Say Hello to Dr. Nurse

[tanthalas]

Came across this today (a tad late):

http://blogs.wsj.com/health/2008/04/02/say-hello-to-dr-nurse/?mod=WSJBlog

It's interesting to see the innovations health care is trying to make to quench the pending shortage. What are your thoughts? Think it'll be successful?:bowingpur

[hypocaffeinemia, BSN, RN]

Most of your points are very well-taken, but here I think you're just wrong. Medical education occurs along a medical model, while NP education proceeds along the nursing model. These are two substantially different philosophies (which is why we have both PAs and NPs). My wife can tell me when I have the flu and give me ibuprofen, but that doesn't mean she is practicing medicine.

And from a more practical standpoint, if you are telling patients that you are able to practice medicine by virtue of your NP certification, you probably will not keep your license very long. Neither physicians nor RNs take very kindly to NPs who claim to practice medicine, and I suspect you would find yourself explaining yourself before a disciplinary committee.

I agree with you entirely-- In fact, my I clarified my ad absurdum to rectify this. There's no doubt 'advanced practice nursing' and 'medicine' hold incredibly different educational models and deeply rooted politics which have led to different terminology. I still find it a bit disingenous to not appreciate that from most patients' perspectives, the difference is akin to splitting hairs.

Or, to be fully tongue in cheeck, we should call NP diagnoses "advanced nursing diagnoses" and so forth.

[mcs1505]

To the whole first name/last name debate:

I think a large part of this is your culture. For example: I grew up in Ohio and we generally used last names so when I moved to Florida several years ago I was shocked to be called by my first name. I was a preschool teacher and hated the kids calling me Miss Michelle because I thought it was disrespectful. Since then I've adapted and actually get really miffed if someone calls me Miss last-name-here because it feels cold and like they don't see me as a person, just an object. However, having a background in EMS and working for a fire department, calling someone by just their last name, no Miss/Mr etc. is more personal to me. (Generally speaking, I mean obviously tone of voice has everything to do with it)

Cultural differences can be weird sometimes.

[celery]

(I'm sorry, I don't understand what you mean ...)

Upon re-reading it, neither do I! Sorry.

[elkpark]

Upon re-reading it, neither do I! Sorry.

That's okay -- we all have those moments ... :balloons:

[woody62, RN]

I use "Mr. or Mrs.", but the "intimidated" comment is irrelevant since I'm not the one who is sick as hell lying in an uncomfortable bed in a foreign place exposed (literally) to complete strangers who are responsible for managing my recovery and/or keeping me alive.

Apples and Oranges.

I have been a nurse since 1968. I have always addressed my patients by Mr., Mrs., Miss., last name. I have never addressed a patient by their first name, or granny, or honey, or dear. If I expected to be called by my last name, then how could I not respect my patients? It is not merely comparing apples and oranges. It is a means of respect for a fellow human being.

It is somewhat funny to hear of this problem since I recently discussed it with a RN friend of mine, in upstate New York. She and I share a similar view. There is a shortage of nurses, in every area of nursing. More importantly, there is a shortage of MSN's and PhD's to teach nursing, both on the undergraduate and graduate levels. What makes those who are proposing this solution think that this is going to alleviate our nursing shortage, let alone the shortage of primary care physicians? It is going to do nothing but create another layer of individuals who will not be paid what they are worth. And will falsely feel smug because they are now doctor.

Woody:twocents: