As somebody who works with NP's in both the outpatient and inpatient fields, I would like to disagree with many of the viewpoints on this thread.
From the outpatient aspect, in a cardiology office, the NP's have free reign. They will manage CHF, HTN, HLD, palpitations, arrythmias ect routinely without physician supervision and they have had excellent outcomes. When they are deficient in knowledge and do not know where or how to proceed, they will consult the physicians. Similarly, in inaptient cardiology, per the physicians that work here, the NP's do act like residents in the sense that they write up the note, ect, and the physician follows up afterwards personally, but there is rarely a change made in the plan.
On the ER side of things, the NP's that work here sure have to have an attestation where the physician co-signs the chart, but NEVER does a physican walk in unless it is a complex patient such as CP, obscure abd pain with positive findings on a CT scan ect. This isn't only the ER at my hospital, but hospitals across the board including "top hospitals" such as Penn, Jeff, UMPC.
Also..."All nursing research is bad research. They don't understand basic scientific principles, don't know how to design studies, don't know how to conduct studies, draw conclusions that don't follow, write very poorly, etc. as has been amply demonstrated by your posts or should I say you're?" According to who's opinion is Nursing Research bad.......Good luck working with midlevels in your practice. You are making broad generalized claims that have literally zero factual support whatsoever.
http://rheumatology.oxfordjournals.org/content/33/3/283.short
http://jama.jamanetwork.com/article.aspx?articleid=192259
http://www.bmj.com/content/324/7341/819.short
http://search.proquest.com/openview/24277706fa09c024d2f2364dfb59775c/1?pq-origsite=gscholar
This is just a small bit of evidence supporting the claim that NP's are adequate practitioners and provide comprable care to physicians.