Called an NP a midlevel...

[gyngyn]

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I dare everyone to watch the entire video linked below without facepalming.

It sounds like she made a good decision based on her goals.
I missed the face palms...

 

[Dr.Sticks]

It sounds like she made a good decision based on her goals.
I missed the face palms...

The latter part I agree with;I would say she is wrong about the fact that doctors don't spend much time with patients.
Wouldn't you?
I would say it is a myth that nurses spend more time with patients than docs..
Tell me a nurse spends more time than a doc who probably will see 15+ patients in a day..
At least that is what I have learned through volunteering and shadowing
I see that the doctors are much more involved with patient care not nurses.
Not to say nurses aren't involved.

 

[Dr.Sticks]

What she says in this video is completely reasonable. She says nursing is less of a commitment in terms of years of training, more conducive to raising a family, and although being a NP isn't the same as being a family doc that more medicine-related route is available. She even went out of her way to say that even though she was a strong student in high school the pre-med path has the uncertainty of not getting in. What's so ridiculous about this to you? That a nurse dared to think that medicine was an option available to her? Do you honestly think that every single nurse is just someone who couldn't handle the path to medicine?

There are a lot of obnoxious little sh**s in this thread, especially ones who haven't even gotten accepted to med school and already think they're better than nurses. Pretty disgusting

#1 one of my providers is an NP
So I visit an NP annually
If I had something against NP's why would I be going to one?
I also had a PA...
What I find objectionable is the first part.

 

[gyngyn]

The latter part I agree with;I would say she is wrong about the fact that doctors don't spend much time with patients.
Wouldn't you?
I would say it is a myth that nurses spend more time with patients than docs..
Tell me a nurse spends more time than a doc who probably will see 15+ patients in a day..
At least that is what I have learned through volunteering and shadowing
I see that the doctors are much more involved with patient care not nurses.
Not to say nurses aren't involved.

I heard her say that nurses spend more time at the bedside.
This is generally true in my experience.
You can ring a call button and get a nurse.

 

[Biochemistry69]

I agree. Its an unfortunate reality.

Most if not all of the nursing majors I know have a severe dunning-kruger complex. They think because they have a white coat and got a B+ in *Introductory* (not general) chemistry, they are on equal footing with pre-meds and even medical students. Conversely, most pre-meds and medical students I know are quite humble about how little they actually know.

I can confirm. I took introductory chemistry as a refresher before general chemistry. Plenty of "pre-nursing" folk complaining about how rigorous it is, when it wasn't. A buddy of mine took survey of organic/biochem, which is what the nurses have to take, and she said most pre-nursing students found the 6 weeks of organic chemistry (basically an introduction to carbon and resonance structures) to be near impossible.

I also cringe when I see "I'm a nurse. What's your superpower?" bumper stickers.

 

[Endoxifen]

I can confirm. I took introductory chemistry as a refresher before general chemistry. Plenty of "pre-nursing" folk complaining about how rigorous it is, when it wasn't. A buddy of mine took survey of organic/biochem, which is what the nurses have to take, and she said most pre-nursing students found the 6 weeks of organic chemistry (basically an introduction to carbon and resonance structures) to be near impossible.

I also cringe when I see "I'm a nurse. What's your superpower?" bumper stickers.

People are never as stupid as you think. We aren't as smart as we think.

 

[Dr.Sticks]

I heard her say that nurses spent more time at the bedside.
This is generally true in my experience.
You can ring a call button and get a nurse.

I am not a doctor like you so my experience is limited; However in private practice the nurse took vitals for the doc, and then the doc would spend 10 minutes with each patient. The doc did majority of patient care.
It was interesting..

Anyways I am not nurse bashing, that's wrong. I also don't think nurses aren't as smart as doctors or vice versa.
I don't think anybody is stupid, I think everyone has the potential to get a 4.0 GPA and a 520 MCAT.
I think I have made it known that my position is that nobody is born intelligent,but everyone has the potential to be very intelligent.

As far as the whole mid level thing goes, many of my friends are midlevels, they do a fine job.. I see an NP annually as well...
They are mid level providers though, and my friends don't find it offensive when I say it.

 

[Citizen #3]

Wooooow, some of what you guys are saying is super condescending. Maybe it's because my mom's a nurse and my grandmother was a nurse, but I really don't get the disdain for nurses that some of you guys have.

I've never heard of "midlevel" being considered an offensive term, but to be fair, the NP and PA that I work with are both referred to as providers. (Before you guys start freaking out, there's not really any harm in this. When you have a bunch of people coming in with a sinus infection or thrush, it doesn't really matter if it's a NP or PA or MD or DO treating you.)

