NYT: Nurses aren't doctors

[New User 122121]

http://nyti.ms/1mVUgVi

I'm glad someone is bringing this up in a public forum. I'm afraid it won't be until years down the road when the data finally starts rolling in that people will realize that nurses shouldn't be practicing medicine. Some of those comments are hilarious. There are lots of angry nurses.

 

[New User 122121]

 

[Poatan Power]

http://nyti.ms/1mVUgVi

I'm glad someone is bringing this up in a public forum. I'm afraid it won't be until years down the road when the data finally starts rolling in that people will realize that nurses shouldn't be practicing medicine. Some of those comments are hilarious. There are lots of angry nurses.

A physician writes an article to protect his field and money scheme? No kidding. FYI, the article is complete garbage asserting causative relationships to correlational information. Not to mention he completely negates to mention the training NPs go through, including a three year "residency" under supervision of an MD including 1,000 clinical hours doing nurse practitioner school. That's in addition to the hours they spend in their primary employment as an RN, and in addition to the 900+ clinical hours they spend in their initial RN training programs.

That IOM report that the article cited (which I've read exhaustively, unfortunately for me), also cited that 55% of cases handled by physicians in the community are low-complexity. PA's and NP's were 56% and 57%, IIRC. In other words, there are 55% of cases that physicians handle that a PA/NP could also do, but the problem is then a physician wouldn't be able to gouge your insurance company for his over-priced time.

FYI, a nurse practitioner is not just a nurse. A nurse could be someone who has a 1 year junior college education (LVN/LPN), a 2 year associate program (ADN-RN), a four year program (BSN-RN), a four year program with an additional two years of education (MSN-RN) and also doctorate programs to go along with the additional training it takes to become a nurse practitioner.

So a nurse practitioner is someone with at least 6 years of education in addition to their years of experience in the acute care setting. This half-wit ass clown is trying to write that only people with an M.D. can do what a primary care physician in an office does. What a load of horse shit.

This attitude is all rooted in MD's shitting themselves because their cash cow (the ACA guaranteeing insured patients) slice of the pie getting smaller. They won't be able to bill your Blue Cross $750 for looking in your ear and giving you a refill on your life-long monthly prescriptions.

I'm off my soap box.

(Guess what I do for a living, by the way?)

 

[New User 122121]

The training is in no way remotely comparable, sorry. If you want to be a doctor, you should go to medical school. I can't understand how you can rationalize equality when you have like 1/10 the training and don't take the same exams. If you want to practice like a primary care doctor, you should be held to the same standards. Go pass the USMLE 1,2, & 3, and then we'll talk.

 

[7437]

The training is in no way remotely comparable, sorry. If you want to be a doctor, you should go to medical school. I can't understand how you can rationalize equality when you have like 1/10 the training and don't take the same exams. If you want to practice like a primary care doctor, you should be held to the same standards. Go pass the USMLE 1,2, & 3, and then we'll talk.

a doctor doesn't need 10 years of training to tell me I have a broken arm or something else simple. complex problems, sure. but most of the time that is nit what people need.

 

[Poatan Power]

The training is in no way remotely comparable, sorry. If you want to be a doctor, you should go to medical school. I can't understand how you can rationalize equally when you have like 1/10 the training and don't take the same exams. If you want to practice like a primary care doctor, you should be held to the same standards. Go pass the USMLE 1,2, & 3, and then we'll talk.

I don't have to, as I already stated, the evidence from the IOM sides with me. Which, by the way, is headed by an M.D. who just so happened to be Dean at Harvard Public Health.

You're so uneducated on the issue it's almost hard to address what you say. You seem to be hypnotized by some magic show in your head about MD vs. RN-NP. You don't know anything about the training either profession goes through, obviously, so I won't bother addressing it. The fact of the matter is it does not take an MD to do the work a PCP does around 50% of the time. I don't create the facts, I just observe and recognize them. Surgery? Intensivist? Specialty consults? By all means, an MD is needed and should supervise NP's and use them as his right hand.

But...a kid with an ear ache? Bronchitis? A physical for high school athlete? A pulled muscle? Someone needs their prescription renewed? There is a plethora of things that NP's and PA's could do that can free up the time of the MD for the other 50% of cases that are higher in complexity where an MD's training and expertise is needed. The only reason anyone has a problem with this is because of their ignorance (you) and MD's who don't want to lose the ability to bill a large sum of money for low-complexity problems. This will actually HELP the profession of medical doctors AND nurse practitioners/PA's, and even better it will also help patients. All the evidence points to it.

a doctor doesn't need 10 years of training to tell me I have a broken arm or something else simple. complex problems, sure. but most of the time that is nit what people need.

Exactly. A physician will have more time to focus on problems with higher complexity, nurses will have higher vertical mobility in their profession, education institutions will make more money educating them, availability of being seen by a well educated health care professional will go up... this is such a great scenario and we have neanderthals trying to under cut it for reasons they cannot cite or provide evidence for.

This will also be HUGE for the mental health world of medicine, a classically underserved field.

 

[New User 122121]

a doctor doesn't need 10 years of training to tell me I have a broken arm or something else simple. complex problems, sure. but most of the time that is nit what people need.

You're right. You don't necessarily need a doctor for simple conditions. A nurse practitioner can diagnose an ear infection. But you should see a doctor because he has the education to catch the bad stuff that you really worry about. NPs just don't have the training to catch the rare/complex things. And a lot of times they are not going to refer out because they don't know what they don't know. That's why they need supervision.

