Controversial Question! Who does more for the patient

[medskool23]

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Ok so I have been a CNA for almost five years now and have work very closely with nurses. Tonight as I was explaining what kind of doctor I would like to be anurse asked me "who do u think does the most for the patient the doctor or the nurse?" I responded that the work is somewhat equal because everyone have their role they play in Healthcare field. She went on the ask "who is there with the patient at night when they are hurting and who knows the patient best?" As a CNA I went on the ask well who is there when the patient needs to be feed, changed, wake up from a nightmare, or just when they need a hug. I also stated that where we work patient refer to them a medicine man or woman and us a nurses( happens all the time and not to say nurses don't do the things I have listed above it just doesn't happen here where we work). Why is it such a debate on who does the most for the patient/resident? Why can't we all just work together as a team?

 

[J ROD]

 

[deleted480308]

As one of my professors says about the midlevel encroachment issue...."all the professions can say what they want, but when someone wheels their grandma in with a car door sticking out of her chest no ever scream anything but "I need a doctor""

 

[WedgeDawg]

OP is a premed so moving to pre-allo

 

[allantois]

Oh, who cares?

 

[7331poas]

Gonna be honest. My time spent in clinical volunteering leads me to believe that the whole process would not even be possible without nurses. I cant even imagine anything getting done at all without the nursing staff.

 

[deleted480308]

Gonna be honest. My time spent in clinical volunteering leads me to believe that the whole process would not even be possible without nurses. I cant even imagine anything getting done at all without the nursing staff.

who ever said they aren't necessary? all parts of the machine are necessary

 

[allantois]

who ever said they aren't necessary? all parts of the machine are necessary

I'd cut out the insurance companies out of the equation, along with all the billing people.

 

[deleted480308]

I'd cut out the insurance companies out of the equation, along with all the billing people.

insurance companies are quite useful to patients for large ticket items, it's actually the government reimbursement causing a lot of the problems because the hospitals can't turn them down and bill the patient directly when they get crazy. They are an issue because of the government requiring people to have them and requiring certain types of coverage. And billing people have to be there because bills have to be paid.

 

[7331poas]

who ever said they aren't necessary? all parts of the machine are necessary

If we lived in a lawless world where either only doctors existed or nurses existed, the nurses would get more done for the patient.

We don't live in such a world so all of you are free to conclude whatever you wish.

 

[Psai]

If we lived in a lawless world where either only doctors existed or nurses existed, the nurses would get more done for the patient.

We don't live in such a world so all of you are free to conclude whatever you wish.

You only need to look at the nyc programs to know that this is not true

 

[235009]

Nurses are definitely with the patient more and the bit about knowing the patient better (on the personal not medical level) is also true. As physicians our time with an individual patient has been reduced dramatically by increasing demands on our time like documentation etc. In fact you may only spend less than 10 min a day with a hospitalized patient. However the whole operation wouldn't run without us so we are a necessary but not sufficient part of the puzzle. Same goes for nurses.

insurance companies are quite useful to patients for large ticket items, it's actually the government reimbursement causing a lot of the problems because the hospitals can't turn them down and bill the patient directly when they get crazy. They are an issue because of the government requiring people to have them and requiring certain types of coverage. And billing people have to be there because bills have to be paid.

What is this nonsense? Go read more about the US healthcare system and come back when you have the basics under your belt. I don't even know what you're referring to with "when they get crazy" but I sure hope it's not the patient. Billing people (or coders) aren't there to pay bills, they're there to send bills to insurance companies to make sure the hospital gets paid.

 

[deleted480308]

Nurses are definitely with the patient more and the bit about knowing the patient better (on the personal not medical level) is also true. As physicians our time with an individual patient has been reduced dramatically by increasing demands on our time like documentation etc. In fact you may only spend less than 10 min a day with a hospitalized patient. However the whole operation wouldn't run without us so we are a necessary but not sufficient part of the puzzle. Same goes for nurses.



