We dont think all nurses are out to get us. There are great nurses and there are duds just like there a bad physicians and good ones.
However, the DNP is nothing more than an attempt to blur the line between physician and nurse in order to practice medicine without the training and education.
These 1000 hour "residencies" nurses are setting up are also a way to further blur the lines.
Nurses arent stupid, why would they want to practice primary care when no other physicians would either.
Heres a blog post by a physician who asked his nurse friends what they thought about nurses moving into primary care.
http://getbetterhealth.com/nurses-may-not-fill-the-primary-care-shortage-were-not-suckers/2008.11.07
"I have a friend whos a nurse practitioner and she had to borrow over $100,000 for her education. Im a three-year diploma nurse so technically I dont even have a college degree - but Im making a lot more than nurse practitioners and I dont have all that debt. Politicians need to know that nurse practitioners cant just pick up the slack from physicians. Nursing and medicine are two different specialties and were trained to do different things."
By pushing the primary care shortage issue they expand their practice rights and can then move onto other specialties like this dermatology "residency" they set up.
All that quote means is that people should not go into NP school because they think they will make a lot of money. MD's and NP's cannot go into their respective training with the MAIN goal to make money. There is no place in medicine or nursing for people to be in it ONLY for the money. Sure if this RN in the example is only looking at money than NP school is not worth it. I know I will take a pay cut when I graduate NP school, but its worth it to me because I know I will be happier in that role.
I think its totally unfair that other practitioners can make more money than some MD's. Not that I think they should cut a nurse's salary after years of hard work and dedication, but MD compensation needs to increase or there will be no more independent MD offices, they will need to go to big groups to survive. If the MD's actually knew how much money the hospitals make off the MD's work in comparison to how they are compensated they would be sick. Attending friends I know make about 200k a year, but billed for over 3 million in one year. I have no idea how much they actually make off of nursing care, but if you actually see a bill someone gets from a hospital and they charge $50 for doing a urine pregnancy test, I'm sure not getting a cut from that! We both have important jobs and we should all be fairly compensated for what we do. The money is going into the pockets of administrators who have never touched a patient in their life, or do they take the risks we do every day.
I 100% agree that NP's are NOT trained to pick up the slack or replace MD's in any way. I think we need to distinguish the NP's going into primary care to join an MD practice and help patients achieve optimal health, from NP's who want to take over. I am willing to bet my year's salary, that 99.9% of the NP's in primary care today or those studying to become primary care NP's have NO intention of replacing MD's or going into practice without some sort of MD guidance.
Those extremists who want to play doctor should be stopped. That is a patient safety issue. I am also 100% against any practitioner who tricks patients into thinking they have more education or training than they actually have, incuding people like naturopathic doctors, lay midwives, and medication techs.
Primary care NP's are trained to diagnose and treat COMMON health care issues. That is defined in the scope of practice in every state regardless if independent practice agreements or whether they hold a doctoral degree. MD's are trained to take care of a wide variety of common and complex illnesses. Anyone who understands these basic definitions can understand that NP does not equal MD.
The purpose of these NP residencies are to give the NP additional training in a specialty area that they may not have had as a practicing nurse or in NP school. A residency trained NP will function with a broader knowledge base than an NP who didn't have this type of training. NP residencies that I am looking at say in their mission statements that the graduating NP will be an asset to a large MD group, not to go off on their own and practice. If an NP/PA residency advertises itself as equivalent training to an MD residency it should be shut down yesterday!
Years ago, hospitals were trying to train techs to replace nurses in order to save money and they failed miserably. Do you remember the advertisements on TV years ago "ask for an RN"? These techs were trained in 1 year programs how to give meds, do simple procedures such as foleys and IV's and other task oriented things that nurses do. What they found was that although they were able to teach techs how to accomplish tasks, the patient outcomes were terrible because these techs are not educated nurses who understand disease process. This will be the same truth that will be shown for any group that tries to replace MD's. Patient outcomes will suffer, because although you can teach a monkey to remove an appendix, they do not have the knowledge base to treat the disease process as a whole. The truth will set you free, and patients will demand that the leaders of their care will be MD's even if they do respect and feel they recieve good care from NP's when treated by them in an appropriate setting.
