Holy poo! Hate for midlevels.

[primadonna22274]

I like medical ethics but don't feel the need to repeat a survey course (autonomy, beneficence, nonmaleficence, yada yada).....

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[Moniker]

Makes a lot of sense. These are the things I want to learn because I'm uncomfortable with not knowing them well enough. But please, there are things like medical interviewing and physical exam/diagnosis courses that I did as a PA student and have been doing for 8 years...to have to repeat those is just an exercise in frustration.

agree- I would need to take antidepressant meds to repeat biopsychosocial issues in pt care, history taking, or medical ethics....

I like medical ethics but don't feel the need to repeat a survey course (autonomy, beneficence, nonmaleficence, yada yada).....

Medical school education is standardized across medical schools. The M.D. denotes that you have completed all required coursework at an LCME accredited institution. Suggesting that you can (or should) ditch out of it just because you've got previous experience in a similar field is like saying we don't need to require any firearm training for military recruits in army bootcamp if they're in the NRA. Just do it like everyone else.

(Oh I edited it for brevity)

 

[primadonna22274]

Oh shush. It's not about ego, it's about the fact that I've done this for 8 years and TAUGHT it over and over again.
So fine, if I get into an MD program and have to take it, I'll suck it up, and ace it (again). But it would be nice for said program to look at me as an individual and recognize which courses I may not have to repeat (and pay for? probably a stretch).
I fully recognize this probably won't happen. I'm prepared to shaddup and do it, as you say. I still say it's typical old-school establishment nonsense.
L.

What if they specifically taught a different technique that they expect you to use in their hospital in M3/4 rotations? What if there are state-specific laws they plan to teach you? What if they have to satisfy LCME requirements to ensure every medical student takes the same coursework on the same grading scheme?

Suggesting that you're in some way above doing the sometimes ridiculous courses that everyone needs to do is silly. Just like it would seem silly to teach a Ph.D in biochemistry about the Kreb's cycle, it may be silly to teach former PA's about doing a history. But what if they graduated, but never practiced? Is that person more deserving of a "get out of history taking 101 free card"? What if they completed some of the coursework, but transferred before they graduated? What if they failed the course the first time around? How would avoiding the course fit into their GPA? Is it fair to relieve select members of a med school class from part of the courseload, thus allowing them more time to study for other courses? Why wouldn't you just take it and shaddap like the rest of us? Just like it may be silly to teach a former lawyer about medical ethics/law. We can't tailor an education, the strength of which hinged upon high, standardized requirements, to what each person feels like is silly to teach them, especially when the only reason not to do it, if only to cover our bases and yours, seems to be ego.

 

[Moniker]

Oh shush. It's not about ego, it's about the fact that I've done this for 8 years and TAUGHT it over and over again.
So fine, if I get into an MD program and have to take it, I'll suck it up, and ace it (again). But it would be nice for said program to look at me as an individual and recognize which courses I may not have to repeat (and pay for? probably a stretch).
I fully recognize this probably won't happen. I'm prepared to shaddup and do it, as you say. I still say it's typical old-school establishment nonsense.
L.

whatever, people have taught things at various levels that are often covered again in medical school - they all have to take it and pass it at a medical school level. It is about ego - as evidenced by: (1) the fact that you emphasized that you "TAUGHT it over and over again" (to whom, at what time, by whose authority, by whose supervision, in what context...we don't know) which is pretty irrelevant, and (2) you claim a bit arrogantly that you'll "ace it (again)". The fact is that there are 16,000 medical students entering medical school every year. It's ridiculous to demand to have your education custom-tailored to what you think you're good at (which you sort of acknowledged), especially when there's a damn good reason to have everyone do the same coursework. Pride cometh before the fall, my friend. Or at least before eyerolls from your classmates.

I'll make you a deal. I won't complain about how below me courses I ace are (that you might struggle in), and you won't complain about how below you the courses you ace are (that I might struggle in).

 

[Taurus]

I don't know why people are making this such a big deal. This shouldn't be the deciding factor whether you go to medical school or not. This is barely a bump in your long training.

If you're already a pro at something, great. It will be a breeze for you while other students are sweating it out for the first time. You can spend that extra time on things you haven't learned yet.

There are FMG's who already finished 3-7 year residencies in their home countries and have to redo residency over again. It's all about not letting things slip through the cracks, which always happens when you loosen the standards. On occasion they have loosened the standards in the past and the results have usually not been good.

So just suck it up and do it. This is a long marathon not a sprint.

