What top notch facilities are you referring to? I’ve worked at Yale Children’s Hospital and Children's Hospital of Philadelphia (the 2nd best CH in the nation) and their critical care NPs do everything the attending physician can do. In fact, they lead the team during rounds and are the first person the bedside RN goes to, the attending is more support/directive when there is a complex patient. I do recognize this post was written almost a decade ago haha, but just for anyone new lurking around and wondering - if you choose to go a different route than MD, you still have the capability (although keep in mind your scope of practice) to do what a doc can do as an NP.