NP vs MD scope of practice

[WilliamsRower]

Hello all,

Right now, I am in the BSN portion of Columbia's accelerated ETP to MSN/DNP program. When I entered the program, my plan was to go into a PMHNP and do pediatric psych. However, now that I am in the throes of the program, I am realizing how much I LOVE working in the hospital, how fascinated I am by the mechanism of illness, and how deeply I want to get into this. After thinking about it fairly extensively and learning more about it, I've become increasingly interested in pediatric ICU or pediatric oncology. However, before I entered the program I had only looked into the scope of practice of a PMHNP because that was my field. Now I'm at the point where I'm strongly considering switching to a postbac and medical school (I'm turning 24 in a few days so I feel like I have time to do this). However, I don't know if it's worth it for me to switch over because I don't really actually know the difference between what an NP and MD can do in these types of settings. Any NPs out there working in a hospital, preferably in peds ICU or onc (but other opinions welcome!), want to comment on the scope of practice, constraints, autonomy, etc? Do MDs really not get that much time with patients? Do NPs do as much as a doctor does? What are the biggest differences? Anyone ever have the same choice and choose the NP? Perhaps silly questions, but I just don't know.

Thanks for any thoughts or advice.

[umcRN, BSN, RN]

I can give you some info. I worked two yrs in a neonatal icu, level IIIc. We had nnp teams and fellow teams. All teams were led by an attending however when the attending went home nnps had pretty much the same autonomy as a third year fellow. They did all procedures :picc placement, intubation, chest tubes, pericardial aspiration, lps, they were the "go to" if your baby was an np baby and crashing, they typically called all the shots. The only major attending decions were if a kid needed ecmo and the attending called the shots on that one whether an np or fellow baby, and if a kid was crashing and likely not to survive the attending would be kept in the loop the whole time but not typically present, attendings only had to come in off hrs if a baby was going on ecmo.

Yes you will get less "face time" as both a doctor and an np because you will have more pts

Also most np programs I have heard of require some amount of bedside experience

I'm not sure if the np role is similar in picu

Sorry for the typos, /my internet it out and I'm using my phone!