 

[foreverLaur]

Maybe schools could compromise and allow students who have already taken the course to attempt to test out of it? If the student aces the medical school ethics course, then they don't have to take it... or something of that nature?

On the bright side, if you do have to take it again it should be an easy A and you shouldn't have to really spend that much time on it anyways. I'm hoping that is the case when I take human anatomy w/ cadavers for the third time (undergrad, nursing, PA).

 

[Moniker]

Maybe schools could compromise and allow students who have already taken the course to attempt to test out of it? If the student aces the medical school ethics course, then they don't have to take it... or something of that nature?

On the bright side, if you do have to take it again it should be an easy A and you shouldn't have to really spend that much time on it anyways. I'm hoping that is the case when I take human anatomy w/ cadavers for the third time (undergrad, nursing, PA).

naturally, i mean they don't want to punish you for having a background in it, but they do have to hold everyone to the same standards.

personally I don't think it's a good idea to have students "test out" of things for the reasons I've already stated. I mean heck, where's the line? can we just study on our own for a year and take the USMLE, thus "testing out" of med school? heck no.

 

[primadonna22274]

I've had a few hours to mull this over without posting my kneejerk response. I want to be like the Thai gyn onc doc. I agree there is some risk to loosening standards and I don't mind proving I can do it again. What I lament is the added debt and loss of income and time required by the whole enchilada. C'est la vie.

When I was an MS3, our Ob/Gyn program one FMG in it.

He was an intern, who had previous been a practicing Gyn Onc in Thailand. His surgical skills were superior to most of the attendings. He was brilliant, and everyone knew it. But he never complained, always went through the appropriate chain of command, and was a singularly impressive individual.

You will hear stories like this all over the country.

If a guy like that can suck it up, take a crappy residency all over again, and never whine about how he was better than everyone else (which he was), then the rest of us can shut up and accept having to take some gay little "Medical Ethics" course a second time around.

 

[zenman]

I'm hoping that is the case when I take human anatomy w/ cadavers for the third time (undergrad, nursing, PA).

You don't work on human cadavers in undergrad or nursing school... at least no place I know of. Frog and cats in undergrad and live people in nursing school.

 

[deleted6669]

You don't work on human cadavers in undergrad or nursing school... at least no place I know of. Frog and cats in undergrad and live people in nursing school.

My upper division biology course in human anatomy at the university of ca. was 4 days/week x 3-4 hrs/day x 15 weeks in the lab working only on cadavers from top to bottom.
great class, better in fact than my a+p class in pa school.

 

[Farmer Jane]

You don't work on human cadavers in undergrad or nursing school... at least no place I know of.

I did. Freshman year A&P, Viterbo University, LaCrosse, WI.

 

[primadonna22274]

Mine too, A&P with human cadavers at Western Oregon U. They had some agreement with OHSU to borrow cadavers and it was great. They also had a prosection class (which I did not get to take) and Histo (also wish I had taken). Cheap tuition too.

I did. Freshman year A&P, Viterbo University, LaCrosse, WI.

 

[foreverLaur]

Yea my anatomy at Ohio State has cadavers. They are prosected. We do it on the same floor as the OSU med students so I peek into their labs sometimes and watch dissections until I get kicked out. Our exams are half lab practicals. The professor will put a pin in a muscle on the cadaver and we'll have to name the proximal/distal attachment, name of the muscle, name its function(s), the innervation, and the blood supply. We then have to trace the innervation back to the spine or the blood supply back to the heart. The class is designed for premedical students. Nursing students, athletic training students, etc take the same lecture, but don't have the lab component with the lab practical. Mine has a 3 quarter waiting list - it is crazy. Plus, we have to cover the entire human body in 9 weeks. I feel so rushed, but at least I'll (hopefully) know it inside and out by the third time

What will anatomy in a BSN program be like?

I'm hoping to get into a PA program that has a dissection anatomy. I'd feel a lot more comfortable doing surgery having previously done a human dissection. I feel the prosected anatomy lab in PA school will be a deja vu of undergrad.

 

[Miss Mab]

Forgive me, hearing something actually true kinda threw me for a second.....

We actually did use and disect human cadevers in my pre-req anatomy class, too.

Surprisingly, this was actually at a JC (!) in California----so yay us for actually being ahead of the curve in education )



ETA: You don't take Anatomy in a second degree BSN program. It is a univeral pre-req.

 

[Chronic Student]

Slightly off topic.

I am sooo grateful that my gross antomy did not use prosections for the main component. There were a few such as the inner ear. However, the practical experience from doing the dissections is something that I have found to be extremely beneficial.

