Getting into Nursing, yet Concerned

Flightline, BSN, RN · Nov 30, 2008

First a background on myself. 22 y/o M working as a Paramedic for a very busy ambulance service. I spend half of my day in the ER dropping pts of so I get a chance to interact with nursing staff very often.
I am finishing up a college degree now and have become interested in getting my BSN. I have had some wonderful experiences with nurses and they have taught me a lot.
HOWEVER . . .
I have encountered a few very concerning issues with some nurses that really irk me and force me to reconsider going in to nursing.
1. I have a friend in nursing school who says she is going to get her DNP and she will be, and I quote, "at the same level as an MD/DO" and "my patients will have to call me DR". Yeah it doesn't work this way. DNP training does not equal MD/DO. I respect the DNP position but this is ridiculous. If you want to be a DR goto medical school. There are a thousand different roles to fill in healthcare, and while the MD/DO may be the "top dog" per se, they certainly do not have the market cornered and need to show some more respect.

You're absolutely right. That person is an idiot and don't base your concept of nursing on his/her outlook. They have self-esteem issues and a warrped sense of morality in that they think caring for people is a low thing to do, like picking through garbage for aluminum cans--actually they think it is worse. Jesus would have a real problem with that nurse's philosophy, and so do I, and so should you, and apparently you do. Good for you.

2. In the same vein, NPs need to come down off their hight horse. The ones I know walk and talk with a sense of entitlement. They speak as if they are truly on par with physicians. Look, you may be very good at what you do but you are not a doctor. You are a mid-level provider. And if you think I am bashing NPs, I am not. I usually see my NP for most of my visits. But for somethings, you need a doctor. Sorry to disappoint.

100% again. I don't consider NPs to be nurses any longer. I know they will disagree with me, and I realize that technically, they are nurses, and have to be RNs in order to be an NP. But I hold to a very strict definition of our profession, and the image I have of our profession, our crest if you will, is a bedpan, a bowl of soup, and a wash basin. And I take great pride in that. I feel there is divine power in that. We are a profession of caring. We professionally care for people who can't care for themselves. Sometimes that care is very advanced (like with a fresh post-op CABG pt.) Sometimes it is just doing the laundry for a senior during a home health visit. But in both cases it is caring. MDs don't care for patients. They diagnose disease and prescribe treatment for that disease. NPs, in my opinion only, are MD assistants, they are no longer nurses. I don't want to get banned for saying that. I fully admit that it is only my opinion, and that I tend to be somewhat warrped.

Example: I saw a doctor get a cup of water for one of my patients once (I know how rare that is, believe me; he was a resident.) My first instinct was to slap it out of his and and beat him to a pulp in the parking lot. How dare he "care" for one of my patients! Of course I just said, "Hey, thanks a lot!" I guess I can be pretty militant in my regard for the roles within medical care. To me there is the MD and the RN and everyone else is an assistant to one or the other.

So, all I'm trying to say is that I connect with your observation of how some NPs can be.

So I guess you could sum up my concerns by saying nurses have a role and are not doctors, so stop thinking you are. That being said, I have learned more from nurses than anyone else so I am eternally grateful. That is why I am considering it. I hope to get in and work in the ER. Maybe one day go on a pursue CRNA, we'll see.

Ah, I see: so you're only complaint is that you too think nurses are lowley compared to MDs, and you too want to become a nurse so you can reach from your humble position toward the greatness of being a "Doctor Assistant." Well, I suggest you remain a paramedic, or become one. Nursing is about caring for patients. If you want to be an anesthesiologist, go to med school, but don't come to my ICU as you're climbing over nurses to get to be like an MD in the OR. All I'm saying is: don't be a nurse if you're not going to be a nurse.

greatone1210 · Nov 30, 2008

Ah, I see: so you're only complaint is that you too think nurses are lowley compared to MDs, and you too want to become a nurse so you can reach from your humble position toward the greatness of being a "Doctor Assistant." Well, I suggest you remain a paramedic, or become one. Nursing is about caring for patients. If you want to be an anesthesiologist, go to med school, but don't come to my ICU as you're climbing over nurses to get to be like an MD in the OR. All I'm saying is: don't be a nurse if you're not going to be a nurse.

