Vanderbuilt Starts Acute Care Nurse Practitioner Intensivist Fellowship

[xenotype]

Lawyers and increased transparency over bad outcomes will stop them, but it will take a lot of time before the public and politicians wake up to the dangers of cutting corners with poorly trained substitutes. The Flexnor report came out a hundred years ago. Time flows like a river, and history repeats itself. If you read about the Flexnor report in the modern context of the DNP degree, it is terrifying how many parallels you can draw.

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[bigkahunaburger]

xenotype, great point I thought the exact same thing (ever read "the great influenza"). I think that the lack of access to medical care may trump that, but to what extent who knows? Every single pulm/cc doc I've met has known their **** inside and out which is why I respect them and one day want to become one. These dumb @ss noctors claiming to have the same level of understanding pisses me off so bad. When someone's mom or dad is hurt by a simple medical error hopefully more restraints are put on them.

 

[MD Dreams]

We as physicians need to unionize! Pilots protect one another and their profession through unions. Why don't we? Why is standing up for ones profession and protecting our patients welfare wrong? When we join together and take to the streets of Washington then we can bring to light the foolishness of allowing people who are inappropriately trained to take on patient care. We need to wake up and act.

 

[Bostonredsox]

Jeez guys!

First of all.... We have to get with reality. There is a shortage of intensivists in the near future and we live in an era of work hour regulations. So we mUST work with midlevels.

That said my comment was meant as the following: an EXPERIENCED NP is much more capable of managing and dealing with critically sick patients compared to a bright eyed second year resident in July. Now one could argue.... Maybe there are some things a good third year surgery or anesthesia or medicine resident could do that may have an up on even an experiences NP. That's true. But on average, I think you are underestimating the ability of these midlevels once they gain experience. EXPERIENCE is the key word. Remember how little you knew as a second year resident?!

I'm not talking about the PA or NP fresh out of school here. I'm talking about an pa/NP with years of Icu experience.

Let's not get ahead of ourselves here.

It's all about experience. And it applies to a variety of fields. If you HAD to choose between a CA-2 in September or a nurse anesthetist with 10 years experience (no attending in this hypothetical)... Who would You rather put u to sleep?

This disgusts me. As a senior resident who has accepted a position as a critical care hospitalist after graduation (boarded IM working 7 on 7 off as ICU attending but no fellowship) this makes me laugh. By the end of intern year, I had spent over 4 full months in ICU, I had put in over 100 lines, intubated over 50 people, all emergently, floated a half dozen emergent trans venous pacers and even one ballon pump. Countless chest tubes, LPs , emergent dialysis catheters, etc. etc. etc. and oh yes, the hundreds of hours of critical care medicine. At the halfway point of my intern year there is not a single NP or PA who I nor my attendings would have trusted more than me or the seniors. To suggest that an NP or PA is in anyway more competent than a senior medicine resident in a critical care unit says you have God-awful residents at your place. Nothing more. They don't belong in any critical care fields. Yes the intensivist shortage is large. So start offering 1 year fellowships to IM attendings or allow critical care hospitalists to sit for the CC boards (not pulm too obv) after 5 years or so of practice.

 

[SunnyCCM]

Whew...just saw this old post. Glad it didn't come to reality. Intensivist work is damn hard enough without taking additional liability under the wing. Each ICU has a physician MD intensivist at our place.

The hospitalist group has NPs to help mostly with discharges but they DO NOT have privileges in the unit! We keep the peace amongst ourselves and our respective units.

 

[Socrates25]

Whew...just saw this old post. Glad it didn't come to reality. Intensivist work is damn hard enough without taking additional liability under the wing. Each ICU has a physician MD intensivist at our place.

The hospitalist group has NPs to help mostly with discharges but they DO NOT have privileges in the unit! We keep the peace amongst ourselves and our respective units.

Do you have inside info? According to this page, this "fellowship" is still active.

http://www.nursing.vanderbilt.edu/dnp/acnp_fellowship.html

I love this quote too:

Fellows are hired as junior faculty members within the School of Medicine

Somebody needs to ask this guy why he has a job at Vandy since the nurses he has trained as "intensivists" obviously cost a lot less money than he does.

Why should we pay Dr Nathan Ashby 300k per year when one of his nurse intensivists can do the same job for half the price? Sounds to me like he has priced himself out of the market.

 

[SunnyCCM]

No inside info. Just coming out of my "cave" after 5 years dual IM/ER residency 2 years CCM fellowship. Seriously, according to this "advertising" you can train a nurse to do my job in that short of time.

Hmmm....where are the patient outcomes of said "graduate NP Intensivists?" Not bashing anyone, as NPs have their place in the facility where I trained and currently practice. That place at present time is not the units. Our CCRN & CNRN on Neuro are seasoned and we work as a team for our patients.

Heck, even I know my limitations in a rough crashing patient when I need to page in the surgery team. Patient morbidity & mortality is highest in trauma center ICUs on weekend night shift thus the MD intensivist-Nocturnist role=enhanced patient outcomes. Curious if the data is there to support this and not just cost saving. Curious how others feel.