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.
I am an RN. I am not an NP nor an NP student. So with that out of the way I just want to say one of my clinical instructors was an NP and she could run circles around any MD in the facility we were at. She was very intelligent. NPs can also work alone in private practice and I know where I live they can prescribe narcotics. They are not used as fill ins for physicians. I have an NP for a primary care provider through my insurance. She is an FNP and that means she can work with pediatrics all the way up to geriatrics just like a family doctor can. She also makes darn good money. More than I would ever make as an RN.
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..?
Maybe if your bedside nursing was better the NP wouldn't have to waste their time by coming into the room to reinforce the MD's plan of care.
Specializes in Oncology; medical specialty website.
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."
I don't agree with this at all. I've had more than my share of MDs who were able to do more than just "treat the disease." Why the need to denigrate MDs just to defend NPs?
In all honesty, I would prefer to see an MD over a mid-level.
Specializes in Oncology; medical specialty website.
Hmm, interesting comment, please elaborate your reasoning for one over the other. I've worked with both over the years and found them equally competent. Just curious as to why people believe one to be better than the other. I've never seen it nor do I believe as a PA that I will be better than a NP, I'll see them as a colleague.
I'll take that one.
The handful of PAs I worked with were not that swift, and they had major attitude that was hard to deal with. I don't need to hear a spiel on how you are just as qualified as an MD. In one case, the PA ordered a tx that would have been lethal to the pt. and told me I had to follow his orders because "he was the PA, and I was the nurse." So, as "the nurse," I called his SP who agreed with me and countermanded the order. Lucky pt...that day, anyway.
I think a lot of nurses are going into the NP field due to the poor working conditions at the hospital. I don't blame them, sometimes I wish I had done this years ago. Floor nursing is very difficult, stressful and dangerous! Let's not kid ourselves!
NP's still are caught in the assembly line pace at clinics, but at least they don't have to do any heavy lifting and have a better quality of life, more pay and more prestige. Granted you don't have to be a primary care NP, many just work as an assistant for doctor groups, cardiologists, surgeons, etc. Not a bad gig, if you can get it, in my opinion.
Floor nursing is very frustrating, you are forced to work in understaffed, at times unsafe conditions, have no real control over your work environment and I'm sorry I don't see magnet status and shared govt really do much to change things. The bottom line is always money, there's no money in the budget, blah, blah, blah! It's very common for nurses not to get a paid break for lunch to be forced to work thru lunch, etc, etc.
It seems it will take an act of congress to get the hospitals to provide safe lift equipment to provide a no-lift environment when the patients are becoming ever more obese 200-300 to even 500+ pounds!
Why is it the hospitals always have money to pay the top dogs $100,000's to over a million when they say their non-profit or throw $400,000 away to the Ritz for customer service but never have the money to pay for adequate staffing ratios, equipment, lift equipment, etc, etc!
Since we don't have real control over are work environment, are overworked, overstressed, and put in needless dangerous situations to save a buck; I would advise people to consider going back to school for NP or something like that! If you have the money and time and ability, it would be a risk worth taking.
Know that you may have to compete and actively market yourself, let doctors know your avail, or be willing to relocate if necessary but it is a better choice than staying in floor nursing wondering how you'll make it and hoping you don't end up crippled with a disabling back/neck injury or suffering in chronic pain!
If you have a choice, its just not worth it! Once you are injured you'll be set aside and they'll just put a new person in your place. So I think NP is a good choice rather than staying in dangerous, poor working conditions!
Well WillRegNurse, I haven't read the full thread, but here's a link to some data that concludes that NPs are equal to MDs in quality of care http://www.acnpweb.org/i4a/pages/index.cfm?pageid=1 There's plenty more out there for you to research on your own.
I feel that you are young and new and are unable to see the full picture of a patient's health. Bedside nursing is ESSENTIAL and important. Bedside nurses are the first to detect when a pt starts to go bad and can catch it before they code. They are also there for education and psychological support, pain control and palliative care. They can make a huge difference in the patient's recovery process.
But where does health care begin? Could that pt have been prevented from being in the hopsital? Could their time of good health have been prolonged? Primary care NPs address this issue by providing preventive care. They are trained to emphasize this along with measures that will improve the pt's health and quality of life. They are trained to look at all aspects of the patient, not just the portion that presents physcially.
