Education requirement for nurse practitioner

karenG · Apr 7, 2009

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nursing, even now, is struggling, maybe harder than ever, to define itself as a profession among the accepted professions. it fails if it tries to be "just as good as a doctor." because it will never be "just as good as a doctor." for one, it's not medicine--it's caring. we provide professional "care" for people who for whatever reason and in whatever way cannot "care" for themselves. that is our profession. so, the center of glory must be with the bedside nurse. if we call nps "advanced practice" then we inadvertently play catch up to doctors.
the centre of glory must be with the bedside nurse?? i am an nurse practitioner and havent worked at the bedside for 20 years.. i work in general pratice, a doctors office (i think thats what you call it). i have never played catch up with the doctors- my skill set is different to theirs. so are the only real nurses, the ones who work in secondary care?? (hospitals?) do those nurses who chose to work in primary care not deserve some of the glory?
we are nurses! our degrees are the adn/diploma, bsn, msn, ph.d. and maybe some of the newer ones i'm not too familiar with and like most new doctorate programs are probably just wannabes for a ph.d. we have been around longer than mds. we are the original healthcare providers.
i'm not a wannabe anything! i have a masters degree in repiratory medicine.. this ensures that i take the lead in my practice with patients with respiratory disease, i help them to understand and manage their illness. my masters gives me the tools and the knowledge to do this.
the fact is mds are useless without us, and they are threatened by us. they are threatened because in the arena of patient care, when they come to the floor, they know they don't have it within them to "care" for people. they knew it all along, and so they became doctors. anyone who's ever worked a shift as a nurse or a cna, and really gave a damn about the work they were doing, knows how much strength it takes to care for a patient. doctors don't have it within them to do that, and yet such a person who can care for another person is indispensible in our world.
you must work with some rotten doctors.. the ones i work with are great.. and have you ever worked in ophthalmics and seen the joy on both the doctor and patients face when a cataract op goes well and the patient sees for the first time in years?? doctors care.
doctors are the highest profession; no one disputes that. every parent wants a doctor in the family. society holds them up as all-important, and they are given great pay for the extremely hard academic road they have to travel to get to that professional level. but nursing is the greatest profession, and everyone knows it, including doctors. we do what they are afraid of doing. we do what they have climbed a massive wall to avoid doing. they are high, but we are great--never forget that.
i suspect there are a lot of people out there who feel that their profession is the greatest.
not even going to go there with the bible quotes.. i'm wiccan!

i am proud to be an np and to see patients as a nurse.. and yes.. i do dressings, take out stitches and do the nurse stuff, as well as the np stuff.. i work as a nurse, i am working to the best of my ability to deliver the best care i can. i am a maxi nurse... not a mini doctor!!

we all care for our patients, some of us do in different ways. please dont think the bedside nurse has the monopoly on caring.

Flightline, BSN, RN · Apr 7, 2009

the centre of glory must be with the bedside nurse?? i am an nurse practitioner and havent worked at the bedside for 20 years.. i work in general pratice, a doctors office (i think thats what you call it). i have never played catch up with the doctors- my skill set is different to theirs. so are the only real nurses, the ones who work in secondary care?? (hospitals?) do those nurses who chose to work in primary care not deserve some of the glory?

hello, karen g. by the way i notice you're from london. i lived for six years in swindon, which is in wiltshire, and in fact, my daughter still lives there with her husband daniel who is in the raf. so, kudos on your location!

yes, the glory of nursing must be at and with the bedside nurse (be that in a hospital or a home, or snf, what have you.). if we consider the "grunt" work of nursing to be the worst part or the lesser part, then nursing will cease to be a profession of caring. if we are not the profession of caring, then we are nothing. if we do not derive the glory from nursing then we are left with deriving only a paycheck from nursing.

i'm not a wannabe anything! i have a masters degree in repiratory medicine.. this ensures that i take the lead in my practice with patients with respiratory disease, i help them to understand and manage their illness. my masters gives me the tools and the knowledge to do this.

great so you're a doctor--kind of. i'm not denigrating what nps do or suggesting they aren't necessary to the medical profession, i'm saying they are not beside nurses. and i contend that bedside nursing is the "real" nursing, and it's the nursing that is in short supply, and always will be, and it is the nursing that gives the whole field of nursing meaning in its own right.

you must work with some rotten doctors.. the ones i work with are great.. and have you ever worked in ophthalmics and seen the joy on both the doctor and patients face when a cataract op goes well and the patient sees for the first time in years?? doctors care.

