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 don't agree. Its not like the NP is going around pretending to be something he/she is not. There is nothing wrong with mid-level care as you call it. Why wait hours at an ER for a minor problem that can be taken care if in minutes by the NP at a urgent care facility. I plan to become a nurse practitioner myself and the field is growing and rapidly at that.. so im sure eventually they will be able to do all the things that you think they can't or shouldn't :)
In the end, it's the appendectomy that saves the patient with appendicitis. Not the NP's "holistic" spew.
And who performs the appendectomy? The emergency room physician who first suspected that the patient has appendicitis? Nope. They call in surgeons to do that one.
You keep coming back to surgery as The Thing that NPs can't do that therefore makes them inferior, but MANY doctors will never perform surgery: it is a highly specialized subfield within medicine.
Do you question the identity of the family practice physician who must refer his/her patients to specialists when the problem is outside his/her scope? Because even if you take mid-level practitioners out of the equation, there is still a history of the PCP handling basic issues and reaching out to specialists as needed for more complicated cases.
I think you underestimate the impact that lack of access to primary health care has. It's not just a matter of "waiting a little longer" to get an appointment for many people but a matter of having access to a primary care manager, period. That's a huge deal, and as increasing med school costs make general and family practice less feasible for newly graduated doctors, the ability for PAs and NPs to step in to those roles isn't an issue of identity confusion but an avenue for improving access to healthcare. And improving access to healthcare is hardly a new function to nursing.
Considering that NPs are hardly new and the increasingly cost-conscious aspect of healthcare, regardless of what you think about them, I think calling it a "craze" like it's something that will blow over in a few years (like slap bracelets or something) just sounds like someone hasn't done some very basic homework on the subject.
It's funny b/c I guess I'm involved in the nurse practitioner craze too. I actually just started my program (an extra 3 years of schooling). It's true that some see NPs and PAs simply as physician extenders. However, to the millions of uninsured or under-insured persons in this country..a NP or PA could be a life saver. I have great insurance, but I still have no idea what my actual primary care physician even looks like. However, I know his NP very well. The purpose of the invention of nurse practitioner role was to help fill the gaps left by the shortage of physicians in the primary care field due to the increasing rates of specialization (e,g., surgery). So the fact that you state that NPs would have something real if they could do surgery would defeat the entire purpose of becoming a NP. If you want to do surgery, become a surgeon...go to medical school. These are two completely different fields (medicine vs. nursing). You have a right to your opinion. However, I suggest you do your research before stating that you find a certain field (NPs) to be of no use. We're not spouting sentimental c**p out of loyalty to the nursing profession. You simply haven't done any research. There's lots of research regarding the level of care provided by advanced practice nurses. If you're actually willing to do the research, here's a site.
P.S. It was a physician collaborating with a nurse which led to the first nurse practitioner program. Also, many physicians have no respect for NPs in the same manner that they have no respect for RNs. Thus, physician opinion doesn't rank high on my list of reasons for doing anything at the end of the day. Plus, in my opinion, better to go to school, get a degree, and get paid a lot more to put up with the crap that RNs do everyday. More money, less butt wiping, less back breaking. :)
How was that a mistake?Should the NP have apologised because, bless her heart, your grandmother did not want her services?
The way I see it,she was at the right place at the right time,( her place of work), your grandma did not want her services, so yup, she would have to SPECIFICALLY request the doctor only or truth be told, I'd have kept on sending the NP in.
I guess I should clarify a few things. This was in a very small town where everybody knows everybody. My grandmother had been going to this doc for over 20 years and the nurses and office assistants recognized her before she even opened her mouth. That's why I say they probably should have remembered that she would only see the doc.
Specializes in med-surg, psych, ER, school nurse-CRNP.
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..?
I smell a troll.
And I also call bull. Bull, you don't mean to disrespect the NP profession, when every post you've made from the get-go has smacked of ignorance and disdain. Shame on you.
Someday, (mods, forgive me) I hope you get to experience what we and our "crappy little scripts" can do. And I hope if you ever are in the position, you enlighten the staff as to your feelings. I'd pay money to see the reaction you'd get.
OP, you're viewing the entire health care spectrum through the lens of acute inpatient care. It's only natural, as you're new and lack the big picture perspective as of yet.
Having said that ... you're free to hold whatever opinion you like.
You're still going to have to implement the orders of NPs who work with your patients.
Will's feelings are not original. They were first voiced by Martha Rogers herself. I don't agree with her either, but Will should give credit where credit is due.
