Flying scalpels and the future of health care

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Have you ever seen a physician throw anything?

  • Yes, a scalpel

    Votes: 7 11.5%
  • Yes, an object, but not a scalpel

    Votes: 11 18.0%
  • No

    Votes: 43 70.5%

  • Total voters
    61
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"In the 1990s, health care cost-cutting began to overwhelm nursing care. Insurance companies slashed patient length of stays. Decision-makers had little idea about what nurses actually did for patients and so they began replacing nurses with less expensive techs and medical assistants. These workers dress like nurses, but they are no more capable of replacing nurses than they are physicians. So patients die."

Irony
 
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"Nurses ... are often seen as "cost centers." [but] hospitals exist to provide nursing care; otherwise patients would go to outpatient centers."

Hmm, I guess I never thought of hospitals this way. Interesting idea.
 
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A majority of nurses on hospital boards? Lol, total power, basically. "That would be a great start."
 
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A majority of nurses on hospital boards? Lol, total power, basically. "That would be a great start."

Well, if hospitals are really nursing institutions, it does seem insane nurses aren't in charge of them.
 
Well, if hospitals are really nursing institutions, it does seem insane nurses aren't in charge of them.
Nowadays they aren't. They're medical institutions. They were nursing institutions back in the days when they were places for people to go and be tended to until they died (or miraculously recovered). With the advent of modern medical treatment, however, physicians became integral to hospitals, as we could cure rather than merely "nurse," or tend to, the ill and dying.
 
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Physicians aren't in charge of the business side either.

For all the cynicism here, and there is a place for it at times, just remember to be nice to nurses and take their concerns seriously, especially when you are an intern. Nurses really do save lives, partly by intervening when necessary in emergencies, but more often by recognizing a problem and notifying the physician before it becomes life or limb threatening.

A good nurse who likes you can also make you look like a rockstar. In July of your intern year, while you are still trying to figure out which end of the stethoscope to put in your ears, when they call you at 3 AM for a fever or chest pain or whatever, the nurse can say "Dr Intern, normally in this situation Dr Attending likes this, this, and this." Then when you call your senior resident, you have a plan rather than having to get the plan from the senior.

That same good nurse, if s/he doesn't like you, can decide that 3 days of constipation is something really critical for you to know about at 3 AM. Then they will refuse to take a verbal order for Dulcolax so you need to go to the floor and write it.
 
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Compelling read is quite the overstatement. I don't agree with the anti-physician tone of the article as the author is very hyperbolic in her support of nurses. No one goes to the hospital to be nursed, if they need nursing care then they would go to a skilled nursing facility. Patients go to the hospital to have their medical issues diagnosed and treated by physicians. But she makes a lot of good points. We wouldn't have so many nurses going for all those extra certifications and aggressively pushing into medicine if nurses weren't so dissatisfied with their current situation. They could use lower patient ratios and spend more time actually nursing the patients instead of just passing meds and charting that the remote was in reach.
 
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...I don't agree with the anti-physician tone of the article as the author is very hyperbolic in her support of nurses. No one goes to the hospital to be nursed, if they need nursing care then they would go to a skilled nursing facility. Patients go to the hospital to have their medical issues diagnosed and treated by physicians.

It ran during nurses week, so it would have been odd if it wasn't supportive of nurses. Do you really think patients don't get nursing care in hospitals? How do you think they get better in the 23 and a half hours in between our visits?
 
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Compelling read is quite the overstatement. I don't agree with the anti-physician tone of the article as the author is very hyperbolic in her support of nurses. No one goes to the hospital to be nursed, if they need nursing care then they would go to a skilled nursing facility. Patients go to the hospital to have their medical issues diagnosed and treated by physicians. But she makes a lot of good points. We wouldn't have so many nurses going for all those extra certifications and aggressively pushing into medicine if nurses weren't so dissatisfied with their current situation. They could use lower patient ratios and spend more time actually nursing the patients instead of just passing meds and charting that the remote was in reach.

I agree.

However, hospitals need doctors and nurses. The author is the article is right that people can go to doctors' clinics to see doctors and you are right that they get nursing care at a SNF.

People come to hospitals to get diagnostic and treatment services for complex or life/limb/vision threatening conditions. This requires doctors of all specialities, nurses, techs, etc.
 
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Psai, just noticing your profile picture with the nurse pushing her boobs back and forth at the physician. What is up with that? How disrespectful to nurses. Can't you find something that is more respectful?
 
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Psai, just noticing your profile picture with the nurse pushing her boobs back and forth at the physician. What is up with that? How disrespectful to nurses. Can't you find something that is more respectful?
Don't you have anything better to do with your time than criticize a cartoon drawing on the internet?
 
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I agree.

However, hospitals need doctors and nurses. The author is the article is right that people can go to doctors' clinics to see doctors and you are right that they get nursing care at a SNF.

People come to hospitals to get diagnostic and treatment services for complex or life/limb/vision threatening conditions. This requires doctors of all specialities, nurses, techs, etc.

Hospital care does require a team, but outpatient centers are are where physicians are on their own with far few nurses (sometimes none). If a patient is really sick, physicians could probably diagnose them at either hospital or outpatient center, but there'd be no nurses to take care of the patients at the outpatient center, which is why they go to a hospital instead
 
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You support a group by supporting the group, not denigrating others. I don't support doctors by talking about how much I disagree with the existence of medical malpractice lawyers.

And I am incredibly offended about how you stereotype women as obviously being the nurse. For your information, the lady in the picture is a doctor that is preparing to throw her scalpel at the male nurse.
 
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Compelling read is quite the overstatement. I don't agree with the anti-physician tone of the article as the author is very hyperbolic in her support of nurses. No one goes to the hospital to be nursed, if they need nursing care then they would go to a skilled nursing facility. Patients go to the hospital to have their medical issues diagnosed and treated by physicians. But she makes a lot of good points. We wouldn't have so many nurses going for all those extra certifications and aggressively pushing into medicine if nurses weren't so dissatisfied with their current situation. They could use lower patient ratios and spend more time actually nursing the patients instead of just passing meds and charting that the remote was in reach.
Yeah, the only reason they look to get away from patient care in the first place is because it's so awful, hence the NP degree chasing and the desire to do as close to what we do as possible.
 
