Nurses Masquerading As Doctors (INSULTING)

[djaychris]

The growing shortage of medical doctors, which will be made much worse by health care reform, will mean more and more patients are cared for entirely by "nurse specialists" and nurse practitioners, instead of physicians. Nurses are lobbying for increased prescribing privileges and for the right to be addressed as "doctor" in health care settings.

(link removed - the page is no longer available)

What do you guys think about this idiot, and the ignorant nonsense he is blabbering over on fox news? Kind of insulting to those of us who have spent years pursuing advanced degrees such as CNP, and often save lives and clean up messes made by arrogant, egotistical physicians...

[nguyency77, CNA]

Fox News... Hahahah, hilarious. To tell you the truth, for primary care I much prefer NP. Sometimes I work as a patient escort at a SNF and I often take people to the doctor. My patients hate it when I leave them alone in the exam room with the doctor, so I usually sit with them.

I really hate the way physicians approach patient assessment. It is so detached, and many of the younger ones seem to believe that prescribing blood pressure medications will magically drop their blood pressure by itself. They rarely ever mention the need for diet changes and exercise. NP for life.

[PMFB-RN, RN]

No one works through medical school. There is no time. Almost every student takes out the full amount of loans to go to medical school. Very few people in my class had their parents paying for everything. So it makes no difference if you come from money or not. This is also why the average medical school debt is $160,000

One of our ICU nurses in in his 3rd year of medical school. He comes and works every other Saterday night as an ICU nurse to maintain health insurance for his large family and some other benifits. He tells me all the time he wishes he didn't have to do it. I have known this man for years, since he was an LPN. By the time he is done he will have hit nearly every step on the health care ladder. CNA, EMT, LPN, associates degreee RN, BSN, MSN-ACNP, second pre-med masters and soon DO physician with ambitions of being a trauma surgeon in the same medical center he has worked since he was a 16 year old CNA. Even though he works one shift a pay period he is certainly not working his way through med school, though most of the cost is covered by the army reserve.

[Hampter320]

My patients hate it when I leave them alone in the exam room with the doctor, so I usually sit with them.

Every patient I've encountered in the outpatient setting wants to be alone in the exam room with the physician, as they want to keep their healthcare information private. A patient escort sitting in an exam room with a patient during a history and physical exam is a blatant HIPPA violation and I promise you no physician would allow it on a regular basis, unless every single patient provides written documentation that it's ok for you to be there with them. So I call BS.

I really hate the way physicians approach patient assessment. It is so detached, and many of the younger ones seem to believe that prescribing blood pressure medications will magically drop their blood pressure by itself. They rarely ever mention the need for diet changes and exercise. NP for life.

Really? I have high BP, and my physician held off on prescribing blood pressure meds for over a year, trying to get me to modify my diet and follow a strict exercise regimen. And for the record, beta blockers, ACE inhibitors, and calcium channel blockers WILL "magically" drop blood pressure by themselves. However, a pill is not the ideal solution.

Sorry to call you out, but I can't stand bias.

[KatieMI, BSN, MSN, RN]

[quote=Hampter320;6124759

Really? I have high BP, and my physician held off on prescribing blood pressure meds for over a year, trying to get me to modify my diet and follow a strict exercise regimen. And for the record, beta blockers, ACE inhibitors, and calcium channel blockers WILL "magically" drop blood pressure by themselves. However, a pill is not the ideal solution.

Sorry to call you out, but I can't stand bias.[/QUOT

If you're relatively young and in reasonably good shape, it is against guidelines to jump start your treatment from pills, and that's right for HTN and cholesterol (except for some special situations described in the same guidelines). Most doctors (and PAs, as well as many NPs for that matter) watch these guidelines as hawks because otherwise they're headed straight into possibility of really big trouble. That's not because they're so smart or care so much about you; they all just cover their backs.

From my (unfortunately) abundant experience from patients' side of the story I just know that if you want a health care provider who won't blindly follow some piece of paper written by some guys (none of them seeing a real patient for year, if ever at all) in D.C., won't cry in terror if you want to use something outside of evidence-based practice and will be willing to work with you as partner, you'll need the greatest luck on the green Earth to find such a doctor, especially if you want only an M.D. But it is relatively easy to find just such a mid-level, especially NP.

[Hampter320]

If you're relatively young and in reasonably good shape, it is against guidelines to jump start your treatment from pills, and that's right for HTN and cholesterol (except for some special situations described in the same guidelines).

You have not uncovered ground breaking news or the cure for cancer with the above statement. This is well known, and all the physicians I've interacted with follow the above.

Most doctors (and PAs, as well as many NPs for that matter) watch these guidelines as hawks because otherwise they're headed straight into possibility of really big trouble. That's not because they're so smart or care so much about you; they all just cover their backs.

Ah, so now you're saying MDs, PAs, and NPs don't care about their patients. So you must be the only person who cares about others.

