Contributions of Master's Prepared Nurses

dudette10, MSN, RN · Nov 15, 2015

I had the pleasure of attending a conference recently at which all of the presenters were board certified psychiatrists. The keynote speaker, however, went on and on about some nurse theorist and her nurse theory. She presented a graphic -I suppose in effort to tout the worthiness of the theory - comparing their theory to Maslow's hierarchy and she had the audacity to say "as you can see it's almost the same thing" to which some nurses were nodding their heads about. I was like, #$%&, you're reinventing the wheel just to give your spectrum personality some sense of accomplishment and think you're fulfilling some nursing prophecy."
My overall and total view of nursing is that it exists to provide the treatments and environment ultimately ordered by licensed physicians or in some cases denists or podiatrists. What's a nursing intervention? "Therapeutic touch," a back rub, rolling someone over in bed, presence???? Anybody off the street can walk into the room and do all of those things. I think it's all a heaping load of excrement. If nursing wants to make itself a psychosocial discipline then forget learning anything about biology, medicine, or the provision of healthcare and become some pseudo psychology-sociology hybrid and stamp your feet over reimbursent, i.e. let me enter the room and provide billable "presence." I think it's totally off putting. They may as well be chanting with feathers and healing crystals and giving out herbal supplements but wait that would require a physician order.
On another note, I took a few sociology courses, at least a half dozen psychology courses, and and a couple of philosophy courses and in none of them did words like "construct" and "paradigm" show up like they do in explanations of nursing theory.

I'm so glad you became an NP about six months ago so that you could sit at the big boy's table and sneer at the nurses who are forever banned from a seat.

Good lord, between you, sauce, and occasionally Jules, the NP behind your names turned you all into senior frat boys on pledge night. Pretty pathetic. After all, in the provider world, you are the lowest rung in the ladder, but in the nursing world you're the highest rung. I think it's pretty clear why you still like to hang out here, rather than going over to SDN where your "peers" are.

Psychcns · Nov 16, 2015

Dudette--now I understand the negativity. I am proud of my nursing background of over 30 years and I always support inpatient nurses because these are really hard jobs. The responsibility without authority, having to work in a group, rotating weekend and holidays to cover units, and take care of patients. I like being a provider because it suits my personality but I always uphold nursing and good nurses help me. And nursing advocated for us so that we are providers APRNs. Under nursing. So what if there is an overlap to medicine. We came from nursing..maybe people could try to be more respectful.

Jules A, MSN · Nov 16, 2015

Good lord, between you, sauce, and occasionally Jules, the NP behind your names turned you all into senior frat boys on pledge night. Pretty pathetic. After all, in the provider world, you are the lowest rung in the ladder, but in the nursing world you're the highest rung. I think it's pretty clear why you still like to hang out here, rather than going over to SDN where your "peers" are.

Very true in the provider world NPs are the lowest rung which I think is unfortunate. I have worked tirelessly to elevate my practice to the level expected of physicians and be a positive representative of our profession. Despite my criticism of what I believe are some embarrassingly silly tendencies of nursing and frustration that there are so many who don't manage their career as a business I have continued to hope that things would improve in our profession and have attempted to offer suggestions on how to negotiate for top dollar.

FWIW I never joined SDN because I don't think student docs are my peers but you are correct in that I don't seem to have many peers left here either. With complete sincerity, thank you for articulating what I have sensed for a while now.

WKShadowNP, DNP, APRN · Nov 16, 2015

Thats a tough one. Mostly because nurses dont contribute much to medical knowledge besides nursing theory. And nursing theory is pretty much a copy of psychological theory with the word nurse and/or bedside thrown into the mix.
I've read quite a few psychology books and to be honest have yet to find anything that is really "new" in nursing theory articles. Not that I read nursing theory articles since school, but I have been researching new forms of capital punishment and it seems forcing somebody to read nursing theory is considered more inhuman than the electric chair.

It's the taco bell approach. Same ingredients delivered in a different way. :)

dudette10, MSN, RN · Nov 16, 2015

Very true in the provider world NPs are the lowest rung which I think is unfortunate. I have worked tirelessly to elevate my practice to the level expected of physicians and be a positive representative of our profession. Despite my criticism of what I believe are some embarrassingly silly tendencies of nursing and frustration that there are so many who don't manage their career as a business I have continued to hope that things would improve in our profession and have attempted to offer suggestions on how to negotiate for top dollar.
FWIW I never joined SDN because I don't think student docs are my peers but you are correct in that I don't seem to have many peers left here either. With complete sincerity, thank you for articulating what I have sensed for a while now.

