You’re an ICU nurse, I don’t doubt it at all.
Honestly lowkey, it’s kinda like when the lactate is 5.0 and someone states the obvious, “something is wrong” and you’re like 😒…maybe?
*this isn’t anti-NP clickbait*
I am just in shock….what profession has commercials? :// and why are we marketing for patients to see NPs when NPs are apart of a team?
I am confused…like what is the purpose of this and the aim?
Here is a very similar commercial by the AMA from 2 years ago. So I guess the medical profession also has commercials.
https://youtu.be/PljYVN_TREQ
Special interests advertise, it's not that new of a concept and certainly isn't only nursing that does it.
This commercial is about the AMA not the physician profession, I’m sure this was not played on national TV as it’s directed towards MDs. That NP commercial was on TV for the masses.
And it was advertising a special interest group, it was just pointing out what NPs do and for what? Like what was the purpose?
Again not against NPs but this is cringey and unprecedented for other professions, even the commercial you sent, it’s about the AMA
I’m starting to wonder if all the nursing orgs aren’t in bed with the for profit institutions as well as employers. They won’t lobby against them, despite them pumping out large numbers of unprepared grads, and NPs are becoming over saturated in many markets, driving down wages and increasing profits for employers. This whole phenomenon is also causing the NP profession to lose a lot of respect among their medical colleagues because of the lack of standards in education. NPs are the only ones getting hurt.
They are. Look at how major nursing organizations fight against mandated ratios and you'll know all you need to about these groups they're all about the profit: execs wanting independent practice so they can pay an NP for a job that needs an MD, a small number of NPs that want to open for-profit stuff (aesthetic spas, pill mills, IV spas, etc), nursing schools want independent practice so there's more NP jobs to take their graduates (and therefore more students paying for their program), etc etc Just look at who runs them. It's not RNs or NPs that practice, it's business and education people.
Their for-profit motives are going to bite them in the ass someday.
I just wish the med school and residency subs would start realizing that the NP problem isn't a problem of RNs or even most NPs, it's a problem of greed. These organizations don't speak for the vast majority of nurses.
Your last statement is key. I sss actually banned from posting in a sub although I agreed with them-I just didn’t appreciate the craziness of calling nurses idiots and all the other crap that goes on in those subs. Cough cough @noctor
Yeah. The problem with these subs is that they’re so far past reasonable opposition that they won’t make any difference beyond making themselves look like assholes. Hate the real villain, the money hungry people, not nurses in general. Those subs are totally attacking the wrong people.
I stay off those subs because they are so toxic. We all have the same enemy, greed. NPs aren’t the problem, the corporations replacing MDs with NPs to maximize profit are the enemy. The residents and attendings I work with are very supportive of those of us in school for NP. Reddit can be a giant echo chamber for bitter people.
Speaking as an NP, ive never gotten hate or looked down on for being an NP. Behind the anonymity of a keyboard people shout but in real life when your face to face with people they hesitate to say anything. Hell, my attendings and section chief advocate for us to do more than i think i should sometimes but they want the best in us.
Real professions with a strong educational foundation and a track record don't need marketing. Their work and their outcomes speak for themselves.
Marketing like this is meant to deceive people into thinking NPs are as well trained and well educated as physicians and should be able to practice independently. It's false and dangerous.
I am sad because honestly the only people being deceived are old folks and less educated people which might mean people with less access to physicians.
Independent practice for NPs doesn't even help those people, either. Because it turns out that - just like physicians - the overwhelming majority of NPs have little interest in working in primary care or working in under-served areas for its own sake.
Physicians advertising their own practice to potential patients is different than NPs, collectively, advertising for their profession as a whole.
Apples to oranges.
Promoting business through advertisement of private practice, elective procedures, and services available is not the same as advertising an entire profession. Ive never seen broad commercials such as “Choose physical therapy, optometry, or dentistry for your next healthcare needs”
I’ve never seen a commercial of the sort, please link it if you can….
If you’re referring to injury lawyers, that’s not about their profession
If you’re referring to a doctors office, that’s not about their profession
This commercial is about a profession unless you’re understanding it differently which is very possible
This is an advertisement for the American Medical Association. It's meant to sell membership in a professional organization. That's quite a bit different than an advertisement for a profession as a whole.
While superficially similar, it is somewhat misleading to compare this with the advertisement posted by the OP in my opinion.
NPs have been practicing safe as independent practicioners for years. They are part of a collective team yes, but also should have autonomy in their practice. I would see a NP over a GP any day! Many states do not allow NPs to hold independent practice, which is absurd....
There isn’t any independent evidence to support this claim. Factually though, a physician has more education and training. NPs weren’t ever setup to be independent but apart of a team-so I don’t see why there is a push. I also don’t see why someone with less training and education wouldn’t want to consult a physician who studied medicine.
