When did we become???

[Dave ARNP]

The other day I was thinking (I know, I'm not susposed to do that outside of a clinical setting on my own), wondering when we became the personal property of the physician we worked for?

Note that for some, this certainly does not apply, but how many times have you heard of a NP being referred to as "Dr. Joe's Nurse Practitioner" or even worse... "Hello, I'm Dr. Joe's NP".

Even if our STATE doesn't consider us independent, I think we sure as heck can walk w/o a leash. Why on earth would ANY NP even consider introducing themself as a SOMEONE's NP? I can understand saying you work with someone, but to say that you are their NP?

Just doesn't make sense to me!

Maybe I'm ranting...

Anyone care to join in?

David Adams, ARNP

-ACNP/FNP

[mbess02]

Your statement that NP's are equally as trained as physicians is simply inaccurate. I understand that you are proud o fyour profession, and you should be: you are an educated professional who is able to provide skillful and compassionate medical care to those in need. However, medically you do not have the training an MD has.

I think the "attitude" goes both ways: you have "no use" for MD's, and you have all this hostility towards medical doctors, but then you balk when they seem to "mistreat" you.

Maybe if you showed them respect, they would respect you in kind. They ARE superior in training to NP's, and that is why they have higher privileges. That doesn't make them smarter or better people.

Bess

[EastCoast]

bess, I appreciate your point however, I think if you review some of MD TErm's background you will see he practice is parallel to his physician counterparts. If your 'vision of an NP is simply the person who gets your throat culture or does preventative care you need to see what is going on. The scope and practice of the NP has expanded to the degree that one wishes to practice. In my state I can hang a shingle without a physician counterpart and most of the people i work with in this hospital will openly tell me that i will provide more comprehensive and thorough care than many of the docs. I am not blowing steam either. While the basic didactitcal portion of edcuation is certainly much more comprehensive for the med student nothing can stand in a person's way of furthering their knowledge throughout their life. I know a lot of docs who stopped learning 20 years ago and their rate of admits and complications is testimony to that.

The other nite in a matter of 20 minutes i did a thoracostomy (look it up) , intubated, central lined and then ran the code. The surgeon arrived after the fact and didn't add much to the picture.

Perhaps what is best is that our experience in nursing only compliments our delivery of care as so much of what we learned and practiced in nursing is given to our patients while we still maintain respect for the nurse in the forefront of healthcare.

Thanks for listening.

[mbess02]

The other nite in a matter of 20 minutes i did a thoracostomy (look it up) , intubated, central lined and then ran the code. The surgeon arrived after the fact and didn't add much to the picture.

I dont appreciate the condescension with the little "look it up" reply. I am a medical professional and you are NOT above me, dear- so don't act superior.

My mother is an NP and my father is an MD. My mother would NEVER purport to have the level of expertise my father has.

Perhaps doctors dislike NP's because the NP's do not give proper respect to the fact that in the treatment world, the doctor is their superior.

I am done here, my wish is not to start a conflict, but people like MD terminator just perpetuate the idea that NP's are jealous of the privileges of the MD's, and have to make it known in hostile ways.

[meandragonbrett]

You ought to go and read the posts that Dave has made. I see that you are new to this board. Just because his screen name is MD Terminator.....doesn't mean he has no respect for physicians.

[EastCoast]

Originally posted by mbess02

I dont appreciate the condescension with the little "look it up" reply. I am a medical professional and you are NOT above me, dear- so don't act superior.

My mother is an NP and my father is an MD. My mother would NEVER purport to have the level of expertise my father has.

Perhaps doctors dislike NP's because the NP's do not give proper respect to the fact that in the treatment world, the doctor is their superior.

.

My dear,

None of the docs i work with dislike any of the midlevels to my knowledge. My personal interaction with docs is usually positive/collabortive/friendly and mutually respectful. I'd go so far as to say that a lot of times its fun. Good for me.

I think MD terminator likes docs so much he married one.

Also, I wasn't being graciously kind when i said 'look it up' ..i was being a bit of a snot just like you were in your response. I also think your response has been quite strong from one who is neither a nurse or an NP and has not stood in those shoes or even attained that degree.

Gee, I'm glad that's out of the way.

As a poster said previously...most NP's don't hold themselves in more or less regard than any physician counterpart. It stands to reason that there are probably some things we do better than docs and likewise.....(i'm sure your dad would agree) .

Medicine is not just about the time you spent in school and education afterall.

Also....does your dad dislike your mom because she is an NP as you suggest?

[Dave ARNP]

Mbess,

If you are a NP I certainly hope that you do not protray this attitude to other people; however by guessing I would say that you are either PA-C or seeking your MD.

To state that a NP's training is inferior to a MD simply shows your lack of knowledge of the NP profession. While your mother may be a NP, her reflection of the profession portrayed to you appears to be unique. I would have real issues with your father if he didn't correct your mother when she said she has less training than she does.

I will condceed that when it comes to a surgical speciality, or other highly specialized field, MD's do have additional training. I will openly admit that Cardiac surgeon father has more cardiology training than I do. However, I would invite you to ask a Cardiac surgeon where to even begin in the treatment of primary care issues. When I say that I have equal training to any MD, I speak in terms of MD's trained in my speciality.

Look at the studies. Those Np's that you state are undertrained have statistically been proven to provide equal or superior care to an MD, have greater patient satisfaction, and do it a lesser costs in regards to tests ordered and medications prescribed.

Finally, do not attempt to assume that I have no respect for MD's. I work in a very collabrative arrangement with a doc, and it is not just implied, but understood that we are equals. We are both aware that we possess strengths that the other does not, and frequently consult and share patients with each other. This is not to say that I do not possess the strenghts because of my lack of training. He simply does not like gynecology, and dislike dermatology.

Perhaps you should do some one on one work with an NP before you assume beleifs that are imposed by others.

David Adams, ARNP

ACNP/FNP

P.S. If you were to ask a patient if they would seek heathcare from a person who had less training than they had, I think you would find they would refuse this. So why is it that I have several MD's... who are MY patients?

[Dave ARNP]

Mbess,

If you are a NP I certainly hope that you do not protray this attitude to other people; however by guessing I would say that you are either PA-C or seeking your MD.

To state that a NP's training is inferior to a MD simply shows your lack of knowledge of the NP profession. While your mother may be a NP, her reflection of the profession portrayed to you appears to be unique. I would have real issues with your father if he didn't correct your mother when she said she has less training than she does.

I will condceed that when it comes to a surgical speciality, or other highly specialized field, MD's do have additional training. I will openly admit that Cardiac surgeon father has more cardiology training than I do. However, I would invite you to ask a Cardiac surgeon where to even begin in the treatment of primary care issues. When I say that I have equal training to any MD, I speak in terms of MD's trained in my speciality.

Look at the studies. Those Np's that you state are undertrained have statistically been proven to provide equal or superior care to an MD, have greater patient satisfaction, and do it a lesser costs in regards to tests ordered and medications prescribed.

Finally, do not attempt to assume that I have no respect for MD's. I work in a very collabrative arrangement with a doc, and it is not just implied, but understood that we are equals. We are both aware that we possess strengths that the other does not, and frequently consult and share patients with each other. This is not to say that I do not possess the strenghts because of my lack of training. He simply does not like gynecology, and dislike dermatology.

Perhaps you should do some one on one work with an NP before you assume beleifs that are imposed by others.

David Adams, ARNP

ACNP/FNP

P.S. If you were to ask a patient if they would seek heathcare from a person who had less training than they had, I think you would find they would refuse this. So why is it that I have several MD's... who are MY patients?

[mother/babyRN, RN]

I tell my patients I am their nurse.....I think if you don't want to be referred to as someones NP, then perhaps you should go on to become a doc .....Just kidding. Why would anyone want to do that. I guess I just don't see the problem the way you do...

[Dave ARNP]

Another note to Mbess,

When I posted my reply I was under the impression that I was speaking to a colleague of medical model training who had simply fallen victim to the down talking of mid-level providers. It was pointed out to me that you are phelbotomist.

I'd like to invite you to discuss the NP profession once you obtain some training as a clinician and have first hand expeirence working with my kind. Perhaps then, you can provide a subjective opinion based on first hand knowledge, rather than social beleifs.

David Adams, ARNP

ACNP/FNP

[mbess02]

I'm not a phlebotomist, I am a medical student, and I do phlebotomy as needed.

I don't wish to argue with you. I don't think MD's are better than NP's, and I always say that when I'm sick, i'd rather talk to my FNP mother than my surgeon father- I just don't like your signature that implies that MD's are incapable of talking to patients in a collaborative way.

Thank you for explaining your posts. I am not going to post anymore in this forum!!

[mother/babyRN, RN]

VERY well said....

[lmd32]

Hope you all won't mind a slight change of subject. I wandered off to work and when I came back the tone of this thread had changed before I got a chance to put my .02 in.

A patient's point of view:

A few years ago, my GP referred me to a specialist who, I felt, treated me badly. I now see the NP in the office who is wonderful. She listens to me (what a change), encourages me, respects my opinion.... I could go on. My problem is that every time I go in for an appointment, the office staff refers to me as "Dr. K's patient". I always correct them and say "No, I am Ms. T's patient". I think I am getting a rep for being difficult but I'm not giving up.

I'm looking forward to the day when I can say "I'm an NP" like docs say "MD" and have people know what it means.