NP Wikipedia Article

[Riburn3]

Has anyone taken a gander at this recently? Looks like someone with a pro-physician lobby has gotten ahold of the page and it really casts NPs in a very negative light.

Some of the statements like contact hours and education aren’t inaccurate, but they definately go out of their way to make us look bad and it’s very one sided. Many of the “articles” cited are actually just surveys conducted by physicians. Kind of funny.

Theres a whole section on “quality of care” that is basically bogus and doesn’t care to reference or mention any articles that are based on systemic reviews that say we actually have better ourcomes than physicians in many regards.

[hogger]

18 minutes ago, djmatte said:

Possibly compared because they are the comparable part of the profession that is actually seen at the bed side regularly Who are actually writing the notes and developing plans. Not just tagging a smart phrase stating "I have read the plan and independently assessed the patient (yeah ok) and agree with what's started here".

It is possible at some places but not most. Not at mine for sure. Nor do the studies explicitly state that. It’s still a comparison of residents vs midlevels who had probably never rotated in the icu before this rotation. So they are actually doing well keeping up

[hogger]

2 minutes ago, Riburn3 said:

It’s sort of funny you mention “an NP run hospital”.

I work as a hospitalist in a group that is 50/50 physician and NP hospitalists. We are part of a pilot program by our company to determine if a larger pool of NPs in a group is effective and safe. Effectively our company wants to know if they can get away with this model because we are paid a lot less than the physicians, so it’s a big cost saver.

We split the assignments, admissions, acuity, hours worked, committee memberships, and everything else evenly. It’s an independent practice state so there’s no co-signing.

After two years, the NPs as a whole have a better satisfaction rating, lower readmission rate, equal length of stay, equal consultation frequency, fewer adverse outcomes, and fewer core metric fallouts.

As a result, several of our sister hospitals are eliminating physician positions in favor of more NPs in the practice group.

Since our group started this we surprisingly have more consultants that have moved to the area. No one has fled!

I know these are overblown statings since I work for a similar type of company and know of this not happening. Actually many hospitals are limiting midlevel scope due to declining educational standards and hospitals have picked up on this and even in states that require no collaborate hospitals subsequently still do. This is a forum however so truths are not to be expected to be prevelent

plus making it sound as consults come to an area since midlevels are the hospital service is one of the more ridiculous things I have heard lol. I’ve never seen that on s job recruitment ad!

[Riburn3, BSN, MSN, APRN, NP]

6 minutes ago, hogger said:

I know these are overblown statings since I work for a similar type of company and know of this not happening. Actually many hospitals are limiting midlevel scope due to declining educational standards and hospitals have picked up on this and even in states that require no collaborate hospitals subsequently still do. This is a forum however so truths are not to be expected to be prevelent

plus making it sound as consults come to an area since midlevels are the hospital service is one of the more ridiculous things I have heard lol. I’ve never seen that on s job recruitment ad!

Hmmm you sure like to just make up a lot of bologna. My comment on consults was in regard to you saying they would run away at an NP run hospital. My point is lots of NPs isn’t scaring anyone away, we live in an underserved area so many consultants come here to finish their visas, then end up staying.

You seem to live in the world and have a mentality that if you haven’t heard of something happening or seen it , then it must not be true. What’s it like being so omnitient?

[hogger]

Usually if the first place one here’s of something is on a nursing forum it is no less than propaganda for midlevels. We hear all the time the need for physician oversight is so great but not everyone wants to blindly do it now since many of your kind graduate from online nursing programs. Most I know only supervise pas of nps they knew before school.

But if what you said was true true it must be why dr hospitalist groups are offering us ridiculous salaries since we aren’t needed

[Riburn3, BSN, MSN, APRN, NP]

9 minutes ago, hogger said:

Usually if the first place one here’s of something is on a nursing forum it is no less than propaganda for midlevels. We hear all the time the need for physician oversight is so great but not everyone wants to blindly do it now since many of your kind graduate from online nursing programs. Most I know only supervise pas of nps they knew before school.

But if what you said was true true it must be why dr hospitalist groups are offering us ridiculous salaries since we aren’t needed

Well it is True True, but I admit one of the program struggles initially was getting the right kind of NPs into the job as it requires a very high level of autonomy and critical thinking (we cover ICU as well). Once we found our core, it’s been smooth sailing, but we did burn through a couple folks quickly that weren’t ready for it.

I also dont disagree with your comment about precepting. There are certain schools I won’t precept from, and I usually now only agree to take student that I know.

[djmatte, ADN, MSN, RN, NP]

11 minutes ago, hogger said:

Usually if the first place one here’s of something is on a nursing forum it is no less than propaganda for midlevels. We hear all the time the need for physician oversight is so great but not everyone wants to blindly do it now since many of your kind graduate from online nursing programs. Most I know only supervise pas of nps they knew before school.