no, no, no. your mixing the definitions of "care." i have no doubt that some doctors emotionally care about their patients. i have no doubt that some doctors provide care in the sense of a treatment for the patients illness. i use the term care to mean providing round-the-clock provision to sick people who cannot care for themselves. this includes adls, medication administration, psychological support, education, monitoring, etc. round-the-clock.

i suspect there are a lot of people out there who feel that their profession is the greatest.

but they would be wrong. caring for another person is the highest act one can do. jesus agreed that the greatest law was to recognize god as god. but he added to that with the golden rule: he said the second law was like the first: love your neighbor as yourself. in other words, we love god by loving our neighbor. that act of love is best demonstrated in caring for another person. again, jesus described almost the entire nursing career in the story of the good samaritan.

so, you can sell shoes and think that's the greatest profession in the world, but it's not. nursing is the greatest possible profession, and in nursing the beside nurse is most directly performing nursing care.

not even going to go there with the bible quotes.. i'm wiccan!

i'm a follower of jesus christ. i can't change that anymore than i can change my skin color. so everything i think and say is thought and said through that filter.

i am proud to be an np and to see patients as a nurse.. and yes.. i do dressings, take out stitches and do the nurse stuff, as well as the np stuff.. i work as a nurse, i am working to the best of my ability to deliver the best care i can. i am a maxi nurse... not a mini doctor!!

i can't comment on what your specific duties are, but where your duties are that of a nurse, then you are a nurse. just like a cna (certified nurse aid) is a nurse when they are doing nursing duties. but that you can do some of the duties of a doctor does not make you a maxi-nurse. you are a maxi-nurse when you do the job of a nurse at the beside. that is, when you take a patient assignment and provide round-the-clock (or for whatever portion of the clock is your shift.) care.

but even having said that, if you want to consider yourself higher than a nurse--a maxi nurse--because you are more like a doctor than an ordinary nurse is, then you must see how that makes nursing secondary to being a physician, and you must see how that demeans our profession.

it's so hard to be a nurse that many nurses i know will spend huge amounts of money and time to become nps so they can get away from the bedside and be seen as better than "just a nurse." but it is the hard of nursing that makes it great. it is the hanging on a cross each and every shift that makes us more like christ. to be looked down upon by members of our own profession who think we are "just a nurse" and that they are more because they get to act like doctors in some ways and write orders in the chart is just part of the suffering we have to endure in our pursuit of caring for the patient.

when we are older and less energetic, and we can no longer perform the duties of a nurse, then there are the other options away from the bedside (teaching, managment, np, crna, etc.) but this should always be done with the humility that recognizes the greatest glory is at the bedside.

we all care for our patients, some of us do in different ways. please dont think the bedside nurse has the monopoly on caring.

the bedside nurse does the hard part. thus, the bedside nurse must always be given the glory.

but they won't be given the glory, and yet being paradoxical as he often is, god has seen that being denied the glory the world gives is part of the glory that he gives.

i'm sure you're a great np. and i'm sure, i would welcome your orders in my patients chart, and i'm sure that i would gladly carry them out for the greater good of loving my neighbor who is my patient. it's been great replying to your response. thanks.

ed

Silverdragon102, BSN · Apr 7, 2009

OK, things appears to have gotten a bit off track and no longer discussing nurse practitioner requirements.

In my opinion it doesn't matter if you are a bedside nurse, work in a doctor's surgery, outpatients, Informatics or anywhere else as a nurse, CRNA, NP you are doing something that you love and to the best of your capabilities and I think it has become a shame that we as professionals are arguing over who is the best nurse.

Polley93 · Apr 8, 2009

wow, I have been floored with some of the posts. It takes many to take care of the whole world of patients. To think that any one facet of the profession has the corner on the market so to speak is rediculous and speaks loudly of the educational level of the writer. It is only with learning and growth can we expand our horizons out of the box. This is NOT a competition! We are all on the same team, working on different levels and trying to reach the same end. It is with this autonomous "holier than thou" thinking that has chipped away at our profession over the past two decades. If we didn't all have a heart of caring, then we wouldn't have a place in the profession. True, a nurse is on the front lines, but without the physician or the NP who can diagnose and order care, what exactly could be done?

Embrace each other for the gifts we each posess and appreciate the place that each of us has.

Flightline, BSN, RN · Apr 8, 2009

wow, I have been floored with some of the posts. It takes many to take care of the whole world of patients.

