N.P vs MD/DO ?

[RGMSU]

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Please give me an example of how you heal a person.

It depends on how you define healing. If a person comes to a psychiatrist in a desperately depressed state or even suicidal and said psychiatrist skillfully oversees medications that make their life worth living, there is healing in that I believe. The psychiatrist can be amicable in the process. A compassionate nurse who is not as adept at handling the medical complexities is not engaging in any more healing, according to my definition, perhaps less so. If a person is dying in the hospital, and the internist works to keep them alive and comfortable as long as possible and is compassionate, respecting their wishes throughout, there is healing in that, even though the patient ultimately dies. The nurse practitioner might be just as compassionate or even more so, but are they going to be able to manage a terminally ill patient with liver failure, peritonitis, ascites, respiratory difficulties, CHF, decreased albumin, elevated bilirubin, decreased GFR, and pain as well as an internist can? Doubtful. To put it plainly, there's more to healing than just patting somebody on the back and listening. You have to know the physiology and pathology behind what you're doing as well. That's where medical education eclipses nursing education because we "waste" our time with all the biochemistry, biophysics, molecular biology, genetics, pharmacokinetics, and such.

 

[deleted87716]

Another smart physician (leader) move:

"The AAFP today announced a corporate partnership with The Coca-Cola Co..."

Believe me, physicians are divided on this issue as well. Corporate alliances are part of an effort to decrease our dependence on big pharma for funding CME and other AAFP programs. Arguably, that's a laudable goal. However, many of us wish they'd chosen a less controversial partner. We'll see how it goes. One group of doctors in California resigned from the AAFP over this. Personally, I think that's overreacting.

 

[deleted87716]

It's well known that, other than knowing medicine, physicians are basically worthless...You're so busy you don't know what's happening in the real world.

Wow. Do you really believe that...? 😕

Incidentally, the people posting in this thread on our behalf are not our appointed spokespeople.

 

[RGMSU]

Incidentally, the people posting in this thread on our behalf are not our appointed spokespeople.

Not sure where you're going with this.

 

[fab4fan]

Wow. Do you really believe that...? 😕

Incidentally, the people posting in this thread on our behalf are not our appointed spokespeople.

I think he does. However, the nurses who post in this thread on our behalf don't speak for all of us, BD. 😉

 

[Paseo Del Norte]

I think he does. However, the nurses who post in this thread on our behalf don't speak for all of us, BD. 😉

Word.

 

[J1515]

You spend a lot of money to have facts crammed into your head so fast that you can't remember half of it and think that you've had a great education.

Dumbest thing I've ever read. I remember most of my first two years of med school, and the important stuff was reinforced clinically during years 3 and 4. Anything I forgot is quickly refreshed when I glance at it. Those 4 years of med school allow me to know how to manage zebras like Tuberous Sclerosis, what to screen them for, and what precautions need to be taken. There is more to medicine than you nurses doing a rapid strep test and then sending them on their way with PCN if it's +. How about a persistent strep pharyngitis, would you know to have a retropharyngeal or peritonsillar abscess in the differential? Or would you just keep throwing different antibiotics at the patient until they became septic and ended up in the ICU? How about when that strep patient starts peeing blood? Do you waste our healthcare dollars sending them for urology and nephrology consults? I wonder what you would do if a patient had elevated BUN/Cr and abnormal urine electrolytes? My guess is all of a sudden you wouldn't want to be so "independent."

I know when you look at a typical outpatient FP clinic, nurses and high school students must say "heck, I can do this!" It's the stuff you don't see that's going on inside the doctor's head that makes the difference between a doctor and a nurse.

 

[RGMSU]

Dumbest thing I've ever read. I remember most of my first two years of med school, and the important stuff was reinforced clinically during years 3 and 4. Anything I forgot is quickly refreshed when I glance at it. Those 4 years of med school allow me to know how to manage zebras like Tuberous Sclerosis, what to screen them for, and what precautions need to be taken. There is more to medicine than you nurses doing a rapid strep test and then sending them on their way with PCN if it's +. How about a persistent strep pharyngitis, would you know to have a retropharyngeal or peritonsillar abscess in the differential? Or would you just keep throwing different antibiotics at the patient until they became septic and ended up in the ICU? How about when that strep patient starts peeing blood? Do you waste our healthcare dollars sending them for urology and nephrology consults? I wonder what you would do if a patient had elevated BUN/Cr and abnormal urine electrolytes? My guess is all of a sudden you wouldn't want to be so "independent."

