I should have gone to med school! (rant)

*ac* · Nov 19, 2009

Coming from a staff RN who works with many NP's:

I love working with NP's and am very happy when a service I have to work with has one because I find them more accessible, respectful, helpful, and usually more empathetic to my situation. They have been great teachers; i.e., when they order that some care be performed that I'm unfamiliar with, they have no problem showing me what they want. I've had them come in when I'm struggling with something, and they jump right in to help. How many doctors do all that?

The most important part is that they ask for my input and trust my judgment. I wonder if you do that? There is a huge amount of mutual respect. I wonder if you have that.

tencat · Nov 19, 2009

If I were young again....sigh...and/or did not have kiddos, I'd probably go the MD route. But, as I have a family and not enough time to devote to med school, I'll be going the NP route. Is it ideal? No. But I think as an NP in my state I'll have more choices and more autonomy. The local hospital doesn't think much of NPs, and won't let them admit patients, but I don't plan on sticking around here forever....

elkpark · Nov 19, 2009

Have you ever felt like this? I am having one of those weeks right now, lol. Sometimes I feel that I missed the mark by going the nursing route. I feel that as an NP I don't have the autonomy and respect that I really want. Not only do the docs not take me seriously or trust my judgement, but the nurses don't either. A part of me wants to go ahead and apply to med-school, but I don't want to borrow more money! It will also take a long time to finish, and I wouldn't be practicing as an MD until I'm over 40!

Nursing isn't for everyone, and it's a shame to spend your entire career "settling." My father was an RN who went to medical school -- he was over 40 when he finished medical school, before he did his residency, but he got into the top residency program in the US in his specialty and had a long, full, satisfying career as an MD. If you really have the fire in the belly for medicine, go for it!

BmoreCRNP · Nov 19, 2009

Coming from a staff RN who works with many NP's:
I love working with NP's and am very happy when a service I have to work with has one because I find them more accessible, respectful, helpful, and usually more empathetic to my situation. They have been great teachers; i.e., when they order that some care be performed that I'm unfamiliar with, they have no problem showing me what they want. I've had them come in when I'm struggling with something, and they jump right in to help. How many doctors do all that?
The most important part is that they ask for my input and trust my judgment. I wonder if you do that? There is a huge amount of mutual respect. I wonder if you have that.

I do that not only with the nurses, but the aides. I have always operated that way. People are more willing to help you and work with you.

BmoreCRNP · Nov 19, 2009

Hey BemoreCRNP,
I have a question for you. So you went to a direct entry program, from BSN to MSN without prior nursing experience..correct? I'm just curious because I am planning on doing the same soon, and I always wondered how are these types of nurses received. I hate it when I hear stories like this of nurses hating on other nurses, we should stick together and help each other.
I'm sorry that you are going through that and I hope that it gets better.

No I had 13 years of nursing experience before I started working as an NP. I can't speak for those NPs that chose to go the BSN-MSN route without prior experience. I personally don't recommend it, but everyone has a different opinion.

allnurses Guide · Nov 21, 2009

BmoreCRNP and others,

I am so sorry that you've had these experiences. It's very demoralizing to be disrespected by peers, superiors, and others. I am a new grad FNP from a direct entry program, with NO RN experience. I was quite worried that I would run into some of those issues, as I had while doing some of my clinicals. I brought up this concern during job interviews and was able to ascertain which position would be supportive for me. Fortunately, I made the right decision. I am very lucky to work in a place where the NPs and MDs truly work collaboratively. Most of the docs are just out of residency, so we're all newbies and look out for each other. I have a background in laboratory medicine and that is respected and valued by the other providers. One of the other new NPs is the derm queen and even the experienced docs go to her for the crazy rashes. We need and love our nurses and medical assistants, and make sure they know that. So, it's not all bad out there. Believe me, my job is far from perfect, but the issues don't lie with staff respect. I know I'm lucky, but I hate to think that my job is the exception rather than the rule. If med school is truly your calling, then go for it. Don't let the age thing hold you back. We're all going to get older regardless, so you might as well be doing what you love.

christvs, DNP, RN, NP · Nov 27, 2009

I understand your frustrations. Once in a while, I will think the same thing about going to medical school. I graduated from my NP program a year ago and although I absolutely love the clinic job I have been working at for 10 months now, I do still feel insecure in my knowledge level at times.

I think I tend to compare myself with the other NPs and docs who work with me, who have been working here for over 10-15 years, and I get frustrated very easily with myself about why I didn't realize something when others point something out. But I keep trying to tell myself that I am still new in comparison to them, but that at least I realize how much I still don't know, and I am always very willing to ask someone my questions and/or look them up. And every day I go to work, I become that much more experienced! :)

jjjoy, LPN · Dec 2, 2009

No advice here, just thoughts...