But if what you said was true true it must be why dr hospitalist groups are offering us ridiculous salaries since we aren’t needed

Why the hell are you even here if what you read is nothing more than mid level propaganda? You hear there's some great need for more physician oversight by the same lobbying bodies that are trying to limit np scope. Nothing more. Ridiculous salaries exist because there aren't enough physicians. Not because somehow nurse practitioners aren't capable.

[Dodongo, APRN, NP]

9 hours ago, Riburn3 said:

It’s sort of funny you mention “an NP run hospital”.

I work as a hospitalist in a group that is 50/50 physician and NP hospitalists. We are part of a pilot program by our company to determine if a larger pool of NPs in a group is effective and safe. Effectively our company wants to know if they can get away with this model because we are paid a lot less than the physicians, so it’s a big cost saver.

We split the assignments, admissions, acuity, hours worked, committee memberships, and everything else evenly. It’s an independent practice state so there’s no co-signing.

After two years, the NPs as a whole have a better satisfaction rating, lower readmission rate, equal length of stay, equal consultation frequency, fewer adverse outcomes, and fewer core metric fallouts.

As a result, several of our sister hospitals are eliminating physician positions in favor of more NPs in the practice group.

Since our group started this we surprisingly have more consultants that have moved to the area. No one has fled!

Is anyone planning on writing this up and publishing the results? If so, when can we expect it? Even after only two years the data would be nice to have to bolster our argument when attending legislative hearings for FPA to counter the physician's (true) arguments regarding declining NP educational standards. "Physicians for Patient Protection" is just such a group that is hell bent on fighting NP practice tooth and nail every chance they get.

[Riburn3, BSN, MSN, APRN, NP]

15 minutes ago, Dodongo said:

Is anyone planning on writing this up and publishing the results? If so, when can we expect it? Even after only two years the data would be nice to have to bolster our argument when attending legislative hearings for FPA to counter the physician's (true) arguments regarding declining NP educational standards. "Physicians for Patient Protection" is just such a group that is hell bent on fighting NP practice tooth and nail every chance they get.

To be honest I don’t know. It’s still not a very large sample size and it’s just now only being tried in other places

I also mentioned earlier it was really tough finding the right NPs to fill the role. In the first year, 3 NPs essentially left only a few months in because they didn’t feel comfortable operating so independently in a state that already has had independent practice for a long time.

As proud as I am, you don’t really experience that from physicians freaking out and quitting. Not that these NPs were bad, and some were already hospitalists before, they just weren’t quite ready.

[Dodongo, APRN, NP]

11 hours ago, Riburn3 said:

...you don’t really experience that from physicians freaking out and quitting.

I won't patronize anyone by explaining why that is.

NP education (primarily the CCNE and ACEN) needs an overhaul. Period.

[OUxPhys, BSN, RN]

I have no dog in this fight but I am curious, what do you think of RN's going to NP school right out of nursing school or starting NP school with 1-2 years worth of floor/ICU experience?

[Riburn3, BSN, MSN, APRN, NP]

20 minutes ago, OUxPhys said:

I have no dog in this fight but I am curious, what do you think of RN's going to NP school right out of nursing school or starting NP school with 1-2 years worth of floor/ICU experience?

There are tons of discussions about this over the years on here.

Youll see posters say that experience matters. You’ll have some that didn’t have any experience and say it didn’t hurt them.

My personal belief is that its helpful in many ways.

I felt very prepared in my program because I had 6 years of ICU/CCU when I started, and didn’t struggle in the program like some folks with less experience

That experience also left me with better connections for employment, and my first job out of school was a direct result of having experience. Many in my class likewise.

[Ksan]

Additionally to what has already been mentioned, the NP page is extremely skewed towards the NP role & education/licensing in the US.

Anyone can edit Wikipedia and it is generally self-correcting, in the sense that when someone inserts some sort of nonsense, there will be another editor to remove it, or if someone argues a one-sided perspective, another author will include information on controversy within the field. However, if I recall correctly, once you add content to a wiki page you get a notification whenever it is edited by other contributors.

The way to fix this page imo would be to move the "introduction" (if we can call it that) to its own section titled something like "Controversy regarding scope of practice" or something similar. This way, you don't remove the other author's text which does meet the wiki guidelines.

A new introduction should summarize what the NP role entails, how it came to be, differences in licensing, education and scope of practice across different english-speaking countries (there are NP pages in other languages).

There should be no arguments in the introduction. The intro is meant to be a concise definition of the wiki topic.

If someone would like to fix the page, this is how I would go about it.

(I'm not even a nursing student yet so I wouldn't be the right person for this, otherwise I would have attempted an edit. I'm also supposed to be writing my thesis now but I can't help procrastinating >_< )