The institution which I am currently rotating at has a culture in which nurses are free to throw hissy fits and criticize doctors all day long. If I doctor was ever to point out that a nurse was incompetent, the doctor would be considered to be an as***** and an elitist.
Must be at one of those liberal-bent academic institutions. Disgusting.
 
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Apologies for posting in this thread, since I'm not yet a medical student; however, before joining the Navy, I was an OR tech for a little over 7 years. I witnessed maybe two surgeons throw things, but one surgeon in particular sticks out in my mind. It was never directed at anyone, but still dangerous. I saw another tech hand him something he decided he didn't want and rather than give it back or leave it on the field, he pitched it across the room and yelled at her. He threw a scalpel once.

I noticed an inverse relationship between the amount of yelling and confidence in one's own abilities as a surgeon. The guy who threw **** and screamed all the time was always talking about how great he was, but he was always the most stressed out and on edge when things went a little sour (which they seemed to a lot with him).
 
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"In the 1990s, health care cost-cutting began to overwhelm nursing care. Insurance companies slashed patient length of stays. Decision-makers had little idea about what nurses actually did for patients and so they began replacing nurses with less expensive techs and medical assistants. These workers dress like nurses, but they are no more capable of replacing nurses than they are physicians. So patients die."

Irony

This reminded me of a time a few months ago when I was sitting in the middle of two DNP students who were upset about LPNs. The two were saying that a local hospital was so busy that it had to hire LPNs again (which it hadn't in > 10 years). The two students then proceeded to get very irritated (and appalled) at the fact that these "lesser trained LPNs" could still be hired to do the same job as RNs and how could a hospital think that they could "do the same job without the same level of training?" They then proceeded to discuss the poor patient care and danger associated with a lesser trained person.

Can't make this stuff up. It took every fiber of my being to hold my tongue...
 
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This reminded me of a time a few months ago when I was sitting in the middle of two DNP students who were upset about LPNs. The two were saying that a local hospital was so busy that it had to hire LPNs again (which it hadn't in > 10 years). The two students then proceeded to get very irritated (and appalled) at the fact that these "lesser trained LPNs" could still be hired to do the same job as RNs and how could a hospital think that they could "do the same job without the same level of training?" They then proceeded to discuss the poor patient care and danger associated with a lesser trained person.

Can't make this stuff up. It took every fiber of my being to hold my tongue...

So ironic i died of poisoning
 
This reminded me of a time a few months ago when I was sitting in the middle of two DNP students who were upset about LPNs. The two were saying that a local hospital was so busy that it had to hire LPNs again (which it hadn't in > 10 years). The two students then proceeded to get very irritated (and appalled) at the fact that these "lesser trained LPNs" could still be hired to do the same job as RNs and how could a hospital think that they could "do the same job without the same level of training?" They then proceeded to discuss the poor patient care and danger associated with a lesser trained person.

Can't make this stuff up. It took every fiber of my being to hold my tongue...

My wife just told me about a nursing student that got "fired" from her clinic for being grossly inappropriate and rude. She was planning on going straight through to an NP program and not even practice as an RN. My wife said she was so rude and condescending to everyone, like she was better than them because she was going to be an NP. Some of the things she told me...Lord, child.
 
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Don't you have anything better to do with your time than criticize a cartoon drawing on the internet?

Really? You don't know that "jokes" are one of the most power vehicles people use to promote hatred and discrimination against other groups? This is why I wish pre-meds included more social sciences in their undergrad education
 
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So ironic i died of poisoning
This reminded me of a time a few months ago when I was sitting in the middle of two DNP students who were upset about LPNs. The two were saying that a local hospital was so busy that it had to hire LPNs again (which it hadn't in > 10 years). The two students then proceeded to get very irritated (and appalled) at the fact that these "lesser trained LPNs" could still be hired to do the same job as RNs and how could a hospital think that they could "do the same job without the same level of training?" They then proceeded to discuss the poor patient care and danger associated with a lesser trained person.

Can't make this stuff up. It took every fiber of my being to hold my tongue...

Before you get all high and mighty Psai, research shows advance practice nurses provide care that is at least as good as physician care. Yet research also shows that lesser-trained nurses lead to increased mortality. Base your contempt on evidence-based research, man
 
Yeah, the only reason they look to get away from patient care in the first place is because it's so awful, hence the NP degree chasing and the desire to do as close to what we do as possible.

The nurses I know love being nurses and taking care of people, you know. What they hate is what bean counters have turned nursing into. They are stretched so thin and run like crazy every day, can't even get a drink of water, which is good because they don't have time to go to the bathroom either, and they don't feel like they are able to provide the care they want to provide. Maybe you wouldn't like to practice under a nursing model, but that doesn't mean that model is bad or wrong. Maybe you don't even know there is a nursing model! Or licensure or a code of ethics... And NPs provide care to a lot of people that physicians don't want to--working with disadvantaged populations or in rural areas. Why so contemptuous of them?
 
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The nurses I know love being nurses and taking care of people, you know. What they hate is what bean counters have turned nursing into. They are stretched so thin and run like crazy every day, can't even get a drink of water, which is good because they don't have time to go to the bathroom either, and they don't feel like they are able to provide the care they want to provide. Maybe you wouldn't like to practice under a nursing model, but that doesn't mean that model is bad or wrong. Maybe you don't even know there is a nursing model! Or licensure or a code of ethics... And NPs provide care to a lot of people that physicians don't want to--working with disadvantaged populations or in rural areas. Why so contemptuous of them?
I'm under the impression that all healthcare providers are stretched thin (including nurses and physicians and techs). Everyone is in this together, no?

And I don't see how what Mad Jack said showed contempt.

