NYT: Nurses aren't doctors

[AznTrojan]

Yeah, my post was a bit of hyperbole and maybe over the top. But I have 300 clinical hours in with nurses, so your assessment of my lack of knowledge is incorrect. I was lucky to do those hours in some busy places at some busy times for the most part. That is when Nurses and Doctors shine together. I saw wayyy to much of nurses calling Doctors a*sholes behind their back for basically nothing but acting like a Doctor should, and I actually saw a bit of the Union "we deserve more for this" attitude as well. It's a tough job, but so are a lot of jobs. Nurses and Police officers should not and can not be the high paying jobs of choice for everybody, because they do not create wealth. Anyways, I worked at U of M Trauma burn, an OB unit (I was always there holding feet and helping more than the student docs that would stand 10 feet away, because I have so much experience with my own kids) and an emergency room. I like nurses, overall. BUt I alos saw the ol' modern American unprofessionalism, the one where as long as the woman was "cool" she could get away with it, and I saw the modern divide and conquer techniques I have seen with (I'm sorry) women too often in the last 15 years. With women, and with Nurses, I saw a power struggle with the Doctors which should NOT have existed. Nurses are there to help patients, and help doctors, and perform more advanced procedures at times than people would think they would, like lavages and vacuum dressings. But Nurses need to STFU and let Doctors be Doctors, even though they are wrong sometimes like everybody else. Nurses get paid really well for their education level.

that's par for the course if U of M = miami.. i did my residency there and the people (not just nurses) are rude as fuck..

 

[nhbfan8080]

Yeah, my post was a bit of hyperbole and maybe over the top. But I have 300 clinical hours in with nurses, so your assessment of my lack of knowledge is incorrect. I was lucky to do those hours in some busy places at some busy times for the most part. That is when Nurses and Doctors shine together. I saw wayyy to much of nurses calling Doctors a*sholes behind their back for basically nothing but acting like a Doctor should, and I actually saw a bit of the Union "we deserve more for this" attitude as well. It's a tough job, but so are a lot of jobs. Nurses and Police officers should not and can not be the high paying jobs of choice for everybody, because they do not create wealth. Anyways, I worked at U of M Trauma burn, an OB unit (I was always there holding feet and helping more than the student docs that would stand 10 feet away, because I have so much experience with my own kids) and an emergency room. I like nurses, overall. BUt I alos saw the ol' modern American unprofessionalism, the one where as long as the woman was "cool" she could get away with it, and I saw the modern divide and conquer techniques I have seen with (I'm sorry) women too often in the last 15 years. With women, and with Nurses, I saw a power struggle with the Doctors which should NOT have existed. Nurses are there to help patients, and help doctors, and perform more advanced procedures at times than people would think they would, like lavages and vacuum dressings. But Nurses need to STFU and let Doctors be Doctors, even though they are wrong sometimes like everybody else. Nurses get paid really well for their education level.

I don't know how doctors create wealth any more than how nurses and policemen don't and this thread must've pricked a raw nerve amongst doctors since NPs will probably make more money than regular nurses.

And its my understanding that there isn't supposed to be a hierarchy of the nursing staff as mere help for doctors but both branches are supposed to be working together since doctors do not have certain skills that the nurses do.

 

[Amerikuracana]

I don't know how doctors create wealth any more than how nurses and policemen don't and this thread must've pricked a raw nerve amongst doctors since NPs will probably make more money than regular nurses.

And its my understanding that there isn't supposed to be a hierarchy of the nursing staff as mere help for doctors but both branches are supposed to be working together since doctors do not have certain skills that the nurses do.

Doctors really do not create wealth much either, except for things like people coming in from other countries to have procedures done.

 

[LucasWithLidOff]

Just because someone doesn't create wealth doesn't mean they aren't valuable to society or any less valuable than someone who does. Government doesn't create wealth either.

 

[UpaLoompa]

BUt I alos saw the ol' modern American unprofessionalism, the one where as long as the woman was "cool" she could get away with it, and I saw the modern divide and conquer techniques I have seen with (I'm sorry) women too often in the last 15 years.

It is sad that you lack introspection. This sort of statement is pretty damn pathetic.
Anything to protect an old boys club though, huh?

 

[Amerikuracana]

It is sad that you lack introspection. This sort of statement is pretty damn pathetic.
Anything to protect an old boys club though, huh?

Just being honest.


