All this talk of professionalism and being respected by doctors makes me sick.
I am a professional. I am a nurse. My job is to diagnose and treat human responses to illness (care for the sick). I also educate patients, assess their physical condition, and rehabilitate them. Society considers an RN a professional position, so I am a professional. I am not a doctor, I don't work for a doctor; I am not a doctor's assistant. I work for my hospital and my nurse manager.
A doctor is an academically prepared individual who diagnoses and treats medical problems in human beings. We use doctors in caring for patients who have medical problems. We need their medical orders (orders for the patient--not orders to us as in "ordering" us to do something), because we can't legally administer medical interventions without them, why? because we are nurses not doctors!
I'm in the profession of caring for people, especially sick people, and in my case especially sick people with cardiac conditions. So, naturally I have problems with the nurse practioner being considered an "advance practice nurse." In reality they are a doctor's assistant. Our professionalism does not come by being more like a doctor but by being more of a nurse.
I respect doctors, but then I respect patients as well, and I respect strangers on the street. Doctors are not nurses, and I feel they are missing out on the greatest spiritual vocation available. If they think they are above me, professionally, then they are as misguided as the nurse who thinks he's not a professional if he can't write a prescription for amoxacillin.
NP's don't have to work under a doctor, you need to check your facts. They have prescripted authority in most states and don't need a doctor for anything. They can set up their own practice too.
Joe I am with you. Defensive thread. Lets stick together. We are all professionals who need to unify for ourselves and for our patients. I have only been treated poorly by two docs and they actually apologized.
Currently in New Zealand, the role and status of the nurse is under much discussion. Nurses are no longer willing to be regarded merely as the 'handmaiden of the physician'. The trend is towards the professional approach, thus making nursing more comparable with such professions as law and medicine. The concept of a professional includes accountability and autonomy for personal actions. Fundamental to any professional discipline is the development of a scientific body of knowledge that can be used to guide its practice and commitment to practice based on sound reliable knowledge is intrinsic to the idea of a profession and practice discipline. Nursing is in this way no different from any other profession. All nurses are responsible for their own practice. The research shows that NP improves the health outcomes of the patients - and ultimately - isn't that our aim?
For some reason the idea of clinical scholarship does not sit well with some nurses....what do you think?
be careful when you say your job is to diagnose patients.
why do you think this is defensive. the string is about what makes a nurse a professional. it's about what defines a "nurse."
as for diagnosing, i think you need level one again. remember the nursing process: anaylizing, daignosing, planning, intervention, evaluation? haven't you ever heard of the nanda listed nursing diagnoses? nurses diagnose and treat human responses to illness. physicians diagnose and treat human illness.
I think I know what you are saying. Is it response to some of the threads about "what makes nursing a profession".
You do have some good points, that are understandable.
I see too what you're saying about the NP. The line between Nurse Practioner and the nurse on the floor is very blurry, and they do indeed have more incommon with a PA as more time goes by. But they aren't nurse's assistants either.
However, I think the path to the nurse going from a diagnosing and treating responses, to diagnosing and treating illnesses is a logical one.
I see too what you're saying about the NP. The line between Nurse Practioner and the nurse on the floor is very blurry, and they do indeed have more incommon with a PA as more time goes by. But they aren't nurse's assistants either.
However, I think the path to the nurse going from a diagnosing and treating responses, to diagnosing and treating illnesses is a logical one.
Hey pal, I appreciate the agreement we have on some things, but this one isn't it. For instance, I agree that NPs are not nurse assistants; they are physician assistants who used to be nurses. Since they still hold an RN, they can return to being a nurse if they want to, but as an NP, they are a physician assistant.
You see, IMHO, everyone wants to be a nurse, or to be thought of as one. Physicians, when they're being filmed by "TLC" try to act all compassionate, as if they really are--just as good as a nurse, by Jove!. But Physicians, if they are compassionate, are simply compassionate people, it's not part of their profession as it is with a nurse.
Physicians are applied academics who have chosen to apply medical science to a clinical situation to alleviate human suffering. That in itself may be compassionate, but their profession is about seeing multiples of patients to dx their illness and prescribe a treatment or carry out a procedure. They aren't there to hold hands and alleviate fears and change dressings and make sure the person is eating and eliminating and ambulating or being cleaned up or to teach them or even to administer the medications they prescribe. That's caring; That's what is done in the profession of nursing.
Society calls what the nurse does "low" and no physician should have to do what a nurse has to do. But everyone knows that while we need doctors and will pay them well, being a nurse is like being Christ. Being a nurse is being Christ at the last supper washing the disciples feet. It's where the real power is--everyone knows it. So of course, doctors want to look down on nurses becasue otherwise they'd have to admit the truth--that anyone with a good brain could do their job. And NPs know that they have tried being nurses and failed. The ANA is wrong to include them in the nursing profession. IMHO.
So many nurses hate nursing, but they want the "unspoken" authority of a nurse, they want the OK pay they get; they want to be thought of as "compassionate." But unlike medicine, nursing is as much a spiritual calling as it is a professional vocation.
I once went to a graveyard in a rich part of town and there was a family plot, and there were four generations of physicians burried there. I thought, OK, they were rich. Rich people are limited in the occupations they can hold, so they were all doctors. If there were such a family plot and they were all nurses, it would have been hallowed ground.
Bottom line: nurses are professional caregivers. Physicians are professional healers. You have to have both or you will not have effective elimination of physical suffering. There is the M.D. and the R.N. That is the modern medical model in every culture and country. Everyone else is an adjunct to those two people. The NP, the RT, the PT, OT, the PA, the CNA, the PCA, the Resp Therapist, the dietitian, the housekeeper, all of these could be done by the RN or the MD, but RNs and MDs are hard for society to produce in sufficient quantities to keep patient load small enough to allow this.
meandragonbrett
2,438 Posts
Umm...if I'm not mistaken, an assistant to a physician would be a Physician's Assistant and not a NP.