That goes back to what Psai said. It is possible for nurses to say "We feel overworked and stretched-thin and this is causing harm to patients." The story shouldn't be "We are stretched thin when we care more about the patients than doctors and do more for patients and know just as much as doctors and basically run the hospital while these techs pretend they can do our jobs." NPs were meant to function under a team model, but a small subsect of them think they are above being on a team and want independence. I don't know any doctor who minds working in a group with NPs- the problems only come when NPs don't recognize their limitations
 
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The nurses I know love being nurses and taking care of people, you know. What they hate is what bean counters have turned nursing into. They are stretched so thin and run like crazy every day, can't even get a drink of water, which is good because they don't have time to go to the bathroom either, and they don't feel like they are able to provide the care they want to provide. Maybe you wouldn't like to practice under a nursing model, but that doesn't mean that model is bad or wrong. Maybe you don't even know there is a nursing model! Or licensure or a code of ethics... And NPs provide care to a lot of people that physicians don't want to--working with disadvantaged populations or in rural areas. Why so contemptuous of them?

I agree with your sentiment, but I think the nursing student I mentioned upthread is a good example of why NPs give off bad juju with physicians. This is a girl who will be in school for a total of 4 years with extremely restrictive clinicals and no experience in practice, after which she will have prescribing rights and essentially independent practice rights. That's scary in and of itself, but the attitude that goes with that--this feeling that they don't know what they don't know--makes it even more frightening.

That said, I know some fantastic NPs. It's dependent on their attitude, since their schooling is pretty subpar.
 
The nurses I know love being nurses and taking care of people, you know. What they hate is what bean counters have turned nursing into. They are stretched so thin and run like crazy every day, can't even get a drink of water, which is good because they don't have time to go to the bathroom either, and they don't feel like they are able to provide the care they want to provide. Maybe you wouldn't like to practice under a nursing model, but that doesn't mean that model is bad or wrong. Maybe you don't even know there is a nursing model! Or licensure or a code of ethics... And NPs provide care to a lot of people that physicians don't want to--working with disadvantaged populations or in rural areas. Why so contemptuous of them?
You mistake my comments for contempt. I'm fully aware of the nursing model, I worked alongside nurses for many years as an allied health professional before I started medical school and considered becoming a nurse myself. We had many long discussions about how we wanted to get out of direct patient care because of the mill it had become. The only way to do so was to either leave nursing entirely, enter management, or become a NP that did as little direct patient care as possible. It isn't that they don't like caring for patients, or that I didn't, it's that they didn't like having 8 patients at a time (nor did I like having 20-50 as a respiratory therapist, or a mere 6-8 if I was working the ICU). Tasks get tiring when people want you to crank out as many of X task as possible. They're why I'm so loathe to enter a proceduralist field. Most of them chose the NP route (or CRNA, so that they could care for one patient at a time). I chose the physician one rather than doing a direct-entry nursing program, because I didn't want to have a substandard set of knowledge and skills.
There are certain institutions where physicians are viewed as wrong by default, because their culture is "progressive" and thus the majority opinion (since we're all a part of a team) holds sway over the truth. Given that there's more nurses than physicians, the opinion nearly always falls in their favor in such places, leading to nurses being rather abusive of residents. The residents comply, because to speak up would be to risk being labeled a troublemaker and having their contract rescinded. The nurses can always find a new job, but if a resident is dismissed, that's gg, no re.
 
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You mistake my comments for contempt. I'm fully aware of the nursing model, I worked alongside nurses for many years as an allied health professional before I started medical school and considered becoming a nurse myself. We had many long discussions about how we wanted to get out of direct patient care because of the mill it had become. The only way to do so was to either leave nursing entirely, enter management, or become a NP that did as little direct patient care as possible. It isn't that they don't like caring for patients, or that I didn't, it's that they didn't like having 8 patients at a time (nor did I like having 20-50 as a respiratory therapist, or a mere 6-8 if I was working the ICU). Tasks get tiring when people want you to crank out as many of X task as possible. They're why I'm so loathe to enter a proceduralist field. Most of them chose the NP route (or CRNA, so that they could care for one patient at a time). I chose the physician one rather than doing a direct-entry nursing program, because I didn't want to have a substandard set of knowledge and skills.

There are certain institutions where physicians are viewed as wrong by default, because their culture is "progressive" and thus the majority opinion (since we're all a part of a team) holds sway over the truth. Given that there's more nurses than physicians, the opinion nearly always falls in their favor in such places, leading to nurses being rather abusive of residents. The residents comply, because to speak up would be to risk being labeled a troublemaker and having their contract rescinded. The nurses can always find a new job, but if a resident is dismissed, that's gg, no re.
My sister's exact reason for going NP was the prospect of not being on the patient floors and that fact that if she ever does have to work on the floors she'll at least get paid more per hour than she would as a RN, haha
 
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I'm under the impression that all healthcare providers are stretched thin (including nurses and physicians and techs). Everyone is in this together, no?

And I don't see how what Mad Jack said showed contempt.

That goes back to what Psai said. It is possible for nurses to say "We feel overworked and stretched-thin and this is causing harm to patients." The story shouldn't be "We are stretched thin when we care more about the patients than doctors and do more for patients and know just as much as doctors and basically run the hospital while these techs pretend they can do our jobs." NPs were meant to function under a team model, but a small subsect of them think they are above being on a team and want independence. I don't know any doctor who minds working in a group with NPs- the problems only come when NPs don't recognize their limitations

What limitations exactly? Like a Pediatrician has to consult with an orthopedist when one of their patients fractures a leg? NPs have to consult with outside practitioners as well. How is that any more of a limitation than what physicians have?
 
because I didn't want to have a substandard set of knowledge and skills

How could NP knowledge and skills be be "substandard" when research shows their care is just as good as physician care?
 
How could NP knowledge and skills be be "substandard" when research shows their care is just as good as physician care?

That research is nebulous and based on patient satisfaction surveys (at least the paper I read). Also, just look at their education. It is well below medical education and even PA education. You can go from nothing to NP in four years with almost no clinical experience and not much more than nursing theory and science for nurses courses.
 
What limitations exactly? Like a Pediatrician has to consult with an orthopedist when one of their patients fractures a leg? NPs have to consult with outside practitioners as well. How is that any more of a limitation than what physicians have?
A different knowledge and training background allows physicians to spot and manage cases that NPs can't. A physician has limitations, but less than a NP and physician should be there to oversee when a NP is missing something.