Now that I've been practicing for awhile I would love the chance to do it again as I've got more context for what the hell I'm looking at.

 

[foreverLaur]

You don't take Anatomy in a second degree BSN program. It is a univeral pre-req.

True. I just made an assumption based on the fact that some PA programs require anatomy as a prereq and you take it again in class.

Well, hopefully if I take a prosected anatomy lab in PA school it will be an "easy A" cuz I'll (hopefully) remember everything from undergrad . I'm really hoping I get into one with a dissection lab though. I would think it would be an necessity (or at least a huge help) for anyone hoping to go into a surgical field.

 

[deleted6669]

True. I just made an assumption based on the fact that some PA programs require anatomy as a prereq and you take it again in class.

Well, hopefully if I take a prosected anatomy lab in PA school it will be an "easy A" cuz I'll (hopefully) remember everything from undergrad . I'm really hoping I get into one with a dissection lab though. I would think it would be an necessity (or at least a huge help) for anyone hoping to go into a surgical field.

don't count on that "easy A" in a+p in pa school. the physiology is much more intense than you had in undergrad. I got 1 of 5 A's in a class of 80.....and there were maybe 12 B's....lots of C's and a bunch of D/F grades....and if you don't keep a 3.0 in many pa programs you are gone.....

 

[foreverLaur]

don't count on that "easy A" in a+p in pa school. the physiology is much more intense than you had in undergrad. I got 1 of 5 A's in a class of 80.....and there were maybe 12 B's....lots of C's and a bunch of D/F grades....and if you don't keep a 3.0 in many pa programs you are gone.....

i haven't taken physiology yet. ohio state doesn't offer physiology with a lab and apparently nobody around here does except columbus state community college so i have to take it there.

my anatomy class is just strictly human anatomy. i can't imagine what else they could teach us in PA anatomy. I use Netter's to complement my anatomy class and we've covered almost everything in there (or will be). It amazes me because over the summer when my roommate was a 2nd/3rd year med student I looked at her Netter's and it looked like another language.

What else is taught in PA anatomy that isn't covered in my undergrad class I described above? We cover a lot of histology too. It's an insane class for 9 weeks. I wish I wasn't taking it with 21 credit hours.

 

[deleted6669]

PHYSIOLOGY....that's the P in A+P.....

 

[foreverLaur]

PHYSIOLOGY....that's the P in A+P.....

Not all PA schools do Anatomy & Physiology I/II. I have been looking a lot at KCMA and they do "Advanced Anatomy-Cadaver."

My undergrad school also doesn't do that. We have anatomy and physiology as two completely separate courses.

Anatomy: ANATOMY 199, ANATOMY 200, or EEOB 235
Physiology: PHYSIOCB 311, PHYSIOCB 312, or EEOB 232

(I chose PHYSIOCB 311/312 and ANATOMY 200)

Look 'em up if you don't believe me: http://buckeyelink2.osu.edu/cbulletin/cbulletin.aspx

The University of Toledo PA program also teaches anatomy and physiology as two separate courses.

http://hsc.utoledo.edu/healthsciences/pa/prospectus.html#curriculum

 

[deleted6669]

When and if you get into pa school come back here and post your grades for us.....
in my graduating class of 80 there were 2 folks with a 4.0.....
I had a 3.97.....1 B+ in 3 yrs...and that B was 89.4%

 

[PhysioMan]

True. I just made an assumption based on the fact that some PA programs require anatomy as a prereq and you take it again in class.

Well, hopefully if I take a prosected anatomy lab in PA school it will be an "easy A" cuz I'll (hopefully) remember everything from undergrad . I'm really hoping I get into one with a dissection lab though. I would think it would be an necessity (or at least a huge help) for anyone hoping to go into a surgical field.

You will do quite bad if you go in with this assumption. I watched fellow classmates (Nurses with 15+ yrs experience, FMG Docs...) struggle through A&P while in PA school. Like the old saying goes, "You ain't seen nothing yet baby!". Consider your experiences to date an appetizer...there is a reason they call them prereqs

 

[foreverLaur]

When and if you get into pa school come back here and post your grades for us.....
in my graduating class of 80 there were 2 folks with a 4.0.....
I had a 3.97.....1 B+ in 3 yrs...and that B was 89.4%

I didn't say PA school would be easy. It will be anything but easy. I said that i was HOPING that anatomy would be easier for me due to the extensive nature of my anatomy class and the fact that it is modeled after medical school anatomy and designed as a prep for medical school. The extensive cadaver labs and lab practicals have been a huge help as well.

