Contributions of Master's Prepared Nurses

llg, PhD, RN · Nov 16, 2015

To the OP: Another approach to your assignment would be to look at specific aspects of care and review the research-- and see who the authors are. For example, in the clinical field of neonatal nursing, NNP's write a lot of the articles in their journals. Other nurses in other types of advanced roles do to. Pick any field and you will probably find much of the same thing. Pick a couple of topics that interest you and that you are sufficiently knowledgeable enough to make some judgments about the importance of articles you find. Look at the authors of those articles, and you will probably find lots of advanced practice nurses making lots of important contributions.

Ignore the bitter group of "physician wanna be's" who will never be happy with nursing because it wasn't the "medical" career they really wanted. Unfortunately, it appears they are not happy with their career choice and just want to bring the rest of us down with them. The nursing profession has a long and valued history -- and a bright future. Sure, it is not perfect (what is?) and there are those who don't value the same aspects of the profession. But you will find that in any profession. Don't let them drag you down.

sauce · Nov 16, 2015

Lol seems like this dudette person has been offended. I believe we have tarnished her golden trinket of nurseness that she ever so proudly wears along her neck. As I said before, we could care less if you have like 30 years of nursing experience. It just means your a very good follower. Because as psych dude said, nursing would be nothing without the physicians and other providers that tell them what to do. I mean what can you do without a Dr.s order? Wipe butt? ice packs? Orange juice? Roll the patient over? Tilt the bed? Start an iv? None of these skills require much thought, intelligence, or judgement. Probably the most difficult aspect of nursing is waking up that chief of surgery because you think something is wrong with his patient.

To be honest, a plumber, electrician, carpenter, etc have more freedom in the power of what they do. At least they can make decisions without have the Doctor of Carpentology paged so they can get some bigger nails to lay the floor with.

Nursing is and always will be nursing. it will never equal medicine, engineering, physics, or freshman level biology... no matter how hard you all try. It is called nursing for a reason.

Nursing would be a much better profession if they spent time teaching students important stuff, because to be honest, at the hospital I previously worked at as a hospitalist, NONE of the nurses with under 4 years experience had a clue on what to do, and continually paged me over stupid stuff and never had a clue what was going on with the patient, much less know what a normal set of vitals are. And to blame is most likely the wasted time on nursing diagnoses, theory, etc, for which that time would have been better spent teaching people actual job related skills, and not trying to fluff up the profession like a giant ball of cotton candy.

PG2018 · 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...

I'm not working below anything. I'm doing exactly what I hoped for and envisioned. I'm actually quite grateful.

PG2018 · Nov 16, 2015

To the OP: Another approach to your assignment would be to look at specific aspects of care and review the research-- and see who the authors are. For example, in the clinical field of neonatal nursing, NNP's write a lot of the articles in their journals. Other nurses in other types of advanced roles do to. Pick any field and you will probably find much of the same thing. Pick a couple of topics that interest you and that you are sufficiently knowledgeable enough to make some judgments about the importance of articles you find. Look at the authors of those articles, and you will probably find lots of advanced practice nurses making lots of important contributions.
Ignore the bitter group of "physician wanna be's" who will never be happy with nursing because it wasn't the "medical" career they really wanted. Unfortunately, it appears they are not happy with their career choice and just want to bring the rest of us down with them. The nursing profession has a long and valued history -- and a bright future. Sure, it is not perfect (what is?) and there are those who don't value the same aspects of the profession. But you will find that in any profession. Don't let them drag you down.

Well you're partly right, but I didn't know it when I began skipping down this merry little path. What I can say is there a nothing about my job that being a physician would really change and the cost isnt worth the 15-20%. However, if we pushed for enhanced scientific training, as nurses, we'd be better off as a professional body. It's so peculiar to find nursing in opposition to development.

llg, PhD, RN · Nov 16, 2015

Well you're partly right, but I didn't know it when I began skipping down this merry little path. What I can say is there a nothing about my job that being a physician would really change and the cost isnt worth the 15-20%. However, if we pushed for enhanced scientific training, as nurses, we'd be better off as a professional body. It's so peculiar to find nursing in opposition to development.

I'm not against development -- or against improving the quality of nursing education. In fact, I have argued for high educational and performance standards on this site for a long time. But that doesn't mean I feel a need to bash the good work that has been done by nurses over the years.

I value "hard science" ... but I also value the social sciences and philosophy. We need all types of knowledge to be strong as a practice discipline and profession. We need both quantitative research and qualitative research ... and solid philosophical inquiry ... and aesthetic inquiry ... etc. etc. because nursing is such a comprehensive endeavor. More than most disciplines, nursing commits to meeting the patient's needs regardless of what they are -- be they for physiological knowledge or gentleness or intuitive understanding or statistical expertise or physical strength or compassion -- whatever. We can't be capable of all these things without be grounded in all types of knowledge. To limit the types of knowledge we "allow in" our profession would be to limit our usefulness -- and that goes against our culture and purpose.

So I choose to include all types of knowledge in my orificenal -- and welcome high standards regarding the all. I choose not to exclude any of them out of hand and choose not to attack those sincerely trying to contribute as best they can to the well-being of others.