 

[Josh]

Wow, ignorant thread. Good work dousing the propaganda with facts Veggie.

 

[Poatan Power]

You're right. You don't necessarily need a doctor for simple conditions. A nurse practitioner can diagnose an ear infection. But you should see a doctor because he has the education to catch the bad stuff that you really worry about. NPs just don't have the training to catch the rare/complex things. And a lot of times they are not going to refer out because they don't know what they don't know. That's why they need supervision.

I'm sorry that I'm being rude and abrasive, that's just how I am. I just think you're grossly overestimating the need for an MD in the community setting, and grossly underestimating the training of a nurse practitioner in handling situations in the community setting. Also, your assertion that they are not going to refer out would actually fly in the face of the literature.

I think you also need to consider the needs of the community over the next twenty years thanks to the ACA.

Anyway, I'm not as objective as I'd like to be on this issue and I'm fairly rude about it, so I'll sod off.

Wow, ignorant thread. Good work dousing the propaganda with facts Veggie.

Ha, thanks Josh. Working nights in the unit leaves me in a permanent foul mood. Not digging nights anymore, lol.

 

[New User 122121]

All the evidence points to it.

The very limited evidence we do have is that when you attempt to hold nurses to the same standard, they fail horribly (e.g. 50% of DNPs failed a very watered down version of the USMLE 3, an exam that 97% of MDs pass without even needing to study).

 

[New User 122121]

http://www.cumc.columbia.edu/nursing/dnpcert/rates.shtml

Here is the data from 2008-2012, in case anyone doubts what I said.

I think the most telling fact is that they were smart enough not to continue the study. They want no part of physician exams.

 

[5H3RD0G]

The problem is nurses start handing out prescription drugs without the advice of the doctor. That has happened countless times at every hospital. Seriously do they know the meaning of teamwork. It's a complete circus in hospitals at times. They have to set rules and guidelines before any prescriptions or any operations are performed. When all are in agreement move forward or do the wise thing patients ask 2 handfuls worth of doctors if they are on the same page or if each one has a different method of approaching the prognosis in a different manner. Many times doctors change nurses often because they are not on the same page.

 

[tkotom]

a doctor doesn't need 10 years of training to tell me I have a broken arm or something else simple. complex problems, sure. but most of the time that is nit what people need.

Well, no respectable university has a 10 year training course.

And yes, to properly diagnose a broken arm, you need years of training.

 

[7437]

Well, no respectable university has a 10 year training course.

And yes, to properly diagnose a broken arm, you need years of training.

no you dont. I broke an arm, and immediately suspected that was what was wrong. nurse put me under an x-ray and we could both see it was broken. with my 0 years of training I figured it out, im sure a nurse practitioner can with 6.

 

[tkotom]

no you dont. I broke an arm, and immediately suspected that was what was wrong. nurse put me under an x-ray and we could both see it was broken. with my 0 years of training I figured it out, im sure a nurse practitioner can with 6.

You're not listening.

A cave man could figure out that his arm was broken. What I said was that you need training to properly diagnose a broken arm. And then on top of that, to properly treat an arm you need training as well. A nurse is not a doctor.

 

[7437]

You're not listening.

A cave man could figure out that his arm was broken. What I said was that you need training to properly diagnose a broken arm. And then on top of that, to properly treat an arm you need training as well. A nurse is not a doctor.

wtf is properly diagnosing a broken arm? if you can tell it is broke, that's all you need to know. and " slap a cast on it" isn't exactly a modern marvel of medicine.

 

[tkotom]

wtf is properly diagnosing a broken arm? if you can tell it is broke, that's all you need to know. and " slap a cast on it" isn't exactly a modern marvel of medicine.

This is a very ignorant statement, I'm sorry to say.

 

[KnightTemplar]

You're not listening.

A cave man could figure out that his arm was broken. What I said was that you need training to properly diagnose a broken arm. And then on top of that, to properly treat an arm you need training as well. A nurse is not a doctor.

And a Cop is not FBI Hostage Rescue Team. But you don't need HuRT to respond to every 911 call.

I don't have a dog in this fight, but I would be genuinely surprised if a Nurse did not have sufficient training to diagnose and treat a broken arm.

 

[tkotom]

And a Cop is not FBI Hostage Rescue Team. But you don't need HuRT to respond to every 911 call.

I don't have a dog in this fight, but I would be genuinely surprised if a Nurse did not have sufficient training to diagnose and treat a broken arm.

I never said a nurse cannot receive enough training to diagnose a broken arm.

But the poster I was responding to was making ignorant statements. As though anybody can just say "yep, broken, cast, done". That is patently ignorant.

I was also saying that a nurse is not a doctor, no matter how much people want them to be. I had friends who went to medical school and followed on from there and the training that they received and the grueling examinations - both practical and theoretical - that they had to go through would be too much for a nurse that couldn't get into medical school.

Doctors are on another level.

 

[7437]

I never said a nurse cannot receive enough training to diagnose a broken arm.

But the poster I was responding to was making ignorant statements. As though anybody can just say "yep, broken, cast, done". That is patently ignorant.

I was also saying that a nurse is not a doctor, no matter how much people want them to be. I had friends who went to medical school and followed on from there and the training that they received and the grueling examinations - both practical and theoretical - that they had to go through would be too much for a nurse that couldn't get into medical school.

Doctors are on another level.

a level that is rarely required