Nurse Practitioners with Medical students

[Alexxoxox, BSN]

For those Nurse Practitioners that work at an academic medical center, what are you all able to do? I know that many medical students and residents/ fellows train alongside you, but what do you do in an inpatient setting if there are always residents? For instance, in a CVICU, if there is the primary surgeon, 2 residents, and you (APNP), who is in charge of the patient (besides the surgeon)? Do you prescribe the meds and do procedures (ex - chest tubes), or do the residents/ fellows? I hope this makes sense!

[Corey Narry, MSN, RN, NP]

In our setting, patients are assigned to either NP or resident typically dividing the census based on the number of providers present. The NP will be responsible for everything pertaining to the management of their patients including writing orders and notes, doing procedures, coordinating consults, talking to patients and their families, etc. The resident would do the same for his/her patients. The fellow is an attending in training and works with both the NP's and residents as the attending's designee. They do focus their teaching role more towards residents who are on their ICU rotation. Ultimately, the attending intensivist is responsible for all the patients in the ICU.

We do have both medical students and NP students (as well as Pharmacy students and Critical Care Pharmacy residents). Medical students are sub-interns that work with residents. NP students work with an NP preceptor (one of us typically takes on that role). There are some instances when we cross roles and do some teaching to medical students (such as when they are watching us do lines, etc). But the way the medical school is set-up, medical students must work under the direction of a resident, a fellow, and a faculty attending physician.

[Neuro Guy NP, DNP, PhD, APRN]

In my current role, I often precept medical students. However, in addition to being a graduate nursing professor, I was also just appointed as faculty in the medical school as of August. The courses in our medical school are all team taught and I lecture on neuroscience topics. I'm the first nurse to hold such an appointment though in the school's history. So, long story short, yes it is possible - though less often - that you could be involved in the education of medical students.

[angel337, MSN, RN]

Congratulations on your new role, that's awesome for the medical profession as a whole and NPs of course.☺

[SopranoKris, MSN, RN, NP]

For those Nurse Practitioners that work at an academic medical center, what are you all able to do? I know that many medical students and residents/ fellows train alongside you, but what do you do in an inpatient setting if there are always residents? For instance, in a CVICU, if there is the primary surgeon, 2 residents, and you (APNP), who is in charge of the patient (besides the surgeon)? Do you prescribe the meds and do procedures (ex - chest tubes), or do the residents/ fellows? I hope this makes sense!

I'm still a student. However, the NPs in our ICU work directly with the respective medical practices in the ICU (e.g. CV surgery, pulmonology, etc.). The residents only care for the patients assigned as "hospitalist" patients. If the patients are a specialty patient, then that group's NP or PA cares for the patient. There's no cross-over between the groups. We are a teaching hospital for a major university, so they keep it separate on purpose to ensure their education follows a consistent track. So, in a nut shell, it really depends on your hospital.