IMH(umble)O, the problem is that many NPs (and PAs as well) never lose that narrow-mindedness which comes with type of education they get, associated with permanent fear of missing or not documenting something. in case of NPs, it also gets complicated with typically nursing developmental defect of "being task oriented".
The education NPs and PAs get is normally more limited as compared with one of MD/DO school. That by itself wouldn't be a problem - after all, we all know doctors who, being wonderful specialists in one area, seem to be not aware of pretty baseline facts from another. The thing is, though, that training of MDs/DOs, especially in residency, teaches them to have a broader and more complex view of things. Even if they not know something, it is much easier for them to integrate new facts into a picture once they get them. This, the proverbial "seeing patient as a whole" in medical point of view, is not a skill which can be taught by books. And I see PAs and NPs missing it. Instead, they seem to concentrate of problems which wouldn't even arose for and MD. A patient who is hypothyroid, on Norco 10/325 Q4h PRN home + dilaudid 1 mg Q2h PRN in house, poorly mobile and "dry" overall (with limited oral intake postop for urgent ortho case) can reasonably expected to be constipated. As long as he is completely asymptomatic, doesn't need GI workup for any other reason, etc. everything that needs to be done is ordering standard bowel protocol on admission. After all, he might have a BM once weekly at home and nobody will be greatly concerned for it. Being "dry" and poorly mobile is WAY more important problems to treat. Yet, I'd seen GI consultant fuming about called just for such patients, as well as loading poor dude with insane amount of laxatives for the sake of getting him goin' and documenting "daily BMs".
It is OK for an RN to fret about that (not at 3 AM and not calling Ortho Surgery on call for that, though). It is, again, IMH(umble)O, NOT OK for someone acting on provider level to do that instead of figuring out why this dude refuses PT/OT or what is better way to control his pain woth not that much of narcs, or what is the best way to hydrate him or why his TSH is sky-high while T4 is WNL and only one symptom of hypothyroid he seems to have is constipation.
Perhaps, all that "Nursing Research" and "Role developement" fluff and buff of NP schools should be substituted for 2 courses 12 credits each: "Advanced Clinical Thinking" and "Business of Healthcare 101".