Think of it like this: I took algebra-based physics while physics majors take calculus-based physics. We both know physics, but knowing the calculus derived physics allows you to adapt the equations and your knowledge to new and more complex situations that I can't even dream of solving with something as limited as algebra. There is so much in physics that you can't even begin to comprehend without calculus
 
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How could NP knowledge and skills be be "substandard" when research shows their care is just as good as physician care?
Research doesn't show that- see the other thread on comparison studies for details. No study has ever compared nurse practitioners with equal patient loads and no physician support to physicians. It hasn't been done and never will- the studies to date have all been very small groups of hand-picked nurses treating specific conditions with no other parameters taken into account (physician collaboration, time per patient, etc). I want a study of 100 nurses and 100 FM docs with a 2,000 patient panel each, with the nurses having zero physician support. Then let's look at outcomes, unnecessary tests ordered, efficiency, etc. I guarantee doctors will come out on top in every regard, which is precisely why such a study hasn't been conducted.
 
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Really? You don't know that "jokes" are one of the most power vehicles people use to promote hatred and discrimination against other groups? This is why I wish pre-meds included more social sciences in their undergrad education
Ah yes because a couple of economics courses will make us all as easily offended as you haha
 
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What limitations exactly? Like a Pediatrician has to consult with an orthopedist when one of their patients fractures a leg? NPs have to consult with outside practitioners as well. How is that any more of a limitation than what physicians have?

"Medical student," my ass.
 
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This is a girl who will be in school for a total of 4 years with extremely restrictive clinicals and no experience in practice, after which she will have prescribing rights and essentially independent practice rights. That's scary in and of itself, but the attitude that goes with that--this feeling that they don't know what they don't know--makes it even more frightening... their schooling is pretty subpar.

First, pretty sure they only accept adults into the NP program, not "girls." What century are you living in, dude? And "in school for a total of 4 years," meaning 4 years of elementary school, high school or something else? I have no idea where you get your information. Most nurses start their professional training in their undergraduate educations, 2 years of sciences and liberal arts following by 2 years of nursing. It used to be NPs would then go on to graduate school for another 2 years, but now they go to graduate school for 4 years for a DNP. This makes 6 years of education in their profession compared to our 4. That's why you should watch your contempt. And they get a lot of practice in between their undergrad and graduate educations in general, which gives them a more solid base to build their graduate educations on. I doubt they would mind residencies, but they don't get the same funding for their residencies that we do.
 
First, pretty sure they only accept adults into the NP program, not "girls." What century are you living in, dude? And "in school for a total of 4 years," meaning 4 years of elementary school, high school or something else? I have no idea where you get your information. Most nurses start their professional training in their undergraduate educations, 2 years of sciences and liberal arts following by 2 years of nursing. It used to be NPs would then go on to graduate school for another 2 years, but now they go to graduate school for 4 years for a DNP. This makes 6 years of education in their profession compared to our 4. That's why you should watch your contempt. And they get a lot of practice in between their undergrad and graduate educations in general, which gives them a more solid base to build their graduate educations on. I doubt they would mind residencies, but they don't get the same funding for their residencies that we do.
http://www.merriam-webster.com/dictionary/girl

And time spent learning doesn't matter as much as the "what" you are learning. Back to my previous example, someone who learns 1 yr of calc based physics will be able to do stuff that I wouldn't understand after 5 yrs of algebra based physics
 
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Ah yes because a couple of economics courses will make us all as easily offended as you haha

I was thinking of psychology, sociology, philosophy, anthropology, the classics, history even...
 

Really, you're going to tell me what's culturally appropriate based on some outdated, stodgy dictionary?

http://everydayfeminism.com/2015/06/grown-women-are-not-girls/
Calling Grown Women ‘Girls’ Is Sexist As Hell – Here Are 4 Reasons Why
June 30, 2015 by Carmen Rios

I landed my first feminist internship when I was a freshman in college. And it was there that I made a very frequent mistake: In writing about situations involving grown women, I would repeatedly call them “girls.”

It didn’t take long for me to be informed that it was unacceptable, especially in writing and particularly news writing, to refer to adults as “boys” or “girls.” This seems like common sense now, although actually putting it into practice can still be hard for me.

And that’s because saying “girl(s)” comes naturally to me, as it does to so many of us. But just like calling groups of people “guys” is a widespread and completely normalized practice that inadvertently minimizes the existence of women, so does calling groups of people “girls.”

And yet, unlike using “guys” as a third-person plural catchall, the use of the word “girls” to refer to women is very rarely called out on as sexist. In fact, it still goes largely unnoticed, even by people who should “know better.”

Even I’m still guilty of calling women “girls.” Even though I know I shouldn’t, the word still finds its way to the tip of my tongue. And I hear it everywhere in my circles, too.

People, including me, go out with “the girls,” identify themselves and their friends to the world as “girls,” and talk generally about women’s issues by talking about the lives of “girls,” even when they mean “women.”

Even media with feminist leanings use “girls” as a catchall for adult topics or stories about adult women.

Think of shows like Girlfriends, New Girl, Gilmore Girls, and even Lena Dunham’s own Girls. Ormovies like Girl with the Dragon Tattoo; Girl, Interrupted; and Dream Girls. Even the book Girlboss is guilty of it.

That’s because calling women “girls” is commonplace, and most people don’t bat an eyelash when they do it or when they hear someone else doing it.

In fact, calling women “girls” is so normal that people actually feel uncomfortable calling them “women” instead.

Countless think pieces chronicle an author’s journey to decide when one is not a girl or, conversely, not yet a woman. Feminists and non-feminists alike have documented their own attempts to nix the phrase completely, often, in the process, realizing how weird it feels to call the adult ladyfolks in their lives “women.”

But here’s the thing: Calling a woman a “girl” isn’t okay.

When we call women “girls,” we’re using the force of language to make them smaller. We resist and deny their maturity, their adulthood, and their true power.

When you call a woman a “girl,” you’re actually saying a lot of very serious things about gender politics and womanhood.