Not all students are lucky enough to take an anatomy this in depth and extensive. Not all PA schools require an anatomy lab and I feel my knowledge of human anatomy would be a lot lower than it is had I not had the cadaver lab. I have looked at syllabi for other schools a&p I/II courses and I haven't found one this in depth yet. It obviously isn't PA/med school level, but I feel that this anatomy course will give me a slight boost over other students who weren't as fortunate with their anatomy course.

We shall see.

 

[horsenurse25]

You may find that the folks who % midlevels" also look down on other classes of people. Don't let them determine your goals.

Been gone for a long time now, but a little bored so thought I would check out the usual bs just for fun. Miss me Taurus???


What a tiresome crew you mid-level fearing people can be.

Bottom line....



IN THE REAL WORLD mid-levels are cherished, valued and competent co-workers. It is only on this student wanna-be board where the little guys are frightened of their jobs being taken that there is this kind of animosity.

The old class system is rapidly disappearing, the old docs are dying off thank God and the young ones value and are actually very grateful for their competent nurses.

Nurses are extremely autonomous in the hospital setting.

ICU nurses are GOD/DESSES and they tell the docs like it is...and they are usually right. Any smart doc always consults with the nurse who cares for their patient.

Nurses are indeed expected and required to double check the orders. Do you know how many I have caught myself??? And no, it is not because I am saying that they were incompetent and I am Super NP. No. We are all part of a team!!! And everyone makes mistakes.

Most nurses taht I know of could have gone to med school. Hell, many, many people who are not in the medical field could have gone to medical school. Big deal.

And finally, it takes a good nurse to get people out of the hospital. The 5 minutes that the doc wings through the ward inthe mornings is not what gets people back home.

Spend a few days with an NP in the real world and don't listen to anyone on this board. Even me.

 

[Moniker]

Nurses are extremely autonomous in the hospital setting.

"extremely autonomous" is overstating it and kind of a scary thing to say, actually. you're not supposed to be autonomous.

ICU nurses are GOD/DESSES and they tell the docs like it is...and they are usually right. Any smart doc always consults with the nurse who cares for their patient.

wow, talk about self-righteous. take the bravado down a notch there

Most nurses taht I know of could have gone to med school. Hell, many, many people who are not in the medical field could have gone to medical school. Big deal.

based on what? your own assessment of them? your projected MCAT scores? your own assessment of what medical school is probably like, compared to what you think your friends could probably do? and what do you mean 'could have gone to med school'. I mean anyone can 'go to med school', if we're talking about a vacuum where med school just "exists" for those who "go". glossing over the whole "getting in", "passing classes", and "passing exams" is another story. I'm glad you think highly of your colleagues. we do too, you are competent professionals. but don't belittle medical school or physician training by saying "whatever, anyone can do it". i don't go around saying "whatever, anyone can be a nurse, who cares".

And finally, it takes a good nurse to get people out of the hospital. The 5 minutes that the doc wings through the ward inthe mornings is not what gets people back home.

yeah, the physician is totally uninvolved in the care of patients. we have no impact on whether patients get better or worse. in fact, they did a study where they killed off all the doctors in a hospital in Pennsylvania, and all the patients got out of the hospital in 1/2 the time.

jeez, you really seem hell-bent on attacking us. pretty petty, especially when youre just spouting off opinion that's so obviously extremist. no one is trying to belittle the role of nurses, stop pretending they are as an excuse to get defensive and competitive with your insecurity.

Spend a few days with an NP in the real world and don't listen to anyone on this board. Even me.

Will do.

 

[primadonna22274]

Forverlaur: I had human A&P TWICE in undergrad, once on cadavers (first was a survey course at JC level, second bio major course). Human Anatomy & Human Phys (we broke them up into individual courses with individual grades) kicked my butt in PA school. We went into so much greater depth and still didn't cover everything we wanted to. I can't remember what we didn't get to. It broke my heart that I got a high C (I think 79 or so) in Anatomy and it was my lab anatomy class that saved me. Phys was a high B even with a 97% on the final exam (I studied like heck since I thought I was going to fail out and be dismissed). Every grade after that was an A, phew! But it was a rude awakening that I couldn't think of PA school the same way I thought of undergrad.
None of the nursing programs I am familiar with have an anatomy component. It's prereq.
Like E said, don't be too cocky yet.
(Moniker, note I never said I didn't need to repeat Anatomy.)

