Hey, why does everyone hate nurse practitioners?

[RAMPA]

No doubt you will be a good vent jockey...and then PA, right?

thats the plan!!! PA school then something like this http://www.ohsu.edu/anesth/recruitment/PA.htm

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[fab4fan]

I agree, chimi. What continues to confound me is the amount is venom here aimed at nurses, when in the real world, we (docs and nurses) manage to get along fairly well. Sometimes it's not so great, but nothing like what you see here. If it was, there wouldn't be any nurses. (There's a really wicked part of me that would like to see docs try to function for 24h without nurses, but I feel too sorry for the poor pts to really want that to happen.)

I also want to see a doctor if I'm sick. Why? I guess it boils down to having had bad experiences with NPs and PAs. Yes, I have had bad experiences with docs, too, but I have never had a good experience with an NP or a PA, and at this point, I'm not in to mood to give it another go. I have a new doc that I like and trust. End of discussion.

Funny what a difference a month makes. I'm actually seriously considering going back to school to become one of those evil NPs everyone here hates.

Why? The last few weeks have been so terrible when it comes to how some of the medical staff have been treating the nursing staff. I'm not talking picayune crap; I'm talking abusive behavior.

Some of it was going on long before my original post. I'm willing to overlook bad behavior to a degree because everyone has a bad day now and then. But there are things I can't just shrug off, and I guess I have reached the point where I am really getting sick of it and can't imagine having to put up with it for another 20 years. I need options.

Will I actually go through with it? I don't know. I do know that this is the first time I have ever given it this much serious consideration, to the point that I've narrowed down the schools I'm interested in and know exactly what area I want to pursue. For the record, no, I don't want to hang out my own shingle and I don't want a DNP. A master's and working under the supervision of a doctor will be perfectly fine with me.

Time will tell. But something has to change, and I guess that's going to have to be me. Whether it's going on to be an NP or even getting a degree in something else and leaving nursing altogether, something will have to change.

 

[Tired]

Why? The last few weeks have been so terrible when it comes to how some of the medical staff have been treating the nursing staff. I'm not talking picayune crap; I'm talking abusive behavior.

If you or anyone else is being abused in a workplace, you have a responsibility to file a grievance with the union, hospital administration, or anyone else who will listen. The days of doctors getting away with openly abusive behavior is long gone, but to make it stop you have to speak up.

 

[fab4fan]

Incident reports have been and continue to be filled out. What you don't understand is that ultimately, the doc will at most come off with a slap on the wrist, nothing more. He'll continue to behave the same way, and the nursing staff who fill out greivances as they should will be subject to recriminations. I've already gotten enough "if looks could kill" over the last week from one that would have had me dead several times over.

It's not just that. There's also the helpless feeling you have as a nurse when something is going wrong with a pt and you know it, and you know what needs to be done, and there's nothing you can do because Dr. Wonderful has decided to be in a stiff-necked mood. It's an incredibly helpless feeling. Yes, you can run it up the chain of command, but like I said, little to nothing gets done.

It's not every doc who's like this. But there are a few, and unfortunately, we see a lot of them in my dept. It only takes those few to make life a living hell for the rest of us.

I want more, and I want to be out of an area where docs= Gods. If I acted 0.1% like one of these guys, I'd be unemployed, possibly reported to the BON for unprofessional behavior.

 

[chimichanga]

It does happen, more often than it should...

It takes an administration w/ gumption to deal w/ unruly staff (docs, nurses, etc)...And a medical director w/ more gumption to specifically deal w/ the unruly docs...

 

[zenman]

He'll continue to behave the same way, and the nursing staff who fill out greivances as they should will be subject to recriminations, I've already gotten enough "if looks could kill" over the last week from one that would have had me dead several times over.

Have you thought about taking his wife out to dinner for a friendly chat about her spouse's behavior? God, I bet that could be a fun trip,especially when he finds out about it lol!

 

[fab4fan]

Have you thought about taking his wife out to dinner for a friendly chat about her spouse's behavior? God, I bet that could be a fun trip,especially when he finds out about it lol!

Big surprise...he's not married.

Anyway, it's more than just this one individual. It's a growing dissatisfaction with bedside nursing, combined with having to deal with this sort of garbage that has just made me rethink what I want to do with the rest of my career.

 

[horsenurse25]

Anyway, it's more than just this one individual. It's a growing dissatisfaction with bedside nursing, combined with having to deal with this sort of garbage that has just made me rethink what I want to do with the rest of my career.