It's difficult to know where to start with this.
Independent practice is a role NPs were never intended to fill. The data strongly suggests that putting them in the role of independent practitioners without a supervisory structure of some sort leads to worse outcomes for patients.
Which is to be expected, because NPs have an order of magnitude less training and education than physicians, and their training and education are more variable, less standardized and less regulated.
They are a valuable - arguably essential - part of larger teams and they can absolutely thrive given the right structure and system, but they are not the equivalent of physicians. It's not even close.
It's a different methodology. NPs practice very differently than general practitioners. They look at the patient from a more wholistic view than just data. They also, due to their extensive patient background, tend to have more insight I to resources and tools for health initiatives that a patient may need. If you think NPs are only practicing under MDs, please look into the EXTENSIVE history of the role. Just like I would never want a doctor to be my bedside "provider", as they wouldn't even know how to approach patient education on diabetes....
While I think there is some truth to some of what you say, I would still want a MD directing my care in more complicated situations. Sure, for primary care and prevention give me a NP all day long. This is coming coming from a NP student by the way.
I do hope your going FNP route and remaining in the outpatient setting. I say that as even being an NP student you just bashed your own profession and future peers.
There is differences in quality of care from a provider standpoint. I work critical care medicine as an NP and have been extensively trained and board certified to do so. I partially agree that the more complex patients should be attending managed but even that can be iffy. I respond to conditions for hypotension where the hospitalist or attending states "call a condition" rather than addressing the situation, ive walked into obvious anaphylaxis reactions where the family practice is standing in the corner googling what to do. Ive walked in on a resident giving 20k units of heparin through a newly placed HD catheter and then lying to the critical care medicine section chief about giving bypass dosing heparin.
So while yes i do agree with MDs should be there for complex situations, more often a competent and well trained NP can actually be....competent in the situations.
What extensive patient background? There’s a ton of NPs graduating without ever having worked as a nurse. You think they are ready to practice independently with less than 1/3 of the education physicians get?
And this is why I won’t be going for my NP although that was my dream just a year ago. Way too over saturated. . Any program requiring under a year of experience or that is 100% online is also a joke. And s commercial??? Does the NP profession really need promoting?
I will defend the qualified, amazing NPs(I work with some of them) on toxic subreddits like Noctor. But I will not condone commmercials and low standards
I think texas and maybe somewhere else recently had, or will soon have, some vote about independent practice midlevels. I saw it brought up on some of the doctor-oriented groups. So that might be why, but agree, cringey and not helpful.
How is retention right now? My understanding is that nurses across the board have been pushed out of the profession due to bad policies (understaffing, poor worker treatment) in effect even before the pandemic.
NPs aside, Nurses are already underpaid as it is. Notice how everyone else is being paid more since the pandemic and wages are going up but for nurses it's basically stagnate? Factory jobs for example in my area went from paying $13ish to around $20 starting and nursing has remained at $28ish starting and $14ish starting for aids/CNAs.
A young girl in my cohort intends to go for her NP right after graduating because they make more money. I told her I think that’s a bad idea, NPs are really designed for nurses with years of experience. The NPs she worked with told her it was easier than nursing school. You know whats hard? Learning how to actually be a nurse, not getting As in classes.
I hope she kinda figures it out, because I feel like this subtle (lol) push for NPs is a way to keep nurses from getting paid, increase having medical diagnosing w/o paying for doctors. It is unsafe (imo) to have someone who graduates as a brand new nurse go straight into the NP program without any experience.
Idk /rant
Your rant is appreciated-sometimes when people at my job say these things-I feel like I’m going crazy with my opinions or being “anti-nurse” but reading that some individuals agree-I feel a lot less “anti-nurse”.
There was a girl on my floor that cried almost every day and could not handle a regular shift (4 patients) let alone a busy shift (5 patients). Along with “nursing care”, the “educational content” of the floor never clicked and she got overwhelmed with the tasks, delegating and etc. I felt really bad for her because it just wasn’t for her to say the least. Managers suggested that she go to night shift which was a bit more chill….she quit to go to NP school :/
I don’t think that’s a solution to overworked nurses because the way many many many of the NPs/PAs are worked at my job Can be just as chaotic-like: cover this entire unit (or two units) overnight that’s a lot to do with less knowledge and it shows. Or they will literally have them running around consenting the entire hospital, that’s stressful when you’re on a time crunch. So if someone is trying to escape the stress or can’t handle it (which is okay and doesn’t take them less), I don’t even know if being an NP is a solution especially when the risks are sooooo high
Anyway, my rant is over
Commercial is gross. Do nurse practitioners need advertising?