This is a call to action. We need to actually start using “women” when that’s what we mean. Because when we refer to women as “girls,” this is what we’re doing.

1. When We Call Women ‘Girls,’ We’re Infantilizing Them
The textbook definition of a “girl” is a female-identified person under the age of 18.

In that way, the term refers to children. And using it to talk about adult females – women – infers that women are, in some way, still immature or childish.

In that way, calling women “girls” (very actively) infantilizes them.

The infantilization of women occurs across realms, especially in American culture.

Advertisements and other forms of media portray women as being childlike and immature. People of all genders are socialized to see women as helpless, irrational, weak, and in need of protection, and legislators feel it’s okay to tell women how to run their lives and what to do with their bodies. We handle women with “kid gloves,” as if their emotions are going to make them incapable of rational behavior in times of stress or conflict.

Of course, our shared cultural tendency to refer to adult women as “girls” isn’t the only example of our culture’s infantilization of women or obsession with women’s youthfulness.

We live in a society where women’s bodies are only seen as attractive, desirable, and – thus, because of the patriarchy – worthy and valid when they fit an ideal standard of beauty. That standard is undeniably sexist. But it’s also racist, ableist, cissexist, heteronormative – and ageist.

Women are only seen as beautiful when they’re young – and a huge amount of pressure is put on women to look, act, and seem young for as long as possible.

As women age, they also see less of themselves reflected in the world around them. They’re less likely to encounter stories similar to their own in books, movies, or television shows. Advertisements rarely apply to them, unless they’re for anti-aging products. And the women they do see who are their age are being praised for “not looking” it.

As our culture demands women stay young forever in order to retain their socially constructed sexual attractiveness (and thus, usefulness to the patriarchy), it also sexualizes young women and girls – and the adult women who look like they’re under 18.

American Apparel came under fire over and over again for producing advertisements that sexualized either adult women who appeared to be underage or actual minors.

Adult actresses are routinely asked to play characters who are younger than they are (and even minors!), which results in a skewed media portrayal of young womanhood. And as a result, actual girls – who are under 18 and not legal adults – are seen as sexually desirable and available.

And thus…

2. When We Call Women ‘Girls,’ We Perpetuate Rape Culture
The end result of all that infantalization and sexualization?

Our society’s obsession with women looking, acting, and being young has fueled a rape culture that victimizes young women and girls.

Here’s what that looks like:

Older women are told they’re not desirable, and advertisers coax them into doing all they can to preserve their youth and vitality. Meanwhile, younger women and girls are bombarded with messages that tell them their worth is measured via their sexuality.

An APA study in 2010 found that young women and girls are sexualized rampantly in our culture. The study defined “sexualization” as occurring when:

a person’s value comes only from his or her sexual appeal or behavior, to the exclusion of other characteristics;

a person is held to a standard that equates physical attractiveness (narrowly defined) with being sexy;

a person is sexually objectified – that is, made into a thing for others’ sexual use, rather than seen as a person with the capacity for independent action and decision making; and/or

sexuality is inappropriately imposed upon a person

Sound familiar?

I know it does.

Because it’s rape culture.

And that same rape culture also infantilizes adult women (as well as young women and girls) by denying them their sexual agency. Survivors of sexual assault are questioned, and they’re overwhelmingly not believed. They’re seen as irrational and perceived to be devious and untruthful.

When we call women “girls,” we’re playing in to all of that.

We’re feeding the double-standard that says grown men are sexy into their 60s, while women are best appreciated when they’re close to 18 (“barely legal,” anyone?).

We’re perpetuating a norm in which being a “woman” means the end of being desirable and the beginning of the slow death of someone’s societal worth.

By reclaiming the word “woman,” and using it to refer to grown-ass adults as we should, we fight back against the infantilization of women. And when we do, we cut short a rape culture that sexualizes actual girls at the same time.

3. When We Call Women ‘Girls,’ We’re Disrespecting Them
Despite what appears to be a widespread discomfort with the term “women,” folks don’t seem to be uncomfortable disrespecting women by referring to them en masse as children.

We don’t seem to realize that “girl” is a diminutive term or to think critically about the ways in which perceiving of women as “girls” disrespects them.

Our society regularly discredits women, often because they’re perceived as immature, incapable, or otherwise less than their adult male peers.

That’s because, for the most part, our culture sees women the same way they see actual girls: weak, frivolous, dependent, foolish, irrational, impulsive, and impetuous.

When we call women “girls,” we conflate them with their younger counterparts in the turn of a phrase. We’re indicating that they are more alike to children than to adults.

And that’s incredibly disrespectful, not to mention disempowering.

Calling women “girls” plays into a sexist culture that refuses to see women as whole, independent people with valid feelings, thoughts, and opinions.

When we call women “girls,” we make it easier for their bosses to dismiss their suggestions or look them over when it’s time to promote folks to leadership positions. When we call women “girls,” we fuel an academic system that sees women’s philosophical and intellectual pursuits as meaningless. When we call women “girls,” we make it easier for people to assume they lack strength, capability, and competency.

When we call women “girls,” we communicate that we don’t see a huge difference in the minds or behaviors of women and girls. Instead, we insist that women, of all ages, are childlike and immature.

We don’t do that for men.

We don’t call men “boys” on the regular, and that’s because we see men as adults – as authority figures in their own lives as well as the lives of others, as wise, as rational.

That empowers men to take risks, innovate, and go their own way. It also bestows upon them the male privilege of being assumed to have expertise, skills, and knowledge that we wouldn’t assume boys have, because they’re kids.

As a culture, we refuse to envision the same growth for girls who become women.

That’s why calling women “girls” is so problematic – it hinders women’s abilities to really see themselves as leaders, thinkers, and doers.

Women are already swimming in a sea of male privilege and entitlement. They’re surrounded by and often part of male-dominated institutions in what is undeniably a male-dominated society.

Being seen as on par with their male peers – and using equivalent terms to address and categorize them as we do men – can empower women to really tap into their potential and push other folks to take them seriously.