Aw, you don't feel you belong, huh? Well maybe it has more to do with you Three Stooges acting like *******s, rather than your role.

WKShadowNP, DNP, APRN · Nov 16, 2015

I recently had a FNP tell me "the reason NPs are better than doctors is that we are willing to take the time to sort through the fine details". I attempted to keep a straight face but would guess there was a horrified stink eye involved, lol. It is as if we divert the focus from a lack of billable skills with hugs and flowers. Why can't we focus on our clinical abilities and have the bleeding heart stuff be a subtle bonus not our only attribute worth grandstanding over?
Worth noting they had just said they only see 7-10 patients a day in their clinic. Not exactly bridging the provider gap with those lack luster numbers. No way would my employer pay me what I make to only see 7-10 primary care patients. It has gotten to the point where I am very negative about so much of the BS that seems to be nursing now. It makes me sad because I do believe nursing is the backbone of health care but this whole "thou doth protest too much" makes me weary and embarrassed for our profession. I enjoyed being a floor nurse in psych and love being a NP but cringe when exposed to the insignificant rhetoric my peers tout with such righteous indignation.

I found when I saw patients with the physician for peds this past quarter that our most stimulating conversations about finding improvements and developing better processes dealt with existing medical and psychosocial paradigms. I did not feel I was eschewing my nurse backgroundâ€”rather I felt I was supplementing it.

Use your MSN to be a part of the service delivery, not to be sucked into the divisiveness that seems to abound. Whether that is as an educator and you spout off realistic knowledge that higher education is great but not all should aim for advanced practice because education for bedside nursing is important too, but it doesn't have to be the be-all, end-all. Or if you want to set an example as an NP that you are different but for all intents and purposes, equal. (Jules A kicks butt doing this!)

WKShadowNP, DNP, APRN · Nov 16, 2015

Very true in the provider world NPs are the lowest rung which I think is unfortunate. I have worked tirelessly to elevate my practice to the level expected of physicians and be a positive representative of our profession. Despite my criticism of what I believe are some embarrassingly silly tendencies of nursing and frustration that there are so many who don't manage their career as a business I have continued to hope that things would improve in our profession and have attempted to offer suggestions on how to negotiate for top dollar.

I honestly do not see what is wrong with that. No matter what role any of us play, this should be our modality: elevate ourselves to the best of our role. There's no shame to be had for consistently matching our physician counterparts. We've long surpassed the 'extender' or 'midlevel' role, although some parlance has yet to catch up to it.

I will extoll your virtues again, if it weren't for the advice you and others here have shared, I'd be accepting a much lower salary at my job offer next month (give or take a few weeks). I also would not have had the inspiration to look up and research what I needed to know to have a modicum of understanding of what I don't know. In other words, the business side of professional nursing.

That being said, as a bedside nurse, I still love what I do. It's hard, and can be demeaning, but there is no shame in taking care of someone's needs, even if they accidentally poop on you when you rush to get the bedpan on them.

PG2018 · Nov 16, 2015

I'm so glad you became an NP about six months ago so that you could sit at the big boy's table and sneer at the nurses who are forever banned from a seat.
Good lord, between you, sauce, and occasionally Jules, the NP behind your names turned you all into senior frat boys on pledge night. Pretty pathetic. After all, in the provider world, you are the lowest rung in the ladder, but in the nursing world you're the highest rung. I think it's pretty clear why you still like to hang out here, rather than going over to SDN where your "peers" are.

Thank you for your challenge. It shows backbone.

To address your remarks, nursing isn't my first profession. True, I'm new to the field, however, I entered for the express purpose of doing what I now do so that shows gumption. What I'm not new to is tenacity, integrity, generating revenue, administering an organization, or leadership.

I believe someone has sold nursing this hugs and feel good pill and while someone ought to care a profession shouldn't be grounded on caring. Regardless of the nursing scope of practice, nurses would not exist if a higher echelon of provider (physician, dentist, podiatrist, and followed in tow by PAs and NPs). Sure, we're independently licensed, etc. and have our own scope, but just what the heck could most nurses move in and do without a physician run hospital, nursing home, clinic, or other entity?

