Quote from Teresag_CNS
I disagree. APNs refer patients readily if there is doubt that their condition may require specialist consultation. I recall reading studies indicating that NPs refer more readily than physicians. The idea that an NP might "miss something" is flawed because the history and physical exam plus maybe a few labs that the primary care provider has to make their decisions do not contain "hidden" hints about serious illness. Interpreting this information is mastered pretty quickly by health care professionals with post-graduate study, whether nurse or physician. In fact, the whole system of medical training (which is part of what NPs get) is geared toward detecting serious illness so it can be ruled out first. There is absolutely no evidence that health problems are missed by NPs, and there is plenty of evidence that APNs of all stripes provide safe and effective care.
As far as education, whether APNs get less education than physicians or not is a matter of perspective. Most nurses who enter graduate school do so after spending some time in clinical practice, unlike physicians. The master's degree APN has more credits than the vast majority of master's degree graduates in other fields. When the DNP becomes the standard for APNs, years of education between nurses and physicians will dwindle even further, making residency and fellowship the main difference. DNPs will not have as many hours of residency as physicians, because our profession does not have the money to make that happen. Most nurses pay their own way, while physicians doing residencies are paid through federal programs that are quite lucrative for the hospitals that employ them. However, the lack of residency hours is made up at least in part by the fact that most APNs are already experienced nurses when they begin graduate school.
Can you please provide the study that you mentioned above? Can you please provide a specific percentage of nurses that have experience when they begin graduate school?
I will provide the medical side of view:
Med student 1st and 2nd years in class from 8-5 every day.
3rd and 4th years in the hospital/clinics 5-6 days per week from 8-5 and staying until 12AM when on call with residents and in some places overnight.
Resident for IM spends 70 hours per week in average at the hospital which translates to 3640 hours per year so at the end of a 3 year residency they have 10920 hours of experience if the avg is 70 hours. This 10920 (give or take since we have 3 weeks of vacation so thats 210 less hours) hours doesnt take into account the hours that resident spend at home/library preparing for the Step 3 (weeks-1 month of preparation) and ABIM (4-5 months of preparation) and reading after their duties in the hospital.
The nurses at the hospital where I work have 12 hours shift 4 times per week= 48 hours per week. Therefore in a year nurses work 2496 hours (if no overtime) and in those 3 years that a resident works its 7488.
10700 vs 7488, and lets not forget one is directed entirely at medicine and the other at nursing (therefore no pathology/treatment training 100% of the time).
In terms of pathology/treatment training you cannot compare one to the other, they are different schools
with very different training objectives in mind. And again this is not to flame, is just to ilustrate that physicians and nurses have different roles in the healthcare system and they were trained for a specific objective.