4. When We Call Women ‘Girls,’ We’re Not Taking Them Seriously
We don’t take kids seriously.

We care deeply about their well-being and personal growth and we listen closely as they articulate their own needs – or at least we should – but we don’t take them seriously.

We don’t trust them with major decisions about finances and lifestyle choices; we don’t task them with complex and meaningful work; and we don’t expect them to be self-sufficient or entirely responsible.

We don’t treat men the way we treat boys – and we shouldn’t. Because we shouldn’t treat adults the way we treat children.

But often, we don’t take women seriously enough to do the same for them. Often, we treat women like children by disregarding their voices, experiences, and ideas altogether.

For example, their political demands aren’t often taken up, despite the fact that women represent a majority of the voting population and consistently turn out well for elections.

Women have fought political battles for the right to do what they will with their own bodies, pursue the same leadership opportunities as men, and end some of the tragic circumstances of their own lives like violence and the feminization of poverty.

But legislators and the general public alike have spoken over them, insisted they know better, and sometimes even insisted they were limiting women’s options for their own good.

Further, their ideas and suggestions are ignored, mocked, or silenced – and sometimes, credit for those ideas and suggestions are even stolen.

Women throughout history have had their contributions to science, math, philosophy, and politics rendered invisible by sheer ignorance or blatant misinformation. They’ve been effectively cut out and pushed out of positions of power through which they could spark change. They’ve had their ideas shot down, laughed out, and robbed from them by men in positions of power.

And their own needs and experiences are mansplained back to them, dismissed as excessive, or straight-up unacknowledged.

When women explain how they’re feeling, they get gaslighted: Other people tell them they’re “just imagining it,” or that they’re “crazy” (which is hella problematic in and of itself).

People try to explain away their realities and challenge their own intuitive sense of self. Women who speak up demanding to live free from violence, discrimination, and harassment are told they’re asking for “special treatment.” And often, women who claim to have experienced violence, discrimination, and harassment aren’t believed.

And these examples may feel unrelated, but the truth of the matter is that this huge system that consistently puts women at a disadvantage (uhh, we call that “patriarchy”) works both in major and minute ways.

And when we call women “girls,” we’re feeding into the same machine that reminds them constantly that we don’t take them seriously.

And that means they don’t matter.

***

Because our society diminishes women and their contributions, they’ve remained largely invisible in our history. We erase them, or rewrite their stories, or tell their stories without ever saying their names.

And we do this to reduce them so as to make them take up less space and garner less recognition. We do it to make them smaller. Like girls.

But women deserve space. Women deserve recognition. Women deserve to contribute.

Women deserve to be perceived as capable, intelligent, independent, freethinking, rational, self-sufficient, responsible, and mature.

Women deserve to be acknowledged for what they are: Grown Ass Women.

And anything less just won’t do.

Carmen Rios is a Contributing Writer for Everyday Feminism. She splits her time disparately between feminist rabble-rousing, writing, public speaking, and flower-picking. A professional feminist by day and overemotional writer by night, Carmen is currently Communications Coordinator at the Feminist Majority Foundation and the Feminism and Community Editor at Autostraddle. You can follow her on Twitter @carmenriosss and Tumblr to learn more about her feelings.
 
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I was thinking of psychology, sociology, philosophy, anthropology, the classics, history even...

ooohhh, maybe also a history of nursing class, how to advance the nursing agenda, maybe a research "thesis"? We could do them all online too and get a certificate and extra initials to show our mastery of the social sciences?
 
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@JamesAK,

Why did you feel the need to post this entire article?

You need to stop comparing undergraduate and graduate education of NP's to physicians. It is based on two completely different models.

Can you imagine how many medical students worked as medical professionals before starting medical school? This argument that RNs have years of experience before going to NP school is baseless. It seems like it is a fall back whenever the nursing lobby attempts to compare the education of an RN/NP/CRNA/etc to that of a physician.

I have over a decade of experience as a pre-hospital care professional and my a** was in a sling the first week of medical school. At least I admit that n=1.

Edit:clarification and spelling

Sent from my iPhone using SDN mobile app
 
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Really, you're going to tell me what's culturally appropriate based on some outdated, stodgy dictionary?

http://everydayfeminism.com/2015/06/grown-women-are-not-girls/
Calling Grown Women ‘Girls’ Is Sexist As Hell – Here Are 4 Reasons Why
June 30, 2015 by Carmen Rios

I landed my first feminist internship when I was a freshman in college. And it was there that I made a very frequent mistake: In writing about situations involving grown women, I would repeatedly call them “girls.”

It didn’t take long for me to be informed that it was unacceptable, especially in writing and particularly news writing, to refer to adults as “boys” or “girls.” This seems like common sense now, although actually putting it into practice can still be hard for me.

And that’s because saying “girl(s)” comes naturally to me, as it does to so many of us. But just like calling groups of people “guys” is a widespread and completely normalized practice that inadvertently minimizes the existence of women, so does calling groups of people “girls.”

And yet, unlike using “guys” as a third-person plural catchall, the use of the word “girls” to refer to women is very rarely called out on as sexist. In fact, it still goes largely unnoticed, even by people who should “know better.”

Even I’m still guilty of calling women “girls.” Even though I know I shouldn’t, the word still finds its way to the tip of my tongue. And I hear it everywhere in my circles, too.

People, including me, go out with “the girls,” identify themselves and their friends to the world as “girls,” and talk generally about women’s issues by talking about the lives of “girls,” even when they mean “women.”

Even media with feminist leanings use “girls” as a catchall for adult topics or stories about adult women.

Think of shows like Girlfriends, New Girl, Gilmore Girls, and even Lena Dunham’s own Girls. Ormovies like Girl with the Dragon Tattoo; Girl, Interrupted; and Dream Girls. Even the book Girlboss is guilty of it.

That’s because calling women “girls” is commonplace, and most people don’t bat an eyelash when they do it or when they hear someone else doing it.

In fact, calling women “girls” is so normal that people actually feel uncomfortable calling them “women” instead.

Countless think pieces chronicle an author’s journey to decide when one is not a girl or, conversely, not yet a woman. Feminists and non-feminists alike have documented their own attempts to nix the phrase completely, often, in the process, realizing how weird it feels to call the adult ladyfolks in their lives “women.”

