Explaining the NP role to pts and everybody else

Jules A, MSN · Sep 1, 2015

I get asked so many times, "So you're like a doctor?". People really just don't get it.

If this is what they are asking you, they do get it. My answer is "yeah baby". I model myself after physicians and function in the same role as a physician in my specialty.

anh06005, MSN, APRN, NP · Sep 1, 2015

I agree with Jules. I explain that we do a lot of the same things as doctors but have a different type of schooling and the nursing background.

PG2018 · Sep 1, 2015

This is how I introduce myself. I say this quickly to avoid questions so I can get into the meat of their visit and get them on out the door.

"Hi. I'm Psych Guy. I'm a nurse practitioner, and I do psychiatry. So how are things going?"

When someone catches it and does ask questions, my general answer is "we do the same things." (Imagine all of the physicians getting ticked off over that, lol). For the many kids I have taking psychostimulants, my answer is, "Well, the only difference for you is that I cannot sign a stimulant prescription, but I have a guy that mails me stacks of signed prescriptions for stimulants so you're covered. And that's my only limitation."

I don't get into education or anything. If asked specifically, I just say something like "my school was three years, physicians go for four." (Again, imagine all of the seething physicians.)

It's really an irrelevant discussion with patients. Only the brightest seem to grasp a full explanation of our roles perhaps because many of my SMI have no substantial education. No matter how many times I tell them I'm not a doctor I get called "Dr. Guy," etc. Our staff still refers to me as "the doctor." Whatever.

When the random public asks what I do for a living, such as the case when shopping for some new furniture this past weekend, I say "psychiatry" because that's what I do. Most people, educated or not, have no clue that psychiatrists are physicians. I don't really care what the public thinks so I don't feel like I'm impersonating anyone I'm not. "Psychiatry" keeps the conversation short. If it's a new friend that I wish to engage in dialogue with I'll actually say somehthing aking to "I'm a nurse practitioner specializing in psychiatry." Most of the public seems to think counselor, psychologist, therapist, psychiatrist, "head doctor," etc. are all synonymous. I don't care. The patient's paperwork and billing lists my credentials or NPI (which lists my credentials) so I'm fine with whatever their perception is as long as their attentive during their visit and adherent to their treatment. Fortunately, I'm able to convey adherence pretty well.

Riburn3, BSN, MSN, APRN, NP · Sep 1, 2015

I just tell patients we are a different type of provider with our background founded in nursing, and that from a patient perspective you are likely to notice little difference.

allnurses Guide · Sep 1, 2015

I always introduce myself as a nurse practitioner. It's pretty rare for me these days that someone is confused, when it happens more often than not it's because they have seen my name with a "Dr." title in front of it or they hear another patient call me "Dr. "firstname" which many patients insist on doing.

If people are confused I first tell them that I am a PCP, just like many MD/DO/PAs. If they still have a question I tell them that in the primary setting we all function exactly the same.

If they still ask I use the line that my physician colleagues always give me a hard time about: "as an NP I was taught assess and treat both the disease and the patient's response to the disease rather than the medical model which teaches to asses and treat the disease process.".

Advanced Practice Columnist / Guide · Sep 1, 2015

I also always introduce myself as a nurse practitioner and emphasize that because at times, I will get introduced even by bedside nurses as "he is part of the team of ICU doctors taking care of you". I agree that if the response you got was "so you're like a doctor?" then that patient gets the idea and it's their own way of analyzing the situation and looking at you as their provider.

You can always follow-up with "if you meant doctor as in physician, then yes, I am able to provide care to you like a physician does as I am a nurse with advanced license and training". To avoid confusion as I'm part of a collaborative ICU team, I also say "I work with Dr. ___ who is a trained ICU physician and we will be taking care of you (or your family member) while you are here in the ICU".

Trauma Columnist · Sep 2, 2015

I'm a CNS and I introduce myself as "Hi, I'm TraumaRUs, an advanced practice nurse who works with Dr XYZ (whoever their particular nephrologist is). We are going to provide you with great care and this is how we are going to do it...."

And then I go into the expected care, tests, etc., that the pt may experience. I also always provide my business card to every new pt and family I meet. I have an unusual and difficult to pronounce last name so this helps them remember who is providing what care.