What is this nonsense? Go read more about the US healthcare system and come back when you have the basics under your belt. I don't even know what you're referring to with "when they get crazy" but I sure hope it's not the patient. Billing people (or coders) aren't there to pay bills, they're there to send bills to insurance companies to make sure the hospital gets paid.

If someone doesn't collect those bills, people get fired and places close down. Getting paid is part of providing a service

The "crazy" is the crazy documentation/overhead reqs put on the providers

 

[JustaDO]

If we lived in a lawless world where either only doctors existed or nurses existed, the nurses would get more done for the patient. We don't live in such a world so all of you are free to conclude whatever you wish.

And in said world, more patients would be dead too.

 

[mimelim]

If someone doesn't collect those bills, people get fired and places close down. Getting paid is part of providing a service

The "crazy" is the crazy documentation/overhead reqs put on the providers

I don't think you know what the billing/coding department is.

 

[tiedyeddog]

If we lived in a lawless world where either only doctors existed or nurses existed, the nurses would get more done for the patient.

We don't live in such a world so all of you are free to conclude whatever you wish.

Yes, if you quantify useless charting as getting stuff done.

 

[raiderette]

Yes, if you quantify useless charting as getting stuff done.

Most charting isn't useless. I will agree that no system is perfect yet but it isn't all CYA. We still have far too many medical errors technology can improve results in many cases.

 

[deleted480308]

I don't think you know what the billing/coding department is.

I do...but feel free to clarify the point you are clearly trying to make

 

[allantois]

I do...but feel free to clarify the point you are clearly trying to make

Your libertarian partisanship often gets in the way of looking at things.

 

[Psai]

Most charting isn't useless. I will agree that no system is perfect yet but it isn't all CYA. We still have far too many medical errors technology can improve results in many cases.

Let me know when you've rotated on the wards and seen it for yourself. No doubt I've read some nurses' notes that were excellent and had exactly the information I was looking for but the majority are full of unhelpful nonsense. Some of the physician's chart is useless as well. I don't see why we can't just put in the assessment and plan since that's all people read but of course we must satisfy billing requirements and governmental meaningful use requirements.

 

[Lost in Translation]

I'd cut out the insurance companies out of the equation, along with all the billing people.

Oh look babby's first healthcare discussion.

The reason for exorbitant healthcare costs starts with the pharma companies, and the FDA letting them run wild with their "R&D costs need to be recouped" BS. A single pill of acetaminophen shouldn't cost $8 or whatever it does in an ED. Even if you factor in "R&D", the cost of R&D for that drug has more than been paid back by now.

 

[deleted480308]

Oh look babby's first healthcare discussion.

The reason for exorbitant healthcare costs starts with the pharma companies, and the FDA letting them run wild with their "R&D costs need to be recouped" BS. A single pill of acetaminophen shouldn't cost $8 or whatever it does in an ED. Even if you factor in "R&D", the cost of R&D for that drug has more than been paid back by now.

Acetaminophen doesn't cost $8 in the ED because of big pharma, it costs $8 there because emtala means a ton of people aren't paying so they soak the ones that actually do pay to cover the difference. Captive audience helps to....why does a watered down beer cost $12 at the stadium? Because where else to you buy a beer without leaving

 

[7331poas]

Oh look babby's first healthcare discussion.

The reason for exorbitant healthcare costs starts with the pharma companies, and the FDA letting them run wild with their "R&D costs need to be recouped" BS.

You mean capitalism BS?

Who cares how much it should cost. An iPhone should cost 300$ but it doesnt.

 

[Lost in Translation]

You mean capitalism BS?

Who cares how much it should cost. An iPhone should cost 300$ but it doesnt.

As long as a drug is under patent, its maker can charge however much they want for it. And if a patient needs this drug, then the hospital has to pay the pharma that BS price, and then that gets passed on to the patient and their insurance provider. And because the FDA doesn't regulate drug prices, this is allowed to continue–remember that guy that just got arrested (for unrelated charges) that raised the price of a drug because he could?