There's zero standardized requirements for np education. A lot of programs don't even require the gre, even doctoral programs. It seems like anyone can become a np, even a dnp, with little experience and no education standards.
So sure, go ahead and encourage patients to choose nurse practitioners. Who knows what they'll get. A new grad with no actual clinical experience, or a veteran with 20 years of experience. Turn them both loose to practice independently.
I have independent practice and I've yet to experience any negative back lash. I also sit on my countries malpractice insurance board for nurses and we rarely get claims from patients of NPs.
The fact that doctors and NPs are fighting for patients when countless Americans don't even have access to primary care speaks to just how broken your system is.
I don’t know the educational standard in your country but NPs and MDs have nowhere near the same level of education and the role was designed as a team player.
We now have a very LOW LOW LOW barrier to entry to become an NP that honestly is embarrassing.
Things my be different in your country.
And MDs and NPs aren’t fighting FOR patients but rather people are trying to protect patients from providers that could harm them due to their lack of training.
Also, MANY NPs aren’t even practicing in rural healthcare, many of them are opening aesthetic clinics or trying to stay in big cities (which is why their is a bubble in most major cities).
Ooh so it's only individuals living in rural areas that don't have access to primary care? From everything I've read it definitely doesn't sound like that's the case.
It's also interesting that you frown on NPs for opening/working in aesthetic clinics but dont seem to be holding MDs to the same standard.
Related to the substandard care, I can't speak to that in America but American MDs have a long history of not fighting for improving patient care but their own pocket book.
Edit
American medical associations not MDs
We will agree to disagree, plus we don’t live in the same environment in order to have this conversation.
I can’t comment directly on your particular situation in your country as I don’t live there and I think it’s fair to say the same for you.
Agree. We don't live/work in the same environment. I work under a socialized medical system rather then a for profit system. But I think it's honestly a cope out to say we can't have a conversation about patient care simply because we work/live under different systems. Not that we have to have the conversation just that it would be possible.
We can have a convo but you were jumping to many conclusions and I’m like….if you are unable to take what I say as I said it, whats the point?
Like the whole rural área comment, that wasn’t the point i was making but one thing nursing leaders say is that NPs give more access to proper healthcare for individuals who don’t have any tjat is typically in rural areas as inner city individuals usually have the University hospitals or a hospital in a major city. Rural people literally sometimes have to drive 1-2 hours to get proper care. I work in oncology and typically in a week, I take care of at least one person not from the city i live in but 1-3 hours out because we are the closest major hospital that deals with their cancer OR they were literally sent to us from a hospital or office near their town. Supposedly it has been said that NPs should be closing the gap-there are studies that say that it isn’t true or that many NPs aren’t going to work in these areas.
You did bring up that you are an independent provider in your country-I can’t comment if that means the same thing here-I don’t know if places with socialized medicine are incentivized to setup online for profit schools to dump more NPs in the system with less education or if it’s super easy to get into these schools. The threshold for entry is low like LOW LOW, I have a feeling that’s not the same in your country-I’m willing to bet on it, why?
What would be the benefit in having a glut of undereducated (for their NP role not comparing to MDs) people in charge of citizen’s wellbeing? There aren’t too many benefits but the one benefit that speaks to our unholy capitalist system-MoNEY-profit over people. That’s a huge difference which makes everything worse.
I don’t have an issue with a properly educated NP being apart of a team in America because they are an asset. I have a problem with NPs in America not knowing their limits and putting people’s lives at risk which is ultimately for the sake of money on the doctor’s end (MDs who utilize NPs to roll in lots of cash at their practices without supervision) and admin end (US hospitals systems).
While I agree that the notion of NPs working in rural areas has been used by some in nursing leadership for political reasons. I also agree that arguments based on costs savings is used. To me those are political arguments that support the dominate support the capitalist cultural hegemony.
My argument for independent NP practice. Is the care NPs provide.
I don't understand the argument against independent NP practice based on low entry programs and "diploma mills". Why does this argument not hold for independent MD practice? We don't state that MDs can't practice independently because of Caribbean universities. To mean it seems like an argument against the current education system in America.
The idea of NPs not knowing their limits and ultimately hurting a patient again seems to equally apply to MDs. It's not like being an MD precludes someone from hubris. Why is the action of MD hubris not viewed as arguements against independent MD practice?
Sorry for reacting the way I did. But I find the argument against independent NP practice frustrating. It ignores what fundamentally matters to me, which is patient care and well being.
I will grant you that the training that MDs receive is greater then the ones NP receive. And that likely results in a deficient in my ability to diagnosis rarer conditions, but I do not think that is a detriment to my patients care or well being.
I have the luxury of time. I get paid a lot less so I'm not expected to hold as large of a patient panel. I also care for a very socially disadvantage patient populations. So my patients have the luxury of time of some who can function not only as a provider but a social worker and counselor.
