So the director of psychiatry and some senior psychiatrists at my hospital are in a funk. It appears surrounding hospitals are offering incentives (increased salary and other benefits) to attract psychiatrists to their institutions - and its working. So far, we have lost four psychiatrists in the past five months to nearby hospitals that are offering those incentives. Those facilities also hire FNPs and PMHNPs whereas my hospital doesn't. Clearly there is no way for my hospital to match the benefits of the other competitive institutions and there is a huge shortage of psychiatrists in the area. So... I suggested that we start hiring NPs.
Bad move.
I never seen so much hatred from health professionals. One of the senior psychiatrists actually shouted at me for coming up with "a stupid idea." He then proceeded to tell me how many years of schooling and training he's had out of some need to compare himself to a PMHNP. What really bothered me is that the director said, "I HATE Nurse Practitioners" as if that was a good enough reason for not hiring them in our facility. What they think is what they think; I can't change that. But would I be overstepping boundaries if I drew up a presentation at our next meeting to outline the benefits of hiring NPs? The chief director of psychiatry will be present at the next meeting and I really think its worth a mention.
I don't have to go to Tx to see bad healthcare. I see that in my own back yard. My hometown where I was born and raised. You really think Tx is the only state with PCP shortage??? Open up your eyes. Its in every state. Even in universal systems $$$$ still matters because you have to have a balanced budget for the system to sustain itself and survive. It not just the money for me. Its the capitalist America way of life. Work harder longer with less resources. Lean works in factories but not in bedside nursing. NP/PA are A cheap quick fix produced from capitalistic American empire. This is just the way our system is. Its a product of privatization of healthcare. But just because its the way it is doesn't mean it has to always be this way. I hope that one day my grandchildren will never have to worry about paying for healthcare. I hope they dont have to drive hrs away just to see a dr. I hope that MD PA and NP can work cooperatively with one another with Number of MD being greater than number of midlevels. This MD shortage aint no joke. And I'm sorry I refuse to jump on the bandwagon. Or the gravy train as I like to call it. I will not endorse a system that replaces MD with immense knowledge talent and experience with NP's from an online puppy mill school in the name of capitalism. All for the almighty purse strings. Sorry I refuse! And if you can not see the problem with this. Then you must be blind!
It's very subjective and all depends on supervising MD. Not uncommon for MD to open do major part then bounce! Sometimes MD won't even open. It varies greatly. I do have to say though. All the surgical PA's I know are awesome! But I refuse to support a system that uses cheap labor to solve an MD shortage. Which is why I said to think twice about going the NP route. There is a difference in scope of practice. Don't just see the $$$$. Think about your goals in life what you really want to do.
Well, to be completely honest...you sound like a fear mongering ideologue. You can't really have an intelligent and fact based discussion with someone like that so I'm bowing out. Oh, and I am a bedside nurse so think before you judge someone.
There are 10,000 reasons not to go the MD route. But there is alot of advertising propaganda. I cant help but to think that influences the decisions students make. Just logging into all nurse I got two pop up advertisements for puppy mill nursing schools. In my state PA's can assist and perform surgery.I would not be surprised if in the next few yrs NP's will be allowed to assist/perform surgery. I have no problem with midlevels in primary care. When I have a cold sure I'll see a midlevel. But if I'm having chest pain and SOB. It's a different story. You have to understand there are groups with a vested interest in pushing NP. Even my beloved NNU. *sigh* We must open our eyes and question their motives. And ask ourselves is this the best thing for the health of society? Time will tell!
In my state NPs can assist in surgery. They do the endoscopic vein harvest for a CABG, and assist our CT and vascular surgeons during all their other cases. They (and our surgeons) seem to do a really good job, our CVICU has great outcomes with our surgical patients.
It's fine to have an opinion, but your spewing out yours like it's an indisputable fact.
Primary care providers deal with complex issues, but it's not rocket science. I have yet to see any data indicating that a properly trained NP isn't competent to function independently in the primary care setting, or assist an MD in acute care.
In my CVICU it seems that NPs take care of the more mundane issues, freeing up physicians to focus on the real critical care. An NP will come around and order some labs, increase a patient's dose of coreg, and start them on some potassium. The physicians are managing vents, balloon pumps, and LVADS. It works just fine.
Yet you are thinking backwards (or perhaps sideways) and you have no evidence to base your opinion on, in fact, your position is directly opposed by every extant study on the topic.
It's pretty simple to me. Cheap labor is bad for healthcare! NP/PA are cheap labor!
It's "simple"'to you because you don't have more than a superficial understanding of the problem.
There is a difference between "cheap" and "cost-effective". NPs have been demonstrated in a myriad of major studies to provide equivalent outcomes to physician counterparts and at a lower cost to the system.
When you go grocery shopping do you try and find the store with the highest price on milk?
That isn't the real issue though. The real issue is that there is a shortage of primary care and mental health providers, in fact a growing shortage. This is due to a limited supply of physician in these practice area. This limited supply is created by the physicians themselves in an effort to have higher salaries (through both limiting supply and by preferentially moving towards specialities and away from primary care). If you have concerns about the number of MD/DOs then why don't you ask them why they don't pick these areas of practice?
Nope that's how it is in my state. It's like how doctors can train medical assistants to perform tasks that nurses normally do. Is there really a difference between cheap and cost effective??? I mean really think about it before you buy into that propaganda. Dear lord what states allow NP to perform surgery? Because I never want to live there!
How is it backwards thinking to want a healthcare system with more MD's than NP/PA? Would you want your unit run with 1 RN and 10 CNA's? Its the same concept. Look you can presented all the "evidence" you want. I'm not buying it. That "evidence" is biased and years from now we will see the true cost of cheap labor.
Crazynut
160 Posts
I don't have to go to Tx to see bad healthcare. I see that in my own back yard. My hometown where I was born and raised. You really think Tx is the only state with PCP shortage??? Open up your eyes. Its in every state. Even in universal systems $$$$ still matters because you have to have a balanced budget for the system to sustain itself and survive. It not just the money for me. Its the capitalist America way of life. Work harder longer with less resources. Lean works in factories but not in bedside nursing. NP/PA are A cheap quick fix produced from capitalistic American empire. This is just the way our system is. Its a product of privatization of healthcare. But just because its the way it is doesn't mean it has to always be this way. I hope that one day my grandchildren will never have to worry about paying for healthcare. I hope they dont have to drive hrs away just to see a dr. I hope that MD PA and NP can work cooperatively with one another with Number of MD being greater than number of midlevels. This MD shortage aint no joke. And I'm sorry I refuse to jump on the bandwagon. Or the gravy train as I like to call it. I will not endorse a system that replaces MD with immense knowledge talent and experience with NP's from an online puppy mill school in the name of capitalism. All for the almighty purse strings. Sorry I refuse! And if you can not see the problem with this. Then you must be blind!