 

[gyngyn]

I am not a doctor like you so my experience is limited; However in private practice the nurse took vitals for the doc, and then the doc would spend 10 minutes with each patient. The doc did majority of patient care.
It was interesting..

In the office, the doctor often has more face time.
I believe the student in the video was referring to inpatient care, though.

 

[Dr.Sticks]

Wooooow, some of what you guys are saying is super condescending. Maybe it's because my mom's a nurse and my grandmother was a nurse, but I really don't get the disdain for nurses that some of you guys have.

I've never heard of "midlevel" being considered an offensive term, but to be fair, the NP and PA that I work with are both referred to as providers. (Before you guys start freaking out, there's not really any harm in this. When you have a bunch of people coming in with a sinus infection or thrush, it doesn't really matter if it's a NP or PA or MD or DO treating you.)

Paramedics are called providers too so I don't get the offense to that term.

 

[Dr.Sticks]

In the office, the doctor often has more face time.
I believe the student in the video was referring to inpatient care though.

I wouldn't know; My only experience with inpatient care is being a patient myself.
I saw the residents a lot, the attending not that much. Probably saw the resident more than the nurse.
I have shadowed private practice and based on that experience I find her opening statement to be not completely accurate.

 

[Dr. Stalker]

You called?

The award for best username on SDN goes to you!

 

[AnatomyGrey12]

I just think it's time nursing started to police their own more, being a bit more critical of who they let graduate, enforce higher standards and make their role in the complex health system clear early on in training. Many Nursing professors at my uni have an open disdain for MDs, which bleeds into their students who then assume doctors are dumb and nurses are the real brains at the hospital.

Amen. My wife who actually graduated from a pretty rigorous nursing program would agree as well. The biggest problem with the nursing pathway is the variability, some programs are pretty great and others are basically nurse shadowing and eating Lorna Doone's, preceded by joke classes that don't really teach anything.

Obviously they feel that they aren't getting the respect that they deserve.

The sad part is that the large majority don't feel this way. At the community hospital I work at the mid-levels are valued like gold by the docs because they know their role and they do it exceptionally well. Their leadership are the ones that really push this agenda and "lack of respect" angle.

I would say it is a myth that nurses spend more time with patients than docs..

You haven't spent very much time in a hospital then. Your experience wasn't even remotely close to the common reality in the community. Most patients see their docs for maybe 5 minutes in the day when they round, a lot of others don't even know what their doc looks like because they see their PA/NP.


At the end of the day a good nurse or mid-level can be worth their weight in gold, you just hear of the vocal and inadequate minority. Also want to say that the idea that nursing/PA/NP students are just those that couldn't hack it in med school is an outdated notion. Maybe it was true a few decades ago but now with lifestyle considerations becoming very important socially many of them chose their path over medicine and could have easily done medicine if they wanted.

 

[Dr.Sticks]

You haven't spent very much time in a hospital then. Your experience wasn't even remotely close to the common reality in the community. Most patients see their docs for maybe 5 minutes in the day when they round, a lot of others don't even know what their doc looks like because they see their PA/NP.


At the end of the day a good nurse or mid-level can be worth their weight in gold, you just hear of the vocal and inadequate minority. Also want to say that the idea that nursing/PA/NP students are just those that couldn't hack it in med school is an outdated notion. Maybe it was true a few decades ago but now with lifestyle considerations becoming very important socially many of them chose their path over medicine and could have easily done medicine if they wanted.

Yes I agree my experience is limited, I said that to gyngyn as well. (Shadowed private practice and did some volunteering on a hospital floor but it was more of a rehab type setting)
I agree, I think anyone can get a 520 MCAT and a 4.0 GPA.

 

[freak7]

No one is a low level.

Work in a hospital, am a low level. What do?

 

[Lollygag]

Can I just ask an honest question guys, I don't mean to derail but I really feel like I'm missing something. The majority of midlevels I have met function similarly to a family medicine doc. I understand midlevels aren't as knowledgeable, but the only thing my family medicine doc ever did for me was give me Zpack's when I got a cold. When I sprained my ankle he sent me to ortho. When I had migraines he gave me a prescription told me to come back in a week, when it didn't work he sent me to a neurologist. When I had stomach cramps I was shipped off to GI. It seemed like anything that had even the slightest potential to be bad, I was sent off to a specialist anyways.

