No respect as an NP?

[AAHC]

Can anybody share their experiences with gaining respect as an NP?

I have been a nurse for 8 years and an NP in geriatrics for 4 of those years. I work for a company who very much respects APPs. We are valued as independent providers, we see our own panels of patients, and are fully autonomous (of course we have physician colleagues we can reach out to if needed). I started my practice in an underserved community where I was respected and appreciated by my patients. I have since moved to a different side of town where the patients are a bit more 'upscale' if you would. I have never been made to feel so incapable in my career as I am now.

The patients at this clinic are blunt and frequently during visits say things such as, "are you as qualified as an MD to see me?” Some of them are rude about it and won't even look at me or take me seriously/give me a chance. I am constantly being asked when I will be going back to finish school, what school I graduated from, etc. I spend significantly more time with the patients to educate them, fully examine them, and more, and find that they still request to see an MD at their next visit. I am fairly young (30 years old) and feel this may be one of the deterring factors. There have been a few patients who were reluctant with seeing an NP, but have now fully transitioned to my care and are very happy. However, it is so hard to feel like a valuable part of a healthcare team when so many of the other patients say belittling things and question my ability.

In an effort to help you understand my qualifications, I graduated from a prestigious  school at the top of my class, I work extremely hard and care more than you could imagine to make sure I am on top of everyone's care and don't miss a beat, I spend more time with them to fully explain test results/medications/disease processes, etc., I do more hands on exams/more extensive exams than physician counterparts (from what the patients have told me), and I will go out of my way to help them in any way I can. 

I'm starting to burn out and feel like this is not my path. It is too late to go back to the other location and I just do not feel connected with these patients. I am starting to get in my own head and feel defeated. It makes me really regret becoming an NP in the first place, and not going to medical school. Doing the same or better work with such little respect makes me want to change careers.. 

Has anyone else experienced this? Do you have any advice that could help? I wonder if having a DNP would make any difference? 

 

[FullGlass, BSN, MSN, NP]

I am so sorry you are going through this.  Getting a DNP will not help with this patient population.

I have never experienced what you describe, but I also don't treat an "upscale" population.  If you are that unhappy, then go get another job!  There are lots of jobs out there.  Plenty of places that serve "downscale" populations pay very well, so there is no need to put up with this.  Those populations are more rewarding to work with, in my opinion.

Also, "upscale" types may not be treating doctors very well, either.  I know a PsyD in Silicon Valley and am appalled at how many of her rich patients treat her and talk to her.  I knew a psychiatrist in Beverly Hills who flat out told me he found a lot of his patients stupid and boring - the typical Beverly Hills housewife with blonde hair and who is vacuous.  He volunteered at organizations serving more needy populations and did a lot of work with them.

[aok7, NP]

I have also had experiences like you are describing.  It feels horrible, and the tendency I found was to try to work harder to "prove" that I am worthy.  A very kind (and impressively confident) NP colleague at the time (this had been in my 2nd year during my first job) shared with me the power of owning our "power," and she compared the importance of genuinely trusting our value to that of the senses of a horse, where she described how horses KNOW if we are anxious, nervous, or whatever.  They'll knock us off, no doubt, she said.  She compared patients the same.  And the more we try to please this type, or serve, the more they will pounce.  This was completely practice-changing for me.  There are always going to be a few patients who are difficult, and they likely would be for physicians or anyone else, too, but we have to get to a point where we truly believe we are a gift, OUR time is their gift, so to speak.  And it is all with the same patient-centered respect, the same great care regardless.  And whatever you do, do not show you are "trying hard" for them, no matter how you feel inside.  

[Corey Narry, MSN, RN, NP]

I like your answer aok7. OP, I would consider a career coach of some type if you can afford it rather than getting a DNP. I know you feel your youth is working against you but you can overcome that with a sense of "power" and ownership of your role as a provider. I don't know you but in many cases, the way we carry ourselves in terms of body language, tone of voice, etc can be perceived in a negative way by patients. Sometimes, we are not aware of these qualities because we have never been in such a situation where this has come to light. I attended a series of NP leadership classes once where we were assigned to a coach and to me, it helped a lot in understanding how we can make a positive image of ourselves just by the way we present ourselves.