Nurses are Not Doctors

[BostonFNP, APRN]

At the prominent university NP programs I checked, the number of clinical hours for a master's degree varied between 400's to 600. Compare that number to a physician's training. Look up how many hours a physician trained in the US spends in medical school, residency, internships, fellowships, specialty training. Do you see a difference between NP training and US physician training? What do you think that difference means?

1. At least 600 hours are required for national certification so I doubt there are many 400 hour programs out there....

2. The difference in medical and APN education means the MDs/DOs have a much larger scope of practice than that of NPs; I have never seen an NP arguing to be the attending surgeon or radiologist. In many ways MD/DOs are trained much more as generalists. It adds cost to to the system but there is not any published data that it demonstrates it improves outcomes. Please feel free to cite any study you think helps demonstrate why that added cost benefits the patient population? I have great respect for MD/DOs especially in the speciality and surgical settings.

[CantDecideUsername]

I am serious. We only see them as the "gold standard" because that's all that has existed for a long time. That doesn't mean that their level of education is what is truly needed. More education is wonderful in many situations....doesn't mean it is necessary.

And yes I have been very sick with a complicated issue....I also have children who have been very sick with complicated issues. There have been cases where doctors were wrong and the NP figured it out. In fact, with my one child we had an MD in the room and an NP. The MD insisted there was nothing wrong with the child. The NP questioned many "things" going on making it clear she didn't think the child was fine. The MD was so wrong....child had a brain based lifelong condition AND and connective tissue disorder that was unrelated to the first issue.

So MD gold standard for overall care? Only because for long time we didn't have NPs and when we did we didn't recognize their capabilities. We have no proof that MD is the gold standard. We just don't...they are just what we assume to be "the best".

Your anecdotal evidence/personal stories are very inspiring

However-

I am not convinced based on your personal experience that more training and knowledge doesn't correlate to better patient diagnosis in complex scenarios

Of course there are studies stating that the care from an NP is no different than from an MD, and I am not going to argue that... But receiving care (care for basic maladies/ ordering and interpreting labs etc) and receiving a hard-to-determine diagnosis are two different things IMHO, and for the latter, please don't kid yourself into thinking that more knowledge/experience/training isn't helpful!

Again, I am not refuting/trying to insult your personal experiences in any way, just stating that 600 clinical hours is very different than 4 years of residency. (When it comes to things outside the typical medical issues)

As an aspiring NP I'm sure I'll enjoy the autonomy. But I'll never even begin to compare myself to an MD.

Also I'm very pleased that the studies come out favorably for the NP's but I just hope things don't change in a few years when they include the NP's who are trained online by the greedy for-profit schools (that are known for poor training, but are unfortunately becoming more common)

[IrishIzCPNP, MSN, RN, APRN, NP]

Your anecdotal evidence/personal stories are very inspiring

However-

I am not convinced based on your personal experience that more training and knowledge doesn't correlate to better patient diagnosis in complex scenarios

Of course there are studies stating that the care from an NP is no different than from an MD, and I am not going to argue that... But receiving care (care for basic maladies/ ordering and interpreting labs etc) and receiving a hard-to-determine diagnosis are two different things IMHO, and for the latter, please don't kid yourself into thinking that more knowledge/experience/training isn't helpful!

Again, I am not refuting/trying to insult your personal experiences in any way, just stating that 600 clinical hours is very different than 4 years of residency. (When it comes to things outside the typical medical issues)

As an aspiring NP I'm sure I'll enjoy the autonomy. But I'll never even begin to compare myself to an MD.

Also I'm very pleased that the studies come out favorably for the NP's but I just hope things don't change in a few years when they include the NP's who are trained online by the greedy for-profit schools (that are known for poor training, but are unfortunately becoming more common)

My story was to show to show a case where the md was completely wrong. The reality is studies favor NPs and that's a great thing. More education isn't a bad thing...but there are times it isn't needed and more education doesn't always mean better care.

Interesting tidbit...lots of NPs are training med students.

[wtbcrna, MSN, DNP, CRNA]

Your anecdotal evidence/personal stories are very inspiring

However-

I am not convinced based on your personal experience that more training and knowledge doesn't correlate to better patient diagnosis in complex scenarios

Of course there are studies stating that the care from an NP is no different than from an MD, and I am not going to argue that... But receiving care (care for basic maladies/ ordering and interpreting labs etc) and receiving a hard-to-determine diagnosis are two different things IMHO, and for the latter, please don't kid yourself into thinking that more knowledge/experience/training isn't helpful!