You can bet NPs are at the lowest rung and will forever remain that way, however, despite being the lowest rung we can certainly become a stronger rung. I do hang out a SDN. I follow a lot of forums there. I enjoy the psychiatry forum and frequently learn from it. I interject my thoughts on occassion. I also follow the midlevel forum and whatever other thread happens to stand out. In fact, I had a SDN account that I followed going back to 2008 or 2009. Approaching NPdom I made a new one. My avatar is TR, and I chose him for a reason.

I became a nurse practitioner as a RN regulated by a nursing board so, yes, it's within my purview to interject my thoughts on the direction and misdirection of nursing. True, I find nursing theory to be vapid and shallow and most nursing interventions to be base. I'm not interested in your years of experience because you've merely endured.

PG2018 · Nov 16, 2015

Aw, you don't feel you belong, huh? Well maybe it has more to do with you Three Stooges acting like *******s, rather than your role.

I think most have historically thought of naysayers innovators as being stooges and ******s. We're not content with what we've got. The three of us would all love to be physicians but realized that too late. Frankly, I enjoyed my first line of work too much to have sacraficed that for anything else. We're all very much interested in turning our abilities to do something well into revenue. We could do that as physicians, but with cost v. benefit, I would never catch up with time and revenue lost if I put down everything and went to medical school followed by a period of indentured residency.

dudette10, MSN, RN · Nov 16, 2015

I think most have historically thought of naysayers innovators as being stooges and ******s. We're not content with what we've got. The three of us would all love to be physicians but realized that too late. Frankly, I enjoyed my first line of work too much to have sacraficed that for anything else. We're all very much interested in turning our abilities to do something well into revenue. We could do that as physicians, but with cost v. benefit, I would never catch up with time and revenue lost if I put down everything and went to medical school followed by a period of indentured residency.

Your ego certainly fits that of a Chief of Surgery. Innovator? Really? Your innovation extends as far as your wallet from what I've read. Nothing wrong with picking a career due to the income potential, but you sound sooooo misguided with the, "I gots myself a doctorin' degree on the cheap!" Yeah, that's what I want....a provider that celebrates choosing the path of least resistance to prescribe meds that affect my brain.

With that, I'm done here. Out of all the posters here, you and sauce give me the creeps with your mercenary hubris.

PG2018 · Nov 16, 2015

Your ego certainly fits that of a Chief of Surgery. Innovator? Really? Your innovation extends as far as your wallet from what I've read. Nothing wrong with picking a career due to the income potential, but you sound sooooo misguided with the, "I gots myself a doctorin' degree on the cheap!" Yeah, that's what I want....a provider that celebrates choosing the path of least resistance to prescribe meds that affect my brain.
With that, I'm done here. Out of all the posters here, you and sauce give me the creeps with your mercenary hubris.

Unfortunately, when I entered this endeavor, I was misled into believing that both RNs and NPs were better scientifically prepared. Nonetheless, I've made great gains to push myself beyond what nursing would expect of me. I'm glad you disagree with me because it shows the failures of nursing's past.

Psychcns · Nov 16, 2015

So sauce and psych guy are working below their level of interest expertise or something and want to discharge their frustration onto all of us. We need a "yuk" button. I think there is room to critique the nursing profession without talking about "excrement" "turds" etc. and I think it could be done respectfully.

Jules- you are one of my role models about the money. On my last locum tenens job I used the "I do the job of a psychiatrist, my reimbursement is 80 percent, I should get 80 percent of what they make." I got a higher rate than I would have otherwise.

I love psychiatry and I am so grateful to work as a provider. As a locums I am never burned out because I work in spurts, and I am a hard worker by nature.

I have had years of training in psychiatry and nursing before graduate school. I have observed many psychiatrists and others in action and learned from them. Now I learn from patients, from listening and thinking. I take advantage of any supervision I can because it can only help. But I love the intimacy of the therapeutic encounter and people sense that I care and tell me things that help in my case formulations, diagnoses, prescribing. I love clinical interviewing. I learned the base of this kind of approach as a nurse and the built on it with psychotherapy and then psychopharmacology. I don't hand-hold per say but I listen as deeply as I can. I am also very efficient. And I keep up with new meds and new thinking...