going crazy NP or MD?

[billydoc]

He Guys!
I'm new to this forum.So please forgive me if questions like mine have been discussed on here before.
Basicaly, I'm at a loss.I've never been in the situation like this before, where I'm stuck, and unable to make a decision. I'm an RN with about 15 yrs of diff clinical exp, and administrative paper pushing.I'm 35 y.o guy, married, with a child. Last year I was accepted to a few Caribbean med schools. I chose ROSS, went over there kind of in a hurry (one month from acceptance date),haven't been to school for at least 10 yrs before that. Of course, by the end of the semester I realized that no matter what I do I'm bound to fail at least 1 out of 4 subjects. But my problems were not only academic ones. I went over there without my family, which emotionally had undermined me the most. I'm also type 2 diabetic, whichgenerally is well-controlled, but with the crappy food choices, and under huge amount of stress got really decompensated.
Here is my dilemma: I still have my acceptance to another Carib school, which is on a much better island, and I'm prepared for a basic scince a lot better, than a year before. But I kind of lost my confidance, and now thinking, may be I should opt out for NP.Primary care (IM/FP) is what I wanted to do as an MD. So is it really worth it to go all the way, considering my past exp, and a current state of health?
I'm sorry I went on too long. But any thoughts, advices or ideas are greately appreciated.
Thanks a lot.
Bill

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[deleted6669]

don't rule out pa as a choice. 30% of pa's are former rn's...there are also joint pa/np programs(u.c. davis, stanford ) which would let you play the whole field.....if I had been an rn I would have gone to davis....alas, as a humble paramedic that choice was closed to me.....

 

[guetzow]

Midlevel sounds like the route for a stress-out, time-constrained guy like you. Med school will probably kill ya.

 

[jaylily]

there are also joint pa/np programs(u.c. davis, stanford ) which would let you play the whole field.....

That's sound advice. I've been debating RN/MD too, and for me, RN seems to make the most sense (my long term goal is NP)
From what I've heard about caribbean medical schools, your odds of getting a job in the US after graduation isn''t that great either. I say take the NP/PA route.
Just my advice, it's your decision to make.

 

[billydoc]

Thanks to all who repplied. PA would be a good choice, but an RN to NP is a much quicker fix. I'm also a licenced acupuncturist and have been in private practice, before starting med school last year. I think I truly enjoy it. This obsession "nothing less than MD will do" started when many of my happy patients started telling me something like "too bad you are not a doctor, I realy would change my doc for you in a heartbeat" and so on. It was happening long enough, before it pushed me (almost off the cliff). So I think I will defer my med school for some more time, realy concentrate on my own health, and will take it from there.
But one thing I still would love to here, from those of you in the know, how do you kind of combine traditional role, as an NP with a holistic practice, esp in outpatient settings. Also if you are an NP who works independently llease pm me.
Thanks a lot

 

[guetzow]

Considering your previous fixation with MD, PA is really the better way to go......."MEDICAL MODEL".

 

[oldManDO2009]

Thanks to all who repplied. PA would be a good choice, but an RN to NP is a much quicker fix. I'm also a licenced acupuncturist and have been in private practice, before starting med school last year. I think I truly enjoy it. This obsession "nothing less than MD will do" started when many of my happy patients started telling me something like "too bad you are not a doctor, I realy would change my doc for you in a heartbeat" and so on. It was happening long enough, before it pushed me (almost off the cliff). So I think I will defer my med school for some more time, realy concentrate on my own health, and will take it from there.
But one thing I still would love to here, from those of you in the know, how do you kind of combine traditional role, as an NP with a holistic practice, esp in outpatient settings. Also if you are an NP who works independently llease pm me.
Thanks a lot

NP allows for a more independent practice model but IMHO PA school is much more rigorous in the sciences and I think a basic requirement for safe patient care - I did not know there was a dual PA/NP program - forget quick - check out that program. Depending on where you work the "extra" skills will be invaluable

 

[Freeeedom!]