I know when you look at a typical outpatient FP clinic, nurses and high school students must say "heck, I can do this!" It's the stuff you don't see that's going on inside the doctor's head that makes the difference between a doctor and a nurse.

Very true.

 

[zenman]

It depends on how you define healing. If a person comes to a psychiatrist in a desperately depressed state or even suicidal and said psychiatrist skillfully oversees medications that make their life worth living, there is healing in that I believe. The psychiatrist can be amicable in the process. A compassionate nurse who is not as adept at handling the medical complexities is not engaging in any more healing, according to my definition, perhaps less so. If a person is dying in the hospital, and the internist works to keep them alive and comfortable as long as possible and is compassionate, respecting their wishes throughout, there is healing in that, even though the patient ultimately dies. The nurse practitioner might be just as compassionate or even more so, but are they going to be able to manage a terminally ill patient with liver failure, peritonitis, ascites, respiratory difficulties, CHF, decreased albumin, elevated bilirubin, decreased GFR, and pain as well as an internist can? Doubtful. To put it plainly, there's more to healing than just patting somebody on the back and listening. You have to know the physiology and pathology behind what you're doing as well. That's where medical education eclipses nursing education because we "waste" our time with all the biochemistry, biophysics, molecular biology, genetics, pharmacokinetics, and such.

Curing refers to act of treating a specific condition which is why physicians learn a reductionist practice to try to pinpoint an exact cause. Healing refers to looking at a person as an integrated system which includes not only physical but spiritual aspects. Healing transforms your life, and like you say, does not always result in a cure. Healing is a journey that one goes through, not a procedure that someone does.

Most in health care work at level #1. Healing occurs at the other levels. Scientific knowledge can actually get in the way of healing.

1. Physical - lot of info and knowledge
2. Symbolic – level of mind, lot’s of words, some knowledge
3. Mythic – stories, dreamtime
4. Energetic – pure spirit

Disclaimer: This is distance education so be careful you don’t actually learn something.

 

[zenman]

Wow. Do you really believe that...? 😕

Incidentally, the people posting in this thread on our behalf are not our appointed spokespeople.

Remember that I had this in my post also: "(they've told me that personally)."

But let me clarify that they have told me that they were worthless outside of medicine, not just "worthless." Or as one thoracic surgeon told me, "I'm useless at parties because I don't know what's going on outside the OR."

 

[zenman]

Dumbest thing I've ever read. I remember most of my first two years of med school, and the important stuff was reinforced clinically during years 3 and 4. Anything I forgot is quickly refreshed when I glance at it. Those 4 years of med school allow me to know how to manage zebras like Tuberous Sclerosis, what to screen them for, and what precautions need to be taken. There is more to medicine than you nurses doing a rapid strep test and then sending them on their way with PCN if it's +. How about a persistent strep pharyngitis, would you know to have a retropharyngeal or peritonsillar abscess in the differential? Or would you just keep throwing different antibiotics at the patient until they became septic and ended up in the ICU? How about when that strep patient starts peeing blood? Do you waste our healthcare dollars sending them for urology and nephrology consults? I wonder what you would do if a patient had elevated BUN/Cr and abnormal urine electrolytes? My guess is all of a sudden you wouldn't want to be so "independent."

What I'm saying is that our educational method of delivery, from public school on up, is not very efficient. Take that for what it's worth.

I'm all for you as a physician to known all about the zebras. I just like to have some of the knowledge. For example last Sat, while on a dive trip in Pattaya, my wife woke me up about 0100 with severe RUQ pain. I got a taxi and got her to the ER. I was out of the exam room dealing with passport issues every time the physician was in to see my wife. I popped in once and my wife told me they had given her some IV pain meds through a really big syringe and she felt fine now. "At least they diluted it" I'm thinking. Then I finally see the doc who tells me she has diagnosed my wife with Viral Gastroenteritis. My wife says the doc never touched her.

