Question from a doc on NP education

Specialties NP

Published

Hello, I am coming here to see if I can pick some information off of you all. I will state that I appreciate ahead of time the responses I will hopefully receive and hope to put them to good practice.

I am an ER physician in the southeast-ish area of the US, and usually do much travelling around. I work for various staffing agencies, usually just taking the most needed bids and such. I tend to work with many different nurse practitioners and physician assistants in the various locations, mostly in the bigger ERs. The smaller ones usually it is just me since the volume is low.

The reason I come here is because I am looking or some info on the education of nurse practitioners. Sine I occasionally lecture on ER topics at one of the local PA schools in front of medical students and Pas I have been able to get a thorough glimpse at the PA ED model, which really is not too much different than a condensed version of ours it seems. I did go to a med school here in the US which also has a PA program close by so I understand this aspect.

I have noticed at many of the facilities I work at, a higher than average (in comparison to PA and other docs) the nurse practitioners often (not a total majority) seem to be oblivious to many aspects of ER level care. Some are unable to understand the interpretation of a basic set of lab panels, X-rays, and some are unable to suture well, if at all. There are a few that are Excellent at what we do (the term we used because we are a team and I dislike the dichotomy many use separating physician practice from other types of providers since it just stems unneeded conflict and perpetuates social gaps).

I have not noticed such a large gap in practice from the physician assistants that I work with though. Nearly all of them are able to suture, interpret labs, splint, suture, read most X-rays (abdominal X-rays can be very difficult to read at times, often we physicians consult rads on these). (I am also referring to flat plate x rays not CT/MRI and the such when providing the term Xray).

The gap is narrowed it seems between the PA/NP when it comes to diagnosing illness in the fast track though, I do notice it seems the PA do edge out slightly on better diagnosis (but my time is limited in the fast track, I am only there when they have a question about something, if something gets miss-triaged, or if family requests to see me, etc etc.)

But the whole point of me coming here is to ask if they teach nurse practitioners during their educational adventure how to read X-ray, suture, splint, read basic lab panels, intubate, and what not. I have looked through curriculums but course names often do not tell accurate stories in any aspect of education.

I would feel rather rude asking my coworkers these questions, since they may take it as demeaning and I like to maintain great relationships with the other providers. So again, here I am looking for a bit of info on what type of education they provide nurse practitioners in school (we use mostly FNPs in er) to see what you all thought of the situation.

Hope I am not stepping on toes with this,,,, just looking to gather some information in an objective manner.

Best wishes

Specializes in Neurosurgery, Neurology.

This sounds like a junior high school comeback.

He uses that exact phrase multiple times as medical student W19 on SDN.

:yes::roflmao:

Specializes in RETIRED Cath Lab/Cardiology/Radiology.

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Thank you.

Specializes in Hospice.
Big ERs have the benefit of having in-house radiology who can do an immediate read on all xrays but clinics, urgent care centers, and small town ERs don't have that. If the primary provider cannot make heads or tails of a CXR then they are not equipped to practice medicine. I'm not suggesting every non-radiology provider be able to see a small pneumonia or a tiny lingular infiltrate but they better be able to see the obvious CHF or huge right lower lobe infiltrate starring them in the face. Being that FNP education lacks this basic skill I will always be careful to never have an FNP assess me or anyone I love and care about for anything remotely related to their lungs.

Worst yet- if an FNP doesn't know how to read a basic CXR they may not order one when it's certainly warranted. They will likely miss a huge infiltrate, send a patient home with nursing order to "rest", and the PT will expire.

You are just silly. Research doesn't support your fears or comments at all

I was trained and tested on reading x Rays as a fnp.... And anyone can read a basic cxr......But for the record even the physicians I work with don't dx or act without talking to radiology. I work in a clinic and we get a read very quickly.

Specializes in Education, FP, LNC, Forensics, ED, OB.

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