So, not everyone thinks highly of NPs.

zenman · Feb 19, 2009

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Who does he think he is???

Apparently someone who is on the receiving end of NP education. :smokin:

CraigB-RN, MSN, RN · Feb 19, 2009

Sounds like someone who see's one side the system that others don't.

For all this talk of autonomy, I've worked in states that required "protocols" for NP's to work. If the protocol said CXR for the sniffles, it was ordered no matter what. All though I think he was picking on a certain group of providers, the ones in his catchment area" it's a problem everywhere. We treat the lawyers and legal system and not the patients. We treat someones checkbook and not a medical problem. In the urgent care clinic I was doing clinical, CXR's were ordered on everyeone with a cough, and an ekg was ordered on everyone with any type of CP at all no matter age or risk factor. We could bill for the XR and the EKG.

*RN123ABC* · Feb 19, 2009

I work with an ED physician who is widely known (by other docs as well) to order every available test just to cover his own incompetence, so it doesn't shock me that a NP might. I just don't think it is fair to make blanket statements, regardless of who they are about. It speaks more about the person saying it than whomever he is referring to IMO.

ANPFNPGNP · Feb 22, 2009

My 11 year old daughter is having a sleep study done tonight and my husband is staying with her. He called me to tell me she was hooked up and getting ready for bed and he mentioned he was talking to the technician at the sleep center. The tech said he was an x-ray tech before he started working at the sleep center. He thinks my daughter should have been referred to a ear, nose and throat specialist first, but said so many doctors will just willy nilly start ordering tests. Then, the tech said NPs were the worst about this, and their lack of diagnostic skills were the cause of many needless tests. He said they will send someone in for an x-ray for every sniffle and stubbed toe, it was ridiculous.
I'm glad my husband didn't tell the tech I'm supposed to be starting a NP program soon.
Who does he think he is???

I totally disagree with that technician. I've seen residents and new doctors order more tests than ANY NP! I work part-time at an urgent care clinic and my boss has fired many residents and new physician b/c they can't keep up the pace. They order just about everything under the sun, even though a patient is there for an episodic illness. My boss actually told one of them, "Look, you don't need to do a PAP smear on someone with a sore throat!" I also work PRN with a large IM/Family Practice group and they've fired a lot of new doctors as well. If the patient is THAT difficult to diagnose, then send them to a fricking specialist!

RedCell · Feb 22, 2009

Unfortunately, due to the legality issues in the current healthcare system...practitioners are forced to practice defensively. No one wants to bust their ass for a license just to have some trial lawyer take it away from them. I really couldn't say if NPs order more useless test than physicians, but I am sure that the majority of tests ordered by both groups are purely for a CYA purpose.

RedCell · Feb 22, 2009

Craig, didn't read your post before posting my comment, but I could not agree more.

karenG · Feb 22, 2009

its a bit different over here.. NP's have had a hard time getting permission to actually request stuff like xrays.. so we are careful to have a good clinical reason for asking for it.. also patients dont pay for heath care.. its free at point of contact.. and maybe that makes it easier to tell someone they cant have an MRI scan because they've had a headache for a day!

I would agree that we also practice defensively.. we cover our backs every time.

over here, a lot of nurses dont think much of NP's, we are seen as wannbe docs.. it makes life a bit hard at times. I dont want to be a doctor.. just be the best nurse I can be!

Jolie, BSN · Feb 22, 2009

How inappropriate for the tech to express his negative impressions of any health care practitioner to a patient. A private conversation with a friend or family member is one thing. A statement made to undermine the education, skills or authority of a fellow professional made to a patient is another. He ought to be reported to his supervisor.

His education and experience as a tech hardly qualifies him to second guess the diagnostic decisions of physicians and NPs. If he questions their orders, he needs to direct those questions to the prescribers (which he doesn't have the nerve to do), not the patient.

ANPFNPGNP · Feb 22, 2009

its a bit different over here.. NP's have had a hard time getting permission to actually request stuff like xrays.. so we are careful to have a good clinical reason for asking for it.. also patients dont pay for heath care.. its free at point of contact.. and maybe that makes it easier to tell someone they cant have an MRI scan because they've had a headache for a day!
I would agree that we also practice defensively.. we cover our backs every time.
over here, a lot of nurses dont think much of NP's, we are seen as wannbe docs.. it makes life a bit hard at times. I dont want to be a doctor.. just be the best nurse I can be!

Where do you live? I can't imagine having to get permission to order a test on a patient! When nurses "don't think much of NP's" that implies that they don't think much of their profession.

core0 · Feb 22, 2009

Where do you live? I can't imagine having to get permission to order a test on a patient! When nurses "don't think much of NP's" that implies that they don't think much of their profession.

She's in the UK. Its not just NPs its the whole system. You essentially have to be seen by a specialist to order an MRI. If I remember correctly there are more MRIs in Dallas than in the whole of the UK. This is the flip side of a national health service. You don't get what you want you get what they say you can have. In one way it forces you to develop better clinical assessment. On the other hand you have people waiting around in the hospital for days for observation when you could do the test and have them out the door or on to definitive treatment. There are good and bad parts for both of our systems. Also the regulatory environment for NPs is very different over there than it is here. There are also a wider range of nursing services that are classified under NP and some that are part of nursing there that would only be found under the NP practice acts here (at least thats what I gather talking to the NHS).

David Carpenter, PA-C

istat · Feb 26, 2009

It is really funny how so many people do not understand the concepts of "screening" and being complete. I not a big fan of "gestulting" (sp) it. I was trained that you do not just think it-PROVE IT! You end up not missing a lot of things this way, And yes I do understand that some people get carried away. But in my experience it is the exception rather then the rule:angryfire