PG2018 · Nov 16, 2015

I'm not against development -- or against improving the quality of nursing education. In fact, I have argued for high educational and performance standards on this site for a long time. But that doesn't mean I feel a need to bash the good work that has been done by nurses over the years. I value "hard science" ... but I also value the social sciences and philosophy. We need all types of knowledge to be strong as a practice discipline and profession. We need both quantitative research and qualitative research ... and solid philosophical inquiry ... and aesthetic inquiry ... etc. etc. because nursing is such a comprehensive endeavor. More than most disciplines, nursing commits to meeting the patient's needs regardless of what they are -- be they for physiological knowledge or gentleness or intuitive understanding or statistical expertise or physical strength or compassion -- whatever. We can't be capable of all these things without be grounded in all types of knowledge. To limit the types of knowledge we "allow in" our profession would be to limit our usefulness -- and that goes against our culture and purpose.So I choose to include all types of knowledge in my orificenal -- and welcome high standards regarding the all. I choose not to exclude any of them out of hand and choose not to attack those sincerely trying to contribute as best they can to the well-being of others.

I agree that there are psychosocial elements of healthcare. The philosophy side of things is a bit puzzling. Western medicine is a science-based system. The theories that arise in nursing which seem like little more than philosophical twists to standing psychological or sociological theories is the absence of application and the premise that we can make a profession out of caring. Anyone can care, and it doesn't take any serious degree of education or indoctrination to partake in nursing interventions. The introduction of such things as NANDA, NIC, and NOC are ridiculous. No one outside of nursing understands these, and I submit that most members of nursing think they're ridiculous and would rather have been given more education in various pulmonary pathologies rather than "impaired gas exchange" and vague treatment planning. Presently, RNs are trained in a biology and medicine-lite context with a "nursing" atmosphere. Just what nursing theory has been applied to patient care, and what outcomes can we see that those theories have improved upon? This is what I don't grasp, and it seems ridiculous to beat the drum over and over about how such theories matter particularly when they're not integrated outside of academic health centers.

sauce · Nov 17, 2015

It all comes down to pretty much what psychman is saying. You cannot change the world of diseases without really taking basic sciences first.

Nursing skips out on these.

Patho is not in depth enough at all....... even at the graduate level. Neither is basic chemistry required for nursing programs.

But then again for rns that should be enough. But please require at least a one semester of biochem, organic, and upper level molecular biology/genetics prior to entry into nurse practitioner school. Man it would make us more reputable by a long shot.

Sure, symptom recognition can work a large percent of the time, but to be honest without actually understanding somewhat on a molecular level of what is occurring will hinder patient outcomes more than the ''non holistic care'' that physicians provide according to the AANROFLP

Susie2310 · Nov 17, 2015

Oh dear, the attitude of some NP's who, (with 600 or so hours of clinical training), seek to tell the rest of us how esteemed and qualified to diagnose, treat, and prescribe they are (just like physicians really, if only people would believe it!).

elkpark · Nov 18, 2015

It all comes down to pretty much what psychman is saying. You cannot change the world of diseases without really taking basic sciences first.
Nursing skips out on these.
Patho is not in depth enough at all....... even at the graduate level. Neither is basic chemistry required for nursing programs.

Maybe your nursing program didn't require basic sciences, inc. "basic" chemistry. My hospital-based diploma program bused us to a college in another part of town, where we took a full year of organic chemistry (the same o chem that the college's chemistry and pre-med majors took; we were in class and lab with them), a year of A&P (the same A&P course and lab that the college's bio and pre-med majors took, again), and the same microbiology course and lab that the college's science and pre-med majors took, in addition to nutrition, psychology, and sociology. We didn't take a formal, dedicated "pathophysiology" course, but all of our specialty nursing courses covered the pathology of the common disorders of each specialty in significant depth. I feel I got a strong science background in my prelicensure nursing program, in addition to an excellent overall education in nursing. I understand that many nursing programs don't operate that way, but that doesn't mean that there aren't good, strong programs available. Perhaps people should be selective about what program they choose to attend.

Psychcns · Nov 18, 2015

I also had a strong science foundation in my nursing pre-requisites. My BSN program was demanding and I studied hard. By the time I got to graduate school I had years of experience and had had extensive in service education. Prescribing was just starting when I got to graduate school and curriculums were catching up. I learned to prescribe working with a psychiatrist who was ok with my interrupting his sessions to ask questions and would come into my sessions to consult. I had enough background to fill in my own learning gaps. And I continue to study and learn.

PG2018 · Nov 19, 2015

Oh dear, the attitude of some NP's who, (with 600 or so hours of clinical training), seek to tell the rest of us how esteemed and qualified to diagnose, treat, and prescribe they are (just like physicians really, if only people would believe it!).

Is that what we're doing? I think my whole thesis is that no nurses are trained sufficiently focusing instead on frivolous theory and fluff skills.

Psychcns · Nov 19, 2015

NP's and other APRN's have a track record of over 50 years of safe effective practice.

Yes curriculums can be revised, updated, made more rigorous. I think one issue is there aren't enough advanced practice nurses in academics for all kinds of reasons.