I feel your pain and this is why I went for my NP. It wasn't anger at the docs in my case. It was the frustration of dealing with the strict scope of practice that is imposed upon nurses. It was maddening to know exactly what needed to be done but be unable to do so without a doctor's consent.

It would be so frustrating having to wait to get hold of a doc, only to have them say "yeah, I thought so too." and give the ok. I cannot tell you how many hours are wasted with this garbage.

I specialized in the ECU. You just try getting a doc to come pay attention to a 87 year old person with multiple health concerns who starts to complain about something new. Most of the time I would get the family involved to harass the doc to return phone calls, much less visit. And meanwhile we can do very little for her while we wait.

So I know what you are speaking of, and I heartily support you. Like you, I never plan on working completely independently - and quite honestly, how many doctors do nowadays? - but it is nice to be able to take care of little things and not so little everyday things without having to run to the phone every time.

And I also also completely support any push from nurses for more independence. Not to replace doctors (of course) but to help facilitate better care. Nurses do the grunt work of medicine and receive little thanks for it. An experienced RN of 5 or more years is often more knowledgable (in their field) than any newly graduated doctor... Thankfully, just about every doc that I have dealt with knows this and takes nurses very seriously.

 

[fab4fan]

Well, another piece of this was what you were describing. Sorry I can't be more specific, but you never know who lurks here. It was a situation I would prefer not to go through again, but if I stay a bedside nurse, I know it will happen over and over.

 

[schutzhund]

An experienced RN of 5 or more years is often more knowledgable (in their field) than any newly graduated doctor...

I'm not sure I took this the right way but...

I have been a nurse for a lot longer than 5 years (critical care and ER) and I have also completed medical school. Let there be NO doubt the level of medical "knowledge" that is learned in medical school is FAR, FAR, in excess of what any nurse has after 5 or 50 years.

Since I am still a nurse and still very much appreciate the job that nurses do, this is not meant as an insult. Nurses are experts in nursing. Doctors are experts in medicine. I can tell you firsthand, after doing both, I was way too confident in my knowledge when I was a nurse. Of course, I didn't realize that back then.

I am strongly opposed to giving nurses "more independence" but I was all for it when I worked as a nurse. I remain a strong nurse advocate but I firmly believe that medical decisions should be made by the medical experts, physicians. As I have said before (as well as almost everyone I knew that was a non-physician prior to medical school), I am frightened how little I knew before.

 

[horsenurse25]

An experienced RN of 5 or more years is often more knowledgable (in their field) than any newly graduated doctor... Thankfully, just about every doc that I have dealt with knows this and takes nurses very seriously.

No, I was in a hurry and worded it wrong. What I meant was that an experienced RN has the benefit of that experience and knows quite a bit about medicine and illness.

Perhaps they do not have formal medical training, but that does not mean they do not have a 'gut instinct' and a very good idea of what is happening and what should be done. Working every day in a ward at the bedside, seeing the same things come in and out day after day, applying whatever interventions the doctor prescribes first hand themselves, seeing what works or does not work, spending 8-12 hours at a time looking at the patient, etc.,etc. You would have to try really hard NOT to get a hands on education.

Often the doctor will see a patient for just a few minutes at a time before rushing away. Without a nurse's input they really have no idea what is going on.

What I meant was that a new doctor does not have the benefit of all this experience. I cannot tell you how many times an MD (and not a new one) had asked me what I thought when I was a nurse, and then followed up on my opinion. I am glad for those doctors. They have the best interests of their patients at heart and not their own egos....

The huge gap between nurses and doctors is archaic and does not reflect reality in most cases. I think that is being addressed and it is a good thing. Turf wars do not help the patient which is our true focus...at least it should be.

 

[keny123]

I don't think so that everyone hate nurse practitioners! if you are working in china , many people enjoy nurse practitioners!

 

[Tired]

I don't think so that everyone hate nurse practitioners! if you are working in china , many people enjoy nurse practitioners!

I'm sure many posters here would love to send you all our NPs.

 

[caroladybelle]

If you or anyone else is being abused in a workplace, you have a responsibility to file a grievance with the union, hospital administration, or anyone else who will listen. The days of doctors getting away with openly abusive behavior is long gone, but to make it stop you have to speak up.

Honey, few nurses have unions, administration doesn't give a crap, and if you try to publicize it, it gets shut down, d/t HIPAA or or other privacy garbage.

I just finished and assignment in a wealthy enclave of the WPB area, that made me want to quit Nursing altogether. Many of the MDs were schmucks, and they made me fear for the safety of my license. The facility was private and catered to the overindulged. What is frightening is that it is on its way to becoming a teaching facility.

I would have felt that my patients were in safer hands with NPs/PAs than many of these guys.

