Doctor or Nurse Practitioner??

platon20 · Mar 15, 2007

hi everyone,
you may think this is a very odd question, would i be able to work alone and treat or would i always be under a physicans "instructions" even as a nurse practitioner??? ive found my passion id like to stay a nurse but be able to have some of the responsibility of a medical care given. if i cant get it as a nurse i would consider applying to medical school!!!
come on all you nurse practitioners gimme your advice, please!!
thanks in advance

Depends on the state. Most states require some kind of "collaboration." But there are states that allow total solo practice.

If you want to be "captain of the ship" I would go to med school. It offers the most overall opportunities, and you could do primary care or become a specialist or a surgeon.

If you want to practice solo primary care in a rural area then NP might be the best option.

Psychaprn · Mar 15, 2007

Do you want to practice as a nurse with nursing philosophy of treatment or practice medicine?-that's what you need to decide first.

platon20 · Mar 15, 2007

Do you want to practice as a nurse with nursing philosophy of treatment or practice medicine?-that's what you need to decide first.

There's no difference between "nursing philosophy" and "medicine" when it comes to diagnoses or treatment.

NPs treat HTN, diabetes, heart failure, etc the same way a doc does.

shisalion · Mar 21, 2007

In medical school, you learn how to practice medicine. In NP school, you learn a bit about how to practice medicine, but first they torture you with graduate level "Nursing Theory" and "Nursing Research" and other fru-fru classes that have absolutely no application to the practice of medicine. I learned how to be a clinician from my clinical mentors, most of them MD's. In retrospect, I would have skipped the whole nursing thing and gone to medical school instead. The curriculum is more straightforward.

Psychaprn · Mar 21, 2007

There's a world of difference between how NP's practice(if they stay true to their nursing roots). We practice wholistically, we use systems theory, we LISTEN to patients and families. Nurses treat the whole patient on primary, secondary and tertiary levels. Drs. treat diseases. They limit their treatment to the disease or diseased part of a patient. They only specialize. I've heard doctors tell patients because they haven't seen it or read about, it they couldn't be having aan unusaual side effect from a med.

I can't tell you the times I have picked up medical problems and treated them when the patient just saw an MD. They saw a cardiologist so he didn't notice the signs of hypothyroidism or treat it for example. I've had my patients go to the ER for acute abdominal pain and be sent home with Ativan because they were "Psych. pts."-later they had ruptured appendixes or gall bladder inflammation! I have learned alot about medicine from doctors but more about treating people from nurses and NP's. I feel sad for any nurse who can't see the differences.

jjjoy, LPN · Mar 21, 2007

In an ideal world, wouldn't doctors also treat patients holistically? Isn't the tendency of doctors to focus on the disease more a matter of personal style and time pressures than of formal professional training and objectives? I'm thinking that nursing education originally focused so much on holistic care because nurses could be more proactive that way, whereas they had to rely on physicians to order medical care. For NPs, it would seem to me that they could just as easily fall into the trap of "treating symptoms not patients" especially as they are pressed for time and insurance companies don't want to pay for that extra 10-15 minutes it takes to treat the patient more holistically. Physicians can always choose to practice holistically as well.

Browndog · Mar 22, 2007

I will try again. I agree wholeheartedly with shisalion. If think that if I should hear one more theory, write one more paper, or be presented with one more nursing diagnosis such as "hopelessness secondary to distance from relatives", I shall uncerimoniously barf.

I agree with the wholistic nature of nursing, but when I am sick, I want a provider with a thorough understanding of pathophysiology, pharmacology and biochemistry, not just an understanding of nursing theorists.

Absolutely teach me to be a caring, wholistic caring practitioner who treats the whole person.....but for goodness sake teach me to treat the disease process as well.

What about a model that incorporates the medicine of PA school with the wholistic teachings of NP school?

browndog

foxyhill21 · Mar 22, 2007

it is good to know that about NP school

In medical school, you learn how to practice medicine. In NP school, you learn a bit about how to practice medicine, but first they torture you with graduate level "Nursing Theory" and "Nursing Research" and other fru-fru classes that have absolutely no application to the practice of medicine. I learned how to be a clinician from my clinical mentors, most of them MD's. In retrospect, I would have skipped the whole nursing thing and gone to medical school instead. The curriculum is more straightforward.

curlysin · Mar 22, 2007

yeah i thought this would cause abit of a debate its the old aged arguement between nurse vs doctors!!! i am an etremely good nurse im not being big headed but i am. i always look at my patient holistically to provide the best care i can, but i also think it is vitally important that nurses are well clued in to pathphysiology, biochem, pharma. especially in this day and age with sicker patients and an ageing population.

i love the medical side of things and i would hope if i became a doctor i could bring along the nursing side of me to which may create the all round perfect practitioner???

the qualities of a nurse with the know how of a doctor, would that be the perfect practitioner?????!!!!!!!!!!!!!!!!!!!!!!

prairienp · Mar 22, 2007

i will try again. i agree wholeheartedly with shisalion. if think that if i should hear one more theory, write one more paper, or be presented with one more nursing diagnosis such as "hopelessness secondary to distance from relatives", i shall uncerimoniously barf.
i agree with the wholistic nature of nursing, but when i am sick, i want a provider with a thorough understanding of pathophysiology, pharmacology and biochemistry, not just an understanding of nursing theorists.
absolutely teach me to be a caring, wholistic caring practitioner who treats the whole person.....but for goodness sake teach me to treat the disease process as well.
what about a model that incorporates the medicine of pa school with the wholistic teachings of np school?
browndog

i want a np who understands and applies the theory directing their practice. application goes beyond "understanding", theory should provide the direction to why you are doing something. using social cognitive theory or pender's health promotion model has provided insight in how i can be more effective in my practice. these are well researched models that have been proven to be effective. on the other hand, i have not ever used a nursing diagnosis in my np education or practice. i don't practice medicine or for that matter nursing, i prefer to say i practice or provide health care.

jjjoy, LPN · Mar 22, 2007

I notice that neither theory you mention are nursing theories. The two you do mention more relate to behavior change as opposed to medical interventions. Of course, a good practitioner will teach and encourage their patients and be aware of theories of behavior change. Is there generally anything unique to "nursing practice" when functioning as an NP?

The OP was wondering about the differences in pursuing an NP education versus a MD education and if one has the choice between them, why would one choose one over another. A common refrain is that since NPs come from a "nursing model" they are more "holistic." Do you have any thoughts on that?