 

[foreverLaur]

I (obviously) don't know anything about anatomy other than my undergraduate course. We learned all the muscles (and their function/attachments), all the blood supply, nerves, and all the markings on bones.

I mentioned above what our lab practicals are like. Our written exams are like "xxx patient presents with xxx symptoms or did xxx" you then have to pick a likely muscle that the patient tore, bone that the patient broke, pick the nerve disorder, etc.

I know I will probably do most histology in an upper level course. What else? I'm curious .

 

[deleted6669]

origins/insertion/innervation/vascular supply to every muscle,
range of motion limits of every joint as in the following:
fill in question(NOT multiple choice)
how many degrees of flexion/extension/internal+external rotation/abduction and adduction are the following joints capable of achieving.....

 

[primadonna22274]

seemingly infinite variations on standard human anatomy...gee, this cadaver's pronator teres looks totally different than that one...is this the same muscle? wait, which of the extraocular muscles does what? which muscles and nerves are involved in the swallowing reflex? wait, tell me again the Circle of Willis....and on and on.....

origins/insertion/innervation/vascular supply to every muscle,
range of motion limits of every joint as in the following:
fill in question(NOT multiple choice)
how many degrees of flexion/extension/internal+external rotation/abduction and adduction are the following joints capable of achieving.....

 

[Taurus]

Bottom line....



IN THE REAL WORLD mid-levels are cherished, valued and competent co-workers. It is only on this student wanna-be board where the little guys are frightened of their jobs being taken that there is this kind of animosity.

The old class system is rapidly disappearing, the old docs are dying off thank God and the young ones value and are actually very grateful for their competent nurses.

Nurses are extremely autonomous in the hospital setting.

ICU nurses are GOD/DESSES and they tell the docs like it is...and they are usually right. Any smart doc always consults with the nurse who cares for their patient.

Nurses are indeed expected and required to double check the orders. Do you know how many I have caught myself??? And no, it is not because I am saying that they were incompetent and I am Super NP. No. We are all part of a team!!! And everyone makes mistakes.

Most nurses taht I know of could have gone to med school. Hell, many, many people who are not in the medical field could have gone to medical school. Big deal.

And finally, it takes a good nurse to get people out of the hospital. The 5 minutes that the doc wings through the ward inthe mornings is not what gets people back home.

Spend a few days with an NP in the real world and don't listen to anyone on this board. Even me.

In psychiatry, we call this grandiose delusional psychosis.

 

[Farmer Jane]

Gah. Why, why can't people just emphasize the value of their own careers without denigrating the value of others? I. Don't. Get. It. I am a nurse. I assess and monitor patient status. I do for them what they cannot do for themselves. I am the "eyes and ears" of the physicians who depend upon me to update them when necessary. I do just that. What I do is valuable in its own right. I do not need to insult physicians or PAs or anyone else in order to prove my own worth. My worth is in the quality of care I give to my patients, and it speaks for itself.

 

[horsenurse25]

*sigh*

This is why this board can be so very sad.

You all need to go to a real hospital and work for a while.

Really.

And yes, I actually was in med school. Towards the end of 2nd year I dropped out due to family reasons. Best thing I ever did.

Hello!!...nurses have autonomy. Go look it up. I could go into what autonomy means in the nursing setting...but why bother.

If any of you actually do finish med school and become physicians you will find out soon enough.

And no, I was not in any way attacking anyone. I was merely stating what nurses do. For some reason that appears to threaten certain people.

And Taurus...when was the last time you ever worked in the ICU? In fact, have you ever even BEEN in an ICU??

 

[fab4fan]

*sigh*

This is why this board can be so very sad.

You all need to go to a real hospital and work for a while.

Really.

And yes, I actually was in med school. Towards the end of 2nd year I dropped out due to family reasons. Best thing I ever did.

Hello!!...nurses have autonomy. Go look it up. I could go into what autonomy means in the nursing setting...but why bother.

If any of you actually do finish med school and become physicians you will find out soon enough.

And no, I was not in any way attacking anyone. I was merely stating what nurses do. For some reason that appears to threaten certain people.

And Taurus...when was the last time you ever worked in the ICU? In fact, have you ever even BEEN in an ICU??

If by autonomy you mean that nurses can initiate certain medical interventions in certains clearly defined situation, OK. For example, if I see that one of my post-op lap chole pts. is bleeding out and I start a bolus and do x,y,z while one of my co-workers STAT pages the surgeon, I'll agree. I tend to think of it as having a "long leash," when I even think about it at all. I just do whatever needs to be done to take care of the patient. If someone wants to say I have autonomy as a nurse, fine. If someone else wants to disagree, that's fine too.