From what I seen, and in my opinion, women make good managers and leaders, but are not as good at falling in line and producing at the position they are at if they are lower ranking, sometimes. Maneuvering and politics always have their place, but that place should be behind the actual focus and reason for being at work. I see a lot of guys jumping on board with bitchiness now too, in order to "compete."

If you hire a cleaning person, that means you need a person to clean. I have seen women who thought it their duty to relay messages to the female management about everything that was "going on" when they had no idea what was going on. But since it was a woman, the male owners couldn't say "are you nuts, stop calling me," and the one woman owner used it as an opportunity for maximum drama. I watched a business SINK before my very eyes from this behavior. People need to promote themselves through doing their job well, more than through family style politics, which women seem to excel at, respectively.

I have also, at other jobs/places of work (not that one) seen incredibly capable women outdoing them men where it matters, tbh.. But the men that were being outdone were not trying to ruin the talented women by getting everybody to hate them, either.

 

[James Keith]

It is sad that you lack introspection. This sort of statement is pretty damn pathetic.
Anything to protect an old boys club though, huh?

How is a citation of the "old boys club" not a sexist stereotype also if you object to references to the stereotypical female gossip/drama/bullying in the workplace.

 

[UpaLoompa]

How is a citation of the "old boys club" not a sexist stereotype also if you object to references to the stereotypical female gossip/drama/bullying in the workplace.

Seriously?

 

[nhbfan8080]

Just because someone doesn't create wealth doesn't mean they aren't valuable to society or any less valuable than someone who does. Government doesn't create wealth either.

I think that post about 'creating wealth' reveals something about the conservative bias in their training as medical students. They are unconsciously or overtly taught that nurses are there only as second rate helpers for doctors instead of equal partners with valuable skills that doctors do not possess.

 

[Bob Charlie]

I think that post about 'creating wealth' reveals something about the conservative bias in their training as medical students. They are unconsciously or overtly taught that nurses are there only as second rate helpers for doctors instead of equal partners with valuable skills that doctors do not possess.

& 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.

 

[New User 122121]

While obviously you're going to want a doctor for a lot of things I think you're confusing ideal situations with reality. The 5-10 minutes you spend with your primary care doctor aren't going to lead them to prevent or catch much of anything. Glad the doctor got to me an hour late for that.

Also, the ability of most medical doctors to assess scientific information is on par with the ability of a warm turd to do the same.

So you think pcps aren't screening for diseases, engaging in preventative care, or diagnosing patients?

Regarding research, I think we get a decent amount of training and practice, and a significant percent of physicians do research themselves and have publications. Of course doctors are not spending all their time assessing studies. There are expert committees that do that. Doctors will usually keep up to date and rely on their recommendations.

 

[shallowbay]

& 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.

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?

 

[Josh]

& 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.

Nurses aren't healthcare providers? Really?

 

[FinalFight]

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?)

Someone who actually knows what they're talking about and not just regurgitating talking points to further their own political agenda.

 

[FinalFight]

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.

You don't think a fully qualified nurse has been trained in knowing when a persons are is broken and how to treat it?

What exactly do you think nurses in ER do?

 

[UpaLoompa]

So you think pcps aren't screening for diseases, engaging in preventative care, or diagnosing patients?

Honestly? In the 5 minute visit? Not very well. I don't disagree that an MD is preferable, but I do disagree that they're necessarily doing things they should to make them preferable. Moreover, while I would always pick an MD as a primary care provider, there certainly are situations where an NP or PA would be fine.

Think about urgent care. 45% of the time it is pain relievers. 45% of the time it is antibiotics. 10% of the time a PA or NP won't be enough.

Regarding research, I think we get a decent amount of training and practice, and a significant percent of physicians do research themselves and have publications. Of course doctors are not spending all their time assessing studies. There are expert committees that do that. Doctors will usually keep up to date and rely on their recommendations.

So keeping up with the scientific literature--which another poster mentioned as a distinction--doesn't necessarily apply.

 

[New User 122121]

You don't think a fully qualified nurse has been trained in knowing when a persons are is broken and how to treat it?

What exactly do you think nurses in ER do?

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.

 

[legomaheggroll]

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.

There is a lot more to working in an ER than just following orders.

 

[shallowbay]

Mostly bitch and complain.

You seem quite adept at this as well from your commentary. If you're worried about many functions of the average doctor being replaced in the future, you should assess some of the scientific research on using neural networks for medical diagnosis and start after those engineers.

 

[New User 122121]

You seem quite adept at this as well from your commentary. If you're worried about many functions of the average doctor being replaced in the future, you should assess some of the scientific research on using neural networks for medical diagnosis and start after those engineers.

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