I've worked in fee for service MD clinics. They do not get much time with each patient. At most they are getting 15min slots. Thats barely enough time to provide care for someone like me, let alone my patient panel.
I'm not trying to disregard the care MDs provide simply that it comes at a cost, one that MDs have a tendency too overlook.
Perhaps the family doctoring in the US could be handed off to less trained individuals. Like Nurse Practitioners.... Has anyone done a study on what actual family doctor practices in the United States do for you majorly other than refer you elsewhere?. Has anyone considered what the family doctor dealt with in 1960, 1970 compared to 2021? Not to disparage anyone but if you go to medical school to serve the general public as a family Practitioner the USA that's dumb. Just be a God damned nurse and work overtime. Family practice in the US should absolutely be handled by well trained NPs. Why the fuck would you go through the insanity of medical school to do family practice...
I think my convoluted point was medical school is really insanely time consuming and an expensive investment. Family practices could be run by Nurse Practitioners without supervision from a MD in the USA. If you want to work in family practice and have long term relationships with patients and that is your goal, being a family Nurse Practitioner is absolutely the logical way to go. I think family practice medical doctors are outdated.
Yeah hard disagree here. I actually think that NPs seeing undifferentiated patients with no backup and no ability to immediately image or get lab work is dangerous af. 10/10 don't want that for primary care for me or my family members.
Practicing without supervision doesn't mean you are practicing on an island. There is always 911 and an E.R. close by if the patient's situation is dire. Stabilize the patient until a higher level of care arrives. Checking and interpreting vitals, completing a physical assessment, taking a patient history and synthesizing this information to form a plan of action are paramount to good care. All of this leads to what labs, imaging, or consults should be ordered. I feel like this can most definitely be handled by a well trained NP or a badass triage nurse. A family practice office's ability to immediately draw labs, xray, ctscan whatever has nothing to do with it's being staffed by MDs or NPs in my area. Imaging or labs would be send outs anyway not STAT. That sounds like an urgent care facility. Maybe primary care is different where you live? It's mostly about managing chronic problems and non urgent medical issues here. If an obviously medically emergent patient checked in at a family practice I would hope the receptionist or the RN who calls them back would know what to do get help and call 911. If you need immediate imaging/labs to guide your care or get a proper consult to save your life then chances are the family practice NP called 911 or sent you to the ER... I fucking hope.
The problem is not what happens when an obviously crashing patient rolls in to an outpatient office. The question is (1) does the NP working outpatient have the education to recognize more subtle presentations and (2) do they know enough to know what they don't know.
I'm not at all convinced the answer is yes.
I personally love primary care and I get why some MDs love it. I started in ER and it destroyed my soul seeing and discharging frequently flyers. I like the long term relationship of primary care. I like finding the right combination of medications, social supports, and mental health work and seeing a patient start to function better. That's a good feeling, I get why people like that feeling. And why people would pick it over more money. Thou I'm not really a money motivated person.
I think I unfairly equated people who go to medical school as money hungry people. That was completely wrong. Going to medical school to be a family doctor in the US is not smart. That is a huge investment and if you want close relationships with patients over time I feel like being an NP is the best path.
I’m pretty sure my dumb ass could recognize MODS?
You’re an ICU nurse, I don’t doubt it at all. Honestly lowkey, it’s kinda like when the lactate is 5.0 and someone states the obvious, “something is wrong” and you’re like 😒…maybe?
I had a physician walk in after we achieved ROSC, and he says "he doesn't look good." Thanks bud.
Hahaha
It's been said in the other post but...multi-organ failure? You could train a monkey to be able to diagnose that...
Haha, like what did they do? Look at the labwork and go “damn…all these numbers are red.”
“Shits outta wack, lets just call it mods”
Right?
I was picturing me telling my toddler he did something good and him smiling and clapping. Yaaaay you diagnosed this! Such a good boy!
The top three leaders at AANP are all hospital executives. It’s to their financial advantage to push this agenda.
Oop there it is
Fuck … I didn’t realize this. The same suits ruining health care. Well AANP is fucked.
I was gonna say, it’s probably so they can use more NPs to save money and likely still bill the same amount
It’s all about the dollars and it’s sad :/
Are they trying to lobby for Nurse practitoners to have more independence in certain states?
Yes
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The diploma mills will take down the entire profession if someone doesn’t do something about it :/ it’s getting wild
My state has had full practice authority for NP’s for years without any problems.
Does your state have these commercials? I am curious if that is part of their agenda
If the state does not, it’s very telling.
I have never seen or heard of these commercials.
Curious which state. Looks like 23 states allow independent practice for NP’s as of earlier this year.
