ANA President Barbara Blakeney, MS, RN, CS, ANP, has written a letter in response to an article in the November 2002 issue of Redbook Magazine, ("Advice docs give their own families"), that contains a section warning patients not be "brushed off" onto a nurse practitioiner (NP).
October 18, 2002
Letters
Redbook
224 West 57th St.
New York, NY 10019
Dear Editor:
The American Nurses Association takes exception to the suggestion "Don't let yourself be brushed off onto a nurse practitioner" included in "Advice Docs Give Their Own Families" (November 2002, pg. 64). While we agree that patients should always be able to access their physicians, we are disappointed that the doctors Redbook interviewed chose to make that point by impugning the quality of care delivered by advanced practice registered nurses (APRNs), specifically nurse practitioners (NPs).
APRNs have been providing primary and preventive care to patients for more than 35 years. All APRNs must meet rigorous education, certification and continuing education requirements. Today, there are more than 160,000 APRNs, including 70,000 NPs, in the United States, and research dating back to the mid-1980s demonstrates that in terms of quality of care, patient satisfaction and cost-effectiveness, NPs are among the best values in health care. A 1986 federal government report (Office of Technology Assessment) concluded that APRN care is of equivalent quality to that provided by physicians and that in areas of communication and preventive care, APRNs are more adept than physicians. A 1993 study conducted for the ANA found that NPs deliver primary health care as competently as physicians and provide more health promotion activities, such as patient education, than physicians. The patients of the APRNs reported being more satisfied with their health care provider, complied with their treatment programs and were very knowledgeable about their health status.
More recent research also bears out the high quality of care provided by NPs. A study in the May 2000 issue of the Journal of the American Medical Association concluded that in an ambulatory care setting in which patients were randomly assigned to either nurse practitioners or physicians, patients' outcomes were comparable. In the July 20, 2002, edition of the British Medical Journal, a study found that patients were satisfied with NP care and that no differences in health status existed. In fact, the study indicated that NPs took more time in consultations and used that time to investigate more about the health concern or illness than did doctors, and concluded that increasing availability of NPs in primary care is likely to lead to high levels of patient satisfaction and high quality care.
Both the federal government and Congress have taken action recognizing the high quality of care provided by NPs. In 1998, the Federal Department of Veterans Affairs decided to formally accept NPs without links to physicians. And on Jan. 1 of that year, a federal law went into affect allowing Medicare to reimburse NPs directly in all geographic areas. In communities across the United States, NPs provide care in clinics and other community settings that help reduce the number of emergency room visits and keep frail elderly in their homes. Furthermore, in all 50 states and the District of Columbia, NPs have some authority to write prescriptions for their patients.
Implying that NPs provide a lesser quality of care is a disservice to your many readers who could benefit from the excellent care they provide and from the increased time that NPs spend answering their questions and reviewing their overall health.
I saw that and was INCENSED! If anyone has "brushed me off" it has been a DOCTOR not an NP, who took the time to listen to me, figure out the WHOLE person situation and took more than 2 minutes to do so. I think I will write a letter to that magazine asking them to address this error or cancel my subscription. It was unwarranted and just goes to show the public view of nurses being inferior care providers to the almighty physician.
DITTO on all counts !!!
Well spoken, Blue Eyes ! ... my experience and sentiments exactly !
I, too, see a N.P. for ALL my health care... she is the BEST and I know her interest in my wellbeing is GENUINE !
I saw that and was INCENSED! If anyone has "brushed me off" it has been a DOCTOR not an NP, who took the time to listen to me, figure out the WHOLE person situation and took more than 2 minutes to do so. I think I will write a letter to that magazine asking them to address this error or cancel my subscription. It was unwarranted and just goes to show the public view of nurses being inferior care providers to the almighty physician.
DITTO on all counts !!!
Well spoken, Blue Eyes ! ... my experience and sentiments exactly !
I, too, see a N.P. for ALL my health care... she is the BEST and I know her interest in my wellbeing is GENUINE !
Next will probably be an article about NPs advising people to avoid Redbook.
