are nursing politics preventing hiring NP's?

[westcoastgirl]

I am feeling a little depressed here, because in spite of all the regular hoopla about how NP's are the future of primary care and the need for us in primary care that I always see in my AANP newsletter, I'm beginning to wonder if those folks are doing anything to actually promote that or just blowing smoke?

Several healthcare systems here (hospitals with multiple outpatient family practice clinics) have been hiring PA's for those positions. Please I am not starting a PA vs. NP thing here, it's just disheartening to see a new grad PA hired for a family practice position at a great employer, when I and my friends (several years experience FNP's) aren't seeing any openings.

One reason I've heard through the grapevine is because the RN's are union in those systems and NP's will have to be too and report to Nurse Managers, so the MDs would rather hire a family practice PA instead, since they don't have to then deal with all that and just supervise them directly.

any truth to that, you think?

[sissykim]

That may be the case for me. I have yet to start my first job or have an interview here in NC. However, we are governed by the Medical board and the nursing board. On the other hand, I would not blame a doc for doing what they do. The nursing board is very punitive and controlling. My co-worker thought about studing to be a NP but reconsidered and choose PA shcool.

[Corey Narry, MSN, RN, NP]

This is a very good question. I tend to think that on a national level, AANP does a good job with pushing the nurse practitioner movement. However, the nurse practitioner field (as is the general nursing profession as a whole) does not have a unified voice in my opinion. We have two national NP organizations namely AANP and ACNP and a faculty organization represented by NONPF. We have multiple nurse pracitioner specialty boards, and then you can also throw ANA in the mix with their ANCC arm which is highly involved in certification of NP's. Each of these organizations seem to be disconnected from each other.

On a local level, I think specific georgraphic areas and job markets certainly has NP's with an upper leg on employment opportunities over PA's based on anecdotal accounts. However, I personally feel that the biggest culprit in the lack of exposure of NP's to the likelihood of a greater physician-NP collaboration are the NP schools themselves. We have been cranking out programs left and right with no regard for how we are going to be accepted in the community we are being trained to serve. One particular example are the online programs that have no involvement in where the distance students live and desire to work.

The other piece are the programs that do not closely link with medical schools and medical centers so that both professions realize what each other can offer. I have worked in Michigan and California and the pattern I see is that there are NP programs in the very same universities that also have a medical school and a university hospital. However, how much connection do the NP students get with the university hospital? I see very little I'm afraid. One instutution in Michigan, a well-known university with a medical school and mutliple NP tracks in the nursing school probably hires more PA's than NP's in the university hospital. There's something terribly wrong with that picture.

[llg, PhD, RN]

Interesting topic. It's not my area of expertise, but I'll be checking this thread out to learn from it.