Susie2310 · Sep 2, 2015

I have often thought it would be appropriate to fully explain the difference between education and training between physicians and nurse practitioners. Then patients and the general public understand the education and training the NP has received versus a physician, and can make an informed choice as to who they receive care from. In my opinion it really is untrue to address the difference between nurse practitioners and physicians to patients as "in the primary care setting we all function exactly the same", and "I am able to provide care to you just like a physician does as I am a nurse with advanced license and training", since you are not a physician, have not received a physician's education and training, and do not provide care at the level of a physician.

The last time I checked the number of clinical hours required for nurse practitioner training at the master's degree level, the maximum number of clinical hours I found at reputable universities was around 600-800 hours, although I understand there is some variation. This is a tiny fraction of the clinical hours a physician receives. Physicians spend typically four years in medical school where their training follows the medical model, after having already obtained a bachelor's degree, usually in a science, and then spend several more years in internships, residencies, and often fellowships. Entry for Nurse Practitioner programs varies: one must have RN licensure, but not all programs require a BSN for entry; the program is then typically three years for a master's degree and around 600-800 clinical hours.

PG2018 · Sep 2, 2015

I have often thought it would be appropriate to fully explain the difference between education and training between physicians and nurse practitioners. Then patients and the general public understand the education and training the NP has received versus a physician, and can make an informed choice as to who they receive care from. In my opinion it really is untrue to address the difference between nurse practitioners and physicians to patients as "in the primary care setting we all function exactly the same", and "I am able to provide care to you just like a physician does as I am a nurse with advanced license and training", since you are not a physician, have not received a physician's education and training, and do not provide care at the level of a physician.
The last time I checked the number of clinical hours required for nurse practitioner training at the master's degree level, the maximum number of clinical hours I found at reputable universities was around 600-800 hours, although I understand there is some variation. This is a tiny fraction of the clinical hours a physician receives. Physicians spend typically four years in medical school where their training follows the medical model, after having already obtained a bachelor's degree, usually in a science, and then spend several more years in internships, residencies, and often fellowships. Entry for Nurse Practitioner programs varies: one must have RN licensure, but not all programs require a BSN for entry; the program is then typically three years for a master's degree and around 600-800 clinical hours.

Every NP here knows the differences, but who has time for such longwinded explanations? I find most NPs talk too much about irrelevant matters such as this.

BD-RN, BSN, RN · Sep 2, 2015

In my opinion it really is untrue to address the difference between nurse practitioners and physicians to patients as "in the primary care setting we all function exactly the same", and "I am able to provide care to you just like a physician does as I am a nurse with advanced license and training", since you are not a physician, have not received a physician's education and training, and do not provide care at the level of a physician.
The last time I checked the number of clinical hours required for nurse practitioner training at the master's degree level, the maximum number of clinical hours I found at reputable universities was around 600-800 hours, although I understand there is some variation. This is a tiny fraction of the clinical hours a physician receives. Physicians spend typically four years in medical school where their training follows the medical model, after having already obtained a bachelor's degree, usually in a science, and then spend several more years in internships, residencies, and often fellowships. Entry for Nurse Practitioner programs varies: one must have RN licensure, but not all programs require a BSN for entry; the program is then typically three years for a master's degree and around 600-800 clinical hours.

Physicians always bring up the clinical hours, forgetting that NPs function as a RN BEFORE receiving their NP. The total amount of clinical hours spent with patients is well into the thousands by the time the NP BEGINS their training. Most MDs haven't touched a patient except as a volunteer until they are in med school. And, if you still believe the NP FUNCTIONS differently in the PCP role, explain how? Boston FNP's explanation was actually spot on.

allnurses Guide · Sep 2, 2015

In my opinion it really is untrue to address the difference between nurse practitioners and physicians to patients as "in the primary care setting we all function exactly the same", and "I am able to provide care to you just like a physician does as I am a nurse with advanced license and training", since you are not a physician, have not received a physician's education and training, and do not provide care at the level of a physician.

Emphasis is mine.

Studies have shown time and time again that NP directed care has comparable if not superior outcomes to physician-directed care. The level of care, within the NP scope, has been demonstrated to be on-par with the care of a physician.

Physician's have a longer post-graduate education and a residency requirement, there is no argument about that.