I tell my wife she probably has cholelithiasis and I get her an IM appt. back in Bangkok. Yesterday, an excellent physician saw her, scanned her, and proved me right. She has an appt Mon with a surgeon.

I know when you look at a typical outpatient FP clinic, nurses and high school students must say "heck, I can do this!" It's the stuff you don't see that's going on inside the doctor's head that makes the difference between a doctor and a nurse.

True, and it's what's going on inside my shaman head that makes me different between both fellow nurses and doctors. (Sorry, couldn't resist.) 😀

 

[deleted87716]

I'm all for you as a physician to known all about the zebras. I just like to have some of the knowledge...my wife woke me up about 0100 with severe RUQ pain...I tell my wife she probably has cholelithiasis

Um...not exactly a zebra.

 

[zenman]

Um...not exactly a zebra.

Let me repeat: "I'm all for you as a physician to known all about the zebras. I just like to have some of the knowledge."

Also notice that this particular physician missed a horse.

 

[deleted87716]

Also notice that this particular physician missed a horse.

You're living in the third world. You should be glad it wasn't something life-threatening.

 

[zenman]

You're living in the third world. You should be glad it wasn't something life-threatening.

Actually Thailand has some world class hospitals. Both Bumrungrad and BNH Hospitals are full of international visitors. In my experience, both beat any hospital I've seen in my 37 yrs in health care. I'm so amazed at the efficiency of both that I just like to go and observe. Like any place you'll run into both excellent and not so great physicians, but I can't get over how they operate so efficiently.

 

[PICUPNP]

The nurse practitioner might be just as compassionate or even more so, but are they going to be able to manage a terminally ill patient with liver failure, peritonitis, ascites, respiratory difficulties, CHF, decreased albumin, elevated bilirubin, decreased GFR, and pain as well as an internist can?

RGMSU, No, I don't know as much as one of my intensivists do, but i have been managing critically ill children for the better part of 10yrs. How many 2kg neonates have you intubated and put CVLs into? And what are you doing...oh that's right...you're still in school. When you have the background equal to that of some of these NPs, call me. Most of us, NPs, do not believe that we are equal to a physician. That is something that you and some of your cronies are perpetuating on all of us as a whole and i believe that its just another form of stereotyping. Just because a small group of NPs think that they're equal to docs doesnt mean we all do!

 

[DNPDoctor]

Curing refers to act of treating a specific condition which is why physicians learn a reductionist practice to try to pinpoint an exact cause. Healing refers to looking at a person as an integrated system which includes not only physical but spiritual aspects. Healing transforms your life, and like you say, does not always result in a cure. Healing is a journey that one goes through, not a procedure that someone does.

Most in health care work at level #1. Healing occurs at the other levels. Scientific knowledge can actually get in the way of healing.

1. Physical - lot of info and knowledge
2. Symbolic – level of mind, lot’s of words, some knowledge
3. Mythic – stories, dreamtime
4. Energetic – pure spirit

Disclaimer: This is distance education so be careful you don’t actually learn something.

Exactly. With the aging population, we're going to be seeing even more patients needing chronic and palliative care.
You just cannot "cure" some (many) of the diseases out there.
They have to live with the disease, and we can facilitate them in normalization with their current status and their journey.

 

[Paseo Del Norte]

The nurse practitioner might be just as compassionate or even more so, but are they going to be able to manage a terminally ill patient with liver failure, peritonitis, ascites, respiratory difficulties, CHF, decreased albumin, elevated bilirubin, decreased GFR, and pain as well as an internist can?

RGMSU, No, I don't know as much as one of my intensivists do, but i have been managing critically ill children for the better part of 10yrs. How many 2kg neonates have you intubated and put CVLs into? And what are you doing...oh that's right...you're still in school. When you have the background equal to that of some of these NPs, call me. Most of us, NPs, do not believe that we are equal to a physician. That is something that you and some of your cronies are perpetuating on all of us as a whole and i believe that its just another form of stereotyping. Just because a small group of NPs think that they're equal to docs doesnt mean we all do!

