MDobg

Thanks for the post. It is old news the reasearch has been around for some time, just continues to be ignored. I produced a program to limit carbohydrates and bring awareness to this for 25 years ago and have advocated for it since. Patients and staff wouldn't here of it, because THEY, hypnotized by the latest marketing, knew better. Any provider should know the metacolic differences between polyunsaturates, saturates, fructose and glucose sources of energy. We deserve what we now have. Triple maternal mortality since 1981, lack of access to physicians...

"The proportion of ARNPs over the age of 50 years has decreased from 49.4% in 2008-09 to 41.5% in 2014-15. Conversely, the youngest ARNP age group has increased in size by about four percentage points in the same timeframe (3.7% to 7.5%). While this trend is indicative of a small shift to a younger workforce, the workforce will likely be reduced as a larger portion is aging and entering retirement in the next 5 to 15 years. The retirement of older, experienced nurses will result in a loss of highly skilled mentors with years of organizational and experiential knowledge." (From Nurse Practitioner Supply 2014-2015 in Florida https: //www.flcenterfornursing.org/DesktopModules/Bring2mind/DMX/Download.aspx?Command=Core_Download&EntryId=1196&PortalId=0&TabId=151 take out the space). It looks like more are graduating from school, but not passing the test. (http: //healthaffairs.org/blog/2015/05/26/the-nurse-practitioner-physician-assistant-and-pharmacist-pipelines-continued-growth/ see Fogure 1). Consider that NP training may have been an academic pathway for older besieged RN's. One issue is the cost factor is not improved using NP's as seen in England. https:// Comparing the cost of nurse practitioners and GPs in primary care: modelling economic data from randomised trials It may be that cost factors are what is going to power the future. Many have been convinced that Academics is the most important factor leading to more and more schooling for the same positions.

Dear Nurse I have not read thru all the replies, but please accept this note from a well seasoned OBGYN Physician. You are not alone, and also know that you are not unappreciated. Just un-rewarded. It is a tragedy that Nurses and Doctors have been pitted against each other and that tension used to muscles in Corporate and Investor control of Medicine and Nursing. The middle class MD's and RN's are both being replaced, and the treatment now is pretty much the same for both, and mostly inhuman which is sad for a caring industry. Clinically expert Physicians and Nurses are replaced with non-professionals to care for patients. The authority also has been shifted to the essentially non-clinical Academic supervisory staffing (Masters, PhD and Sub-Specialty Ceritifed) to boss you and me around and take all the scut-work and blame. Nursing is a great and noble Profession. So is Physician-ing (we dont even have a word for it huh). They are not the same thing, and it takes many years and hard work to see it. All I can suggest is to take a deep breath, and take care of yourself. Teaching and academic program funding is being used to subsidize the losses, but it will ultimately crash. Perhaps a reach-out to a good Independent Physician you know can provide support for each other as we try to put back the pieces. Thank you for your caring.