When I was a scribe, we constantly got patients who were told to come to the ED by their NP/PA because the patient came into the office with a symptom that the PA/NP was not 100% sure how to approach and just wanted to have them double checked. Yes, it was annoying because the purpose of the ED is not to be the 24 hour family medicine office, but the few that I have spoken with seem to know their limitations.

So I know I've never stepped foot into medical school and I'll probably look back at this post 6 years from now and want to kick myself lol but I honestly don't understand why everyone has such a beef against them.

I also don't understand why everyone complains that they're "taking our jobs". It is well known that there is a primary care physician shortage. Sounds more like they're helping out to me?

 

[CharlieBillings]

I dare everyone to watch the entire video linked below without facepalming.

As someone who has been admitted in the hospital I spent more time with the doctor
The nurse would come in to check vitals, the doctor would visit more often and actually update me on my care.
So I don't really get what she is saying....

I think she's pretty much one point.

She says she went nursing for

• More patient contact (which from my clinical experience is 100% accurate)
  
• Work and training schedule is more conductive to family life (who could argue that one?)
• There's a risk of a sunk cost in time and money if you do pre-med and change your mind or are not accepted
  

Although it does seem a little silly that she says if she wants to be like a doctor she can just do NP. Although she's right that she would have options to go farther, just not as far as it seems she is implying.

Lastly, she says her grades in highschool were really good and seems to equate that with her chances of getting into med school. That's obviously not true, and we have no idea if she would have ever been accepted.

 

[libertyyne]

Work in a hospital, am a low level. What do?

So if there are Advanced practice providers, does that mean there are lowly practice providers?

 

[3member]

I agree, I think anyone can get a 520 MCAT and a 4.0 GPA.

I caught your /s, no worries 😉

 

[IlDestriero]

Just say sorry Nurse Jones.


--
Il Destriero

 

[3member]

just withhold the lab work done by you from her

 

[Dr.Sticks]

I caught your /s, no worries 😉

About 30-40 hours of studying for a full time schedule after class room time should net a 4.0. (I learned this the hard way, I started freshman strong then took a hit my 2nd semester, reeling it all back in though.. I was being a ***** for no reason)
As far as MCAT goes based on my research those who invest more time and take more practice tests and truly master the content and practice taking it seem to score well above average.
I have not taken it though
I will start prepping for it next year.
Will report back how it goes when I take it my senior year..
Currently investigating and developing a plan for studying.
Probably will study for a year solid
I am figuring out the cost to those practice tests

 

[3member]

About 30-40 hours of studying for a full time schedule after class room time should net a 4.0. (I learned this the hard way, I started freshman strong then took a hit my 2nd semester, reeling it all back in though.. I was being a ***** for no reason)
As far as MCAT goes based on my research those who invest more time and take more practice tests and truly master the content and practice taking it seem to score well above average.
I have not taken it though
I will start prepping for it next year.
Will report back how it goes when I take it my senior year..
Currently investigating and developing a plan for studying.
Probably will study for a year solid
I am figuring out the cost to those practice tests

i will await for ur 520

 

[Dr.Sticks]

i will await for ur 520

I get distracted easily
So I won't know if I will get it lol
It requires dedication to get a really good MCAT score
From what I read those who get high scores pretty much dedicate their life to the mcat for months.
I get a 514 I am good
I could be competitive for my state school

 

[TXMED_1695]

This is far from the standard care at most hospitals. I've worked in a hospital for four years, and other than the ER, I've never seen a doctor stay in one area for 12 hours. Most doctors are too busy to babysit one patient.

I dare everyone to watch the entire video linked below without facepalming.

As someone who has been admitted in the hospital I spent more time with the doctor
The nurse would come in to check vitals, the doctor would visit more often and actually update me on my care.
So I don't really get what she is saying....

The latter part I agree with;I would say she is wrong about the fact that doctors don't spend much time with patients.
Wouldn't you?
I would say it is a myth that nurses spend more time with patients than docs..
Tell me a nurse spends more time than a doc who probably will see 15+ patients in a day..
At least that is what I have learned through volunteering and shadowing
I see that the doctors are much more involved with patient care not nurses.
Not to say nurses aren't involved.

 

[AnatomyGrey12]

I have not taken it though

I also await your 520....

From what I read those who get high scores pretty much dedicate their life to the mcat for months.

Lol, dude of course they studied hard but a lot of the MCAT is just flat out critical thinking ability. Some people are just better at it than others, the highest scorers I know didn't study all that much honestly. Maybe a month or two.

Some people study for months on end, taking practice test after practice test, and get rewarded with a 500.