By the way, all these publications LOVE to have feedback, negative or positive. It makes the writer of the mentioned article appear to be widely read and taken seriously, which only increases his/her marketability and pay, and makes the magazine think that people will now buy and read it, if only to see what this writer is up to next. The ONLY thing they really care about is if advertisers cancel ads.
Next will probably be an article about NPs advising people to avoid Redbook.
By the way, all these publications LOVE to have feedback, negative or positive. It makes the writer of the mentioned article appear to be widely read and taken seriously, which only increases his/her marketability and pay, and makes the magazine think that people will now buy and read it, if only to see what this writer is up to next. The ONLY thing they really care about is if advertisers cancel ads.
Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.
Letter in progress. The more I thought about it, the angrier I became. Rather than react emotionally, however, I will compose a calm and articulate letter pointing the error of their message in that article and if they wish me to continue subscribing and recommending this magazine to my friend/family (nursing and NON nursing alike), they will kindly print a retraction of this statement! Thanks for your encouragement, guys. This is an issue near and dear to my heart, as you can well tell and I SICK of seeing NP's and CNM's maligned by ANYone either in public or by our esteemed AMA.
Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.
Letter in progress. The more I thought about it, the angrier I became. Rather than react emotionally, however, I will compose a calm and articulate letter pointing the error of their message in that article and if they wish me to continue subscribing and recommending this magazine to my friend/family (nursing and NON nursing alike), they will kindly print a retraction of this statement! Thanks for your encouragement, guys. This is an issue near and dear to my heart, as you can well tell and I SICK of seeing NP's and CNM's maligned by ANYone either in public or by our esteemed AMA.
That really pi**es me off!!!! Need I say more? I don't read Redbook, so I hadn't read this article until I saw it on this thread. Not to brag, but I too have patients who don't even WANT to see the Doc. They say I'm more gentle, take more time to educate, and give them that little extra TLC that we Nurses are so good at dispensing. It was irresponsible for them to print that, even if a Doc did say that. By printing it, they are lending it some credibility, even if they are Redbook. Like someone else above said, they should stick to fashion and Faith Hill.
BTW, I think that link above to "webmaster" is just the e-mail address to report problems on the website. I looked for a feedback e-mail, but didn't find one. Maybe we'll have to write letters. Does anybody have a copy of the magazine that lists the address for letters to the editor? Thanks a million!
That really pi**es me off!!!! Need I say more? I don't read Redbook, so I hadn't read this article until I saw it on this thread. Not to brag, but I too have patients who don't even WANT to see the Doc. They say I'm more gentle, take more time to educate, and give them that little extra TLC that we Nurses are so good at dispensing. It was irresponsible for them to print that, even if a Doc did say that. By printing it, they are lending it some credibility, even if they are Redbook. Like someone else above said, they should stick to fashion and Faith Hill.
BTW, I think that link above to "webmaster" is just the e-mail address to report problems on the website. I looked for a feedback e-mail, but didn't find one. Maybe we'll have to write letters. Does anybody have a copy of the magazine that lists the address for letters to the editor? Thanks a million!
and press 'Send'. We'd love to hear your thoughts and ideas! By submitting a letter you grant Redbook Online and/or Redbook magazine permission to publish it if we so choose. Due to the volume of mail we receive, we cannot respond individually to everyone. "
and press 'Send'. We'd love to hear your thoughts and ideas! By submitting a letter you grant Redbook Online and/or Redbook magazine permission to publish it if we so choose. Due to the volume of mail we receive, we cannot respond individually to everyone. "
Following is the email I sent them, no name, not to be published. I do not trust published letters to the editor - in their editting they often make subtle changes that change the entire tone of a letter and the letter writer is denied any say in the final letter.
I just wanted them to get this in their email box, even if they delete it before reading it:
I have just heard of your column in which YOU published the statement, "do not allow yourself to be brushed off onto NPs."
How dare you print such a damaging statement with such little thought? Especially when the damage is to your own readers.
I suggest you poll your readers. Ask how many have been brushed off onto NPs. Then ask them how they feel about that experience. I have faced a number of patients who have felt brushed off before I gave up the nursing field entirely. In every intance, I validated the patients concerns. They had expected to see a doctor and they were seeing me instead. I would then offer to have the receptionist make another appointment for them to see the MD (usually in a week or two, not under my control) or, recognizing they had made a trip in expecting to see the MD, I would try to get him to come in. I would also offer to try to help them with the problem they had since they were there.