If you wish to pursue a medical career and choose to be a midlevel provider, the being a PA is the best choice. The education is superior to that of an NP and more intense. For the sake of the patient DO NOT LOOK FOR THE "QUICK FIX"...there are no shortcuts to superior patient care and education! Would you want an automechanic who took the "short course" or the electrician who " wanted the quick fix to working with electricity and your home"?
I would never discourage anyone from being a physician. Life is what you make of it, and a relaxed person and thrive in any situation and any learning environment a stressed person will be stressed REGARDLESS. Medical school, while intense and long, is the gold standard for learning a complete view of the field of medicine. EVERYONE has a busy lifestyle prior to medical school...at least a third of my class had kids. Don't sell yourself short...it really sounds as if you lost your confidence and are now looking for excuses.

There are options, you could potentially transfer after a year...you can defer for a year. But NEVER NEVER settle.

 

[billydoc]

Hey guys!
Thank You all once again. I really appreciate your comments and advices. I realized that no matter how difficult the road to M.D. is, I just have to stay the course. I have all the mid level I need with 15 yrs as an RN with bunch of dif certs in critical care. Being a doctor is what I really want, and will do!
Thanks all again very much!

Bill

 

[Merovingienne]

If you wish to pursue a medical career and choose to be a midlevel provider, the being a PA is the best choice. The education is superior to that of an NP and more intense.

Can you elaborate on this? How is it 'superior and more intense'?

 

[fab4fan]

Can you elaborate on this? How is it 'superior and more intense'?

Hey, just ignore Freeedom. He's not worth the effort.

 

[deleted6669]

Can you elaborate on this? How is it 'superior and more intense'?

typical pa program : 2 yrs + of full time coursework and rotations to include >2200 hrs of clinical time in all major medical and surgical fields.
typical np program: 15 mo-2 yrs part time(can work as an rn at the same time) with 300-800 hrs of clinical time in a limited number of fields.

I'm guessing this is what freeeedom meant.

 

[Monika]

To elaborate on EMED's statements here is the current curriculum for the incoming PA class at my program..

http://www.sahs.utmb.edu/programs/pas/Prospective_Students/mastersinfo.pdf

scroll down to page 4, under "Professional Course of Study"

Sorry I did not cut & paste but it was a pdf file & I could not do it.

This is a good example of the rigorous & intense nature of most good PA programs. We are also required to create & work on a year-long research project that is most times publishable.

 

[FoughtFyr]

Can you elaborate on this? How is it 'superior and more intense'?

Oh yeah, I second what Monika and emedpa said with one other caveat. The PA is taught within the medical model. The NP is taught through the nursing model. Now, someone gets all hot and bothered and says that it doesn't matter, this very difference in methodology is the excuse used at every institution I know to justify a rule that only a nurse can supervise clinical nursing staff. If this methodological difference is so great that it requires two distinct administrative pathways (medical and nursing) be created in an institution, then it is far too great for me, as a lowly physician, to hire an NP. I mean, I have been flat out told that it is impossible for me to understand nursing's role sufficently to supervise them at the RN level, so how could I, with my limited understanding of nursing, work with an NP?

- H

 

[fab4fan]

You fail to mention that it is possible to enter a PA program with zero experience in the medical field; undergrad degree can be in accounting, for example.

People who enter NP programs typically have several years of nursing experience, often in critical care areas.

In any event, the NP bashers here will never be satisfied; this argument goes round and round and ends up going nowhere.

It sounds like in the OP's heart of hearts, he really won't be satisfied with a midlevel position, and ultimately would be better off in an MD/DO program.

 

[niko327]

You fail to mention that it is possible to enter a PA program with zero experience in the medical field; undergrad degree can be in accounting, for example.

People who enter NP programs typically have several years of nursing experience, often in critical care areas.