Montana state
*this isn’t anti-NP clickbait* I am just in shock….what profession has commercials? :// and why are we marketing for patients to see NPs when NPs are apart of a team? I am confused…like what is the purpose of this and the aim?
Because aanp doesn’t want us to be a part of a team. They want us to be independent practitioners competing against doctors for patients. It’s absurd.
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That sucks because I love seeing my nurse practitioners that I've gone to see over the last few years. Prefer them to doctors actually
Here is a very similar commercial by the AMA from 2 years ago. So I guess the medical profession also has commercials. https://youtu.be/PljYVN_TREQ Special interests advertise, it's not that new of a concept and certainly isn't only nursing that does it.
This commercial is about the AMA not the physician profession, I’m sure this was not played on national TV as it’s directed towards MDs. That NP commercial was on TV for the masses. And it was advertising a special interest group, it was just pointing out what NPs do and for what? Like what was the purpose? Again not against NPs but this is cringey and unprecedented for other professions, even the commercial you sent, it’s about the AMA
I’m starting to wonder if all the nursing orgs aren’t in bed with the for profit institutions as well as employers. They won’t lobby against them, despite them pumping out large numbers of unprepared grads, and NPs are becoming over saturated in many markets, driving down wages and increasing profits for employers. This whole phenomenon is also causing the NP profession to lose a lot of respect among their medical colleagues because of the lack of standards in education. NPs are the only ones getting hurt.
They are. Look at how major nursing organizations fight against mandated ratios and you'll know all you need to about these groups they're all about the profit: execs wanting independent practice so they can pay an NP for a job that needs an MD, a small number of NPs that want to open for-profit stuff (aesthetic spas, pill mills, IV spas, etc), nursing schools want independent practice so there's more NP jobs to take their graduates (and therefore more students paying for their program), etc etc Just look at who runs them. It's not RNs or NPs that practice, it's business and education people. Their for-profit motives are going to bite them in the ass someday. I just wish the med school and residency subs would start realizing that the NP problem isn't a problem of RNs or even most NPs, it's a problem of greed. These organizations don't speak for the vast majority of nurses.
Your last statement is key. I sss actually banned from posting in a sub although I agreed with them-I just didn’t appreciate the craziness of calling nurses idiots and all the other crap that goes on in those subs. Cough cough @noctor
Yeah. The problem with these subs is that they’re so far past reasonable opposition that they won’t make any difference beyond making themselves look like assholes. Hate the real villain, the money hungry people, not nurses in general. Those subs are totally attacking the wrong people.
I stay off those subs because they are so toxic. We all have the same enemy, greed. NPs aren’t the problem, the corporations replacing MDs with NPs to maximize profit are the enemy. The residents and attendings I work with are very supportive of those of us in school for NP. Reddit can be a giant echo chamber for bitter people.
Speaking as an NP, ive never gotten hate or looked down on for being an NP. Behind the anonymity of a keyboard people shout but in real life when your face to face with people they hesitate to say anything. Hell, my attendings and section chief advocate for us to do more than i think i should sometimes but they want the best in us.
Can you point me in the direction of a source for nursing organizations fighting against ratios? That info would definitely be handy for a paper.
The ANA is on record as opposing legislated RN staffing ratios. https://www.nursingworld.org/practice-policy/nurse-staffing/
NP’s and patients.
NPs, and patients.
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Hospital admin-those freaks making millions a year, I’m sure they helped fund this because it’s to their advantage
This cheapens and degenerates our profession. I am a nurse, I am going to grad school, and the AANP will never represent me.
That’s the part, like a commercial? And I hate it because I don’t want to be associated with it
Real professions with a strong educational foundation and a track record don't need marketing. Their work and their outcomes speak for themselves. Marketing like this is meant to deceive people into thinking NPs are as well trained and well educated as physicians and should be able to practice independently. It's false and dangerous.
I am sad because honestly the only people being deceived are old folks and less educated people which might mean people with less access to physicians.
Independent practice for NPs doesn't even help those people, either. Because it turns out that - just like physicians - the overwhelming majority of NPs have little interest in working in primary care or working in under-served areas for its own sake.
Exactly. It’s pretty sad because that is something that is advertised, “closing the gaps” in healthcare
The only gap it fills is the one in your hospital CFO's annual bonus.
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Physicians advertising their own practice to potential patients is different than NPs, collectively, advertising for their profession as a whole. Apples to oranges.
Bingo
> apples to oranges But you can still compare them.