I hear you and have called people out on making sweeping generalizations about all nurses. Unfortunately, the nursing organizations who speak for us at the national and policy making level continue to push this agenda. While we as individuals disagree, our leaders continue to cram this agenda down the throats of the medical community.

 

[RGMSU]

The nurse practitioner might be just as compassionate or even more so, but are they going to be able to manage a terminally ill patient with liver failure, peritonitis, ascites, respiratory difficulties, CHF, decreased albumin, elevated bilirubin, decreased GFR, and pain as well as an internist can?

RGMSU, No, I don't know as much as one of my intensivists do, but i have been managing critically ill children for the better part of 10yrs. How many 2kg neonates have you intubated and put CVLs into? And what are you doing...oh that's right...you're still in school. When you have the background equal to that of some of these NPs, call me. Most of us, NPs, do not believe that we are equal to a physician. That is something that you and some of your cronies are perpetuating on all of us as a whole and i believe that its just another form of stereotyping. Just because a small group of NPs think that they're equal to docs doesnt mean we all do!

You're just wanting somebody to argue with. I don't really care to waste my time entertaining that. Hah, you basically agreed with the substance of my post you're responding to, so I'm not even sure what argument you're making other than to personally attack me. As far as me being a medical student, I will just say that means I have a future as a physician and let you infer the rest. It's very revealing when your insecurities come out as anger.

 

[J1515]

What I'm saying is that our educational method of delivery, from public school on up, is not very efficient. Take that for what it's worth.

I won't comment on high school and college because that's neither here nor there, but there is nothing wrong with the way medical school is taught now. There seems like an infinite number of diseases out there, and yes, it requires 2 years of jamming them down our throats in a classroom, and then another 2 years of seeing them in the hospitals to learn how to treat them, followed by another 3-10 years of residency. This is why medical school is hard. This is why admission to medical school requires certain academic criteria to be met: so that they are assured you can handle the massive amounts of information. To say that we shouldn't have all these facts crammed into our head and that it's a waste of time is an uneducated and ridiculous statement. So we should all be like NPs or PAs and only know half the zebras (or none), and know little about the treatment of said zebras?

Anyone can say RUQ pain = biliary problem. What if your wife's condition was actually cholangitis? Being in another country, what if it was a Clonorchis sinesis infection (which is associated with a certain malignancy). If it is cholangitis, does she need antibiotics? surgery? both? What if it's emphysematous cholecystitis, caused only by certain bacteria in certain patients? Could her surgery wait until monday or does it require an immediate cholecystectomy? (rhetorical questions, I'm not really pimping you)

I'm proud to say I sat in a classroom and had "worthless" facts jammed down my throat for 2 years and was then tortured for another 2 years on the wards, and am now completing a residency, so that I know the answers to the above questions and can manage it myself. Show me a single "Doctor of Nurse Practitioner" who could do the same - yet they somehow feel they are just as qualified to provide the care of a physician simply because they took fluff classes like "nursing management" and "nursing theory"

This isn't a knock against you personally so I apoligize if it came off that way...but there is a method to all the madness that we go through in the medical curriculum. It's hard to understand unless you've been through it, which is why people in medicine realize this whole DNP degree is a load of garbage.

 

[DNPDoctor]

Honestly, I think some of you guys need to grow up, stop being rude and start treating other people (no matter how "inferior" they may seem to you) with some respect.

And what's with all these inferiority complex shown by the students?
You guys are safe, and you will all have great jobs that pay a lot of money at the end. There's enough room for both DNP and MD/DO.

 

[J1515]

Honestly, I think some of you guys need to grow up, stop being rude and start treating other people (no matter how "inferior" they may seem to you) with some respect.

And what's with all these inferiority complex shown by the students?
You guys are safe, and you will all have great jobs that pay a lot of money at the end. There's enough room for both DNP and MD/DO.

This is about patients lives. It has nothing to do with job security or money or superiority/inferiority. This is a field where patients put their lives in the hands of a healthcare provider. An x-ray tech can manage a patient with already controlled DM, typical strep pharyngitis, or a URI. Just because you took a class called "nursing theory" doesn't mean you are capable of managing patients with multiple comorbidities.