In any event, the NP bashers here will never be satisfied; this argument goes round and round and ends up going nowhere.

It sounds like in the OP's heart of hearts, he really won't be satisfied with a midlevel position, and ultimately would be better off in an MD/DO program.

Zero experience? Yes , that may be possible fab4fan, but isn't also possible to become an NP with zero experience? Aren't there combined bsn to masters programs leading to NP. PA programs by the way are just recently trending towards accepting fresh college grads, historically the PA program is geared towards experienced healthcare professionals looking to do something at the clinician level. Whether this recent trend is good or bad for the PA profession is another debate entirely. An accounting degree is not enough to get you in by the way, you will need the prerequisites like chem, bio, micro, a&p, physics, math, etc. This is not meant to be NP bashing by the way, but this stuff about RNs being so experienced that they don't need as much clinical or didactic training is alot of nonsense. Previous experience treating patients as an LPN, RN, EMT, Paramedic, RRT, RT etc is very helpful in future training but is ultimately nothing like taking care of patients at the clinician level. We should fight for every clinical hour and experience we can possibly get. The bottom line: If we think that being an RN or Paramedic previously made all the difference in what we know as clinicians, then maybe we should really examine what we think we know and what we really don't know. Just my opinion by the way.

 

[sunnyjohn]

Emedpa posted on another of these threads that those PA programs that require no previous clinical experience or offer an associate degree are few and are the worst in the country. They are being phased out.

IMO, both the NP and the PA are valuable and have their uses. Better care by an NP or PA than no care at all.

Seems this is another debate that will continue for a long time.

 

[guetzow]

No hocum. Just the facts, ma'am.

 

[Mike MacKinnon]

Zero experience? Yes , that may be possible fab4fan, but isn't also possible to become an NP with zero experience? Aren't there combined bsn to masters programs leading to NP. PA programs by the way are just recently trending towards accepting fresh college grads, historically the PA program is geared towards experienced healthcare professionals looking to do something at the clinician level. Whether this recent trend is good or bad for the PA profession is another debate entirely. An accounting degree is not enough to get you in by the way, you will need the prerequisites like chem, bio, micro, a&p, physics, math, etc. This is not meant to be NP bashing by the way, but this stuff about RNs being so experienced that they don't need as much clinical or didactic training is alot of nonsense. Previous experience treating patients as an LPN, RN, EMT, Paramedic, RRT, RT etc is very helpful in future training but is ultimately nothing like taking care of patients at the clinician level. We should fight for every clinical hour and experience we can possibly get. The bottom line: If we think that being an RN or Paramedic previously made all the difference in what we know as clinicians, then maybe we should really examine what we think we know and what we really don't know. Just my opinion by the way.

Just to clear that up

No it isnt possible to have no critical care experience and be an NP. The worst schools require a min. 1 year of critical care to be an NP and the best require 5+. Having said that you must also recognize the difference between NP and PA in practice.

In some ways NP's are more independant. However, NP's are restricted by the TYPE of NP track they choose. If they for family practice NP they cannot, CANNOT work psych. Emergency etc etc. Acute care nurse prac. can do ER but cannot go and do family practice or psych. etc etc. So you get the idea. While PA's are not always specialized, NP's dont have the choice but to be specialized.

This seems to be a good thing to me. If you narrow the focus of a clinician then you increase their effectiveness. While PA's also do the same thing (surgical PA etc) they do not have to make that perm. professional decision when they enter PA school. Dosent make them better or worse, just different.

Either way it is important to recognize that a PA or an NP is only as good as the individuals drive to BE good. I have seen bad of both.


As far as your assertion that being an RN or EMT-P dosent make a difference in clinician skills i would whole heartly disagree. In the ER or the ICU your clinician IS the RN. There are no physicians there in the evening or night. Moreover the practitioner with the most time with the patient actually assessing will always be the RN. How do you think phsyicians are alerted to changes in status?