This is the kind of academic hair-splitting that makes my eyes cross. I really just don't care. And the more I read stuff like this, the more I want to drag my feet at finishing my degree, because it's going to be more of the same. It's turning into gamesmanship. Between that, the ever-increasing paperwork and the push for concierge style health care delivery, I'm about at the end of my patience.

 

[Taurus]

And yes, I actually was in med school. Towards the end of 2nd year I dropped out due to family reasons. Best thing I ever did.

Sour grapes? Resentment? Bueller?

 

[horsenurse25]

Sour grapes? Resentment? Bueller?

You wish!!!

 

[zenman]

Hello!!...nurses have autonomy. Go look it up. I could go into what autonomy means in the nursing setting...but why bother.

Like it or not horsenurse must speak from some experience...as do I.

I've initiated treatment on patients while someone else was trying to get the physician. Then the physician was about to get off call and wanted me to shuffle it to the oncoming call and of course he doesn't want it. I get crisis team and resident shows up, writes a progress note and leaves. Since I'm apparently smarter than he is, I'm really steamed now and go higher to get an interested doctor who looks at the patient and slaps them immediately in ICU. Guess how many times I've done this?

 

[Moniker]

Gah. Why, why can't people just emphasize the value of their own careers without denigrating the value of others? I. Don't. Get. It. I am a nurse. I assess and monitor patient status. I do for them what they cannot do for themselves. I am the "eyes and ears" of the physicians who depend upon me to update them when necessary. I do just that. What I do is valuable in its own right. I do not need to insult physicians or PAs or anyone else in order to prove my own worth. My worth is in the quality of care I give to my patients, and it speaks for itself.

well said.

 

[RAMPA]

well said.

i second that.

 

[OnPump]

Like it or not horsenurse must speak from some experience...as do I.

I've initiated treatment on patients while someone else was trying to get the physician. Then the physician was about to get off call and wanted me to shuffle it to the oncoming call and of course he doesn't want it. I get crisis team and resident shows up, writes a progress note and leaves. Since I'm apparently smarter than he is, I'm really steamed now and go higher to get an interested doctor who looks at the patient and slaps them immediately in ICU. Guess how many times I've done this?

This may stem from differences in the definition of autonomy. Sure in a general sense we're all autonomous creatures....in the medical setting autonomy means (to many clincians) the ability to assess, analyze, order, treat, etc....prescribing, referring to consultants, obtaining radiographic studies, etc.

There are many settings, CT surgery being specific to my frame of reference, where RNs operate with a lot of freedom within a certain scope- giving fluid boluses, titrating vasoactives, replacing electrolytes, drawing labs, requesting x rays.....however technically all these things are done under the prescribed protocols signed by a provider (MD/PA/NP/etc....)

There is autonomy, and a tremendous body of bedside skill (eg RNs who run circles around residents/fellows on balloon pumps, pacers, etc) in the nursing world, which should be recognized and respected by all clinicians.

 

[horsenurse25]

Gah. Why, why can't people just emphasize the value of their own careers without denigrating the value of others? I. Don't. Get. It. I am a nurse. I assess and monitor patient status. I do for them what they cannot do for themselves. I am the "eyes and ears" of the physicians who depend upon me to update them when necessary. I do just that. What I do is valuable in its own right. I do not need to insult physicians or PAs or anyone else in order to prove my own worth. My worth is in the quality of care I give to my patients, and it speaks for itself.

You as a nurse are far, far more than the 'eyes and ears' of a physician.

Much more.

And you know it.

 

[horsenurse25]

This may stem from differences in the definition of autonomy. Sure in a general sense we're all autonomous creatures....in the medical setting autonomy means (to many clincians) the ability to assess, analyze, order, treat, etc....prescribing, referring to consultants, obtaining radiographic studies, etc.

There are many settings, CT surgery being specific to my frame of reference, where RNs operate with a lot of freedom within a certain scope- giving fluid boluses, titrating vasoactives, replacing electrolytes, drawing labs, requesting x rays.....however technically all these things are done under the prescribed protocols signed by a provider (MD/PA/NP/etc....)

There is autonomy, and a tremendous body of bedside skill (eg RNs who run circles around residents/fellows on balloon pumps, pacers, etc) in the nursing world, which should be recognized and respected by all clinicians.

Probably the best post on here.

 

[Farmer Jane]

Did you not catch the part where I said I "assess and monitor"? Sorry if I didn't list every single thing I do but that would get rather long.