The fact that DNPs ignore the potentially serious consequences of mistreating patients, and instead continue to think the main issue here is that physicians just don't want to give up their piece of the pie speaks volumes about their agenda. The person who invented this ridiculous DNP degree to be equivalent to an MD/DO doesn't realize the trouble and future lawsuits she is starting for the nursing profession.

 

[fab4fan]

What I'm saying is that our educational method of delivery, from public school on up, is not very efficient. Take that for what it's worth.

I'm all for you as a physician to known all about the zebras. I just like to have some of the knowledge. For example last Sat, while on a dive trip in Pattaya, my wife woke me up about 0100 with severe RUQ pain. I got a taxi and got her to the ER. I was out of the exam room dealing with passport issues every time the physician was in to see my wife. I popped in once and my wife told me they had given her some IV pain meds through a really big syringe and she felt fine now. "At least they diluted it" I'm thinking. Then I finally see the doc who tells me she has diagnosed my wife with Viral Gastroenteritis. My wife says the doc never touched her.

I tell my wife she probably has cholelithiasis and I get her an IM appt. back in Bangkok. Yesterday, an excellent physician saw her, scanned her, and proved me right. She has an appt Mon with a surgeon.



True, and it's what's going on inside my shaman head that makes me different between both fellow nurses and doctors. (Sorry, couldn't resist.) 😀

Yes, but how much of that can you chalk up to being a shaman-man v being a nurse for many years and knowing classic sx of GB disease. I mean any exp. nurse worth his/her salt should have considered that as a possibility. No brainer. If anything, it was an example of running into a bad practitioner who didn't do a good workup on your wife.

 

[fab4fan]

Exactly. With the aging population, we're going to be seeing even more patients needing chronic and palliative care.
You just cannot "cure" some (many) of the diseases out there.
They have to live with the disease, and we can facilitate them in normalization with their current status and their journey.

When I read this, I remember why I go to a doctor. I hate "nurse-speak."

 

[deleted87716]

we can facilitate them in normalization with their current status and their journey.

When I read this, I remember why I go to a doctor. I hate "nurse-speak."

Thank God. It's not just me, then. 😉

 

[RGMSU]

When I read this, I remember why I go to a doctor. I hate "nurse-speak."

Good call. I believe I'd rather be treated medically by a physician than be facilitated in normalization with my current status and my journey. Cutting edge science there.

 

[zenman]

This isn't a knock against you personally so I apoligize if it came off that way...but there is a method to all the madness that we go through in the medical curriculum. It's hard to understand unless you've been through it, which is why people in medicine realize this whole DNP degree is a load of garbage.

No problem here...

 

[zenman]

Thank God. It's not just me, then. 😉

Do blue dogs have blue balls??

 

[DNPDoctor]

This is about patients lives. It has nothing to do with job security or money or superiority/inferiority. This is a field where patients put their lives in the hands of a healthcare provider. An x-ray tech can manage a patient with already controlled DM, typical strep pharyngitis, or a URI. Just because you took a class called "nursing theory" doesn't mean you are capable of managing patients with multiple comorbidities.

The fact that DNPs ignore the potentially serious consequences of mistreating patients, and instead continue to think the main issue here is that physicians just don't want to give up their piece of the pie speaks volumes about their agenda. The person who invented this ridiculous DNP degree to be equivalent to an MD/DO doesn't realize the trouble and future lawsuits she is starting for the nursing profession.

Research shows that the nurse practitioners and physician assistants have been providing a good care and service to the patients.
In fact, there is no evidence or research showing np or pa as incompetent in providing the medical treatment for the patients.

Our education is sufficient for the role that we are partaking.