Anyway, without working the job you cannot have a basis for comparison. Sure; MD/DO is the highest level of care and they are absolutely responsible for making decisions but assessment really is a team/collaborative effort. I cant tell you how many friends of mine (nurses and medics) who have found they quickly surpassed their classmates in med school when clinical time came. It is really all experience related and clinical assessement is absolutely based on how much you have seen and done in regards to how good you will be at it.

I also want to say I totally agree with you, nothing compares to the education of a physician. Previous experience is simply helpful and may make an easier transition. Hence the reason im going to med school, its time to take things up a notch.
Anywho have a good one.

 

[FoughtFyr]

In the ER or the ICU your clinician IS the RN. There are no physicians there in the evening or night.

Umm, where the hell did you work? In any ED there is ALWAYS a physician (or mid-level practitioner) there. RNs alone cannot perform work required under EMTALA. And most ICUs are going to at least hospitalists, if not intensivists, 24/7, but even in those that don't / aren't, physicians still must be called before treatment decisions made. Do not confuse proxmity with authority or responsibility.

- H

 

[Mike MacKinnon]

Hey

If you have ever worked in a non-teaching hospital ER where there are 4-5 ambulances in the hallway 30 patients in the waiting room and 2 Doc's, Guess who does all the ordering and assessing? It isnt the physicians. Often the test come back and besides the prelim H&P/assessment all the tests come back and the Doc makes the Dispo.

Also, in the ICU at 3 am when the **** hits the fan and the patient is crumping do you suppose RN's just call a consult and wait the 10 min for the return phone call? LOL. No interventions and treatments get done and the patient gets stablized. By the time the physician calls back they get aprised of the situation and sign off on the treatment. Dont fool youself, hospitals dont work like they do in the textbook, any long term physician can tell you how many a time Nurses saved their ass. It isnt a new thing by any standard. I think after 10 years I have the experience and time in to make that statement.

You mention EMTALA but it seems you do not have an understanding of what it means. EMTALA only related to two thing, appropriate transfers and appropriate intake of patients in regard to a medical screening exam. A medical screening exam can happen at ANY TIME in the ER. Not at the beggining. The first contact with medicine a patient gets is the RN who does an assessment then often orders protocol driven tests.

As an RN in the helicopter i have absolute Tx authority. I place central lines, chest tubes, RSI etc and have 40 drugs which i give as i see fit and make transport decisions all Sans physician. Dont confuse your perception of how things work with reality.

Sorry to bust your bubble.

Umm, where the hell did you work? In any ED there is ALWAYS a physician (or mid-level practitioner) there. RNs alone cannot perform work required under EMTALA. And most ICUs are going to at least hospitalists, if not intensivists, 24/7, but even in those that don't / aren't, physicians still must be called before treatment decisions made. Do not confuse proxmity with authority or responsibility.

- H

 

[guetzow]

Many such ER's without Docs around are run by PA's that do just the procedures you described. That's what Mid-Levels do. I've seen quite a few Hubrus-filled RNs in my years that attempt what you have and were rightly disciplined. As a non-provider performing such tasks at will, especially a Boisterous Cavalier one, it is merely a matter of time before you are stripped of your license.

 

[Mike MacKinnon]

Guetzow

It appears you have no experience with non-teaching hospitals and the legal RN role and scope. The ER and the ICU RN are covered to do a considerable number of interventions/treatments by pre set protocols. These protocols are carried out without the need for a physician as they are allready signed off by physicians. However, my point is that the person doing the clinical assessment to decide the need for the intervention IS the RN not a physician. Its delegated responsibility. Please, learn more about hospitals before you question someone who actually works in one.

Secondly. The "Boisterous Cavalier" interventions you speak of are TOTALLY within the nursing scope of practice. All Air medical RN's do these. In fact all of those interventions are in the nurse practice act as long as a pre established training program is setup which teaches the skill. They can even be done in hospital if the hospital policy allows it. Again, you have no clue. As a flight RN not only have I been trained to do these, but as one of the seniors I am the one teaching these interventions. Sure we have medical directors which oversee everything. However, we do not operate under protocols like paramedics do we have guidelines and practice based on our own clincial assessments.