 

[OnPump]

Did you not catch the part where I said I "assess and monitor"? Sorry if I didn't list every single thing I do but that would get rather long.

It's not about what we do within our respective scopes, it's about how that scope of care is set. By definition, nursing and medical models as different. It doesn't mean nurses "do less" or MD/PA/NPs (I know I know NPs, nursing model not practicing medicine ) "do more", it's simply different. That's not my opinion, it's fact.

Just as being a PA I have a good deal of autonomy yet work within the framework of physician supervision (whose degree is highly variable from job to job), RNs work within the framework of nursing care with a different type of autonomy(whose degree is highly variable from job to job).

I don't get ahead of myself and say that I'm going to repair a mitral valve myself, just as an RN isn't going to order and read a belly CT by themselves either. My previous post shows my respect and admiration for the work nurses do, but RNs are not formulating diagnoses and ordering treatment independntly......

Not better or worse, different! Room for us all in the mix!

 

[Farmer Jane]

I was responding to horsenurse.

 

[Moniker]

I was responding to horsenurse.

and you were not only right, but displaying something no one else seems to show anymore, a little common sense and humility. i mean jesus, a nurse jumped all over you for saying you were the eyes and ears of a physician (whose job and role in patient care differs greatly), claiming "WHAT?! uh, nurses do so much more than that" as if being vigilant on our behalf precludes being an intelligent and responsible member of the care team, or as if you were saying that's the only thing nurses do.

clearly, it's dangerous when anyone's ego gets too wrapped up in their job, be they physician or nurse. we've all got a role to play.

 

[Farmer Jane]

Thank you. Honestly, I think it's pretty significant that the physicians I work with trust me. They often admit patients without having seen them, and rely on my assessment and the information as I present it to make crucial decisions. That is not all I do, but I daresay it's an important role. I don't think that role makes me unintelligent or subservient to men or physicians. I don't think that saying I'm the "eyes and ears" of the physician (along with other roles) is diminishing my profession. I'm honest enough to understand both the strengths and limitations of my role.

 

[chimichanga]

clearly, it's dangerous when anyone's ego gets too wrapped up in their job, be they physician or nurse. we've all got a role to play.

how dare you

signed,

Tired, Taurus, JK, etc...

 

[horsenurse25]

Thank you. Honestly, I think it's pretty significant that the physicians I work with trust me. They often admit patients without having seen them, and rely on my assessment and the information as I present it to make crucial decisions. That is not all I do, but I daresay it's an important role. I don't think that role makes me unintelligent or subservient to men or physicians. I don't think that saying I'm the "eyes and ears" of the physician (along with other roles) is diminishing my profession. I'm honest enough to understand both the strengths and limitations of my role.

I have a thought a little about your posts on this thread Jane. And honestly, I disagree with the basic tone of them.

I have worked med/surg for many years then I went on to become an NP in geriatrics (although I am often in the hospital since so many of our residents end up in medical of course). I really love being a nurse. I do not see my job as being the 'eyes and ears' for the physician. I do indeed think that implies a subordinate role. And this is the issue with nurses world wide.

In California nurses have a very strong voice, and have worked hard for autonomy in their setting. Of course we have a scope of practice. Naturally there are things we cannot do without a physician's order.

HOWEVER, in the eyes of the public the stereotypical subservient handmaiden's role is what they think of when they see a nurse. THAT is why a person of your talents, experience and education gets little more than a teenager at McDonald's.

Here are the conditions for nurses in California http://www.calnurses.org/membership/model-contracts/

As you say, you admit patients and the doctor gives orders based on your assessment. That is huge, and it happens all the time. Why on earth are you getting paid a fraction of their wage then? How many patients have you saved because you are front line and alerted the physician about the condition, who then acted upon it? If you did not have a very good idea of what was happening and what needed to be done, you would not have known to make the call. In many cases the phone call is a formality. And you know as well as I that if I did not have a good idea of what to do and suggestions to make to the doc when I call, I would be delinquent in my duty (and the doc would wonder if I really knew what I was doing or not).

We do not merely 'report' we also advise. We advocate. We tell the physicians what we think, and they are happy to hear it. We act on behalf of the patient, we double check the physician's work. And that is something that most people do not know that nurses do.


Unless nurses start standing up and making the public know what they do, they will continue to work for peanuts.
Doctors, REAL doctors, already know. But the ignorance on this board alone is representative of the public ignorance and that must change.

 

[telenurse]

I have a thought a little about your posts on this thread Jane. And honestly, I disagree with the basic tone of them.