 

[787593]

A physician is top level, and if she thinks NP is not mid-level, then she is implying they are on the same level as physicians. I just don't get it, what is it about the NP profession that makes them think they should be on the same level as physicians as far as patient's medical care goes?? Their training is way shorter and simpler (can even do it online!) and their knowledge base of medical conditions is much shallower. Is it because of their high salary which is comparable to a primary care physician?? Because we can always change THAT.

Lower pay for mid levels?

 

[787593]

I know a few people in NP school and Everytime they asked me Why NPs shouldn't be referred to as Dr., I always tell them :" for the same reason nurses and NPs don't think CNAs should refer to themselves as Nurses"... The lack of the required training.
If they don't want to be called mid-levels, they should come up with a more appropriate term.

If they keep complaining --> Kid-levels?

 

[Dr.Sticks]

I also await your 520....



Lol, dude of course they studied hard but a lot of the MCAT is just flat out critical thinking ability. Some people are just better at it than others, the highest scorers I know didn't study all that much honestly. Maybe a month or two.

Some people study for months on end, taking practice test after practice test, and get rewarded with a 500.

My goal is a 514 to be competitive for my state school.
If it is critical thinking ability I might do well, I am good at thinking things out..
I looked into some practice test I found cars to be the easiest part.
I didn't really get some of the science, haven't taken biochem or organic yet.. (My course schedule is very awkward can't explain it)

 

[cbrons]

The term is formally opposed by both NP and PA associations.

So?

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[IlDestriero]

The time with the patient angle is nonsense. It's a pure BS metric that they think means something. The PICU nurse sits with the patient for 8 hours straight because she's paid to sit with a couple patients for 8 hours straight. THAT'S THE JOB.
The Attending on the other hand sees the patient for 10 minutes twice a day because his/her job isn't to sit with the patient for 8 hours, it's to manage all the the 30 patients on the unit, deal with discharge planning, supervise a team of trainees +/- an NP or two, do procedures, run a code, go to the trauma bay, stabilize and assess the new admits, etc. They wish they could sit outside room 28 and 29 watching a monitor and following orders and algorithms for 8 hours once and a while.
Different jobs requiring different face time. They don't care less, or have a smaller heart, they just have 179 other things to do in the next 8 hours.


--
Il Destriero

 

[TXMED_1695]

They are just fine, the "midlevels", OP will find out quickly that if you go around pissing everyone off, going into your shift will be a nightmare. I think SDN is a great place to talk about these type of situations. But in reality, after 4 years of working at a hospital, there is not that much drama on patient care teams.

Can I just ask an honest question guys, I don't mean to derail but I really feel like I'm missing something. The majority of midlevels I have met function similarly to a family medicine doc. I understand midlevels aren't as knowledgeable, but the only thing my family medicine doc ever did for me was give me Zpack's when I got a cold. When I sprained my ankle he sent me to ortho. When I had migraines he gave me a prescription told me to come back in a week, when it didn't work he sent me to a neurologist. When I had stomach cramps I was shipped off to GI. It seemed like anything that had even the slightest potential to be bad, I was sent off to a specialist anyways.

When I was a scribe, we constantly got patients who were told to come to the ED by their NP/PA because the patient came into the office with a symptom that the PA/NP was not 100% sure how to approach and just wanted to have them double checked. Yes, it was annoying because the purpose of the ED is not to be the 24 hour family medicine office, but the few that I have spoken with seem to know their limitations.

So I know I've never stepped foot into medical school and I'll probably look back at this post 6 years from now and want to kick myself lol but I honestly don't understand why everyone has such a beef against them.

I also don't understand why everyone complains that they're "taking our jobs". It is well known that there is a primary care physician shortage. Sounds more like they're helping out to me?

 

[Dr.Sticks]

They are just fine, the "midlevels", OP will find out quickly that if you go around pissing everyone off, going into your shift will be a nightmare. I think SDN is a great place to talk about these type of situations. But in reality, after 4 years of working at a hospital, there is not that much drama on patient care teams.

I found that there is great degree of mutual respect between everyone, NP, PA, etc

 

[787593]

"Did you just assume my gender?"

There it is...

 

[cbrons]

from the linked article:

"In 2010, the IOM developed a blueprint for the future of nursing. A key recommendation of this report is that NPs should be full partners with physicians and other health care professionals."

and better still:

"When it is necessary to group providers for policymaking or other purposes, more appropriate terms may instead be: primary care providers; health care providers; health care professionals; advanced practice providers;clinicians; and/or prescribers."

Egads...

Referring to physicians as "providers" is offensive.

http://www.aafp.org/about/policies/all/provider-term.html
http://www.aafp.org/about/policies/all/provider-term-position.html

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[gonnif]

So?