I have been involved in numerous medical cases (litigations) as an expert witness and i can tell you that nothing of what I have told you here in unusual in non-teaching hospitals. I do agree there are RN's who are attempting to "practice medicine" in hospital and i have testified against them in orer to protect the patient.

I think there is confusion about what i am talking about. I agree MD/DO is the end of the road for medical athority. What i think you are basing your ideas on is limited experience in teaching hospitals (Less than 70% of hospitals i might add) which is totally different from typical hospitals. In the busy ER when we arent backed up sure, the Docs do the orders as they have time, however that is rarely the case. The reality is the nurses do most of the ordering with the exception of the higher level testd (VQ CT (except in stroke) etc). What your missing is that the physicians KNOW exaclty what we are doing as they have set this in motion in order to keep the ER moving.

I would also suggest that if you (as a med student) told a Nurse in an ICU who was about to cardiovert an unstable patient in vtach with a pulse that they could not because the "attending" didnt sign off on it and they haddent called him yet; you would quickly find yourself being dressed down by the attending as you were trying to explain why the patient is dead.

I believe that those who do not have in hospital experience will probably not learn these things until you are in a hospital that isnt rife with med students, residents and attendings. When that time comes you will see how different hospitals work and how staff is utilized differently.

 

[Mike MacKinnon]

For the information of everyone here is the EMTALA regs:

http://www.emtala.com/faq.htm

1. What is EMTALA?

The Emergency Medical Treatment and Active Labor Act is a statute which governs when and how a patient may be (1) refused treatment or (2) transferred from one hospital to another when he is in an unstable medical condition.

EMTALA was passed as part of the Consolidated Omnibus Budget Reconciliation Act of 1986, and it is sometimes referred to as "the COBRA law". In fact, a number of different laws come under that general name. Another very familiar provision, also referred to under the COBRA name, is the statute governing continuation of medical insurance benefits after termination of employment.

EMTALA is also known as Section 1867(a) of the Social Security Act. It is included as part of the section of the U.S. Code which governs Medicare.

EMTALA applies only to "participating hospitals" -- i.e., to hospitals which have entered into "provider agreements" under which they will accept payment from the Department of Health and Human Services, Centers for Medicare and Medicaid Services (CMS) under the Medicare program for services provided to beneficiaries of that program. In practical terms, this means that it applies to virtually all hospitals in the U.S., with the exception of the Shriners' Hospital for Crippled Children and many military hospitals. Its provisions apply to all patients, and not just to Medicare patients. (See Section 15 below.)

The avowed purpose of the statute is to prevent hospitals from rejecting patients, refusing to treat them, or transferring them to "charity hospitals" or "county hospitals" because they are unable to pay or are covered under the Medicare or Medicaid programs. This purpose, however, does not limit the coverage of its provisions -- see Sections 15 and 16 below.

EMTALA is primarily but not exclusively a non-discrimination statute. One would cover most of its purpose and effect by characterizing it as providing that no patient who presents with an emergency medical condition and who is unable to pay may be treated differently than patients who are covered by health insurance. That is not the entire scope of EMTALA, however; it imposes affirmative obligations which go beyond non-discrimination. See Section 16 below.

 

[hospPA]

Can you elaborate on this? How is it 'superior and more intense'?

PA:
http://pa.mc.duke.edu/s_prog_curric.asp
51 credits didactic (one year, full-time), 47 credits clinical (one year, full-time, 40+ hours per week average)

NP:
http://www.nursing.duke.edu/page/acnp_and_ccns?SON=b32b41cfb2f910aa09a7a8d4693a8715
45 credits

I picked Duke as they are highly regarded in both fields. You can pick any university across the county that offers both and you will see similar results.