From my (unfortunately) abundant experience from patients' side of the story I just know that if you want a health care provider who won't blindly follow some piece of paper written by some guys (none of them seeing a real patient for year, if ever at all) in D.C.,

Blindly? Really? I suggest you read NEJM and learn what evidence based medicine is.

won't cry in terror if you want to use something outside of evidence-based practice and will be willing to work with you as partner, you'll need the greatest luck on the green Earth to find such a doctor, especially if you want only an M.D. But it is relatively easy to find just such a mid-level, especially NP.

The world revolves around evidence based medicine for a reason. There's a reason why MDs don't use orificenic anymore to treat a common cold. If you are trying to talk up mid levels and NPs by bragging that they won't practice evidence based medicine then you are doing them more of a disservice than anything else.

[wowza]

Every patient I've encountered in the outpatient setting wants to be alone in the exam room with the physician, as they want to keep their healthcare information private. A patient escort sitting in an exam room with a patient during a history and physical exam is a blatant HIPPA violation and I promise you no physician would allow it on a regular basis, unless every single patient provides written documentation that it's ok for you to be there with them. So I call BS.Really? I have high BP, and my physician held off on prescribing blood pressure meds for over a year, trying to get me to modify my diet and follow a strict exercise regimen. And for the record, beta blockers, ACE inhibitors, and calcium channel blockers WILL "magically" drop blood pressure by themselves. However, a pill is not the ideal solution.Sorry to call you out, but I can't stand bias.

Since a nurse is part of the healthcare team, I am not sure it would be a HIPAA violation, but I could be wrong.I think most physicians are realistic about how much a given patient will be able to control their cardiovascular risk factors just by diet/exercise alone. That said, any doctor worth his salt, will give it a go for a few months until it is clear that it just isn't going to happen. Technically, you need multiple readings in a doctor's office to be hypertensive so most will do diet/exercise modification before the patient will meet the criteria for hypertension.

[wowza]

Ummm... the people who write those guidelines are clinicians AND the leaders in research who are CHOSEN to be part of the panels that write the guidelines. Almost none of them are from DC. Evidence based medicine is used because it is what has been PROVEN to work. These are what guidelines (usually) are based on

[RhinoRocketRN]

Who cares what everyone else says. When patients are in the hospital or see an NP they see for themselves anyway. Either way Im still a nurse, and proudly so.

[PMFB-RN, RN]

*** What is a patient escort? Something very different than a nurse orCNA? My doctors will absolutly NOT be alone in a room with a patient. When they go in we (RNs or CNA) go in. If we can't then they wait for us. This is an ER.

[leenak]

I joke with my husband that I want to be called Doctor Nurse one day. Although I'm not sure I'd pursue a DNP if I had another choice but by the time I'm done with my BSN, I'm sure most of the NP programs will be converted over to DNP.

I think of Physician as the title that is valid for a MD, correct?

I mean we have clinical doctors in other professions like physical therapy, dentistry, veterinary medicine, podiatry, chiropractic care, etc, I don't see the big deal about DNP. Then there are D.O. doctors which I only learned about fairly recently, do MDs have an issue with them being called Doctor?

I don't know, it would seem confusing to me as a patient to think everyone as nurse from the LVN to the NP. Their roles are obviously quite different but they are 'nurse'.

I personally don't care about titles so it doesn't matter to me in terms of a title but there are lots of Doctors who aren't MDs and are clinical Drs.

[sweetnurse63, BSN, RN]

This doctor talks like he is unsure of himself and he is intimidated by the fact that nurses are highly educated professionals that did not have to spend 8 to 10 yrs in medical school. Nurses do not compare to doctors we have two different scopes of practice but we all should be on the same team with one goal in mind which is to help patients cope with their illnesses and to promote healing. I have a problem with any one who makes other people feel like they are way less important because they have lesser education. I have seen so many doctors who walk around with an arrogant and egotistical attitude and some of them are not approachable, but on the other hand , I have met some doctors who are really down to earth, humble and kind. Doctors and nurses are important to healthcare, one can not function without the other and for those doctors that feel like they can do it all by themselves, let them imagine healthcare without nurses, it would be total chaos, the heaalth care system would shut down, it would be a big mess!!!! So, I don't have to have a medical degree to know that I, as a nurse make a difference and is a valued member of healthcare.

[PennStateGuy]

I would take a NP with years of experience over a doctor straight out of medical school. But this guy has a very legitimate point. Nurses are not doctors, especially those of us that haven't gone for advanced degrees. Medical school IS 10x harder than nursing school and only the most elite get into medical school (not at all true of nursing programs). I'm so sick of the inferiority complex of this profession. You can be proud of being a nurse for a lot of reasons (I think nurses are the backbone of pt care and are generally more compassionate care-givers) but we did not go through the schooling doctors went through and we should recognize that fact.