Several posters had commented they had never heard of this being considered offensive, hence providing the information. I also pointed that the CMS designation of midlevels is being considered for rule change by NP, PA, and RN groups with no formal opposition being proposed by AMA that I can find. So this designation may be changed adminstratively within medicare within the next few years

 

[Mclovin0351]

After tutoring and teaching 50+ people for the MCAT, I think there are adults who could study for years and never crack 515.

 

[tartesos]

https://www.aanp.org/images/documents/publications/useofterms.pdf


The term is formally opposed by both NP and PA associations. There is significant dislike of the term across NP, PA, and RNs across the country. I would suggest that by the time most of you are in practice it will be considered a term of derision. They are promoting changes in CMS to remove the term via regulatory processes. At the moment is remains the legal classification for purposes of billing

The article said not to call np non physician providers because:
"It's not right to call a physician non nursing provider"

But it is right....


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[Flirt]

It sounds like she made a good decision based on her goals.
I missed the face palms...

One mcat exam, a couple interview invitations and few acceptances, and we think we have earned the right to deride other professionals.

At least we now know the arrogance starts even before classes.

 

[Dr.Sticks]

After tutoring and teaching 50+ people for the MCAT, I think there are adults who could study for years and never crack 515.

Why?

 

[cbrons]

I think we should all take a moment to try and empathize with the NPs and PAs. Obviously they feel that they aren't getting the respect that they deserve. Regardless of whether you agree with them or not, imagine going into work every day with the impression that people are looking down on you. It's understandable why they would feel offended by "mid-level". That being said, I absolutely agree that they should not have the same power as physicians. Considering the incidence of physician error alone, it worrying to think that people with less training could gain that level of responsibility. Still, we need to consider our coworkers' position.

No

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By the way, I've never met a PA who cares about being called a mid-level. And very few NPs care (especially the ones who are experienced and have been around for years). The ones I can probably see not liking being called "mid-levels" are typically the ones with little to no nursing experience who got an online Doctor of Nurse Practice degree and want to pretend it is equivalent to an MD. And it isn't.

 

[Gurkhali]

Work in a hospital, am a low level. What do?

You have failed us. Time to commit sudoku.

 

[TXMED_1695]

You're not the first medical student to piss off other people while you're sitting around talking about "midlevels".

I got chewed out for calling referring to the NP/PA at work collectively as "midlevels." I was using the term while talking to a coworker, when an NP who works in a different department overheard me. She came over and told me that I was using an offensive term, then lectured me about how if she is a midlevel then does that make her staff low level.

I am a lab tech. Who on her staff is lower level than me?? I've heard several of the MDs and PAs I work with use the term. So what gives? Is it really an offensive term.

 

[tartesos]

I think we should all take a moment to try and empathize with the NPs and PAs. Obviously they feel that they aren't getting the respect that they deserve. Regardless of whether you agree with them or not, imagine going into work every day with the impression that people are looking down on you. It's understandable why they would feel offended by "mid-level". That being said, I absolutely agree that they should not have the same power as physicians. Considering the incidence of physician error alone, it worrying to think that people with less training could gain that level of responsibility. Still, we need to consider our coworkers' position.

They should have gone to Med school if that term offends them so much.


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[AnatomyGrey12]

Why?

Because the MCAT is hard and it tests a certain skill set that people have in different degrees. I can tell you from experience that honestly around 80%+ of the test questions can be answered simply from deductive reasoning from the info given in the passage.

You can also study everything and know it perfectly but if you can't reason from the passage what they are actually asking there are questions you will never get right no matter how much you know.

 

[Endoxifen]

They should have gone to Med school if that term offends them so much.


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You don't think this whole thread is indicative of exactly the kind of sentiment that they're trying to fight against? The vitriol spouted by all of these people is so toxic, it's hard to believe.

 

[tartesos]

You don't think this whole thread is indicative of exactly the kind of sentiment that they're trying to fight against? The vitriol spouted by all of these people is so toxic, it's hard to believe.

No.


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[TXMED_1695]

What did you get on your MCAT?

Because the MCAT is hard and it tests a certain skill set that people have in different degrees. I can tell you from experience that honestly around 80%+ of the test questions can be answered simply from deductive reasoning from the info given in the passage.

 

[Dr.Sticks]

No

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NPs/PAs know more than any of us pre-meds..
I think as pre-meds we can learn from them, and as people who may end up in med school they would be your colleagues in the future.

 

[AnatomyGrey12]

What did you get on your MCAT?

90%<