NYT: Nurses aren't doctors

[shallowbay]

I have zero worry for myself. I'm more worried about the patients.

If you mean in regards to the neural networks they would likely only become used when shown to correctly diagnose at an extremely high percentage, equal or (more likely) much greater than the average physician.

If you're speaking in regards to a possible expanding role for more highly educated nurses, then in that case I would think you could see how they potentially could come with advantages in terms of patient care as well. Of course there are terrible nurses as you speak of, and there are terrible doctors as well. It's simply that over a large sample you will encounter some on each side of the average, and with there being more nurses a larger raw number will represent the same statistics.

 

[Anung Un Rama]

I agree with the article, and especially this statement from the closing paragraph, one hundred percent.
My father is a retired doctor, and I have 3 aunts and uncles who are doctors. My friends who hear this often ask why I didn't become a doctor, and my answer always surprises them: doctors are under-paid.
I've seen what you have to go through to become a doctor, and what you have to deal with while you're a doctor, as well as the legal risk you place yourself under. Doctors deserve the higher salaries they earn, and should be earning more.

I agree they should probably be paid more, but it would take much more than than to shift the pendulum. If I were a PCP and I was able to double my salary I would probably just hire a PA or NP to help triage my workload.

What makes it really shitty on those of us choosing medical school is the debt (will be about 250k for me when all is said and done). If one gets stuck with a family medicine residency or choose psychiatry, we are in a long haul as far as debt goes. My interest is psychiatry and if I choose this I know I'll be financially much worse off than if I'd become a PA for the first decade or so post residency

The good news is, you're actually interested in psychiatry and aren't just being forced into it.

The bad news is, you're going to be carrying those student loans for longer than a dermatologist or anesthesiologist.

In 10 years you'll know if the juice was worth the squeeze, but I think you'll find that money isn't the deciding factor.


Re: dat Med School Debt:

How many people who want to be doctors go to middle of the road private schools first? I have 2 cousins that just graduated H.S. and want to be doctors. Instead of going to a state school (or even CC then state school) they're going to middle of the road private schools paying $30K/yr in tuition for a bachelor degree just to pay another $30 to $80K/yr for actual Med School.

 

[nhbfan8080]

& what pray tell are those skills?...? Also, just for the record nurses are subordinates of physicians, they are not healthcare providers, thats what this whole NP certification is about, trying to make them something they're not.

The sort of skills interns and newly minted MDs especially do not have. Reality tv shows like (edit ER)commonly show doctors performing the procedures that would ordinarily be done by nurses irl.

Its quite obvious from your earlier post that nurses are only good for being fat complainers digging out fecal matter that you have no idea what nurses do or are taking advantage of internet anonymity to vent.

 

[7437]

Re: dat Med School Debt:

How many people who want to be doctors go to middle of the road private schools first? I have 2 cousins that just graduated H.S. and want to be doctors. Instead of going to a state school (or even CC then state school) they're going to middle of the road private schools paying $30K/yr in tuition for a bachelor degree just to pay another $30 to $80K/yr for actual Med School.

a few places out West that need doctors will pay off a persons loans in exchange for doing their residency there. Wyoming has been doing that for awhile. the loans cant be too crushing, because there are still not nearly enough doctors

 

[Anung Un Rama]

a few places out West that need doctors will pay off a persons loans in exchange for doing their residency there. Wyoming has been doing that for awhile. the loans cant be too crushing, because there are still not nearly enough doctors

I almost took a similar gig out of college but it wasn't that simple. It was something like $15K every 2 years or something. And doing a med residency is arguably more important than where you went to school, so thats sounds like a gamble. I can see why that hasn't been the cure.

 

[crazyjames1233]

I have a feeling a lot of people commenting on this issue have no clue what they are talking about.

 

[7437]

I almost took a similar gig out of college but it wasn't that simple. It was something like $15K every 2 years or something. And doing a med residency is arguably more important than where you went to school, so thats sounds like a gamble. I can see why that hasn't been the cure.

I was under the impression they covered the whole thong now. I would post a link, bit im on my cell. hospitals are that picky about residency? I thought most places were hard up for PCP doctors

 

[Oldmansavage]

The one thing I have learned about doctors is there is nothing more useless than a general practitioner. I don't see why a nurse or a hypochondriac that reads web M.D cannot do the same for less coin.

They take your money and your blood pressure then send you a to a specialist. It would be nice to skip this turd 100% of the time.

