NP in IM (yes another thread lol)

[InternalMedNP]

Before you read this and think oh boy here we go again, or not another one of these threads let me explain lol. As an NP I am not the same as a lot I've met. First off I am against NP's being completely independent. I do think there is a solution for that (I will map out later lol) I have been reading this forum for years and have seen the way NP's are viewed on here. I was an LPN and after 8 years of that I enrolled into a BSN program. Knowing the goal was to be an NP I was determined to not be one of the "idiots" that are anecdotally talked about on here lol. And as a skeptic I understand the dunning-kruger effect. So as I was finishing up my pre-req's for my BSN I took additional science electives (Chem, Bio, etc.) that were not required. I downloaded every book, program, and app that I saw on SDN that is used for MS1 and MS2 (thank god for torrents lol). So for Pathophysiology I read Robbins, and watched Dr. Najeeb, and Pathoma. For Medical Micro I read BRS, Micro made easy..., and watched sketchy. Bate's and UCSD for physical. etc.


I then applied to a NP program that had more clinical hours than the other programs (still not enough) it also had an advanced physiology course and additional cardiology specialization courses. (I took those to gain knowledge for IM not to work in Cards) Due to the low hours I did additional hours with friends that are MD/NP in various areas between semesters/weekends. Of course during all this I continued to read Robbins etc.
After graduation I still wasn't satisfied with my knowledge so I did a one year "residency" in IM with inpatient and outpatient rotations.

Now I practice with another NP and MD in IM and see both out/inpatient. I continue to get supervision but do see more complex patients that most NP's.

I posted this not to try to prove that I'm "equivalent" or to pretend I'm an MD but to show that some of use take learning seriously and that there are rare NP's that take extra time to learn outside of their terrible training. I'm actually about to enter a DNP program in Psych just so I can learn more. (staying in IM though)

With that said what additional things can I do to be a better provider? (before some comedian says "go to med school" I'm not doing that lol) It is possible to learn outside of school..don't bash me too much lol

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[bashwell]

Before you read this and think oh boy here we go again, or not another one of these threads let me explain lol. As an NP I am not the same as a lot I've met. First off I am against NP's being completely independent. I do think there is a solution for that (I will map out later lol) I have been reading this forum for years and have seen the way NP's are viewed on here. I was an LPN and after 8 years of that I enrolled into a BSN program. Knowing the goal was to be an NP I was determined to not be one of the "idiots" that are anecdotally talked about on here lol. And as a skeptic I understand the dunning-kruger effect. So as I was finishing up my pre-req's for my BSN I took additional science electives (Chem, Bio, etc.) that were not required. I downloaded every book, program, and app that I saw on SDN that is used for MS1 and MS2 (thank god for torrents lol). So for Pathophysiology I read Robbins, and watched Dr. Najeeb, and Pathoma. For Medical Micro I read BRS, Micro made easy..., and watched sketchy. Bate's and UCSD for physical. etc.

I then applied to a NP program that had more clinical hours than the other programs (still not enough) it also had an advanced physiology course and additional cardiology specialization courses. (I took those to gain knowledge for IM not to work in Cards) Due to the low hours I did additional hours with friends that are MD/NP in various areas between semesters/weekends. Of course during all this I continued to read Robbins etc.

After graduation I still wasn't satisfied with my knowledge so I did a one year "residency" in IM with inpatient and outpatient rotations.

Now I practice with another NP and MD in IM and see both out/inpatient. I continue to get supervision but do see more complex patients that most NP's.

I posted this not to try to prove that I'm "equivalent" or to pretend I'm an MD but to show that some of use take learning seriously and that there are rare NP's that take extra time to learn outside of their terrible training. I'm actually about to enter a DNP program in Psych just so I can learn more. (staying in IM though)

With that said what additional things can I do to be a better provider? (before some comedian says "go to med school" I'm not doing that lol) It is possible to learn outside of school..don't bash me too much lol

 

[InternalMedNP]

lmao.

Just hoping to show that we don't all think "I did 700 clinical hours, I'm equivalent to a physician now" lol... I've met some that think that!

 

[cbrons]

With that said what additional things can I do to be a better provider? (before some comedian says "go to med school" I'm not doing that lol) It is possible to learn outside of school..don't bash me too much lol

What do you think doing a DNP program is going to give you?
I guarantee you can learn everything you ever wanted to know on the subject by reading on your own. That DNP program is just going to be a waste of money, and its not like its going to give you an increased scope of practice.

