A concerning experience with NPs....

[JustPlainBill]

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I had wondered about this....my program isn't the greatest and I remember in a particular thread BD mentioning that if you were concerned/threatened about a mid-level's skill vs your own, you probably should be concerned. I was a bit nervous about NPs given their repeated attempts to gain independent practice rights in our state and my status as an intern/soon to be minted FM attending w/o the years of experience....

However, that changed today -- seriously. I was on the L&D deck assigned to work with midwives to get my numbers. We work with one of our attendings who's high risk OB certified to get our physician oversight/training and continuity deliveries. Anyway, one of the midwives proudly announces that she's taking her 'clinicals' with trained patients to become an FM-NP. She saw my intern survivial guide and asked if I had one for diabetes(?). I asked if she were putting one together and she said no, that she needed to study. So I said that as we weren't busy, I'd help --- and asked for the definition of diabetes to start with -- Uhh, glucose of 200---fasting or random?....fasting....really?....uh, random....one or two occasions....uh..one....really?....two?..ok, what's pre-diabetes.....uhh,140-200....pre-diabetes?!...uh....140-200....no, 101-125...ok, so you have a patient with diagnosed DM..what labs do you want on your first visit...uh, ast,lipids....really, why?....well....ok, what lipids levels do you want?....well, below normal...what's normal?...uh....Is diabetes a risk factor for heart disease...uh....ok, how often do you do a diabetic foot exam...Every visit...really?....uh....ok, what's your first line treatment...Metformin....ok, when do you initiate insulin...when the glucose is uncontrolled....really, and when is that...uh....

and this is the way it went for half an hour...she kept looking at her buddies trying to get some help but no joy there.....

I later found out that this 'clinical' proctor/professor is known for giving heavy curves, everyone passes and it's the last thing they have to do before they're licensed.....makes me shudder....

 

[nabeya]

Did it make you feel better about yourself after you put this lowly FM-NP in her place? Seems like you weren't really out to teach her anything, but just to humiliate her.

 

[lowbudget]

No actual patient was harmed in the above reenactment.

Look. You did her a favor. You'd rather an intern pimp the FNP student with those questions than a lawyer pimp her during a deposition, with her supervising physician watching, clutching onto his/her medical license.

 

[NRAI2001]

No actual patient was harmed in the above reenactment.

Look. You did her a favor. You'd rather an intern pimp the FNP student with those questions than a lawyer pimp her during a deposition, with her supervising physician watching, clutching onto his/her medical license.

How often do NPs end up in court? Sounds like the docs supervising them hold ultimate liability... atleast thats what the NP will claim in court.

 

[JaggerPlate]

How often do NPs end up in court? Sounds like the docs supervising them hold ultimate liability... atleast thats what the NP will claim in court.

You kidding me? They are totally, 100% independent practitioners, equal (or better than) DO/MDs at every level (flawed studies conducted by the American Academy of Advanced Nurses proves this) ... until 'ish' hits the fan. Then they look for a medical license to hide behind.

🙄

 

[deleted87716]

How often do NPs end up in court? Sounds like the docs supervising them hold ultimate liability... atleast thats what the NP will claim in court.

There are fewer lawsuits against NPs mainly because there are far fewer of them to sue. There are only around 150,000 NPs in the U.S. compared to nearly 1,000,000 physicians. Furthermore, most NPs work in relatively low-risk areas with limited scope, and most are supervised by physicians who end up being the ultimate target in the event of malpractice litigation.