Pat

 

[fab4fan]

Mike: guetzow isn't a med student; he's a PA.

Don't try to confuse him with the facts, in any case. His animus toward nurses is well established, so any type of rational discourse with him is futile.
Nice try, though.

 

[Mike MacKinnon]

Ahhh


Well thats unfortunate and he will learn the hard way. Its sad to see him spouting off about things he clearly knows nothing about. All the other PA's i have had discussions with here like Emdpa have not only been of excellent caliber but very open minded.

ah well, i tried

Mike: guetzow isn't a med student; he's a PA.

Don't try to confuse him with the facts, in any case. His animus toward nurses is well established, so any type of rational discourse with him is futile.
Nice try, though.

 

[fang]

billydoc,

If you're asking for random opinions of people you've never met, here's mine:

Be an NP or PA. It seems like you have a lot going on outside of med school, and it's probably better for your health and your wife/kids if you do something that's medically-oriented and interesting, but less time consuming than medical school. Here's how I'd look at it:

1. med school
-more responsibility
-major debt
-major time away from your family
-it's going to be more of a struggle for you than for someone else who needs to study less

2. pa school
-not as much responsibility
-not much debt
-faster time to complete education and work
-more time with kids both during and after education
-more geographic latitude

 

[niko327]

As far as your assertion that being an RN or EMT-P dosent make a difference in clinician skills i would whole heartly disagree. In the ER or the ICU your clinician IS the RN. There are no physicians there in the evening or night. Moreover the practitioner with the most time with the patient actually assessing will always be the RN. How do you think phsyicians are alerted to changes in status?

Anyway, without working the job you cannot have a basis for comparison. Sure; MD/DO is the highest level of care and they are absolutely responsible for making decisions but assessment really is a team/collaborative effort. I cant tell you how many friends of mine (nurses and medics) who have found they quickly surpassed their classmates in med school when clinical time came. It is really all experience related and clinical assessement is absolutely based on how much you have seen and done in regards to how good you will be at it.

I also want to say I totally agree with you, nothing compares to the education of a physician. Previous experience is simply helpful and may make an easier transition. Hence the reason im going to med school, its time to take things up a notch.
Anywho have a good one.

So anyway, I'm not talking about the advantages in clinical skills you have as an RN or a medic, skills are great, but that's not what I'm disputing. In fact I totally agree with you about surpassing your classmates in clinicals, when you can run a code, get control of the severe COPD exacerbation, or drop the IJ and make it look easy it gets your preceptor's attention. All I'm trying to say is that while being an RN or a Paramedic is great and all, it does very little to add to the level of knowledge you need to have as a clinician. Really I'm not trying to be facetious but neither of these professions prepares you to work at the clinician level. I noticed you immediately jumped on the ICU practice of nurses, and while I don't really agree with the picture you are painting of the RN's responsibility in the ICU, please remember the practice of critical care is only a very narrow slice of the world of medicine. Another poster spoke of hubris among those who work in these hyper acute fields, and I gotta agree with them. When all you do is take terrible situations and turn them around 180 degrees you feel like you can do almost anything, a nice high really, but the vast majority of patients seeking healthcare are not crashing, and that's when you really need to know your medicine. I knew this when I interviewed for PA school and I walked into school leaving my preconceived notions of medicine at the door. I'm sure you'll discover this even more so in med school, somewhere towards the end when you'll reflect on the totality of your training.
P.S. I'm not sure what you meant about not having a basis for comparison without working the job, but I certainly wouldn't have expressed my view if I didn't have such experience. We're not all 20 year old premeds on this site.