Whoa now. I am pretty sure I didn't say nurses are "lowley". I think that NP and CRNA are wonderful additions to the healthcare team and are providing essential care to the patient. But they are not physicians and this must not be forgotten. Nursing is wonderful because of the opportunities it provides. Some of my best experiences of nurses interacting with patients has been CRNAs. I did a few days in the OR intubating for medic class and the CRNAs were excellent with the patients. So I respectfully disagree with you on that part.

Maybe I am slightly more progressive in my views of medicine than you are. That is ok and I warmly welcome your opinion.

Just for the record, I am an excellent paramedic. Not because I can intubate or start an IV, but because I really do care about my patient and what is happening to them and their family.

DU

Flightline, BSN, RN · Nov 30, 2008

Maybe I am slightly more progressive in my views of medicine than you are. That is ok and I warmly welcome your opinion.

Progressing towards what? Pray tell; progressing towards what? What is the RN's role in medicine? If you are more concerned with the science of medicine, then be a medical scientist--be an MD. If you're just passing through nursing because you think it's easier than going to medical school and more available to you, please spare the world one more nurse who really doesn't want to be one.

Just for the record, I am an excellent paramedic. Not because I can intubate or start an IV, but because I really do care about my patient and what is happening to them and their family.

You're using the word "caring" differently than I am, and it's a common error. I'm not talking about emotionally caring about your patient. Doctors, or some of them, emotionally care about their patients. Nurses, or some of them, emotionally care about their patients. I have no opinion about that at all. Some of my patients I care about. Some of my patients I couldn't care less about. But I care for both equally when I'm at work.

Words need to be carefully defined, otherwise nursing is just breastfeeding.

greatone1210 · Nov 30, 2008

Progressing towards what? Pray tell; progressing towards what? What is the RN's role in medicine? If you are more concerned with the science of medicine, then be a medical scientist--be an MD. If you're just passing through nursing because you think it's easier than going to medical school and more available to you, please spare the world one more nurse who really doesn't want to be one.
You're using the word "caring" differently than I am, and it's a common error. I'm not talking about emotionally caring about your patient. Doctors, or some of them, emotionally care about their patients. Nurses, or some of them, emotionally care about their patients. I have no opinion about that at all. Some of my patients I care about. Some of I my patients I couldn't care less about. But I care for both equally when I'm at work.
Words need to be carefully defined, otherwise nursing is just breastfeeding.

What exactly do you want me to think or say?

I have seen nursing in action. Nurses in the ER and flight nurses simply do not meet your views I must say. You form a false dichotomy by almost completely separating medicine and nursing. Nursing is a different discipline, yes. But progressiveness has lead to nursing becoming much more "medically inclined". I don't know if you think that good or bad, but I respect your opinion.

And let me rephrase my "caring" portion. I do "care" for my patient. I ensure comfort and take very good "care" of my patient.

I have nothing but good intentions yet you seem to be so hostile. If I just wanted to be an RN to get to CRNA, I would say that. It is simply an option down the road. I am in no rush except to get into nursing.

DU

SharonH, RN · Nov 30, 2008

First a background on myself. 22 y/o M working as a Paramedic for a very busy ambulance service. I spend half of my day in the ER dropping pts of so I get a chance to interact with nursing staff very often.
I am finishing up a college degree now and have become interested in getting my BSN. I have had some wonderful experiences with nurses and they have taught me a lot.
HOWEVER . . .
I have encountered a few very concerning issues with some nurses that really irk me and force me to reconsider going in to nursing.
1. I have a friend in nursing school who says she is going to get her DNP and she will be, and I quote, "at the same level as an MD/DO" and "my patients will have to call me DR". Yeah it doesn't work this way. DNP training does not equal MD/DO. I respect the DNP position but this is ridiculous. If you want to be a DR goto medical school. There are a thousand different roles to fill in healthcare, and while the MD/DO may be the "top dog" per se, they certainly do not have the market cornered and need to show some more respect.
2. In the same vein, NPs need to come down off their hight horse. The ones I know walk and talk with a sense of entitlement. They speak as if they are truly on par with physicians. Look, you may be very good at what you do but you are not a doctor. You are a mid-level provider. And if you think I am bashing NPs, I am not. I usually see my NP for most of my visits. But for somethings, you need a doctor. Sorry to disappoint.
So I guess you could sum up my concerns by saying nurses have a role and are not doctors, so stop thinking you are. That being said, I have learned more from nurses than anyone else so I am eternally grateful. That is why I am considering it. I hope to get in and work in the ER. Maybe one day go on a pursue CRNA, we'll see.
Special Note: My concerns are not directed at those that do not fit the above criteria. For all of you true blue nurses who are proud to be a nurse and not a doctor, thank you for all you do. You are truly the ones that make the hospitals run and you certainly are amazing.
Can anyone address a few of these issues to put me at ease, lol.
DU