But here’s the thing: Calling a woman a “girl” isn’t okay.

When we call women “girls,” we’re using the force of language to make them smaller. We resist and deny their maturity, their adulthood, and their true power.

When you call a woman a “girl,” you’re actually saying a lot of very serious things about gender politics and womanhood.

This is a call to action. We need to actually start using “women” when that’s what we mean. Because when we refer to women as “girls,” this is what we’re doing.

1. When We Call Women ‘Girls,’ We’re Infantilizing Them
The textbook definition of a “girl” is a female-identified person under the age of 18.

In that way, the term refers to children. And using it to talk about adult females – women – infers that women are, in some way, still immature or childish.

In that way, calling women “girls” (very actively) infantilizes them.

The infantilization of women occurs across realms, especially in American culture.

Advertisements and other forms of media portray women as being childlike and immature. People of all genders are socialized to see women as helpless, irrational, weak, and in need of protection, and legislators feel it’s okay to tell women how to run their lives and what to do with their bodies. We handle women with “kid gloves,” as if their emotions are going to make them incapable of rational behavior in times of stress or conflict.

Of course, our shared cultural tendency to refer to adult women as “girls” isn’t the only example of our culture’s infantilization of women or obsession with women’s youthfulness.

We live in a society where women’s bodies are only seen as attractive, desirable, and – thus, because of the patriarchy – worthy and valid when they fit an ideal standard of beauty. That standard is undeniably sexist. But it’s also racist, ableist, cissexist, heteronormative – and ageist.

Women are only seen as beautiful when they’re young – and a huge amount of pressure is put on women to look, act, and seem young for as long as possible.

As women age, they also see less of themselves reflected in the world around them. They’re less likely to encounter stories similar to their own in books, movies, or television shows. Advertisements rarely apply to them, unless they’re for anti-aging products. And the women they do see who are their age are being praised for “not looking” it.

As our culture demands women stay young forever in order to retain their socially constructed sexual attractiveness (and thus, usefulness to the patriarchy), it also sexualizes young women and girls – and the adult women who look like they’re under 18.

American Apparel came under fire over and over again for producing advertisements that sexualized either adult women who appeared to be underage or actual minors.

Adult actresses are routinely asked to play characters who are younger than they are (and even minors!), which results in a skewed media portrayal of young womanhood. And as a result, actual girls – who are under 18 and not legal adults – are seen as sexually desirable and available.

And thus…

2. When We Call Women ‘Girls,’ We Perpetuate Rape Culture
The end result of all that infantalization and sexualization?

Our society’s obsession with women looking, acting, and being young has fueled a rape culture that victimizes young women and girls.

Here’s what that looks like:

Older women are told they’re not desirable, and advertisers coax them into doing all they can to preserve their youth and vitality. Meanwhile, younger women and girls are bombarded with messages that tell them their worth is measured via their sexuality.

An APA study in 2010 found that young women and girls are sexualized rampantly in our culture. The study defined “sexualization” as occurring when:

a person’s value comes only from his or her sexual appeal or behavior, to the exclusion of other characteristics;

a person is held to a standard that equates physical attractiveness (narrowly defined) with being sexy;

a person is sexually objectified – that is, made into a thing for others’ sexual use, rather than seen as a person with the capacity for independent action and decision making; and/or

sexuality is inappropriately imposed upon a person

Sound familiar?

I know it does.

Because it’s rape culture.

And that same rape culture also infantilizes adult women (as well as young women and girls) by denying them their sexual agency. Survivors of sexual assault are questioned, and they’re overwhelmingly not believed. They’re seen as irrational and perceived to be devious and untruthful.

When we call women “girls,” we’re playing in to all of that.

We’re feeding the double-standard that says grown men are sexy into their 60s, while women are best appreciated when they’re close to 18 (“barely legal,” anyone?).

We’re perpetuating a norm in which being a “woman” means the end of being desirable and the beginning of the slow death of someone’s societal worth.

By reclaiming the word “woman,” and using it to refer to grown-ass adults as we should, we fight back against the infantilization of women. And when we do, we cut short a rape culture that sexualizes actual girls at the same time.

3. When We Call Women ‘Girls,’ We’re Disrespecting Them
Despite what appears to be a widespread discomfort with the term “women,” folks don’t seem to be uncomfortable disrespecting women by referring to them en masse as children.

We don’t seem to realize that “girl” is a diminutive term or to think critically about the ways in which perceiving of women as “girls” disrespects them.

Our society regularly discredits women, often because they’re perceived as immature, incapable, or otherwise less than their adult male peers.

That’s because, for the most part, our culture sees women the same way they see actual girls: weak, frivolous, dependent, foolish, irrational, impulsive, and impetuous.

When we call women “girls,” we conflate them with their younger counterparts in the turn of a phrase. We’re indicating that they are more alike to children than to adults.

And that’s incredibly disrespectful, not to mention disempowering.

Calling women “girls” plays into a sexist culture that refuses to see women as whole, independent people with valid feelings, thoughts, and opinions.

When we call women “girls,” we make it easier for their bosses to dismiss their suggestions or look them over when it’s time to promote folks to leadership positions. When we call women “girls,” we fuel an academic system that sees women’s philosophical and intellectual pursuits as meaningless. When we call women “girls,” we make it easier for people to assume they lack strength, capability, and competency.

When we call women “girls,” we communicate that we don’t see a huge difference in the minds or behaviors of women and girls. Instead, we insist that women, of all ages, are childlike and immature.

We don’t do that for men.

We don’t call men “boys” on the regular, and that’s because we see men as adults – as authority figures in their own lives as well as the lives of others, as wise, as rational.

That empowers men to take risks, innovate, and go their own way. It also bestows upon them the male privilege of being assumed to have expertise, skills, and knowledge that we wouldn’t assume boys have, because they’re kids.

As a culture, we refuse to envision the same growth for girls who become women.

That’s why calling women “girls” is so problematic – it hinders women’s abilities to really see themselves as leaders, thinkers, and doers.