 

[Mike MacKinnon]

So anyway, I'm not talking about the advantages in clinical skills you have as an RN or a medic, skills are great, but that's not what I'm disputing. In fact I totally agree with you about surpassing your classmates in clinicals, when you can run a code, get control of the severe COPD exacerbation, or drop the IJ and make it look easy it gets your preceptor's attention. All I'm trying to say is that while being an RN or a Paramedic is great and all, it does very little to add to the level of knowledge you need to have as a clinician. Really I'm not trying to be facetious but neither of these professions prepares you to work at the clinician level. I noticed you immediately jumped on the ICU practice of nurses, and while I don't really agree with the picture you are painting of the RN's responsibility in the ICU, please remember the practice of critical care is only a very narrow slice of the world of medicine. Another poster spoke of hubris among those who work in these hyper acute fields, and I gotta agree with them. When all you do is take terrible situations and turn them around 180 degrees you feel like you can do almost anything, a nice high really, but the vast majority of patients seeking healthcare are not crashing, and that's when you really need to know your medicine. I knew this when I interviewed for PA school and I walked into school leaving my preconceived notions of medicine at the door. I'm sure you'll discover this even more so in med school, somewhere towards the end when you'll reflect on the totality of your training.
P.S. I'm not sure what you meant about not having a basis for comparison without working the job, but I certainly wouldn't have expressed my view if I didn't have such experience. We're not all 20 year old premeds on this site.

Hey Niko

Excellent post and i believe we actually both agree. Well stated. I agree with your definition of clinician level, i think i initially misconstrued what you meant by the term. However, with this explanation we are definately thinking the same thing.

 

[niko327]

As an RN in the helicopter i have absolute Tx authority. I place central lines, chest tubes, RSI etc and have 40 drugs which i give as i see fit and make transport decisions all Sans physician. Dont confuse your perception of how things work with reality.

Sorry to bust your bubble.

Once again, these are all monkey skills. Don't equate your emergency skills with clinician knowledge. Your emergency skills don't make you an ER specialist or ICU intensivist. While all of the skills you mention are impressive, they do not make you ready to manage somebody's endocrine disorder or an oncology case or any other vast number of internal medicine, surgical, psychiatric issues.

 

[niko327]

Hey Niko

Excellent post and i believe we actually both agree. Well stated. I agree with your definition of clinician level, i think i initially misconstrued what you meant by the term. However, with this explanation we are definately thinking the same thing.

Oh OK, so long as you misconstrued please disregard my above post as it is totally unneccessary.

 

[Mike MacKinnon]

Oh OK, so long as you misconstrued please disregard my above post as it is totally unneccessary.

No prob

That post was not intended for you, was the other fellow who got me riled up

 

[guetzow]

Not true. Only with bad RN's, and that communities blind eye with respect to dealing with it (Or owning up to it).

 

[fab4fan]

OK, then that must mean that 99.9% of the nurses you deal with are "bad nurses," since the majority of your posts about nurses are negative.

I'm glad you cleared that up for us.

 

[guetzow]

..."You have to agree, Mr. Nurse, that there is a lot of petty back-biting among nurses, huh? More often than not, a seasoned nurse will destroy a newbie just for the fun of it. I see it at my hospital all the time. They will go behind their backs and tell us what idiots they are. And the inferiority complexes are REAL! Why else would someone try to burn someone else just to make themselves look good? I haven't read any of guestow's previous posts so I don't know if he has disdain for us as a whole, but the post to which you replied was accurate. I don't know if it is just because it is a career with a majority of women or not...but, I find that most male nurses are not petty. They do their jobs, are very laid back and don't back-stab."

Of course, that also delves into sexist territory (Female vs Male), but it is neither in denial, nor blatantly arrogant (Like many of your posts).

 

[Mike MacKinnon]

..."You have to agree, Mr. Nurse, that there is a lot of petty back-biting among nurses, huh? More often than not, a seasoned nurse will destroy a newbie just for the fun of it. I see it at my hospital all the time. They will go behind their backs and tell us what idiots they are. And the inferiority complexes are REAL! Why else would someone try to burn someone else just to make themselves look good? I haven't read any of guestow's previous posts so I don't know if he has disdain for us as a whole, but the post to which you replied was accurate. I don't know if it is just because it is a career with a majority of women or not...but, I find that most male nurses are not petty. They do their jobs, are very laid back and don't back-stab."