 

[Anung Un Rama]

I was under the impression they covered the whole thong now. I would post a link, bit im on my cell. hospitals are that picky about residency? I thought most places were hard up for PCP doctors

Not every area in the country is as starving for PCPs as rural Wyoming.
One could go there for their residency but then have trouble getting a position in a more competitive area based on their residency. I'm not an MD so I could be wrong.

 

[Bob Charlie]

Nurses aren't healthcare providers? Really?

Its true, believe it or not all nurses have to work under a physician, read about, the whole NP degree is about granting provider status to nurses.

I simply don't understand this type of thinking. Are you just upset the dynamic may be shifting so that nurses are no longer necessarily considered "subordinates"?

I have no relation to the medical field, but it seems obvious that physicians and nurses complement each other so that they make up an overall team with the objective being to increase quality of care. I'm certain there are many instances in which a nurse makes a mistake and has to be corrected by a physician. Conversely, I'm also certain there are many instances in which the doctor makes mistakes which are caught by the nurses.

Secondly, it seems perfectly logical for nurses whom pursue further education, whether it be M.S. or Doctoral (I do know there is already a push for BSN nurses), and training to take on larger roles. Why would they not?

No the position is a subordinate position and that is for the good of the patient. For the record I'm not upset about shit, I have no agenda, don't care if you believe what I say and am being honest. The things you are certain about, from where is your certainty derived? Do you have any experience in the matter, no you don't even have any "relation to the healthcare field"? They would not because its not their job. What is thier job? Do you know what administration of care is? Its vital and people steping outside the bounds of their practice disrupts continuity of care and is dangerous.

The sort of skills interns and newly minted MDs especially do not have. Reality tv shows like commonly show doctors performing the procedures that would ordinarily be done by nurses irl.

Its quite obvious from your earlier post that nurses are only good for being fat complainers digging out fecal matter that you have no idea what nurses do or are taking advantage of internet anonymity to vent.

I don't watch reality TV but I have spent a lot of time in healthcare. The fact that you think that the actual profession of nursing has anytime for sitting around or cleaning up shit shows that you don't know shit. What have I said that isn't true? How is your ridiculous assertion "obvious"? I know nurses, I know nursing, I know what it is in practice and what the job description entails & from your posts on this topic I can see that you don't know shit & that remains true EVEN IF YOU ARE A NURSE.

 

[shallowbay]

No the position is a subordinate position and that is for the good of the patient. For the record I'm not upset about shit, I have no agenda, don't care if you believe what I say and am being honest. The things you are certain about, from where is your certainty derived? Do you have any experience in the matter, no you don't even have any "relation to the healthcare field"? They would not because its not their job. What is thier job? Do you know what administration of care is? Its vital and people steping outside the bounds of their practice disrupts continuity of care and is dangerous.

The only thing I said I am certain about is that 1) nurses make mistakes that are caught by physicians and 2) doctors make mistakes that are caught by nurses. Are you trying to say these simply are not true? I have no direct relation to healthcare, however I'v done research on this part of it working on grants in the past.

Still, as before, it seems perfectly logical for nurses whom pursue further education, whether it be M.S. or Doctoral, and training to take on larger roles. Why would they not? Of course there will still be the normal RN's doing much the same as now, however the additional tier in between RN's and doctor's should be able to be a huge asset if used correctly for a large percentage of standard cases.

 

[VulgarSnaps]

I have my patient viewpoint, as I'm currently working through a few nasty issues.

Use the right tool for the right job. I'm totally ok with an NP or PA for my cold, or sinus infection, or minor nonsense. But I am so sick and tired of my colitis follow ups being with a PA. In non surgical fields, the "condition experts" are like frickin PA/NP farms.

I had a psychiatrist for 3 years I saw once. I had appointments from a week to a month apart. I mean; don't I get a discount? The price is based on a doctor.

I seriously hear crap like "I have to ask Dr So and So". Do we now have to ask for a supervisor with medical care?

 

[Rykusx]

I agree completely with the view that NP's are an essential part of the health care system and I think that hopefully both the growing number of NP's and effective use of them are going to take some of the burden off of the health care system. I think a competent NP can easily handle the majority of cases that come his or her way, freeing the MD to diagnose and treat more complex cases. I have seen several NP's and have always been impressed with their depth of knowledge and skill.