No need to be floored, Polley; I agree with you: it does indeed take many to take care of the world of patients. It takes a nurse to care for them. And I believe the definition of a nurse is that they "care" for patients. MDs on the other hand diagnose and prescribe a treatment for a patient.

I'm not suggesting the NP has no place in health care, or that the NP is in someway a bad thing. I'm simply stating my opinion that an NP, practicing as an NP, has left the field of nursing, and I believe nursing is the greatest possible profession.

To think that any one facet of the profession has the corner on the market so to speak is rediculous and speaks loudly of the educational level of the writer.

I could say that to misspell an insult speaks loudly of the educational level of the writer, as well. But, in truth, I think you did not mean to misspell it, nor are you ignorant of the correct spelling of "ridiculous," you simply are somewhat emotional about this issue. I misspell as well when I get emotional. I apologize for upsetting you; that's not my intent. My intent is to let the bedside nurse know that they are the greatest possible person in the greatest possible profession.

As for my education level, I received a B.Sc. in Liberal Arts where I specialized mostly in psychology and sociology. I also have an A.ASc. in Aircraft Systems, one in General Studies, and of course the most important degree I have is an A.ASc. in Nursing. I'm an amateur mathematician, a longtime religious philosopher and I've written three books. One entitled: Vital Architecture and the New Design of Happiness, another is a novel which has not been published, but is being adapted by another writer into a screenplay, and another is a synthesis of the four New Testament Gospels with the Gospel of Thomas. I've been published in newspapers, magazines, and I won an award for an article I wrote called Samaritans and Tired Clerks. I also have an Advanced Toastmasters (silver) award.

I see that you have a great deal of credentials that are far superior to mine, and I see that you are an FNP. But I would say that nothing you and I have done in our lives will ever be as important as cleaning up the BM of an incontinent patient who can no longer clean themselves. Do you think that is true?

It is only with learning and growth can we expand our horizons out of the box.

True. Or we can stay in the box where all we are capable of doing is serving those who are too feeble to serve themselves and in so doing we will find the greater glory of God. I've known two techs (who had also achieved the level of Certified Nurse Aid) who were both in their forties with no plans to ever complete a college degree, but they had energy and a true compassion for the patients assigned to them. They did the dirty work and did it with professional zeal. I believe God brought them into my life to show me His glory, and they are always in my mind when I am at work. They are my ideal. I'm an RN and in the ICU because my ego and my lust for technical interaction compels me to be there--and because I don't think I have it in me to be as great as those two. Yet recognizing their glory--being able to recognize it--feels like a kind of salvation.

This is NOT a competition! We are all on the same team, working on different levels and trying to reach the same end.

Indeed. Well said.

It is with this autonomous "holier than thou" thinking that has chipped away at our profession over the past two decades.

Again, very well said.

If we didn't all have a heart of caring, then we wouldn't have a place in the profession. True, a nurse is on the front lines, but without the physician or the NP who can diagnose and order care, what exactly could be done?

That's a very good point. First, whether we have a heart of caring or not is only evident in the care we provide. Words, as you know every bit as well as I, are nearly meaningless.

Now, what would we do without MDs and NPs? People would die sooner than they die today. But don't we all die eventually? Medicine must always fail; nursing never fails. Nursing is needed after the MD or NP have done all they can do. That is the glory of nursing. But don't misunderstand me; we need MDs and NPs and PAs. Obviously we need them. Good God, what would we do without them?

But that's not my issue. I am a nurse. I see what nurses do, and I see how low MDs think of them. I see how other nurses look lowly on themselves. I see how academics hold all the power and yet do none of the care. I see nurses running off to NP school so they will no longer be just a nurse, and yet I know in the end, should I be dying of terminal cancer, I will need a nurse and a CNA, not a doctor or an NP. I've seen the last orders of an MD "Comfort Measures Only." So, the MD is higher, yes, but the nurse is greater.

Embrace each other for the gifts we each posess and appreciate the place that each of us has.

I'm glad your final statement is one we agree on 100%. And thanks for letting me answer your provocative response.

Edward

Flightline, BSN, RN · Apr 8, 2009

OK, things appears to have gotten a bit off track and no longer discussing nurse practitioner requirements.
In my opinion it doesn't matter if you are a bedside nurse, work in a doctor's surgery, outpatients, Informatics or anywhere else as a nurse, CRNA, NP you are doing something that you love and to the best of your capabilities and I think it has become a shame that we as professionals are arguing over who is the best nurse.

I appreciate being allowed to voice my opinion on the topic thus far, and these responses and replies have been very good for me. We have, however, drifted from the OP.