I certainly hope that your competence will be proven out over time and your colleagues will trust you and value your input. But meanwhile, it seems that you've got no one in your corner :no: . You are part of the doc's group, but you're not a doctor. And you are not part of the nurses' group as you are in a role that is more aligned with the physicians.

And since working with NPs is new to many and since it's not clear to many what kind of education NP school provides, the simple fact of being an NP doesn't prove anything in their minds in regard to your compentency. Physicians, on the other hand, have their residencies as a proving ground in their area of choice. Plus, NP roles aren't standardized so others can't be sure what exactly any one NPs role is and what exact relationship they may have with the physicians.

And so, it would seem, that you are stuck fighting an uphill battle for now to have your competency acknowledged.

Cardiology EP NP · Dec 24, 2009

As an NP it may be challenging to find a job in a state where you will be respected and are given a lot of autonomy. I know some posters have also mentioned the fact that as a new NP, sometimes there is insecurity in the level of knowledge. I guarantee you that will change with time and experience. The more you do your job, the more you will learn and you will gain people's respect, even the docs.

I used to work in a pediatric office made up of 13 docs and 1 NP. But, boy that one NP sure knew her stuff. She had been practicing for years and she was very well respected and often times, believe it or not, she found stuff the docs didn't. For example, I remember this new doc started working with us fresh out of residency and this 7 year old girl came in to the office with a rash and a fever for 1 week. Well the new doc saw her and couldn't tell what the rash was. So she asked the NP to go in there and take a look at the rash. The NP comes of out the exam room 30 seconds later and says, "It's chicken pox." I always have to laugh at this story because someone could have all the knowledge in the world but they could be lacking so much when it comes experience, which could make all the difference. So, years later let's hope that doc who is no longer a new doc can recognize chicken pox. :nuke:

We all have to give ourselves time to adjust to the role of the NP. Docs train for years. The EP docs I work with have had 7-8 years of training post med school. With time and experience we can perfect our knowledge and skills as an NP. Patience is one the biggest virtues INMHO.

christvs, DNP, RN, NP · Jan 13, 2013

Well said! I agree that we NPs just need to have patience with ourselves and really give ourselves a chance to develop our knowledge and skills. We do get much less clinical training in medicine compared to MDs so it's perfectly ok to realize it will take time to be an expert

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jaznia15 · Jan 18, 2013

If you've ever had the chance to work around 1st year residents, your confidence would be greatly boosted. New residents are quite frankly, clueless and a lot would ask RNs advice when taking care of a patient especially on night shift. I can't tell you how many times I heard "what do the other docs usually do for this" or the flipping pages of some book when calling for an order from a new resident. The great thing about working at a teaching hospital is you got to see these residents progress from the bumbling stage to that of a competent MD as they went along in their residency for those 4 to 5 years. A lot of my classmates have stated several times that a residency for NPs would be a great idea especially that first year out of school. Of course this is not something that is widely offered, but hold fast in the fact that even new MDs need years of experience before becoming confident as well as gaining the respect of the staff. I can't tell you how many eye rolls I've seen or done myself when dealing with a first year resident.

nursetim, NP · Jan 24, 2013

As an NP it may be challenging to find a job in a state where you will be respected and are given a lot of autonomy. I know some posters have also mentioned the fact that as a new NP, sometimes there is insecurity in the level of knowledge. I guarantee you that will change with time and experience. The more you do your job, the more you will learn and you will gain people's respect, even the docs. I used to work in a pediatric office made up of 13 docs and 1 NP. But, boy that one NP sure knew her stuff. She had been practicing for years and she was very well respected and often times, believe it or not, she found stuff the docs didn't. For example, I remember this new doc started working with us fresh out of residency and this 7 year old girl came in to the office with a rash and a fever for 1 week. Well the new doc saw her and couldn't tell what the rash was. So she asked the NP to go in there and take a look at the rash. The NP comes of out the exam room 30 seconds later and says, "It's chicken pox." I always have to laugh at this story because someone could have all the knowledge in the world but they could be lacking so much when it comes experience, which could make all the difference. So, years later let's hope that doc who is no longer a new doc can recognize chicken pox. :nuke: We all have to give ourselves time to adjust to the role of the NP. Docs train for years. The EP docs I work with have had 7-8 years of training post med school. With time and experience we can perfect our knowledge and skills as an NP. Patience is one the biggest virtues INMHO.

I catch stuff that MD miss frequently, especially when I was in prison (working BTW), but also in the heart hospital I work in now. It is possibly due to EMR check box mentality. Take a breath give yourself a break. I'm working in a heart hospital and playing catchup like mad. I'm learning a metric ton and even though some might think what I do is scut monkey work (residents) but I like it. I feel like I'm in nomansland as well. The nurses kept introducing me as the new PA. Not that this burns me or in any way diminishes me, but I am one of them, sort of. No biggie.