NP's answering to Nursing Management?

[ohiosam2]

I am wondering if anyone has any experience with this. I have been an NP in my area for a few years now and I am very familiar with practice at other hospitals. I currently work in an ER. There are both NP's and PA's in the ER. We work under physician management. As far as I know, the other hospitals in the area also work under the physician management teams. Recently there was a very big discussion going on in the hospital. It seems that the nursing management felt that they should be in charge of both PA's and NP's. Fortunately, the hospital physicians absolutely refused to allow this. I was shocked. I do not feel a nurse manager should be dictating practice to those who are advanced providers. During the discussion, nursing stated that many hospitals around the United States are putting their NP's and PA's under nursing management instead of the physicians. Is anyone out there under nursing right now? If so, are you having difficulties with this arrangement?

[offlabel]

Pretty hard position to defend being "medical staff" when much (not all) of the advanced practice establishment clings to the "nursing model". The problem is that while the vast majority of APRN's don't consider themselves nurses anymore, per se, that isn't how they are trained.

Only the most dogmatically politically entrenched CRNA's whether independent or not will insist that when a CRNA does an anesthetic, it is the practice of nursing and when a doctor does the identical anesthetic, that it is medicine.

I prefer to say it is anesthesia, but that's me. Everyone knows what the reality is. All of the rest is a game of semantics.

If you say you're a nurse, a nurse will be your boss.

[IsabelK]

The facility in which my company placed me is weird. I'm credentialed by medicine, but I'm considered part of the nursing department. Makes for some interesting conversations. And I refuse to be dictated to by someone with an associate's degree. Collaborate yes. Dictated to, no.

No provider should be under the direction of nursing. At this point, I'm a nurse but I also cross the line into medicine. All of my work is done as a medical provider. Ergo, I should be governed by medicine.

That said, I'm still proud to be a nurse practitioner...

[Harveyslake]

NP or PA, both are considered Physician Extenders. Most nurse managers I've known where incompetent to manage the nursing staff. The level of incompetence would only rise if allowed to manage physician extenders.

[Psychcns]

Politics

-if we are "physician extenders"we have to report to medical staff

-if we are regulated by Nursing, people say we could report to nursing

-if we are midlevels, and a lot of us don't like being called this, we are in the middle of nursing and medicine

-I like being called a provider...as long as it is a good job

[WKShadowNP, DNP, APRN]

Politics

-if we are "physician extenders"we have to report to medical staff

-if we are regulated by Nursing, people say we could report to nursing

-if we are midlevels, and a lot of us don't like being called this, we are in the middle of nursing and medicine

-I like being called a provider...as long as it is a good job

I am partial to advanced practitioner, myself.

[IsabelK]

NP or PA, both are considered Physician Extenders. Most nurse managers I've known where incompetent to manage the nursing staff. The level of incompetence would only rise if allowed to manage physician extenders.

Actually, the physician extender term is a misnomer in some senses for NPs in many states. For example, in NYS I am an independent provider. I can own my own practice, I do not have a collaborating physician. My limits are dictated by my license and my own competence in certain areas (although go figure the BON does not think I can sign off on an EKG--I know a lot of NPs working in cardiology who read them with ease; I know it's not my cup of tea, but it's kind of like...really???). I am not a physician extender. I am a fully credentialed and licensed health care provider with prescriptive privileges. Now, I would argue that PAs are physician extenders--look at the title and the model under which they are educated. Oh, and that their practice is dependent on the physician's practice. Even NPs with supervising physicians practice within the scope of their own license (i.e.: FNP, ANP, PNP). I could have general practice MD or DO be my supervising physician but I still couldn't see kids. The PA would be able to because the physician does...

Oh, and unlike PAs, my title has nothing to do with "physician"....