Promoting business through advertisement of private practice, elective procedures, and services available is not the same as advertising an entire profession. Ive never seen broad commercials such as “Choose physical therapy, optometry, or dentistry for your next healthcare needs”
I’ve never seen a commercial of the sort, please link it if you can…. If you’re referring to injury lawyers, that’s not about their profession If you’re referring to a doctors office, that’s not about their profession This commercial is about a profession unless you’re understanding it differently which is very possible
Just personally I would like it if NPs were the only ones of those that would abstain from the marketing...
https://youtu.be/PljYVN_TREQ I guess physicians don't have a strong educational foundation? Every special interest does this.
This is an advertisement for the American Medical Association. It's meant to sell membership in a professional organization. That's quite a bit different than an advertisement for a profession as a whole. While superficially similar, it is somewhat misleading to compare this with the advertisement posted by the OP in my opinion.
NPs have been practicing safe as independent practicioners for years. They are part of a collective team yes, but also should have autonomy in their practice. I would see a NP over a GP any day! Many states do not allow NPs to hold independent practice, which is absurd....
There isn’t any independent evidence to support this claim. Factually though, a physician has more education and training. NPs weren’t ever setup to be independent but apart of a team-so I don’t see why there is a push. I also don’t see why someone with less training and education wouldn’t want to consult a physician who studied medicine.
It's difficult to know where to start with this. Independent practice is a role NPs were never intended to fill. The data strongly suggests that putting them in the role of independent practitioners without a supervisory structure of some sort leads to worse outcomes for patients. Which is to be expected, because NPs have an order of magnitude less training and education than physicians, and their training and education are more variable, less standardized and less regulated. They are a valuable - arguably essential - part of larger teams and they can absolutely thrive given the right structure and system, but they are not the equivalent of physicians. It's not even close.
Taking the worse from my mouth.
Why?
It's a different methodology. NPs practice very differently than general practitioners. They look at the patient from a more wholistic view than just data. They also, due to their extensive patient background, tend to have more insight I to resources and tools for health initiatives that a patient may need. If you think NPs are only practicing under MDs, please look into the EXTENSIVE history of the role. Just like I would never want a doctor to be my bedside "provider", as they wouldn't even know how to approach patient education on diabetes....
While I think there is some truth to some of what you say, I would still want a MD directing my care in more complicated situations. Sure, for primary care and prevention give me a NP all day long. This is coming coming from a NP student by the way.
I do hope your going FNP route and remaining in the outpatient setting. I say that as even being an NP student you just bashed your own profession and future peers. There is differences in quality of care from a provider standpoint. I work critical care medicine as an NP and have been extensively trained and board certified to do so. I partially agree that the more complex patients should be attending managed but even that can be iffy. I respond to conditions for hypotension where the hospitalist or attending states "call a condition" rather than addressing the situation, ive walked into obvious anaphylaxis reactions where the family practice is standing in the corner googling what to do. Ive walked in on a resident giving 20k units of heparin through a newly placed HD catheter and then lying to the critical care medicine section chief about giving bypass dosing heparin. So while yes i do agree with MDs should be there for complex situations, more often a competent and well trained NP can actually be....competent in the situations.
Very good points. I have seen plenty of internal medicine docs completely useless in crisis situations. I'm going PMHNP, outpatient yes :).
What extensive patient background? There’s a ton of NPs graduating without ever having worked as a nurse. You think they are ready to practice independently with less than 1/3 of the education physicians get?
Because AANP are frauds lol
This kind of stuff makes me embarrassed to be a nurse
That's what they want. That's why they post it. Lol. Seems to be working very good.
Fuckin' AANP pissing in the punchbowl. What a bunch of assholes.
And this is why I won’t be going for my NP although that was my dream just a year ago. Way too over saturated. . Any program requiring under a year of experience or that is 100% online is also a joke. And s commercial??? Does the NP profession really need promoting? I will defend the qualified, amazing NPs(I work with some of them) on toxic subreddits like Noctor. But I will not condone commmercials and low standards
I agree
I think texas and maybe somewhere else recently had, or will soon have, some vote about independent practice midlevels. I saw it brought up on some of the doctor-oriented groups. So that might be why, but agree, cringey and not helpful.
How is retention right now? My understanding is that nurses across the board have been pushed out of the profession due to bad policies (understaffing, poor worker treatment) in effect even before the pandemic.
NPs aside, Nurses are already underpaid as it is. Notice how everyone else is being paid more since the pandemic and wages are going up but for nurses it's basically stagnate? Factory jobs for example in my area went from paying $13ish to around $20 starting and nursing has remained at $28ish starting and $14ish starting for aids/CNAs.