What concerns? You don't like NPs, what does that have to do with you becoming a nurse? Is it that you are concerned you will find yourself in a position of having to take an order from them, a mere nurse like yourself? Well relax, that will not happen often. If you want to be a nurse, then do it and let go over the hostility towards nurses filling a role different from yourself. And NPs like all RNs and LPNs work in a variety of roles and settings and many, many of them provide advanced nursing, not just medicine. They are in no way, "doctor's assistants".

Rabid Response · Nov 30, 2008

You are right to reconsider applying to nursing schools. If the opinion of one nursing STUDENT and your PERCEPTION of what certain NP's think of themselves is enough to cause you grave enough doubts to post them here, then by all means avoid the profession of nursing.

I have seen first hand the tribulations experienced by people who already know everything attending nursing school and having to be taught by lowly instructors who know less about nursing than they do. You will be exasperated. You will huff and roll your eyes in class. You will interrupt lectures to correct the instructor. You will constantly remind everyone that you are a certified EMT/paramedic/nurse midwife/whatever and that this is all old boring info to you. Nursing school will be torture for you, and you will share the pain with everyone who has to spend time in your vicinity.

So--stay a paramedic! Paramedics are way superior to nurses. It's better that you stop before you waste your time going through the formality of getting a degree in something you could already do now.

Of course, I am basing my assumptions about you on the few paramedics and EMTs with whom I attended nursing school (there was ONE nice one, so I guess they aren't all bad). You shouldn't be insulted by my comments if they don't resemble YOU, right? I mean I'm only basing them on the very small sample of my personal experience, and it wouldn't be fair to extrapolate to the larger group based only on that, would it? Aren't generalizations irritating?

Flightline, BSN, RN · Nov 30, 2008

What exactly do you want me to think or say?
I have seen nursing in action. Nurses in the ER and flight nurses simply do not meet your views I must say. You form a false dichotomy by almost completely separating medicine and nursing. Nursing is a different discipline, yes. But progressiveness has lead to nursing becoming much more "medically inclined". I don't know if you think that good or bad, but I respect your opinion.

Well, that all depends on how long the pt is in the ER or in the air. But there's no dichotomy: medicine diagnoses and then prescribes treatment. Nurses in the ER do not do that. Nurses on airplanes do not do that. Nursing provides holistic care. Some of that holistic care includes carrying out the medical treatments prescribed by the MD. In the hospital, even in the ICU, the mixture of non-medical nursing care and medical care is about 50/50. MDs dont order the linen to be changed or the pt to be bathed or how to feed the patient, or when to change the ecg electrodes or how to toilet them or transfer them from one place to another or how to educate them or counsel them, or provide therapeutic presence, or how to talk with the family, etc. Nor do they order in the chart every single assessment criteria that we should call them about.

Part of caring includes medical care. It never includes the diagnosis of medical pathologies and prescibing of treatments for that pathology. Nurses make diagnoses and carry out interventions related to aspects of care.

I see that you believe nursing is becoming more medically inclined. But that's not true. It can't be; it's not possible. Nursing will never become mixed with medicine. You can't train people to be an MD/RN. As I see it, human beings just aren't built that way, and I'm not sure there isn't an inherent conflict between being a patient's doctor and nurse at the same time. I think what you mean is that nurses are doing more and more complex medical care. And that's true, although I think it's leveling out now.

And let me rephrase my "caring" portion. I do "care" for my patient. I ensure comfort and take very good "care" of my patient.

True. As a paramedic you function as a first-responder medical technician. You do for the pt what they cannot do for themselves. If you work for the fire department, you might even do rescue, which is a very dramatic type of caring.