 

[Tired]

Honey, few nurses have unions, administration doesn't give a crap, and if you try to publicize it, it gets shut down, d/t HIPAA or or other privacy garbage.

I just finished and assignment in a wealthy enclave of the WPB area, that made me want to quit Nursing altogether. Many of the MDs were schmucks, and they made me fear for the safety of my license. The facility was private and catered to the overindulged. What is frightening is that it is on its way to becoming a teaching facility.

I would have felt that my patients were in safer hands with NPs/PAs than many of these guys.

First of all, I'm not your honey, and I'm puzzled about why you would presume to use an overly-familiar term to address me.

Second, the ANA estimates that about 20% of all RNs are unionized, which is a substantially greater proportion than the rest of the American workforce. For many nurses, using the union in workplace conflicts is a viable method of recourse, and should not be ignored.

Finally, I have seen multiple complaints against physicians result in action to correct the situation. If complaints didn't work, and nursing were really as intimidated and powerless as you say, then I wouldn't have to hear them complain all the time.

 

[zenman]

First of all, I'm not your honey,

Tired, she's from the south. That's the way they talk. Just tell her to iron your shirts or wash your pickup truck.

 

[zenman]

Well, another piece of this was what you were describing. Sorry I can't be more specific, but you never know who lurks here. It was a situation I would prefer not to go through again, but if I stay a bedside nurse, I know it will happen over and over.

I will never set foot in a hospital as a bedside nurse again. I've even hired a hit man to kill me if I change my mind.

 

[Tired]

Tired, she's from the south. That's the way they talk.

I went to college in the deep South, so I get that. But generally most people in health care have learned that overly familiar colloquialisms are inappropriate with strangers. They beat that into me in med school, and before that in CNA school. One would imagine this is covered in nursing school as well.

 

[fab4fan]

We're non-union, and as I said before, if it's an issue between a doc or a nurse, doc trumps, always. You probably hear nurses complaining because they are venting since no one else will listen and do something about the problems.

Whatever. At this point, my feeling is more or less resignation. This is how it is, it's never going to get better, so there's really no choice but to look at alternatives.

 

[caroladybelle]

I went to college in the deep South, so I get that. But generally most people in health care have learned that overly familiar colloquialisms are inappropriate with strangers. They beat that into me in med school, and before that in CNA school. One would imagine this is covered in nursing school as well.

My regrets at your offense.

I use the term in an informal sense, as this is the Internet and an informal BB. Especially given the extreme informality of this particular thread.

I was aware that you were a patient and that we were in a formal gathering where professional behavior applied. Especially given the incredible unprofessional comments made here. But I stand corrected.

I will remember to stomp on the toes of all the MDs/interns that call me "Love" or "Sweetheart" in the future. And, yes, I have been called that, informally, behind the desk or in personal discourse. Funny, I blew it off as just friendly. Those bad bad MDs at Beth Israel (Boston and NYC), Cornell and Hopkins. I did however, correct an intern at Hopkins that called me her "girl" in front of a patient.

As far as unions, they are quite useless. The one at BIMC in Manhattan are so g-d forsaken loser that they have no ability to limit mandatory OT and serve to keep the hospital from firing some of the worst deadwood employees that I have ever seen. As an agency nurse, I had more rights than the staff in that regard. If they can't limit dangerous amounts of MO (some staffers doing 2 extra shifts per week at times), they are quite useless.

In Philadelphia, when Tenet refused to limit MO per the union, they closed MCP. Obviously, that did not help the staff.

I also am curious about the 20% quote. While that is hardly a majority of nurses, I have to wonder if all of those were RNs, or if the totals included LPNs, and if it included "ancillary" personnel such as aides, hucs, etc.

Many unions list ancillary nursing personnel and people mistake the numbers as meaning "nurses" when most of them are not. For example, TJUH and Hopkins interns occasionally refer to the facilities as unionized, when the RNs are not. At TJUH, the aides are unionized and at Hopkins, the SAs are - these are not nurses. Were all 20% RNs/LPNs?

Barring CNA in California and the unions in Massachusetts, many unions do little to help RNs on a real basis.

And as most community hospitals consider MDs as "customers", they do little to make them behave. Much like patients.

We are also given the party line of , "their work is so hard and they are just stressed" BS.

 

[caroladybelle]

Tired, she's from the south. That's the way they talk. Just tell her to iron your shirts or wash your pickup truck.

I don't wash 4 wheels and rarely even iron my own shirts, just shake them out from the dryer, unless they need starch.

