic without the massive sacrifices of MD/DO school. But I sort of get the sense that NP's are becoming pariahs.

Now I know this is just an internet forum, but I wondered if practicing NPs or NP students were getting a similar impression?

Thanks!

Specializes in Nurse Practitioner.

i see what the OP is talking about. I just browsed one of the forums out of curiosity and i did not like what i saw there regarding the attitudes toward NPs.

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Specializes in Nephrology, Cardiology, ER, ICU.

Just consider the source: unprofessional children posing as doctor wanna-bes.

For those of us who are out practicing, this attitude doesn't exist.

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Just consider the source: unprofessional children posing as doctor wanna-bes.

For those of us who are out practicing, this attitude doesn't exist.

Which is why I like to go over there and play with the kids :lol2:

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Specializes in Nephrology, Cardiology, ER, ICU.

lol zenman My money is on you....

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Well this is good to hear.

I guess, if anything, the responses that I read make me realize the very real limitations in the education of NP programs (DE NP, specifically).

I'm still excited about the opportunities but I'm planning to augment the regimented education with pre-medical science courses and as much clinical as I can manage to stuff in.

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Wowza has an important point that should be reiterated.

These issues rarely have to do with individual NPs, but rather given roles within the heatlhcare system. Many of us believe that Doctors (physicians) should be in charge of the healthcare team caring for patients, including mid-level providers. There is simply no comparison between the amount of training and education a board-certified Doctor (physician) has and the training/education of a PA or NP. Same can be said with a PA/NP and a RN, or a RN and a CNA. Most people believe a CNA shouldn't start IVs, RNs shouldn't start central lines, and PA/NPs shouldn't practice independently. Unfortunately the incredibly powerful nursing lobby is using their political power to push for expanded practice - including clinical independence.

Other hot topics, as I'm sure you've read, include the transition to the DNP, and the propensity of a select few DNPs to call themselves Doctor in a medical setting. A lot of people disagree with these trends, and for a lot of good reasons.

However heated disagreements about the politics of a profession does not mean there is any sort of "hate" for the professionals who do the job on a daily basis. I disagree with NP independent practice, with the DNP, and with DNPs calling themselves "Doctor" in medical settings...but one of my greatest friends is a NP who helps me with my homework just about every day. (of course, she also disagrees with the independent practice, the DNP, and with the "Doctor" thing as well!!:yeah:)

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Unfortunately the incredibly powerful nursing lobby is using their political power to push for expanded practice - including clinical independence.

"Incredibly powerful nursing lobby"????? What have you been smoking??

If the "nursing lobby" had anything approaching "power," nursing practice and US healthcare would be dramatically different, in many ways, than they are today. It is the hospital and physician lobbies that have all the clout and call the shots in healthcare.

That advanced practice nurses, including NPs, have gotten as far as we have, despite the best efforts of state and national physician lobbies to keep us under physicians' heels, is a tribute to how well received and highly regarded we are by the general public and legislators.

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Specializes in Family Practice, Primary Care.

People do realize it was an MD that started the NP profession, right?

I am in NP school right now and have been a nurse for about 18 months. Last month, I saved a patient's life by catching an error in prescribing that a doctor and pharmacist both missed until I caught it. Both have more years of experience than the amount of years I've been alive.

I have come to view the health professions in a "you either have it, or you don't" manner. I may be "only" an RN, and "only" will be an NP, but I read the NEJM and read biochem, biophysics, and molecular genetics in my spare time. Not only that, I don't think those med students on that forum realize what nursing education is like and go by things such as course names to determine what we learn. At the undergraduate level, student nurses are learning diseases processes, pharmacology, etc. As a new grad RN, I had to help residents with prescribing and how to treat a patient because they didn't know what to order. Education is one thing; knowing how to apply it is a completely different world. I've met great NPs, PAs, and MDs and I have no problem at all with a PA being my PCP as she's the only one to catch a missed diagnosis that several MDs missed.

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The negativity is directed at the NP lobby who is continually pushing for expanded practice rights despite doing nothing to improve the clinical education of NPs and the NPs who really think that they have the same knowledge base and preparation as a doctor. The negativity is not directed at NPs who know their place in the health care team.

Thanks for making the point for independent practice! Statements such as the one I placed in bold clarify the need for NPs to seek independent practice as a contributing member of the health care team. I would encourage a review of history and the impact of those who believed it was their role to keep others in their place.

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People do realize it was an MD that started the NP profession, right?

I always thought Loretta Ford RN and Henry Silver MD collaborated to develop the 1st PNP program in Colorado

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Well this is good to hear.

I guess, if anything, the responses that I read make me realize the very real limitations in the education of NP programs (DE NP, specifically).

I'm still excited about the opportunities but I'm planning to augment the regimented education with pre-medical science courses and as much clinical as I can manage to stuff in.

I think it's wise that you're approaching the DE-NP education with caution as it's true that the programs vary a bit, and clinical education can be inconsistent (even within the same program). You are also smart to supplement your experience w/ additional courses or clinical time. But I'm a DE-NP survivor myself, and I'm feeling pretty good about my decisions (though I wish it hadn't cost so much).

As far as the SDN content (which is what you're referring to, I'm sure)--it totally freaked me out too, before I started practicing as an NP. I've now been working as an NP for almost a year (with a few years of RN experience during school, which was invaluable) and I work in a hospital setting as the sole NP on an inpatient surgical team. Most of the time I'm working with interns/residents/PAs and we have a great time working with each other.

My advice to you is--do exactly what you're doing. Work hard, identify your weaknesses and improve upon them. Identify the limitations of your education and do what you can to maximize your learning and experience. Sharpen your strengths and use them boldly. Do what you like to do. And when you're out there working as an NP, consider your scope of practice every day--and think about WHY it is what it is. That way you will push your practice to the limits as much as possible and be as effective in your role as you can be.

And ignore those threads on SDN. They're silly.

:-)

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Thank you Kanzi, that was very encouraging.

What track did you take, working surgery?

I'll be doing FNP with the goal of working primary care.

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