Now, I should amend my post because pharma isn't the only boogeyman, however insurance companies are also along for the ride, so to blame them is incorrect.

 

[TooMuchPressure]

Nurses spend more time with the patient(obviously) caring for them and tending to their needs. The doctor fixes the problem. They are both equally essential.

 

[235009]

Let me know when you've rotated on the wards and seen it for yourself. No doubt I've read some nurses' notes that were excellent and had exactly the information I was looking for but the majority are full of unhelpful nonsense. Some of the physician's chart is useless as well. I don't see why we can't just put in the assessment and plan since that's all people read but of course we must satisfy billing requirements and governmental meaningful use requirements.

Yes it's all about making sure you click this and that button, "reviewing" this and that part of the patient's chart. It's absolutely maddening and contributes NOTHING to patient care. Best part is they send you your scores periodically

 

[IlDestriero]

Physicians do physician things, nurses do nurse things, janitors do custodial things, and everyone gets paid appropriately for their level of contribution. If nurses wanted to wear the big boy pants, accept the big responsibility, and cash the big check, they went to the wrong school. The physician may only see the patient for 10 minutes because that's all they need to, and they have other things to do, like operate or see 50 patients in clinic, so that they can admit more patients so that the janitor and the insurance specialist, and the special snowflake floor nurse have jobs.

 

[tiedyeddog]

Most charting isn't useless. I will agree that no system is perfect yet but it isn't all CYA. We still have far too many medical errors technology can improve results in many cases.

LOL, life saving charting huh? You must not be reading the same charts I have been reading.

 

[7331poas]

Physicians do physician things, nurses do nurse things, janitors do custodial things, and everyone gets paid appropriately for their level of contribution. If nurses wanted to wear the big boy pants, accept the big responsibility, and cash the big check, they went to the wrong school. The physician may only see the patient for 10 minutes because that's all they need to, and they have other things to do, like operate or see 50 patients in clinic, so that they can admit more patients so that the janitor and the insurance specialist, and the special snowflake floor nurse have jobs.

By that logic the hospital CEO is the most important since they have the most responsibility. "If doctors wanted to be the most important they went to the wrong school."

 

[7331poas]

You only need to look at the nyc programs to know that this is not true

More like you have to look at nyc and VA programs to conclude that. My time in a top hospital has led me to believe this. the nursing staff is excellent and because of them stuff gets done.

 

[IlDestriero]

By that logic the hospital CEO is the most important since they have the most responsibility. "If doctors wanted to be the most important they went to the wrong school."

That's true, if I wanted to make $1M a year sitting at a desk, I should have gone to Wharton. And I don't want to "be the most important" I'm happy as a physician.
But physician responsibility and nursing responsibility and CEO responsibility are all quite different. Nurses, and CEOs, don't diagnose and prescribe treatment plans for patients, that's what I like to do, and that's what I get paid to do. And I spend plenty of time with my patients. Though they tend to be asleep. Which is just fine by me as well.
I also don't cry about the CEO making millions of dollars and not seeing any patients at all like the nurses seem to be in the OPs post. They get paid to do what they do, and we get paid to do what we do. We are all a cog on the big wheel.

 

[NoTownPreMed]

Not really a controversial topic to discuss about. A nurse will obviously spend more time with the patient. Nurses are given a "team" of patients to care for and to perform nursing tasks until their shift ends. Physicians do not have the luxury to spend as much time with patients as nurses do because they have way more patients to see, with so little time. In addition to that, there are other tasks they would have to do (discharges, consults, family/ethics meeting, surgery, admissions, code response and the list goes on). As a nurse, it is my duty to carryout my nursing task while on shift and to also act as the eyes and ears of the physician.

 

[jqueb29]

Nurses are the best. All doctors should be put in jail.

 

[Lost in Translation]

Nurses are the best. All doctors should be put in jail.

http://niceme.me

 

[Gastrapathy]

Nurses do more work for patients. Doctors do more important work for patients. Now OP, go back to that nurse and tell her this is what you think. Be sure to do it within earshot of the rest of her coven.