Women are already swimming in a sea of male privilege and entitlement. They’re surrounded by and often part of male-dominated institutions in what is undeniably a male-dominated society.

Being seen as on par with their male peers – and using equivalent terms to address and categorize them as we do men – can empower women to really tap into their potential and push other folks to take them seriously.

4. When We Call Women ‘Girls,’ We’re Not Taking Them Seriously
We don’t take kids seriously.

We care deeply about their well-being and personal growth and we listen closely as they articulate their own needs – or at least we should – but we don’t take them seriously.

We don’t trust them with major decisions about finances and lifestyle choices; we don’t task them with complex and meaningful work; and we don’t expect them to be self-sufficient or entirely responsible.

We don’t treat men the way we treat boys – and we shouldn’t. Because we shouldn’t treat adults the way we treat children.

But often, we don’t take women seriously enough to do the same for them. Often, we treat women like children by disregarding their voices, experiences, and ideas altogether.

For example, their political demands aren’t often taken up, despite the fact that women represent a majority of the voting population and consistently turn out well for elections.

Women have fought political battles for the right to do what they will with their own bodies, pursue the same leadership opportunities as men, and end some of the tragic circumstances of their own lives like violence and the feminization of poverty.

But legislators and the general public alike have spoken over them, insisted they know better, and sometimes even insisted they were limiting women’s options for their own good.

Further, their ideas and suggestions are ignored, mocked, or silenced – and sometimes, credit for those ideas and suggestions are even stolen.

Women throughout history have had their contributions to science, math, philosophy, and politics rendered invisible by sheer ignorance or blatant misinformation. They’ve been effectively cut out and pushed out of positions of power through which they could spark change. They’ve had their ideas shot down, laughed out, and robbed from them by men in positions of power.

And their own needs and experiences are mansplained back to them, dismissed as excessive, or straight-up unacknowledged.

When women explain how they’re feeling, they get gaslighted: Other people tell them they’re “just imagining it,” or that they’re “crazy” (which is hella problematic in and of itself).

People try to explain away their realities and challenge their own intuitive sense of self. Women who speak up demanding to live free from violence, discrimination, and harassment are told they’re asking for “special treatment.” And often, women who claim to have experienced violence, discrimination, and harassment aren’t believed.

And these examples may feel unrelated, but the truth of the matter is that this huge system that consistently puts women at a disadvantage (uhh, we call that “patriarchy”) works both in major and minute ways.

And when we call women “girls,” we’re feeding into the same machine that reminds them constantly that we don’t take them seriously.

And that means they don’t matter.

***

Because our society diminishes women and their contributions, they’ve remained largely invisible in our history. We erase them, or rewrite their stories, or tell their stories without ever saying their names.

And we do this to reduce them so as to make them take up less space and garner less recognition. We do it to make them smaller. Like girls.

But women deserve space. Women deserve recognition. Women deserve to contribute.

Women deserve to be perceived as capable, intelligent, independent, freethinking, rational, self-sufficient, responsible, and mature.

Women deserve to be acknowledged for what they are: Grown Ass Women.

And anything less just won’t do.

Carmen Rios is a Contributing Writer for Everyday Feminism. She splits her time disparately between feminist rabble-rousing, writing, public speaking, and flower-picking. A professional feminist by day and overemotional writer by night, Carmen is currently Communications Coordinator at the Feminist Majority Foundation and the Feminism and Community Editor at Autostraddle. You can follow her on Twitter @carmenriosss and Tumblr to learn more about her feelings.
So the definition of a word is now culturally inappropriate because a blog said so...

I also find the fact that you are a guy calling attention to this issue to be sexist. Women can't stand up for themselves? They need a white knight to come in and save them?

The reason you addressed the word girl was to attack the other poster and try to discredit what he was saying. That is why you said it with an attitude rather than in a way that was meant to educate the other poster. It is also an ad hominem argument that you posted this article rather than addressing the points I made that were germane to this thread

Edit: To be clear, I agree that "girl" is condescending when used in a condescending way (like if I said, "You don't know anything; you're just a girl"). Just like with all words, context matters.

And if you want to submit that blog post to an academic critique, I can show you that "boy" is used as often to refer to men as girl is to refer to women. And that both words can be used in a non-offensive way or be used with a condescending tone depending on the intention of the speaker
 
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Today I learned calling a female a girl is sexist.

Thanks SDN!
 
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So the definition of a word is now culturally inappropriate because a blog said so...

I also find the fact that you are a guy calling attention to this issue to be sexist. Women can't stand up for themselves? They need a white knight to come in and save them?

The reason you addressed the word girl was to attack the other poster and try to discredit what he was saying. That is why you said it with an attitude rather than in a way that was meant to educate the other poster. It is also an ad hominem argument that you posted this article rather than addressing the points I made that were germane to this thread

I was reading that short bio at the end of JamesAk post. I can't figure out if it's meant to be a joke or not. How is Carmen Rios even qualified other than being a self-proclaimed feminist?


Sent from my iPhone using SDN mobile app
 
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The nurses I know love being nurses and taking care of people, you know. What they hate is what bean counters have turned nursing into. They are stretched so thin and run like crazy every day, can't even get a drink of water, which is good because they don't have time to go to the bathroom either, and they don't feel like they are able to provide the care they want to provide. Maybe you wouldn't like to practice under a nursing model, but that doesn't mean that model is bad or wrong. Maybe you don't even know there is a nursing model! Or licensure or a code of ethics... And NPs provide care to a lot of people that physicians don't want to--working with disadvantaged populations or in rural areas. Why so contemptuous of them?

BaaaaaaaaHaaaaaaaahaaaaa!!!!! Stretched thin????!!!!! No water? Dont have time to pee??? Just wait till residency.

And let me fix this for you: are nurses really this abusive to doctors? YES. YES THEY ARE.
 
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How could NP knowledge and skills be be "substandard" when research shows their care is just as good as physician care?

Please show me the citation.

There has never been an RCT measuring outcomes between cohorts of physicians and non-supervised NPs. Until then, stop claiming research shows their care is "just as good." It is not.
 
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