and i quote...
http://www.medscape.com/viewarticle/514545_2
... and...
http://www.medscape.com/viewarticle/514545_2
this is a bad, bad, BAD idea. why? this will
kill nursing as a primary, terminal degree. fewer nurses will be content simply being a "nurse". less and less actual direct, caring, effective patient care will be provided by nurses (i.e., RNs) who will instead be "eyeing the prize" (just like nearly half of the critical care nurses with whom i regularly interact who, for example, already want to be CRNAs simply because of the perception of increased earning potential and greater autonomy) of climbing the degree food-chain. many of these advance trained nurses, i'm sorry to say, already are more focused on their career than they are on patient care. they are often disrespectful and insubordinate with house staff and even attendings. some even openly disobey physician orders. it is already a bad situation, with many of them (especially the younger ones) thinking they already know more about what's going on with their patients than the doctor does, and that they are going to someday be a CRNA anyway and "
won't have to deal with orders from a doctor anymore" as one 23-year-old critical care nurse recently said to me. but, the physician-nurse relationship has always been - and probably always will be - a somewhat tenuous relationship with occasionally competing patient-care goals and egos (i.e., we both want what's best for our patients, but we often have different ideas on how to get there). i imagine this is the way it's always been.
but, now imagine a system where a nurse has been empowered - clinically - at the "doctorate" level to make greater, if not sole, patient care decisions. what will happen is that this will create a larger responsibility/power gradient within the healthcare team. this will destroy bachelor-level nursing as a discipline, and more and more patient care will be farmed out to individuals with lesser degrees. is that good for patient care? likewise, nurses will likely view the DNP as someone who is not much above them in training, and may be less likely to follow
their orders (after all, they will be competing to get into those advanced-training spots themselves psychologically putting themselves on par with their supposed leaders). this is the breeding ground for bad intra-hospital morale. patients will become more confused about who is ultimately in charge of their care. and, the cost-effectiveness and patient benefit of this model is far from clear at this point.
yes, this is a bad, bad idea that, unfortunately, seems to be gaining steam. get active now in stopping it however you can.[/QUOT
There's consolation in knowing that many of us can be expert witnesses against these so called providers when they start killing patients left and right.