Please note, this happened more often than it should have. I repeatedly asked the front desk to tell a patient they would be seeing an NP, not a physician. It was unfair to me as well as the patient.
Some patients chose to wait then until the doctor could see them. Some chose to reschedule. In those cases I apologized for the inconvenience. Most chose to see if I could help them. Once they did, they generally asked to see me all the time. I listened to them, I heard their problems, and I tried very hard to make sure the needs they had would be met - by me, a specialist, or the physician.
Ask your readers. If you hear what I expect you will hear, I expect you to print a very large and very public apology. There are nurse practitioners who continue to persevere in the hostile environment created by such one sided, thoughtlessly published tid bits as you published. Most do it because they realize they are among the only ones left who will try to hear what the patient needs instead of doing whatever is necessary to get them out of the office fast.
I am no longer among this group. I have abandoned patients as a result of continued harrassment and disrespect. I have been told I was wrong to waste the time it took after I asked a depressed patient if she thought about hurting herself and she said yes. I was told I should not have asked. The physician seemed to feel that the patient might not act on her suicidal impulses (she might not), and if she did, we would not be at fault as, not having asked, we could not have known.
I hope some NPs will remain. I will get sick one day. I want to see an NP when that happens.
These are comments. I do not want my name published, or the contents published. In the current health care climate true statements about how bad it really is are generally met with some form of reprisal.
Following is the email I sent them, no name, not to be published. I do not trust published letters to the editor - in their editting they often make subtle changes that change the entire tone of a letter and the letter writer is denied any say in the final letter.
I just wanted them to get this in their email box, even if they delete it before reading it:
I have just heard of your column in which YOU published the statement, "do not allow yourself to be brushed off onto NPs."
How dare you print such a damaging statement with such little thought? Especially when the damage is to your own readers.
I suggest you poll your readers. Ask how many have been brushed off onto NPs. Then ask them how they feel about that experience. I have faced a number of patients who have felt brushed off before I gave up the nursing field entirely. In every intance, I validated the patients concerns. They had expected to see a doctor and they were seeing me instead. I would then offer to have the receptionist make another appointment for them to see the MD (usually in a week or two, not under my control) or, recognizing they had made a trip in expecting to see the MD, I would try to get him to come in. I would also offer to try to help them with the problem they had since they were there.
Please note, this happened more often than it should have. I repeatedly asked the front desk to tell a patient they would be seeing an NP, not a physician. It was unfair to me as well as the patient.
Some patients chose to wait then until the doctor could see them. Some chose to reschedule. In those cases I apologized for the inconvenience. Most chose to see if I could help them. Once they did, they generally asked to see me all the time. I listened to them, I heard their problems, and I tried very hard to make sure the needs they had would be met - by me, a specialist, or the physician.
Ask your readers. If you hear what I expect you will hear, I expect you to print a very large and very public apology. There are nurse practitioners who continue to persevere in the hostile environment created by such one sided, thoughtlessly published tid bits as you published. Most do it because they realize they are among the only ones left who will try to hear what the patient needs instead of doing whatever is necessary to get them out of the office fast.
I am no longer among this group. I have abandoned patients as a result of continued harrassment and disrespect. I have been told I was wrong to waste the time it took after I asked a depressed patient if she thought about hurting herself and she said yes. I was told I should not have asked. The physician seemed to feel that the patient might not act on her suicidal impulses (she might not), and if she did, we would not be at fault as, not having asked, we could not have known.
I hope some NPs will remain. I will get sick one day. I want to see an NP when that happens.
These are comments. I do not want my name published, or the contents published. In the current health care climate true statements about how bad it really is are generally met with some form of reprisal.
jnette, ASN, EMT-I
4,388 Posts
DITTO on all counts !!!
Well spoken, Blue Eyes ! ... my experience and sentiments exactly !
I, too, see a N.P. for ALL my health care... she is the BEST and I know her interest in my wellbeing is GENUINE !