But I do make decent cornbread, and carry the iron skillet with me on assignment. I am sure that the TSA that checked my bag when I flew into LaGuardia was a bit freaked.

I can also find stores that carry grits in all major cities in the NE. When they flew some of the Katrina survivors up Cape Cod, someone called me to find out where to get grits in Boston (Whole Foods carry yellow organic grits). I also gave them instructions on how to make boiled green peanuts, and that they could be obtained at the Thai grocery in Chinatown. The Haymarket guys had no idea what green peanuts were when I asked for them at the farmer's market.

 

[fab4fan]

I'm surprised they didn't confiscate your skillet.

 

[FoughtFyr]

I don't wash 4 wheels and rarely even iron my own shirts, just shake them out from the dryer, unless they need starch.

But I do make decent cornbread, and carry the iron skillet with me on assignment. I am sure that the TSA that checked my bag when I flew into LaGuardia was a bit freaked.

I can also find stores that carry grits in all major cities in the NE. When they flew some of the Katrina survivors up Cape Cod, someone called me to find out where to get grits in Boston (Whole Foods carry yellow organic grits). I also gave them instructions on how to make boiled green peanuts, and that they could be obtained at the Thai grocery in Chinatown. The Haymarket guys had no idea what green peanuts were when I asked for them at the farmer's market.

Now Carol,

If you manage to get to Ohio on assignment, PLEASE let me know! My wife and I would happily trade a few homecooked meals in exchange for a few cooking lessons! (We split that chore in our house). I haven't had good grits since my days at Fort Benning!



- H

 

[caroladybelle]

I'm surprised they didn't confiscate your skillet.

It was in checked baggage, so they couldn't bust me on it being a weapon. Though it does make an effective one.

FFY, unfortunately Ohio rarely has good traveler hemo/onco assignments. It is also known to be one of the harder states to get licensure by endorsement/reciprocity...thus I doubt that I will be there.

I have pretty much covered the majors on the eastern coast. I think that California or Houston (all onco/hemos need to go to Houston eventially) may be in the future. For now, I am doing work in community hospitals in FL near Mom's, replacing her storm windows, and praying that hurricane season will be kind this year.

And the MDs in community hospitals are much more difficult to deal with. I will be glad to return to teaching facilities.

 

[fab4fan]

I'll bet you wish there were days you could take that skillet to work, and not necessarily for making grits, either.

 

[alpha62]

that's why I'm sick of nurses. but then again, a lot of people in cyberspace do the same thing.

If you have a beef with somebody, why don't you just grow up and confront them with it, rather than "writting them up" like a passive-aggressive little worm that doesn't want to take the heat ?

Chances are, you may be part of the problem, that's why.

If you or anyone else is being abused in a workplace, you have a responsibility to file a grievance with the union, hospital administration, or anyone else who will listen. The days of doctors getting away with openly abusive behavior is long gone, but to make it stop you have to speak up.

 

[fab4fan]

Because it's hospital policy that it be written up so there's a paper trail in case there needs to be disciplinary action, you *****.

And because talking to the individual gets you nowhere, whereas when it comes from a colleague taking a written complaint to the individual, there's at least half a chance the individual in question will behave for a week or two.

It's not our idea to write it up.

 

[zenman]

that's why I'm sick of nurses. but then again, a lot of people in cyberspace do the same thing.

If you have a beef with somebody, why don't you just grow up and confront them with it, rather than "writting them up" like a passive-aggressive little worm that doesn't want to take the heat ?

Chances are, you may be part of the problem, that's why.

You are sick of nurses because they follow HR policies? I usually confront people on their behavior first and have since I was a new nurse. But then I'm a big guy and after telling someone I'm going to rip their head off and crap in their neck they usually behave much better.

But the paper trail serves a purpose.

 

[fab4fan]

Never mind. I just looked at your profile, alpha. Told me all I needed to know. A PA who hates nurses...what a shock.

 

[alpha62]

Never mind. I just looked at your profile, alpha. Told me all I needed to know. A PA who hates nurses...what a shock.

I love nurses.... and I got the titer to prove it.

 

[alpha62]

Because it's hospital policy that it be written up so there's a paper trail in case there needs to be disciplinary action, you *****.

And because talking to the individual gets you nowhere, whereas when it comes from a colleague taking a written complaint to the individual, there's at least half a chance the individual in question will behave for a week or two.

It's not our idea to write it up.

wouldn't you be much happier being a personal injury lawyer " you ***** "

This is why I liked medics instead of nurses at the aid station. First guy to stop bleeding behind the building wins the argument.

 

[deleted87716]

I think this thread has run its course. Closing.