Is anybody else tired of the nurse practitioner craze?

[WillRegNurse]

Hi all. I am a new graduate RN who is enjoying his first job as a med-surg nurse. I don't know about everyone else, but I am so tired of the nurse practitioner craze that seems to be overtaking the newest wave of graduate RNs. Half the people I know at my new job are part-timers in grad school for a master's degree as a family nurse practitioner or a psychiatric nurse practitioner. Good on them, but does anyone else think the idea of a mid-level practitioner has been taken a bit too far?

I don't know about all of you, but if I had a medical issue, I wouldn't bother seeing an NP. I'd go straight to an MD. The idea of an NP seems folly to me. Either you are a nurse or you aren't one. Or, either you practice medicine or you don't. A nurse practicing some form of low-level to mid-level medicine seems absurd.

The position also seems discredited by the variance in the scope of practice among different states and the fact that NPs can never do surgery. If NPs had limitless prescription power, and could be trained for some surgeries, we'd be looking at something real. But the NP's that I have seen "practicing" at my hospital just seem to be adjunct to the MDs who see their patients. The patients don't take the NPs seriously for just that reason. They seem roleless. I feel like the hospital hires them just as tokens. I don't see NP's as the future of nursing -- AT ALL. There is this one lady nurse practitioner at my hospital who goes into the patients' room and says "Hi, my name is Kristen and I'm the nurse practitioner," and begins some interview while I as the bedside nurse think to myself "You know that patient doesn't care right? You know they will just forget about you once they are seen by the actual MD?" Of course I never say that. But that's what is in my mind. I see no point in them.

I see pure bedside nursing as our future. Nursing education. Stuff more involved in social services.

I think NPs are suffering from an identity crisis. Let me know your thoughts too.

[LegzRN]

Wow, are you serious? In PA, mid levels, especially NPs, play a massive role in the health care system.

[WillRegNurse]

People are commending NPs without any actual reasoning here, it seems. I think this is due to loyalty to the profession rather than actual logic. You guys are just giving anecdotal "crappola" testimony rather than showing any data that warrants the notion that FNP's provide equal to or better care than medical doctors. That just does not fly in an academic setting.

I remember one time I was seen by an NP at my university infirmary, she just immediately had the MD see me after suggesting some weird diagnosis, which was contradicted by the MD's true diagnosis minutes later. Then the NP said "Yes, I agree. That's what I thought too."

If people want to give an actual reason for why visiting an NP trumps an MD, I'm all ears. If people instead just want to toot their own horns, then I won't be as receptive to that. That kind of ignorant chest-beating is not intelligent.

My family practice MD would have an appointment ready for me within a week. If FNPs are there just to shorten appointment times, or to "fill a gap," then I think they need to reconsider their role badly! The FNPs that I have seen seem more interested in "proving themselves" rather than following up on care.

[RhinoRocketRN]

like we said, and from what ive heard from ppl outside the profession, its the difference in ATTITUDE as well as other things.

[fromtheseaRN, BSN, RN]

People are commending NPs without any actual reasoning here, it seems. I think this is due to loyalty to the profession rather than actual logic. You guys are just giving anecdotal "crappola" testimony rather than showing any data that warrants the notion that FNP's provide equal to or better care than medical doctors. That just does not fly in an academic setting.

I remember the one time I was seen by an NP at my university infirmary, she just immediately had the MD see me after suggesting some weird diagnosis, which was contradicted by the MD's true diagnosis minutes later. Then the NP said "Yes, I agree. That's what I thought too."

If people want to give an actual reason for why visiting an NP trumps an MD, I'm all ears. If people instead just want to toot their own horns, then I won't be as receptive to that. That kind of ignorant chest-beating is not intelligent.

My family practice MD would have an appointment ready for me within a week. If FNPs are there just to shorten appointment times, I think they need to reconsider their role badly! The FNPs that I have seen seem more interested in "proving themselves" rather than following up on care.

md's come at a patient treating only the disease. np's, coming from a holistic background, treat the whole person. in my state an NP requires 7 years of school, which is just short of a medical student (minus the residency). if you honestly wanted to look at data, you can just as easily type that into google, rather than troll the boards. seems to me like you're the one doing the "ignorant chest beating."

[lckrn2pa]

Ok, lets look at this from another angle. By your logic, Midlevel's can not give a level of care equal to a MD/DO. So get rid of midlevels. Now, same argument, CNA's, MA's, LPN's can not give the same level of care as an RN so why not get rid of them as well. Since an RN can do the job they do but they can't do the job of the RN then I guess they serve no role, going by your logic.

[netglow, ASN, RN]

Last physical I had was with an NP.

Now that's a physical exam baby. Never had such an involved H to H. We talked about me cutting back on the coffee (how to do it) and trying to destress. We talked about ways to strengthen my off and on owie medial L knee... she noticed I slightly favored in ROM. She gave me job hunting advice. Got a flu shot and TB test from her. She didn't have to leave and send another person in to do that.

The time before that, I went to a internist, and got a quick listen to H and L and a blood draw and that was it.

[eagle78]

Beauty is in the eye of the beholder...

My father is currently in an SNF. The MD makes rounds once a week, on Thursday. The NP is there daily, Monday thru Friday. To be honest, the information we get from the MD we have already heard from the NP. I feel that she is more familiar with my fathers case as she makes rounds daily. Sometimes I think the report from the doctor is consisting of information that is consolidated from the NP if not solely her observations.

Now I have had good doctors as well. But there are bad ones. When I had cancer my oncologist drove me crazy, he never listened to me. Yet the surgeons and my primary care doctor were wonderful.

That being said, there are bad apples in every batch, be it doctor or NP, all fields have them. We used to say they are just "a pulse", nothing going on but breathing...

[Katie5]

NPs, are essential, but funny enough,some RNs totally disregard or are critical of NPs. Very ironical.

[netglow, ASN, RN]

I'll add that I had to wait quite some time to see this NP. She has a following. All waiting patients said they never go to MDs for first impression on things much anymore. This NP will send them (and has) to an MD and do not pass go if she feels it is necessary. So no crime no foul.

[WillRegNurse]

In the end, it's the appendectomy that saves the patient with appendicitis. Not the NP's "holistic" spew.

No disrespect to the NPs out there, or their training, but I see the bedside nurses as more important to the patient's care than the NP's visits that usually just reinforce the MD's diagnosis and plan of care. I truly see bedside RNs as more integral to the healthcare team and more vital to the patient's wellbeing than anything an NP could ever do (write limited, crappy scripts).

"Treat the disease not the person" is a silly little overused catchphrase. Please don't repeat it in this thread. This is not an alternative medicine thread. Do you have any evidence that shows that an NP's "attitude" is better than an MD's? Is there a poll? May I see it? Well..?

[netglow, ASN, RN]

Treat the disease not the person.

Well it's your phrase.

[whichone'spink, BSN, RN]

I think NPs do very well in the family practice setting, but the practicum hours differ by state, so they may not have enough time to practice in the hospital. For specialties, PAs may be better, since they train in all specialties. That too probably varies by state.

I wish there was more of a federal standard for how long schooling should be for PAs and NPs.