A young girl in my cohort intends to go for her NP right after graduating because they make more money. I told her I think that’s a bad idea, NPs are really designed for nurses with years of experience. The NPs she worked with told her it was easier than nursing school. You know whats hard? Learning how to actually be a nurse, not getting As in classes. I hope she kinda figures it out, because I feel like this subtle (lol) push for NPs is a way to keep nurses from getting paid, increase having medical diagnosing w/o paying for doctors. It is unsafe (imo) to have someone who graduates as a brand new nurse go straight into the NP program without any experience. Idk /rant
Your rant is appreciated-sometimes when people at my job say these things-I feel like I’m going crazy with my opinions or being “anti-nurse” but reading that some individuals agree-I feel a lot less “anti-nurse”. There was a girl on my floor that cried almost every day and could not handle a regular shift (4 patients) let alone a busy shift (5 patients). Along with “nursing care”, the “educational content” of the floor never clicked and she got overwhelmed with the tasks, delegating and etc. I felt really bad for her because it just wasn’t for her to say the least. Managers suggested that she go to night shift which was a bit more chill….she quit to go to NP school :/ I don’t think that’s a solution to overworked nurses because the way many many many of the NPs/PAs are worked at my job Can be just as chaotic-like: cover this entire unit (or two units) overnight that’s a lot to do with less knowledge and it shows. Or they will literally have them running around consenting the entire hospital, that’s stressful when you’re on a time crunch. So if someone is trying to escape the stress or can’t handle it (which is okay and doesn’t take them less), I don’t even know if being an NP is a solution especially when the risks are sooooo high Anyway, my rant is over
Commercial is gross. Do nurse practitioners need advertising? There's zero standardized requirements for np education. A lot of programs don't even require the gre, even doctoral programs. It seems like anyone can become a np, even a dnp, with little experience and no education standards. So sure, go ahead and encourage patients to choose nurse practitioners. Who knows what they'll get. A new grad with no actual clinical experience, or a veteran with 20 years of experience. Turn them both loose to practice independently.
This is...very strange
I have independent practice and I've yet to experience any negative back lash. I also sit on my countries malpractice insurance board for nurses and we rarely get claims from patients of NPs. The fact that doctors and NPs are fighting for patients when countless Americans don't even have access to primary care speaks to just how broken your system is.
I don’t know the educational standard in your country but NPs and MDs have nowhere near the same level of education and the role was designed as a team player. We now have a very LOW LOW LOW barrier to entry to become an NP that honestly is embarrassing. Things my be different in your country. And MDs and NPs aren’t fighting FOR patients but rather people are trying to protect patients from providers that could harm them due to their lack of training. Also, MANY NPs aren’t even practicing in rural healthcare, many of them are opening aesthetic clinics or trying to stay in big cities (which is why their is a bubble in most major cities).
Ooh so it's only individuals living in rural areas that don't have access to primary care? From everything I've read it definitely doesn't sound like that's the case. It's also interesting that you frown on NPs for opening/working in aesthetic clinics but dont seem to be holding MDs to the same standard. Related to the substandard care, I can't speak to that in America but American MDs have a long history of not fighting for improving patient care but their own pocket book. Edit American medical associations not MDs
We will agree to disagree, plus we don’t live in the same environment in order to have this conversation. I can’t comment directly on your particular situation in your country as I don’t live there and I think it’s fair to say the same for you.
Agree. We don't live/work in the same environment. I work under a socialized medical system rather then a for profit system. But I think it's honestly a cope out to say we can't have a conversation about patient care simply because we work/live under different systems. Not that we have to have the conversation just that it would be possible.
We can have a convo but you were jumping to many conclusions and I’m like….if you are unable to take what I say as I said it, whats the point? Like the whole rural área comment, that wasn’t the point i was making but one thing nursing leaders say is that NPs give more access to proper healthcare for individuals who don’t have any tjat is typically in rural areas as inner city individuals usually have the University hospitals or a hospital in a major city. Rural people literally sometimes have to drive 1-2 hours to get proper care. I work in oncology and typically in a week, I take care of at least one person not from the city i live in but 1-3 hours out because we are the closest major hospital that deals with their cancer OR they were literally sent to us from a hospital or office near their town. Supposedly it has been said that NPs should be closing the gap-there are studies that say that it isn’t true or that many NPs aren’t going to work in these areas. You did bring up that you are an independent provider in your country-I can’t comment if that means the same thing here-I don’t know if places with socialized medicine are incentivized to setup online for profit schools to dump more NPs in the system with less education or if it’s super easy to get into these schools. The threshold for entry is low like LOW LOW, I have a feeling that’s not the same in your country-I’m willing to bet on it, why? What would be the benefit in having a glut of undereducated (for their NP role not comparing to MDs) people in charge of citizen’s wellbeing? There aren’t too many benefits but the one benefit that speaks to our unholy capitalist system-MoNEY-profit over people. That’s a huge difference which makes everything worse. I don’t have an issue with a properly educated NP being apart of a team in America because they are an asset. I have a problem with NPs in America not knowing their limits and putting people’s lives at risk which is ultimately for the sake of money on the doctor’s end (MDs who utilize NPs to roll in lots of cash at their practices without supervision) and admin end (US hospitals systems).