 

[Psai]

I just thought it was cute that you called your one year np training program a residency. Everyone and their mothers thinks that any medical on the job training after graduation is a residency.

 

[Stedari]

I really respect your motivation and work ethic; however, I think your post highlights the fact that you are an outlier. It underscores that you are the exception and not the rule. There are MDs/DOs that have done the bare minimum to get through and won't invest more than they have to to pass recertification. But, for the most part, we have a much better understanding of why we do things than simply following an algorithm. You do you! Be proud of your knowledge base and use it to take of people.

 

[InternalMedNP]

What do you think doing a DNP program is going to give you?
I guarantee you can learn everything you ever wanted to know on the subject by reading on your own. That DNP program is just going to be a waste of money, and its not like its going to give you an increased scope of practice.

Well if I do the Psych DNP it will give additional clinical hours/knowledge. But yeah I'm not sure it will be worth it.

I just thought it was cute that you called your one year np training program a residency. Everyone and their mothers thinks that any medical on the job training after graduation is a residency.

I guess it would be cute if I was the one that named it a residency. I don't agree with it hence why I put "residency" maybe fellowship would be better? I dunno. I was just happy to have the opportunity to learn more.

I really respect your motivation and work ethic; however, I think your post highlights the fact that you are an outlier. It underscores that you are the exception and not the rule. There are MDs/DOs that have done the bare minimum to get through and won't invest more than they have to to pass recertification. But, for the most part, we have a much better understanding of why we do things than simply following an algorithm. You do you! Be proud of your knowledge base and use it to take of people.

Thanks. I hate that there are only a few NP's I know that are constantly reading and doing extra to be better. But we exist and knowledge can be independently gained. It seems some on sdn don't feel like it can though lol.

 

[bashwell]

lmao.

Just hoping to show that we don't all think "I did 700 clinical hours, I'm equivalent to a physician now" lol... I've met some that think that!

1) I admire your passion OP! Keep it going.

2) As I'm sure you know, it's not just doing a lot of "clinical hours" but what you do during those "clinical hours" makes all the difference. Someone could do 1000 clinical hours but all they do is stand there and hold the retractor vs someone who spends the same amount of hours learning how to be a surgeon, how to make various incisions, etc.

3) If you care for patients as part of a nursing team, then you'll learn how nurses care for patients. If you care for patients as part of a medical/physician team, then you'll learn how doctors (e.g., internists, cardiologists, endocrinologists, rheumatologists, oncologists, etc.) care for patients.

4) It might not seem like a big difference looking from the outside in, but it surely is.

This isn't the best analogy, but maybe it's sort of like how med students look at anesthesiologists and think, hey anesthesia is so easy, I got to intubate a bunch of patients, all you do is put the patient to sleep and wake them up, the lifestyle is so nice, etc. vs. when you're actually an anesthesiologist and having to take care of patients, keep them alive during surgery, watch for the subtlest physiological changes, etc. It can be extremely stressful and far from easy or chill. All this is not something that can be learned apart from actually going through an anesthesiology residency and having the same responsibilities and burdens as an anesthesiologist does.

Similarly with nursing and being a doctor. Things might not "seem" all that different when you're just watching the day to day stuff, going on rounds, giving medications, doing procedures, etc. But behind what you see is an entire world with tremendous differences, philosophies or ways of thinking, making decisions, working up a patient, formulating management plans, and much much much more.

But it's very difficult to explain what it's like to someone who hasn't gone through it. It's like trying to explain what color is to a person who can only see black and white. You both can technically speaking "see" things, but what you see and what you don't see is an entire world of fundamental differences.

 

[unleash500]

While I admire your desire to learn more,


Residency is more than learning from a book/reading. It is the part about going through residency that makes the doctor, not the amount of reading he or she did.

Also I will add that it is also more than amount of patient experience you get. I can spend 40 hours in a clinic and not be any better of a doctor(don't get me wrong though, patient experience is crucial to learning). It is the environment of residency that makes the doctor. The stress/the tears/ the feelings of inadequacy/ the mistakes made/the victories/ the guidance from mentors - these make the doctor.