Nurse practitioner vs Medicine turf war?

[Infofreak411]

As someone who is entering the field of nursing with the goal of ultimately becoming a nurse practicioner after gaining experience, I have noticed a lot of "turf wars" and arguing going on between nurse practitioners and physicians.

Nurses said doctors have an issue with it because doctors feel aprns are treading on their turf, and doctors claim aprns are trying to take over their jobs and scope of practice with independent rights with much less training... I can see it from both sides.

Then there is the whole nursing model of education vs medical model of education that Nurse practitioners claim to practice and state that it is more holistic so they claim it makes them a different type of practitioner justifying the independent rights.

But a big question of mine is, when it's all said and done, isn't "advanced practice nursing" really practicing medicine? At that level it's no longer nursing but medicine. It's medicine thats regulated my nursing boards so it's called nursing. And at that point the "nursing model vs medical model" is to me irrelevant, because when youre practicing medicine it's medicine regardless of the model u claim to follow... theres guideline's and protocol. For instance, if you are diagnosing and treating a UTI, it's going to be the same regardless of if you are a NP with the "nursing model" vs a PA or MD with the "medical model"

So can anyone give me insight?

[Jules A, MSN]

And speaking of a "rats patooty" stop spewing out NPs from the rat's patooty allowing those who control the means of production to TELL YOU, "$50 bucks, take it or leave it."

I think I want to "like" your post but haven't had enough of my Starbucks yet this am to be sure I'm following you. If you mean NP schools need to be way more selective in who they admit and that if someone presents a job offer as "take it or leave it" we should leave it, then I love your comment.

FWIW I have and will continue to do the second point because I tell them how much I will need to make if they want to bring me on and they can "take it or leave it" which is nicer language than the words inside my head. Of course those days might come to a screeching halt as all the new grads buck for my job at half my established rate. The sad truth is although my reputation is excellent most employers could give that rats patooty if someone is even competent if they have the credentials and Lord knows nursing has no shame about giving anyone the credentials who can pay the check and pass a few multiple choice questions.

[TheCommuter, BSN, RN]

Moved to the NP forum.

[AAC.271]

Data consistently shows np outcome superior to MD outcomes in Many factors if not equal... We need to tear down the MD gods who have zero competition in their profession. This is a capitalism, market based economy. The skilled tradesman and master cottonweavers are irrelevant to our current economy. Soon we will see that these highly trained doctors are overtrained and not needed when a more cost efficient and effective option exists.

[Salter444]

Honestly some postings on here serve no purpose other than to stir stuff up and offer nothing of value.

[NurseNeLz]

So far I have seen no "turf wars". Most MDs in training are realizing that primary care is not worth it for them and they go into a more lucrative specialty. So thats where NPs and PAs are filling the gap. So in reality we are not taking their jobs. As far as practicing, as an NP you are taught to use the most up to date evidence based guidelines not so much a holistic approach. NPs still have their nursing background so yes it does come into play. I feel having a nursing backround as opposed to medicine gives you an advantage of looking at the patient as a whole. Incorporating all aspects into their plan of care.

[Aromatic]

Data consistently shows np outcome superior to MD outcomes in Many factors if not equal... We need to tear down the MD gods who have zero competition in their profession. This is a capitalism, market based economy. The skilled tradesman and master cottonweavers are irrelevant to our current economy. Soon we will see that these highly trained doctors are overtrained and not needed when a more cost efficient and effective option exists.

lol lol

[HBrnGirl]

There is a turf war. No doubt about it. Look what happened in Ohio when NP's lobbied for independent practice last year. The AMA threw up their heads and howled. Here's the fact: I am not a doctor. I am an NP. Are there things that are beyond me. Of course. We are not asking to be doctors. We are asking for independent practice as Nurse Practitioners. We are not trying to take over medicine or push them out of the picture. We will always need doctors and their expertise. Many of them resent NPs. Many of them do not.

As NP's we practice medicine. I do not practice nursing. I medically manage patients and treat them medically. The more 'holistic' part is in the way I approach the patient. As a nurse, I was taught to make a partnership with the patient and for mutually acceptable goals. I bring that over with me in practicing as an NP. I have noticed that physicians approach patients from a more paternalistic view. They want to dictate the patients treatment and expect them to just follow it. I will explore how the patient feels about the treatment and look into any barriers like: lack of money, social issues, family issues. Do you see the difference in my practice? It is a strange hybrid of a nurses demeanor and love of caring and a physicians practice of medicine. Frankly, it makes for better care and is much more patient-centered.

Having said all of this, you want to keep one thing in mind. Be very careful where you accept a job as an NP. In the ER where I work, NP's are loved and esteemed. The physicians I work with are an incredible group. They treat me as their colleague and afford me the respect of a provider. God help you if you come down to this unit and yell at me or treat me in a less than respectful manner. They will be all over you so fast, you won't know what hit you. They even ask my opinion about treatments and EKG's all of the time. I am very, very lucky. In this same hospital there are NP's who are treated like nothing more than scribes. I asked around, sniffed around and did a lot of research before taking this job. Make sure you are going to work with doctors who will respect you and let you practice at the top of your license.

Wait a minute here. You claim that NP's aren't trying to force MD's out of medicine. Yet there is an AN thread advocating for all NP's in primary care. Because an MD is not necessary in primary medicine. So which is it?

[BostonFNP, APRN]

Just because a poster on one thread says one thing doesn't mean a poster on another thread automatically thinks the same way. We are all trained as independent providers after all. _

Does primary care constitute all of medicine?

And as you said, its a business, and competition is heating up, at least in primary care.

[Aromatic]

i don't see too many people fighting over it. the grass is pretty brown compared to most specialties unfortunately. thanks to government reimbursement