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How do we stop nurse practitioners?
- Thread starter libraryismyhome
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Mutation would make the problem worse. They evolve and get stronger by transducing alien genes.
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Good point. I was thinking of a mutation that would keep them from reproducing.
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The real problem is physicians that train them and make money off of them. They shouldn't exist at all, it's a product of the greed of the previous generation who throw away our future as they call us entitled.
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The only way is to zerg rush them by producing more of us before they become hybrids.
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So how do we undo the wrong?
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We use them for the jobs that we don't want/need to do, yet need to get done. They're not going anywhere.
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But dont we need to control their number and contain them within uninhabitable third world states? How can we put them on a tight leash like we do to PAs?
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There will be less "using" of NPs as they gain rights to practice independently (the case in 20 states). I'm in one of those states and they own their own practices...
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Exactly! This is what i am concerned about. And this is one of major reasons of me not going toward primary care. I dont want others with pathetic background thinking that they can do as good as i do
https://cdn0.onlinenursing.simmons....2e5df08/2U_NursingSimmons_ScopeofPractice.jpg
https://cdn0.onlinenursing.simmons....2e5df08/2U_NursingSimmons_ScopeofPractice.jpg
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There's no stopping a quickly growing group with enough money to bribe politicians and produce policy changes. Just go into a field where they don't affect you. Or pick up a JD and have fun in the medmal ring.
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I suspect that now that the ball is rolling, it is an impossible task. For better or worse, midlevels already have a foothold on independent practice in a good portion of the US. I think it would be next to impossible to undo that. Consequently, I think that goal is a fool's errand.
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- Push loudly and publicly for stricter qualifications to assure patient safety while praising and not disparaging nurses. (Disparaging nurses will backfire.)
- Set higher minimum education and training requirements to assure only experienced and well-educated nurses can attain the credential and that it's not so cheap and easy that anyone can do it.
- Restrict the practice rights to primary care under the supervision of an MD.
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Hilarious GomerBlog post went something like, "Obama Appoints NP Surgeon General of the United States"
In all honestly the surgeon general should probably be a dietitian or gym teacher, because America needs to hustle.
In all honestly the surgeon general should probably be a dietitian or gym teacher, because America needs to hustle.
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Good finally we are talking.
(1) will nurse leaders work with us on regulating np schools?
(2) will they agree on physician supervision? And withdraw their rights on independent practice?
(3) what would they want in exchange?
(1) will nurse leaders work with us on regulating np schools?
(2) will they agree on physician supervision? And withdraw their rights on independent practice?
(3) what would they want in exchange?
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1. Maybe, but only to protect their own bottom line
2. Never
3. N/a. They're not negotiating with us. Legislatures and insurance companies will ultimately make these decisions.
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If the 'more stringent standards' physicians push for are reasonable and they deliver their PR message clearly and effectively that it is for patient safety, the argument can be spun in such a way that it will be hard to fight. Acknowledging that some highly experienced and well-educated nurses are well-qualified to treat minor ailments, but that unqualified practitioners are a threat to public health.
Work to limit, not ban.
Work to limit, not ban.
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Physicians need to become MUCH more politically savvy and start having some spines. Unfortunately many don't think this way and they either only care about themselves or they are too scared to stand up due to lack of leadership or confidence.
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Don't forget about who is training these PAs and NPs to work in more specialized fields like Heme/Onc, Derm, Cardiology, GI, and even the ICU. It's doctors....
My real issue is that I understand why they have gained a foothold in primary care. There really is such a deficit, but I don't understand why they're specializing in fields that that physicians 3-6 years of additional postgraduate education. I guess the same could be true of FP (all those rotations in IM, Peds, EM, and OB really should count for something)!
My real issue is that I understand why they have gained a foothold in primary care. There really is such a deficit, but I don't understand why they're specializing in fields that that physicians 3-6 years of additional postgraduate education. I guess the same could be true of FP (all those rotations in IM, Peds, EM, and OB really should count for something)!
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Can AMA do anything to protect PCPs' rights and regulate nursing schools?
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I wonder if this younger generation of doctors will be able to change legislation to allow us to strike just like how nurses can strike, that's where the real power is at
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I believe they can strike as a union as long as they are salaried employees. They can't if they are independent physicians and hold managerial positions in hospitals. Residents can also unionize.
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Phase out FM/Psych and Gas... leave these specialties for NP.
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Well this would be the reality if we dont do anything but complaining.
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...
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I say let them go wild. Open up 1000 drive through NP schools. Lower standards and when they start shoveling in 2.2 GPA students and people start seeing they don't know how to do ANYTHING it will backfire on the whole profession. People won't know that there are knowledgeable NPs out there if there are 10x as many idiots. The skilled nurses will get lost in the crowd of idiots. People will cry out, laws will change, and then we will get greedy and start the cycle all over again.
If only the patients didn't have to suffer so much for this plan to happen...
If only the patients didn't have to suffer so much for this plan to happen...
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I'm currently seeing a NP at a Psychiatrist's office. She seems OK it's just med management. It's been 8 months and I'm not sure which one is the doctor. She referred to herself as my psychiatrist. Which kind of bothered me. I usually request to see physicians when ever it's possible. As a patient it is kind of annoying when I have to wait to see the physicians a month in advance. Yet a NP and PA can see me that week or the following.
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The current health care system is overburdening physicians with paperwork, incessant recertification and coding. Most doctors I've worked with are happy to have their notes and orders completed in time for a 5 minute lunch, only to repeat the cycle over again until some dismal hour, and then fight insurance companies at home.
Bring forth the newly certified NPs and PAs. Ta-da! If they can ease any burden, they've won their place. And they do ease the burden. There is an important role for mid-levels in our system.