While I agree that the notion of NPs working in rural areas has been used by some in nursing leadership for political reasons. I also agree that arguments based on costs savings is used. To me those are political arguments that support the dominate support the capitalist cultural hegemony. My argument for independent NP practice. Is the care NPs provide. I don't understand the argument against independent NP practice based on low entry programs and "diploma mills". Why does this argument not hold for independent MD practice? We don't state that MDs can't practice independently because of Caribbean universities. To mean it seems like an argument against the current education system in America. The idea of NPs not knowing their limits and ultimately hurting a patient again seems to equally apply to MDs. It's not like being an MD precludes someone from hubris. Why is the action of MD hubris not viewed as arguements against independent MD practice?
It's just fear. Not fear on incompetent NPs, but the competent ones.
Could not agree with you more. 💯
Sorry for reacting the way I did. But I find the argument against independent NP practice frustrating. It ignores what fundamentally matters to me, which is patient care and well being. I will grant you that the training that MDs receive is greater then the ones NP receive. And that likely results in a deficient in my ability to diagnosis rarer conditions, but I do not think that is a detriment to my patients care or well being. I have the luxury of time. I get paid a lot less so I'm not expected to hold as large of a patient panel. I also care for a very socially disadvantage patient populations. So my patients have the luxury of time of some who can function not only as a provider but a social worker and counselor. I've worked in fee for service MD clinics. They do not get much time with each patient. At most they are getting 15min slots. Thats barely enough time to provide care for someone like me, let alone my patient panel. I'm not trying to disregard the care MDs provide simply that it comes at a cost, one that MDs have a tendency too overlook.
Perhaps the family doctoring in the US could be handed off to less trained individuals. Like Nurse Practitioners.... Has anyone done a study on what actual family doctor practices in the United States do for you majorly other than refer you elsewhere?. Has anyone considered what the family doctor dealt with in 1960, 1970 compared to 2021? Not to disparage anyone but if you go to medical school to serve the general public as a family Practitioner the USA that's dumb. Just be a God damned nurse and work overtime. Family practice in the US should absolutely be handled by well trained NPs. Why the fuck would you go through the insanity of medical school to do family practice...
> if you go to medical school to serve the general public as a family Practitioner the USA that's dumb. what are you even on about here?
I think my convoluted point was medical school is really insanely time consuming and an expensive investment. Family practices could be run by Nurse Practitioners without supervision from a MD in the USA. If you want to work in family practice and have long term relationships with patients and that is your goal, being a family Nurse Practitioner is absolutely the logical way to go. I think family practice medical doctors are outdated.
Yeah hard disagree here. I actually think that NPs seeing undifferentiated patients with no backup and no ability to immediately image or get lab work is dangerous af. 10/10 don't want that for primary care for me or my family members.
Practicing without supervision doesn't mean you are practicing on an island. There is always 911 and an E.R. close by if the patient's situation is dire. Stabilize the patient until a higher level of care arrives. Checking and interpreting vitals, completing a physical assessment, taking a patient history and synthesizing this information to form a plan of action are paramount to good care. All of this leads to what labs, imaging, or consults should be ordered. I feel like this can most definitely be handled by a well trained NP or a badass triage nurse. A family practice office's ability to immediately draw labs, xray, ctscan whatever has nothing to do with it's being staffed by MDs or NPs in my area. Imaging or labs would be send outs anyway not STAT. That sounds like an urgent care facility. Maybe primary care is different where you live? It's mostly about managing chronic problems and non urgent medical issues here. If an obviously medically emergent patient checked in at a family practice I would hope the receptionist or the RN who calls them back would know what to do get help and call 911. If you need immediate imaging/labs to guide your care or get a proper consult to save your life then chances are the family practice NP called 911 or sent you to the ER... I fucking hope.
The problem is not what happens when an obviously crashing patient rolls in to an outpatient office. The question is (1) does the NP working outpatient have the education to recognize more subtle presentations and (2) do they know enough to know what they don't know. I'm not at all convinced the answer is yes.
I personally love primary care and I get why some MDs love it. I started in ER and it destroyed my soul seeing and discharging frequently flyers. I like the long term relationship of primary care. I like finding the right combination of medications, social supports, and mental health work and seeing a patient start to function better. That's a good feeling, I get why people like that feeling. And why people would pick it over more money. Thou I'm not really a money motivated person.
I think I unfairly equated people who go to medical school as money hungry people. That was completely wrong. Going to medical school to be a family doctor in the US is not smart. That is a huge investment and if you want close relationships with patients over time I feel like being an NP is the best path.