Interesting Physician Perspective On NPs

Specialties NP

Published

I am not an NP. I am a full time rapid response nurse at a teaching hospital. This morning I stopped in to residents office to update the night residents on what had happened with their patients and what I had done. They were in the middel of sign out to the day team including several interns, residents, the chief resident and the attending. After I was done an intern speaks up and says "PMFB you should become a PA!". This was met with a rousing round of "NOooos" & "no way!" from the residents and attending. The intern looked confused. The chief resident leans over to her and says "PAs are at the bottom of the medical word. PMFB should become and NP, they are at the top of the nursing world".

The attending and other residents all readily agreed. I thought it was an interesting insight into physician thoughts about mid levels.

Specializes in Cardiac, Pulmonary, Anesthesia.

There is a lot wrong with NP and PA scope of practice in the south, particularly Alabama, which has the most restricted scope of any state in the nation for NPs. Louisiana won't allow CRNAs to practice chronic pain management, even though CMS has decided that it is within their scope and can be reimbursed for it. Many more examples.

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It absolutely amazes me how different NP scope of practice is state by state. It sounds like the south is one of the worst places to be. And the idea that nurses have no control over policy just makes me laugh. Tell that to my acute care CNS professor who spent 30 years working in the ICU at a level 1 trauma center... and yes, he has written many of the policies that both the floor nurses and providers (MDs, NPs, etc.) follow, as well as published in the field.

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Specializes in Med-Surg.

I don't get what everyone has against the South. There are ignorant, bigoted people everywhere, although it seems to be a stereotype mostly associated with the South...

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I don't get what everyone has against the South. There are ignorant, bigoted people everywhere, although it seems to be a stereotype mostly associated with the South...
In this case it is the very real resrictions southern states place on NP practice, and not the stereotypes you mentioned.
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In this case it is the very real resrictions southern states place on NP practice, and not the stereotypes you mentioned.

That's right, plus the very low salaries.

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Specializes in FNP, ONP.

5:21 pm by zenman

Quote from SycamoreStudent

In this case it is the very real resrictions southern states place on NP practice, and not the stereotypes you mentioned.

That's right, plus the very low salaries.

Yes, we are referring to practice restrictions, autonomy, salary issues, etc. I don't believe anyone was focusing on social or cultural matters unrelated to nursing/advanced practice nursing issues.

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Specializes in Med-Surg.

Well as far as salary restrictions go, its been my understanding that cost of living is much lower in the South compared to the North. Please correct me if I am wrong though!

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Well as far as salary restrictions go, its been my understanding that cost of living is much lower in the South compared to the North. Please correct me if I am wrong though!
It depends on the state and city. All things being equal I believe salary is lower even when cost of living is taken into account.
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Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
Well as far as salary restrictions go, its been my understanding that cost of living is much lower in the South compared to the North. Please correct me if I am wrong though!

*** I never found that to be true. Where I live in rural Wisconsin is pretty darn low cost of living. After spending a lot of time looking into it I never found anyplace with the cost of living vs pay rate I found here. Living in Wisconsin and working across the river in Minnesota. We bough a 4 br, 2 ba 10 year old house on 43 acres in the country with woods, a stream, fiels and some farm land for well undr $100K. A very nice house in town can be bought in the $50-$60K range. Starter homes in the $30K range. New grad starting pay runs about $65K. With differentials a new Rn can be making $100K year without OT in 4 or 5 years.

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Specializes in ER.

I live in the south and I think the restrictions on nursing practice are just a reflection of broad social and cultural problems. Other New Yorkers tell me it's not really cheaper here. Instead of taxes, you pay for everything individually like garbage service and water.

As for protocol, I basically look at the np job as chart auditing. Any real work is done by the md. The np just answer questions from RNs, does evaluations of issues and decides whether to pass them on to md or ignore them and makes sure all the right orders are in system such as foley, pain meds, etc. if you don't write protocols, you just auditing charts. I bet nurses used to just verbal this stuff to md before the joint commission started looking into it.

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Specializes in ER, Critical Care, Paramedicine.

Great story... Except for using the term mid-level. While it's an accepted term in the medical community I remember reading a position statement from the ANA refusing to use the term... Personally it makes me cringe to hear it when anyone in my hospital uses it... A losing battle I know but I can fight the good fight right???

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Great story... Except for using the term mid-level. While it's an accepted term in the medical community I remember reading a position statement from the ANA refusing to use the term... Personally it makes me cringe to hear it when anyone in my hospital uses it... A losing battle I know but I can fight the good fight right???
Physicians have to pad their egos somehow right? I'm not sure there is a good term for both NPs And PAs. On the other hand I'm not sure NPs and PAs should be lumped together.
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