I have worked med/surg for many years then I went on to become an NP in geriatrics (although I am often in the hospital since so many of our residents end up in medical of course). I really love being a nurse. I do not see my job as being the 'eyes and ears' for the physician. I do indeed think that implies a subordinate role. And this is the issue with nurses world wide.

In California nurses have a very strong voice, and have worked hard for autonomy in their setting. Of course we have a scope of practice. Naturally there are things we cannot do without a physician's order.

HOWEVER, in the eyes of the public the stereotypical subservient handmaiden's role is what they think of when they see a nurse. THAT is why a person of your talents, experience and education gets little more than a teenager at McDonald's.

Here are the conditions for nurses in California http://www.calnurses.org/membership/model-contracts/

As you say, you admit patients and the doctor gives orders based on your assessment. That is huge, and it happens all the time. Why on earth are you getting paid a fraction of their wage then? How many patients have you saved because you are front line and alerted the physician about the condition, who then acted upon it? If you did not have a very good idea of what was happening and what needed to be done, you would not have known to make the call. In many cases the phone call is a formality. And you know as well as I that if I did not have a good idea of what to do and suggestions to make to the doc when I call, I would be delinquent in my duty (and the doc would wonder if I really knew what I was doing or not).

We do not merely 'report' we also advise. We advocate. We tell the physicians what we think, and they are happy to hear it. We act on behalf of the patient, we double check the physician's work. And that is something that most people do not know that nurses do.


Unless nurses start standing up and making the public know what they do, they will continue to work for peanuts.
Doctors, REAL doctors, already know. But the ignorance on this board alone is representative of the public ignorance and that must change.

First off...nurses don't work for the doctor...they work for the patient and the hospital. Nurses work WITH the doctor to provide care for the pt, and it is much easier to work with the doctor if we have a team centered approach versus an antagonistic approach.

Second off , I get much more than a teenager at McDonald's...and I resent that implication, especially coming from a fellow nurse. What do I do that a teenager at McDonald's doesn't do? I hold the hand of a man as the surgeon tells him he has 3 months to live and slips out of the room, I whisper into the ear of a comatose pt on a morphine gtt that it's ok to let go and die. I arrange to have social workers intervene to provide home health aides to assist with daily bathing. I help a homeless person obtain 30 days worth of BP meds, and an insulin pen, so he doesn't have to worry about druggies stealing his syringes at the shelter. I have people come up to me in the mall, hug me and cry and say they remember me and that mom died 2 weeks ago and thank me for recommending hospice.

As for making a fraction of the Doctor's wage?? What world are you living in??? I make more than the residents I work with and I work half the hours they work. If you go on an hourly basis, I make double. For the quality of pay versus number of years schooling + student loan debt+ cost of living, for my area I make a decent living, I have a nice house, 2 vehicles, etc.

Next as for saving patients because I am on the front line, and alerting the physician...THAT IS MY JOB. I feel every time I have a patient start to crash and I intervene and obtain stat orders and stat assessments and consults, then I am performing the most excellent NURSING care I can, and if I standby and let the pt deteriorate to a code, then I have failed as a nurse.

Next, don't get my started on the CNA. I've recieved enough of their unsolicited mail...while standardized staffing ratios would be nice, I am highly insulted by their high-handed assumption that because I am a nurse I should be liberal in my political leanings, and they still refuse to answer any email or letter I send to take my off their list.

I guess I don't like the implication that Jane doesn't understand what nursing entails....Jane, IMHO, seems to understand exactly what nursing entails...To me it just seems that she doesn't seem to think that she needs a special award or special kudos for doing her job.

 

[Farmer Jane]

Exactly. I'm heading to work and coming home to homework, so I can't respond fully right now, but for starters I make way more than a teenager at McDonald's. Where is that even coming from??

In fact, during my last two years of college I was so tired of being a nursing assistant (not to mention I was developing tendonitis in both shoulders from lifting and turning residents so much) that I worked at Dairy Queen. It was actually kind of fun. Anyway, at my first position as a nurse, one day after graduation, I made triple what I made at DQ. I've been a nurse for almost five years now and it's quadruple what I made at DQ, plus shift differentials (I'm weekend program). Just thought I'd share, and that I still have memorized the size in ounces of almost every DQ treat and the ingredients to Blizzards. I also learned to decorate cakes, which is a skill that has come in surprisingly handy.

I'll expand later, but I'm off to work now. You know, the place where I get along with physicians and don't disparage them in order to elevate myself. They don't put me down, so why in the world would I do that to them?