Again, I am not refuting/trying to insult your personal experiences in any way, just stating that 600 clinical hours is very different than 4 years of residency. (When it comes to things outside the typical medical issues)

As an aspiring NP I'm sure I'll enjoy the autonomy. But I'll never even begin to compare myself to an MD.

Also I'm very pleased that the studies come out favorably for the NP's but I just hope things don't change in a few years when they include the NP's who are trained online by the greedy for-profit schools (that are known for poor training, but are unfortunately becoming more common)

Then obviously an MD/PhD must be the platinum standard if MD is the gold standard.

And obviously all the medical societies could devise an simple retrospective study showing that persons with "hard to determine" diagnosis were better treated by physicians, but wait with all their money they still haven't been able to release one study showing a difference in care.

IMHO more education argument is obviously better argument is just grasping at straws.

[PMFB-RN, RN]

Physician training in the US involves a bachelor's degree, usually, though not always, in a science, medical school, residencies, internships, fellowships, specialized training. This training can take 12 years or more. Physicians medically diagnose, prescribe, and treat patients. Physicians are permitted by law to practice medicine independently.

Fist it is very condescending to explain the obvious to people who are already in the know. Despite all of the above being true, that is no guarantee that the physician who sees you in the clinic or the ICU has a degree higher than a bachelors degree. Many of them do not.

[Gluteus]

This NP put it better than I can...

Jun 4 by futureeastcoastNP

PA school requires a lot more pre-reqs than NP school. Yes, someone can go with a history degree...but someone can also go to medical school with a history degree. It doesn't mean they didn't take the required science prereqs to get in, and in June case of PA school they are A LOT more rigorous than for NP school, usually requiring organic chemistry, biochemistry, etc.

Furthermore, the PA curriculum is a lot more standardized, and they have no online, for profit colleges with 99% acceptance rates. You know that your PA colleagues have worked very hard to be where they are and are likely intelligent....the same cannot be said of NPs since your colleague could have gone to a for profit with absolutely NO admissions standards.

Once in school, the PA curriculum is not only more standardized, but also more science heavy. There is a lot less fluff in PA school, and almost every program has gross anatomy, surgery, histology, pathology, etc. All classes that most NP programs skip so they can take bogus filler courses, such as nursing theory.

Finally, all PA programs have predetermined rotations led by faculty of the school in specific hospitals. The school is in ohm molten control of what the student learns during clinical and ensures they learn what they need. Contrast this to NP school - most programs don't even set up your clinicals! They let the student do it themselves and have no idea whether or not the student is learning.

Overall, due to the current rampant greed of both the nursing boards and some colleges, the NP profession has some major, major issues, that are amplifying each year as more and more students give up on trying to get into the real schools and sign up for a for profit online school. The PA curriculum is much more standardized, science heavy, and overall just a lot better than the NP curriculum right now.

[BostonFNP, APRN]

This NP put it better than I can...

That was posted by someone who has neither gone to NP school nor PA school.

[SycamoreGuy]

That was posted by someone who has neither gone to NP school nor PA school.

Along with not being entirely accurate.

[Gluteus]

When are DNP going to demand to be called doctors in healthcare settings? When are they going to demand to have hospital privilege?

[tyvin, BSN, RN]

Is this new? I thought that in several states, NPs could practice and have prescriptive authority without MD oversight. Just looked - it looks like in approximately 15 states, NPs have full practice authority without the requirement of a collaborative agreement. So this is nothing new, and I don't understand why people would get het up over it, when clearly NPs have been doing this successfully for many years in other areas of the country.

This is true, where I am the pracs have full Rx authority even with schedule II's and are not required to work under a doc. It just depends on which state you're in but I thought it was more that just 15 states...oh well :)

It's the PAs that have to work under the guise of a doc's license.

[tyvin, BSN, RN]

When are DNP going to demand to be called doctors in healthcare settings? When are they going to demand to have hospital privilege?

Why couldn't you address them as doctor...their PhD. gives them that right.

[BostonFNP, APRN]

When are DNP going to demand to be called doctors in healthcare settings? When are they going to demand to have hospital privilege?

I have hospital privileges as do a number of NPs at my hospital. What's your point?

Sent from my iPhone.