Of course, that also delves into sexist territory (Female vs Male), but it is neither in denial, nor blatantly arrogant (Like many of your posts).

Guetzow.

Your posts are Anti-Nurse. I have seen them and a more recent example is the CRNA one where you make a comment on a job you know nothing about.

You will learn a hard lesson one day and i can only hope that it is not at the cost of a patients life. From my perspective you are a troll. While i enjoy a good argument as much as anyone, I do my best to get the information i present correct and i have the experience to back up my position. You however, consistantly make statements about things (CRNA, RN's, NP's & EMTALA) which you clearly know absolutely nothing about. It is an attitude like this (one who makes up answers as their hubris is such that they cant bear to not know) which can be a danger inhospital.

You should consider rethinking your attitude as it isnt going to make you friends. Noone here will care if you "have respect" for them as they do not have respect for you.

Take care and look in the mirror.

 

[guetzow]

Nice knee-jerk, but "Justmanda"s post (And a few others) holds "Oceans" of water. Your energy would be better spent policing the personality disorders rampant in the RN community.

 

[Mike MacKinnon]

Nice knee-jerk, but "Justmanda"s post (And a few others) holds "Oceans" of water. Your energy would be better spent policing the personality disorders rampant in the RN community.

guetzow

Ah your prejudice and stereotypical nature rears its ugly head. Thanks for reinforcing what fab4fan said. Ill ignore all your posts from this point on.

 

[guetzow]

....."Justmanda"s post (And a few others) holds "Oceans" of water". In "supporting what I've been saying"(As well as other posts, of course). Ignoring the problem in your community by bashing others only marginalizes you more

 

[billydoc]

Hey Fang!
Thanks for remembering me, the OP he he.
I appreciate your comments. I pretty much know all the facts, and have already studied at med school in the Carib (ROSS). My major problem there was not studying, but being away from my family. I would have expected time to be a bit easier for me in the clinical portion of the program, simply 15 yrs of being an RN counts for something. But I was questioning NP vs MD because for my perpouses I'd like to be able to Dx and Tx independently. I certainly would love to have an expertise of the MD/DO on board, because I want to be in private practice, which concentrates mostly on prevention, and on chronic but more or less stable stuff. I figured this would be a win-win if I would get a partnership with an established doc or a medical group as an NP and an Acupuncturist. But I'm very concerned about saturating market for the NPs. And with all due respect to PAs, a program like this will be somewhat longer and less practical for me as an RN. I want to capitalize on the fact that I am one, not to start from scratch. I do not care about the title I will have, I care about independent decision making and the autonomy could provide if I found my nishe.

Thanks again

billydoc,

If you're asking for random opinions of people you've never met, here's mine:

Be an NP or PA. It seems like you have a lot going on outside of med school, and it's probably better for your health and your wife/kids if you do something that's medically-oriented and interesting, but less time consuming than medical school. Here's how I'd look at it:

1. med school
-more responsibility
-major debt
-major time away from your family
-it's going to be more of a struggle for you than for someone else who needs to study less

2. pa school
-not as much responsibility
-not much debt
-faster time to complete education and work
-more time with kids both during and after education
-more geographic latitude

 

[billydoc]

OOOps!
I forgot to ask if there are any NPs outthere doing preventative type of care, and concentration on more holistic modalities please pm me. I really would like to as you few honest opinions without turning it into public debate Y vs Z.

Thanks a lot again

 

[Sabrn2do]

Billy, to me it sounds as if you are having a difficult time spiritually, emotionally, and physically. However, before you decide to call it quits on being a doctor, remember why you felt it was important to pursue this career in the first place. Times are going to be rough no matter which field you choose, in the end all that matters is that you followed your dreams.