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.
Honestly, I really don't think students are being steered away from those programs. That happened organically. To become a surgeon, you have to go to MD school/residency/fellowship. There is no shortcut there. A PA/NP cannot be substituted for a surgeon. Ain't gonna happen. Now, what does happen is that MDs specialize themselves out of primary care because primary care doesn't make as much money as being a surgeon. Ain't nothing wrong with being a specialist but then primary care suffers due to lack of supply of providers. That's when you have a giant hole to fill and that's where PA/NPs come in. I think they're very effective in the primary care setting dealing with chronic conditions and such. I don't see PA/NPs (especially NPs) being as effective in the acute care position because that is not what the schooling really focuses on. I don't see anything wrong with people going the primary care route if they're passionate about helping underserved communities (because that's who really needs care). I'm just concerned with all these tertiary schools popping up in order to increase supply of NPs. The BON needs to start cracking down on that for sure.
Honestly, I really don't think students are being steered away from those programs. That happened organically. To become a surgeon, you have to go to MD school/residency/fellowship. There is no shortcut there. A PA/NP cannot be substituted for a surgeon. Ain't gonna happen. Now, what does happen is that MDs specialize themselves out of primary care because primary care doesn't make as much money as being a surgeon. Ain't nothing wrong with being a specialist but then primary care suffers due to lack of supply of providers. That's when you have a giant hole to fill and that's where PA/NPs come in. I think they're very effective in the primary care setting dealing with chronic conditions and such. I don't see PA/NPs (especially NPs) being as effective in the acute care position because that is not what the schooling really focuses on. I don't see anything wrong with people going the primary care route if they're passionate about helping underserved communities (because that's who really needs care). I'm just concerned with all these tertiary schools popping up in order to increase supply of NPs. The BON needs to start cracking down on that for sure.
Exactly and the only thing I would add is that if NPs attend an Acute Care NP program then I'm comfortable with them treating acute patients.
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!
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!
PAs cannot perform surgery but they can assist surgeons with suturing and the like. They're directly under the surgeon and will often do follow ups with the patients after surgery. PAs follow the medical model and that is why you see a lot more of them in the surgical/hospital setting. I think you may have an irrational fear of having surgery performed by a 'midlevel'. That is not the route things are going. Each profession has their own lobbyists as does the medical profession. Each is vying to keep their piece of the profession from being shared with other professionals. It's just business. The market will dictate where healthcare goes, but evidence based research has shown time and time again that NPs provide quality care for cheaper in the primary care setting.
But how can puppy mill NP schools produce quality NP's? Sure it's individual. Some NP's that come out of the puppy mill are great. But overall??? No thanks! Midlevels are the capitalists solution to MD shortage. Like I said before. I much rather fix the real problem (MD shortage) than put a bandaid on it ( NP/PA). Several people have commented that they don't understand my point. It's pretty simple to me. Cheap labor is bad for healthcare! NP/PA are cheap labor!
Actually your name is very appropriate. In fact you probably don't even realize how appropriate it is. NPs are one solution to the MD shortage. I think you forget that the term "labor" doesn't always mean that, for example, you are picking fruit, but as an NP, you are bringing in revenue. If you think NPs are cheap labor and bad for healthcare why don't you go to Texas and see why they are the lowest state in terms of healthcare providers. Talk to all the people who are doing without healthcare there. It's always about the money, even at the Vatican. Get over that part. Don't forget to tell us how you're going to fix the MD shortage...and how expensive it will be.
America spends more on healthcare than any other country yet our system isn't the greatest. I don't understand which point you were trying to make by saying "going the cheaper route is a bad idea"? Healthcare has NEVER gone the cheaper route before so that's why we now have a bloated and inefficient system which lacks a huge number of primary care providers. You're just reinforcing what I'm saying without even realizing it.
Lol I created my own screen name. I am self aware enough to realize I'm a lil cray cray. I've always been a lil off my rocker and that's ok with me. I see nothing wrong with being different. Being a forward thinker. Evidence based. Lol! Depends on who funds the research. And why is healthcare so bloated???? Maybe if CEO and insurance companies didnt have million dollar salaries. I'm pretty sure I've said this before. Lol I'm just gonna stop. Yall are that dense you can't see whats right in front of you. I swear Americans are getting more dumb each minute. Smh! Think outside the box. Look at the bigger pic. I give up. I can't fix stupid. *steps off soap box*
Side note: where do you work that they don't go the cheapest route? You must not work in bedside nursing where they intentionally short staff units. Just to save a quick buck!
greygooseuria
334 Posts
You can believe that all you want. However, the facts are not on your side and my anecdotal evidence counters your anecdotal evidence so there's that.