Will is free to see whomever he chooses as his care provider, and I support his choice. If he is uncomfortable with an APN, I do not think he should see one and I sincerely hope the option to see a primary care physician continues to be available to him and everyone who prefers one. However, there is no disputing that for a great many, a primary care physician is not available for any number of reasons and for those people, APNs and PAs are not "second best," they are their lifeline.
My FNP experience thus far has been 100% mission work. I understand exactly what my role is. It is not necessary for me that Will understand it because I don't do it for him, although I would, with a happy heart, if he needed me.
At the end of my day, I go to bed knowing that I have done some good in the world, and that's enough. I hope Will enjoys similar peace at the end of his day, but something about his tone suggests otherwise. Perhaps it will come in time. In the meantime, salud!
OP seems to have disappeared after he probably realized he posed a question in his original post but them proceeded to tell everyone who responded how they were supposed to interpret their experiences...this all of course despite the fact that as a new grad, he has had very few experiences in nursing at all...Will, I, with all respect, suggest you look at all youre medical colleagues as beneficial to the system whether you think they have an identity or not or you might not ever see the light of day outside of your Med/Surg unit from a career standpoint....
Specializes in Emergency Dept. Trauma. Pediatrics.
I may be a new as a nurse, but if you are gloating about how, as if it were supposed to be a "news flash," that a lot of people are disagreeing with me, then I think you need experience more badly than I do. It signifies that you need to grow up.
The purpose of this thread was not to "focus angst into getting people to agree with me." The purpose of this thread was to gather other people's *substantiated* opinions on a discussion that I thought was interesting and worthwhile. Several people in this thread have thanked me for the thought-provoking discussion and posted some legitimate rationales in disagreement, and I thank those people for being respectful, intelligent, and being able to see the larger picture.
The rest of the people in this thread seem to be NPs, NP students, or NP-lovers who got offended by the discussion, attacked me personally, posted faerie-tale stories about some prodigal NP they know, all in an effort to feel that their role is validated. That sort of coping mechanism was expected.
However, I don't feel that "filling the gap of PCPs" and "shortening wait times" and "being less costly" is a sustainable or respectable role. It resounds of settling for someone less educated and less trained due to convenience. By contrast, the bedside nurse has a real identity and a rather irreplaceable role. The NP is there to sub in for someone else's role. That is why I think the concept of NPs is flawed. They have no identity and unlike MDs, are forced into specializing in treating only a certain demographic or age group of patients. Truly, I see regular RNs as being more useful than them. My feelings toward NPs are "what's the point... just be an MD."
It's great to have thought provoking conversations. I love them. But it's a big turn off when you start trying to dictate peoples replies. "Don't reply if you are going to say this or that" "Only reply if you will do this" I think that is where the problem is arising in this discussion. You are very dismissive to peoples opinions because they aren't good enough for you. It's a big turn off for people to want to have a discussion when someone is acting that way.
As far as NP's. I would like to hear your thoughts on a scenario. A woman develops a whopping yeast infection. One that the OTC stuff won't help. She calls the Doc office and is told the doc doesn't have any appointments for 3-4 weeks but they can get her in with the NP that afternoon or the next day. Obviously this woman can't carry on with a yeast infection for 3-4 weeks. Or maybe it's S&S of an STD or something. Pretty basic stuff. So what options does this woman have?? She can go to Urgent Care where it is going to be a much costlier (is that a word??lol ) trip and then have the staff there come to AN complaining about the UC being abused by non emergent situations, or she can co to the ED and have the same as above happen. Or she can get in to see the NP who can do cultures because it's within their scope and look at a slide for yeast and prescribe some Abx.
The doctors can focus on the more serious conditions and patients, UC and ED can focus on more serious cases and this woman can get the treatment she needs promptly. It seems pretty win-win to me.
Specializes in med-surg, psych, ER, school nurse-CRNP.
Just wanted to clarify...in no way was I intimating that the NPs might do anything to cause harm to the OP. Rather the opposite, that an NP may very well save his life, even with the aforementioned "limited, crappy scripts". Having reread my post once the red haze cleared, thought I better edit myself.
Specializes in Vents, Telemetry, Home Care, Home infusion.
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prettymica, ASN, BSN, MSN, LPN, RN, APRN, NP
819 Posts
I don't agree. Its not like the NP is going around pretending to be something he/she is not. There is nothing wrong with mid-level care as you call it. Why wait hours at an ER for a minor problem that can be taken care if in minutes by the NP at a urgent care facility. I plan to become a nurse practitioner myself and the field is growing and rapidly at that.. so im sure eventually they will be able to do all the things that you think they can't or shouldn't :)