I have nothing but good intentions yet you seem to be so hostile. If I just wanted to be an RN to get to CRNA, I would say that. It is simply an option down the road. I am in no rush except to get into nursing.

I'm sorry you see my confrontation as hostility. I'm just making a case for nursing. Everyone who can't stand actually caring for patients at the bedside always runs off to CRNA school or NP school or PA school or whatever and then likes to think they are higher than plain ol' nurse. They seem to like to think that the reason they don't have to care for patients at the bedside anymore is because they've progressed in the field of nursing to the point where they are beyond mere footwork. So, now I have to wax religious--it's Sunday:

Jesus is washing Peter's feet, or attempting to, and Peter says, "No way Lord, you will never wash my feet." Peter saw Jesus as much greater than he.

But Jesus saw Peter in charge of things after Jesus was gone, and that toxic idea that the greatest are served by the least just wasn't going to cut it. Why? because it's not real power. God, the Father, Himself, cares for each and every ant and mosquito.

So Jesus says: "If you don't let me wash your feet, you have no part in me."

My point: The lowest duty in nursing is the highest point in nursing.

Flightline, BSN, RN · Nov 30, 2008

And NPs like all RNs and LPNs work in a variety of roles and settings and many, many of them provide advanced nursing, not just medicine. They are in no way, "doctor's assistants".

I've never seen an NP who was hired as an NP doing nursing care. Not once. I've seen NPs that have been hired as RNs doing nursing care, but then they weren't practicing as NPs. If there is a state where an NP doesn't have to have an MD's oversite, then that is an exception to my opinion that NPs are doctors' assistants.

SharonH, RN · Nov 30, 2008

I've never seen an NP who was hired as an NP doing nursing care. Not once. I've seen NPs that have been hired as RNs doing nursing care, but then they weren't practicing as NPs. If there is a state where an NP doesn't have to have an MD's oversite, then that is an exception to my opinion that NPs are doctors' assistants.

There are at least 11 states plus the District of Columbia that allow NPs to practice completely independent of MDs. But you miss the point; just because you have never seen NPs practice in settings that do not include diagnosing and prescribing does not mean it does not happen. They practice in other settings and they do not always function as medical providers.

Altra, BSN, RN · Nov 30, 2008

1. I have a friend in nursing school who says she is going to get her DNP and she will be, and I quote, "at the same level as an MD/DO" and "my patients will have to call me DR".
...
Can anyone address a few of these issues to put me at ease, lol.

But I hold to a very strict definition of our profession, and the image I have of our profession, our crest if you will, is a bedpan, a bowl of soup, and a wash basin. And I take great pride in that. I feel there is divine power in that. We are a profession of caring. We professionally care for people who can't care for themselves. Sometimes that care is very advanced (like with a fresh post-op CABG pt.) Sometimes it is just doing the laundry for a senior during a home health visit. But in both cases it is caring. MDs don't care for patients. They diagnose disease and prescribe treatment for that disease. NPs, in my opinion only, are MD assistants, they are no longer nurses. I don't want to get banned for saying that. I fully admit that it is only my opinion, and that I tend to be somewhat warrped.
Example: I saw a doctor get a cup of water for one of my patients once (I know how rare that is, believe me; he was a resident.) My first instinct was to slap it out of his and and beat him to a pulp in the parking lot. How dare he "care" for one of my patients!

OP: These are just 2 examples of completely divergent views of nursing. There are hundreds of others. Each of us practices nursing, medicine, or basket-weaving with our own sense of purpose. If either of these 2 views don't suit you, but you continue to have an interest in and desire to practice nursing based on your goals and realistic knowledge of the field -- GO FOR IT. We welcome you. Your professional path does not depend on your friend who is apparently pursuing advanced education not as a growth experience, but as a foil to a current career she finds to be unpalatable ... nor does it depend on another who may hold some other view of nursing which does not mesh with your own.

Good luck to you. :)

Pediatric4077 · Nov 30, 2008

I think you've just run into a bad crop. Most nurses and NP's I know totally understand the difference between a nurse and an MD. The nurse's role is critical and very important and nurses need to help further the reputation of their profession. There are many elements of nursing doctors will never do or understand, just as the same is true for the role of a doctor. We must both respect one another's knowledge and experience. And most of all: Work together for our patients!!!!!!!