The system creates the need for mid-level progression, and it also vouches for the preparedness of mid-levels. What do you think will happen?
I'd also be more worried about catching my son's soccer game than preserving the authority of our profession #lifehappens.
Bring forth the newly certified NPs and PAs. Ta-da! If they can ease any burden, they've won their place. And they do ease the burden. There is an important role for mid-levels in our system.
The system creates the need for mid-level progression, and it also vouches for the preparedness of mid-levels. What do you think will happen?
I'd also be more worried about catching my son's soccer game than preserving the authority of our profession #lifehappens.
SMH..It is exactly this type of attitude that allows for the rampant expansion of NPs and PAs.
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I'm not being prescriptive, I'm being descriptive. Do I appreciate midlevel encroachment? No. But we have to understand how the health care environment is making it an assumed inevitability. If we want change, we need systemic change.
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They are already on the move to replace doctors.
http://www.nursingworld.org/mainmen...014/no2-may-2014/barriers-to-np-practice.html
Abstract
"As healthcare reform evolves, nurse practitioners (NP) will play key roles in improving health outcomes of diverse populations. According to the Institute of Medicine (IOM) 2011 report, The Future of Nursing: Leading Change Advancing Health, nurses should be change advocates by caring for populations within complex healthcare systems. The IOM reports asserts, “advanced practice registered nurses (APRNs) should be able to practice to the fullest extent of their education and training” (IOM, 2011, s8). However, existing barriers in the healthcare arena limit APRN practice. This article will discuss some of these barriers and provide suggestions for possible ways to decrease the barriers."
http://www.nursingworld.org/mainmen...014/no2-may-2014/barriers-to-np-practice.html
Abstract
"As healthcare reform evolves, nurse practitioners (NP) will play key roles in improving health outcomes of diverse populations. According to the Institute of Medicine (IOM) 2011 report, The Future of Nursing: Leading Change Advancing Health, nurses should be change advocates by caring for populations within complex healthcare systems. The IOM reports asserts, “advanced practice registered nurses (APRNs) should be able to practice to the fullest extent of their education and training” (IOM, 2011, s8). However, existing barriers in the healthcare arena limit APRN practice. This article will discuss some of these barriers and provide suggestions for possible ways to decrease the barriers."
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The problem is when midlevels want to become terminal providers who work independently (i.e. not "mid" anything)
I'm all for work-life balance. Most people going down the PA/NP care more about lifestyle than advancing their knowledge or becoming excellent providers. Unfortunately, many doctors and doctors in training today have drifted towards that mentality as well. This is how we help close the gap between the value we provide and that of midlevels.
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There is a reason that those barriers to independent practice exist.
I'd love to set CRNAs free to manage all types of patients with no safety net and see how that goes for them. Unfortunately that study would never happen and patients wouldn't agree to it.
I'd love to set CRNAs free to manage all types of patients with no safety net and see how that goes for them. Unfortunately that study would never happen and patients wouldn't agree to it.
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I don't know that wanting a life outside of the hospital is a bad thing
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I personally agree with this statement. However, as far as I was informed, PAs are under the control of physicians.
However, NPs are not. They want to be like doctors and want to replace us.
The NP Declaration of Independence
http://nurse-practitioners-and-phys...cle/The-NP-Declaration-of-Independence-4.aspx
To be honest, it would be faster to let NPs free to practice independently without a safety net and watch as shi*t flies in the fan. Unfortunately, I don't think it will take anything less than a few really bad outcomes (read: dead bodies) before insurance companies, politicians, and the nursing lobby change their tunes.
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NP practicing primary care independently is not likely to result in mortality or even significant morbidity. It will lead to increased consults and referrals, though. I don't think the public will care too much about that, even with the price tag.
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It's hard to kill people in the hospital, especially gomers. How do you measure a missed malignancy that someone dies from years later? Anyone can miss a diagnosis. A lot of what we do won't make much of a difference in noncompliant patients or those frequent fliers who come in crises but never seem to go away
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Not even dead bodies will change the nursing lobby. No matter how high it stacks. It will still be spun as somehow the fault of the physicians. Probably, it will be that we didn't support them enough, you see, that is why the death toll accrued.
There has virtually never been a political body that didn't seek, above all other priorities, to maintain itself. Cognitive dissonance on the scale of professional lobbying organizations ensures that any result that suggests that the group and its constituents may actually be the source of the problem ensures that the problem is promptly reframed so that blame is deflected.
NPs aren't going away, and they aren't going to be "stopped," either. If you openly oppose them, you set yourself up as a scapegoat. There is a mythology that doctors are all avaricious, sinister, operating in cahoots to keep the practice of medicine inaccessible to goodhearted nurses and others who would make it more available to the people. Questions like "How do we stop nurse practitioners?" feed into that perception. If you are going to even pose it, you gotta build your deeper concern right into it. Like:
"How do we stop patients from being harmed by underprepared, undereducated, and inexperienced, if well-meaning, midlevel providers?"
Yeah, it is longer, and not as catchy, but a lot harder to twist into evidence that the docs are trying to undermine other professionals for their own financial gain or out of some kind of mean-spirited guild based protectionism.
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I think you hit the nail on the head. A great PCP knows when to consult GI or Cards and when to manage it themselves. A bad PCP (NP/PA) will just throw out these referrals willy nilly. The end result will be Cards getting referrals for any palpitation or vague chest discomfort ect..
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So far, the only workable solution is to not to go into primary care where NPs can say that they can do as well as doctors or work in a state where NPs do not have autonomy.
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a family member emailed me the other day about how she didn't understand why her "psychiatrist" wanted to change her medication. I looked the person up - it's an NP. my family member doesn't work in healthcare and had no idea that she was seeing someone who is not a doctor because this NP markets herself as a psychiatrist to patients who don't know any better
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