But, I disagree wholeheartedly with the view that their training is in any way whatsoever comparable to that of a MD. 1000 hours of practical training during their NP accreditation? MD's complete that much during the first 12 weeks of residency.

 

[nhbfan8080]

.....
I don't watch reality TV but I have spent a lot of time in healthcare. The fact that you think that the actual profession of nursing has anytime for sitting around or cleaning up shit shows that you don't know shit. What have I said that isn't true? How is your ridiculous assertion "obvious"? I know nurses, I know nursing, I know what it is in practice and what the job description entails & from your posts on this topic I can see that you don't know shit & that remains true EVEN IF YOU ARE A NURSE.

I got mixed up with your post. I was replying to another person who said nurses were good only menial duties like breaking up fecal impactions.

 

[ralphc1]

A doctor basically compares the symptoms to his knowledge base of diseases or conditions. A computer can do the same thing. You need someone to get a good list of the symptoms. Someone who listens and asks the right questions.

 

[groo]

I'm a med student, will be qualifying in a couple of months, and i have absolutely no problem with NPs. Here in the UK they're becoming increasingly common, and they can be a lifesaver for taking pressure of the docs by dealing with the simpler cases.

Whilst you do need the training a doctor receives to deal with the truly complex stuff, NPs are very knowledgeable and well trained in their own right, in fact, their years of experience dealing with certain conditions makes them better at dealing with those conditions than many junior doctors who simply haven't got the experience yet.

The sad part of this debate is that people seem to think they need to side with either nurses or doctors and disparage the other. The reality is that both do incredibly important jobs and are reliant on one another to care for patients fully.

Patient care is a team job, not a solo effort.

You are more reasonable because you are going to live off a different pay-scale arrangement than American MDs.

 

[groo]

That gets back to the central point of this thread though, what are most doctors doing? The answer to that is probably: Viagra, Lipitor, and Vicodin.

Most doctors don't even read the little pamphlets that the pharmacy reps give them with the free samples.......and still prescribe anyway......:redface:

 

[Poatan Power]

But, I disagree wholeheartedly with the view that their training is in any way whatsoever comparable to that of a MD. 1000 hours of practical training during their NP accreditation? MD's complete that much during the first 12 weeks of residency.

I don't think the focal point of this discussion should be if they are "comparable." I think the more appropriate direction for everyone is whether or not the training of an NP is adequate to handle the low complexity cases that MD's have roughly 50% of the time in clinic settings and PCP situations. I'd say the evidence points to a resounding yes. I do think it's silly to say an NP and an MD are equivalents, they certainly aren't.


It irritates me when people undermine the years of education, training and experience an RN NP has, though. Research shows that nurses are highly trusted health care professionals, but the majority of the ones people interact with are taking blood pressures at a clinic or working in a med-surge setting (which is an entry level position, in spite of its challenges). I don't think people understand the true scope of an RN's practice in the ICU, surgical and emergency settings.

Mostly bitch and complain. Another common nursing skill is being overweight.

Nurses in the ER are putting in foleys, sampling bodily fluids, digging out fecal impactions, giving breathing treatments/shots/meds as directed, rolling fat guys over for xrays, and anything else the ER doc tells them to do.

Oh god. You're still rambling on about this shit. You've been embarrassed at least half a dozen times in this topic by people of all backgrounds and experiences. Tuck your tail between your legs and go lick your wounds and come back when you have a clue.

 

[New User 122121]

It irritates me when people undermine the years of education, training and experience an RN NP has, though.

The whole 15 months and 500 hours of clinical training? Look, I could say a lot of bad things about the majority of the NPs and NP students I've interacted with, but I won't. All these online schools that require no prior clinical experience, no GRE, no interview, & 2.5 GPA are ruining the degree. Barely functional people who have no business anywhere near a prescription pad are starting to flood the market. Idiocracy is actually a documentary from the future.

Oh god. You're still rambling on about this shit. You've been embarrassed at least half a dozen times in this topic by people of all backgrounds and experiences. Tuck your tail between your legs and go lick your wounds and come back when you have a clue.

Unfortunately for the community college nursing students, I'm a physician. AznTrojan and I are the only two posters in this thread qualified to make educated judgments regarding the competence of NPs.

 

[Josh]

Unfortunately for the community college nursing students, I'm a physician. AznTrojan and I are the only two posters in this thread qualified to make educated judgments regarding the competence of NPs.

That's a laughable statement.