In the hospital, a NP provides nursing and pts with an immediate resource in order to improve care. Got a pt with uncontrolled pain or a low K+ or Hgb? The NP is just a call away and treatment can begin much more quickly than waiting on a doc to call you back. In addition to this, the NP takes a good portion of the MDs patient load inthe hospital. If the MD had to take this load himself, he would be much more fatigued and stressed. Do you think he would provide better care in that position? It is often too costly to employ an MD for this purpose. A NP makes an affordable solution and as a result the patient gets more immediate attention and care.
Many people have offered various opinions in answer to your question, yet it appears that you will only be content with the response you want. So why ask? Given that there is a shortage of physicians, the NP role is a vital one. In the end, we all have our own opinions, so I'll leave it at that. Hopefully, as you progress in the nursing role, your perceptions will change.
I would have to disagree that NP's don't have their own "identity". Where I live, the NP's (which can practice independently depending on the state), and PA's(which work under a MD) are becoming the main Primary Care Providers. That is their niche, identity and role. Most of the physician's here go on to specialize.
Without NP-staffed school based clinics that I regularly refer children to for care of basic things like pink eye or rashes that need to be evaluated, these kids would miss a week of school or more waiting for an appointment with their MD. Or better yet, they would clog up the ER with minor complaints. Yep, that is a much better use of medical resources. Thank God for NPs!
I think the OP is expressing frustration with the number of new grad RNs going straight into the NP program without even getting their feet wet. Yes, we all know many GREAT providers but all of them were RNs for years before becoming an NP. This new crop will be Nurse Practitioners without ever having been a nurse!
Yes, 7 years of education is alot but every single PA-C out there will argue to the death they have harder, more in-depth clinical instruction making them "better" then NP/FNP. The NP's I know win that argument everytime as they have the bedside experience to back them up.
If NPs had limitless prescription power, and could be trained for some surgeries, we'd be looking at something real.
Isn't this already occurring in some areas? So do you see this as a possibility and hope for growth of the NP role then?
OP, I see some of your points but agree with some who mention that NPs have a vital role in health care right now. Politics is creating a system where in order to now serve the larger population, we need creative solutions and not rigid beliefs such as ones that assume only MDs can provide medical care. MD schools are tough to get into because of politics and not so much the lack of qualified individuals.
The lingering argument is NP education standards. Regarding this, the governing boards seems aware of the need to create stricter and more universal training tools for the NP role. The solution for this is already on the table, though some may not agree with it (DNP, NP residencies, curriculum overhaul, etc.)
Do NPs go to less school? It Depends. What defines schooling nowadays anyway? These days, what you learn is not limited to the confines of a brick and mortar institution.
The role of NP is evolving quickly. Which way it evolves will determine the health care quality in the future.
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.
Uh...That remark make you sound like a physician who I know, who does not care for NPs....make me wonder about your true identity.:igtsyt::igtsyt:
Fisrt of all, nurse practitioners are not trying to take the place of MDs, we supplement them in improving the care (which is, ultimately everyone's goal, right??). Numerous studies demostrate the advantages of using a mid-level provider by improving customer satisfaction, reducing waiting time (in any setting), and allowing access to health care to those, in areas where a physician may not be readily avilable. Taking for instance, the NP at your facility. Do you ever wonder how long it would take the physician to see a patient, face to face?? The NP fucntion as a liason between that patient, YOU (the nurse), and the physician; which leads to improved care, happier patients and faster discharges. Please grow up (if you are indeed a nurse), and take the time to ask that NP what is her role, since you seem to be clueless about what it is. Be proactive and do a search on the matter, rather than come to this board with such a negative disposition.
Second, I can not believe that you are judging a whole profession based on a couple of negative encouters, which let me to wonder... how will your treatment of patients be affected if you have a prior negative experience by an African American or a gay individual. Instead of putting down your classmates for advancing the profession, do something positive with your time and energy....volunteer, become involved with your hospital commettees or go back to school (you will be amaze how rewarding it can be).
By the way, NP do assist in surgeries (at least in CA. My best friend speacilizes in neurosurgery) as well as having prescription privileges, please do your research (can't stress that out).
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Harrychandler
53 Posts
I am an RN. I am not an NP nor an NP student. So with that out of the way I just want to say one of my clinical instructors was an NP and she could run circles around any MD in the facility we were at. She was very intelligent. NPs can also work alone in private practice and I know where I live they can prescribe narcotics. They are not used as fill ins for physicians. I have an NP for a primary care provider through my insurance. She is an FNP and that means she can work with pediatrics all the way up to geriatrics just like a family doctor can. She also makes darn good money. More than I would ever make as an RN.