Acute Care Nurse Practitioner:
http://nurseweb.ucsf.edu/www/cur-acp.htm

Year 1
Fall:
Assessment/Skills Lab
Clinical Practicum and Conference
Human Pathophysiology & Aging
Theories Related to Nursing Care
Assess & Mgt Psych Signs & Symptoms
Advanced Health Assessment
Health Promotion in Acute Care

Winter:
Diag. & Therapeutics Lecture
Issues in Acute & Critical Care
Human Pathophysiology & Aging
Research Methods
Clinical Pharmacology
Clinical Practicum & Conference

Spring:
Clinical Practicum and Conference
Exacerbations of Chronic Illness
Diag. & Therapeutics Skills Lab
Symptom Assess. & Mgmt.
Research Utilization
Cardiac Rhythm and Theory
EKG Practicum
Antibiotic Therapeutics

Year 2

Fall:
Dx & Rx of Acutely Ill/Injured Patients I
ACNP Residency I and Conference
Dimensions of Advanced Practice Nursing
Introduction to Human Genomics
Clinical Nutrition (unless already taken)
CXR Interpretation

Winter:
Dx & Rx of Acutely Ill/Injured Patients II
ACNP Residency II and Conference
Health Care Economics/Policy (unless already taken)

Spring:
ACNP Residency III & Conference
Cardiac Rhythm and Theory
EKG Practicum

Post Masters:

Fall:
Assessment/Skills Lab
Clinical Practicum & Conference
Assess. & Mgt. Psych Signs & Symptoms
Dx & Rx of Acutely Ill/Injured Patients - I
Advanced Health Assessment
Clinical Nutrition
Health Promotion in Acute Care

Winter:
Diagnostic & Therapeutics Lecture
Clinical Practicum & Conference
Dx & Rx of Acutely - Ill/Injured Patients II
Clinical Pharmacology

Spring:
Exacerbations of Chronic Illness
Diagnostic & Therapeutics Skills Lab
Assessment & Mgmt. of Signs & Symptoms
ACNP Residency III & Conference
Cardiac Rhythm and Theory
EKG Practicum
Antibiotic Therapeutics

Summer:
ACNP Residency & Conference
Chest X-Ray Interpretation

I don't know of any NP saying that he or she is equivalent to a physician.

That Mundinger lady (Resigned) does not represent all/most of us or how we feel.

Good call. I believe I'd rather be treated medically by a physician than be facilitated in normalization with my current status and my journey. Cutting edge science there.

Looks like the physicians don't look at the holistic approach and whole body after all.
You and I both know that there are many diseases in the elderly and other people that cannot be treated.
They have to live with chronic illness.
If they can't find a way to cope with the disease and normalize their current status, they will end up costing the health care system a lot more (example: depression).
You have to find a preventative measure and promote health.
In order to do that, you have to look at the person in a holistic manner.

 

[deleted87716]

there are many diseases in the elderly and other people that cannot be treated. ...example: depression.

You don't think that depression can be treated...? 😕

 

[deleted87716]

Do blue dogs have blue balls??

I know it's pretty lame when you have to explain a joke, but in this case, I'm afraid you'll have to.

 

[DNPDoctor]

You don't think that depression can be treated...? 😕

I was talking about the preventative measures and normalization.

 

[RGMSU]

Looks like the physicians don't look at the holistic approach and whole body after all.
You and I both know that there are many diseases in the elderly and other people that cannot be treated.
They have to live with chronic illness.
If they can't find a way to cope with the disease and normalize their current status, they will end up costing the health care system a lot more (example: depression).
You have to find a preventative measure and promote health.
In order to do that, you have to look at the person in a holistic manner.

Managing a chronically ill patient probably requires more knowledge of physiology and internal medicine than managing many other patients. Just because they cannot be cured, that does not mean they cannot be treated. Two totally different things there. Living with a chronic illness is not just about coping, though this is a factor. While looking at the person in a holistic manner is important, looking at them in a scientific/medical manner doesn't hurt either. Having as much scientific/medical knowledge as possible when you're standing by the bedside of a patient with multiple organ system pathologies never hurts. I find it hard to imagine being medically overeducated in that situation.

 

[DNPDoctor]

Managing a chronically ill patient probably requires more knowledge of physiology and internal medicine than managing many other patients. Just because they cannot be cured, that does not mean they cannot be treated. Two totally different things there. Living with a chronic illness is not just about coping, though this is a factor. While looking at the person in a holistic manner is important, looking at them in a scientific/medical manner doesn't hurt either. Having as much scientific/medical knowledge as possible when you're standing by the bedside of a patient with multiple organ system pathologies never hurts. I find it hard to imagine being medically overeducated in that situation.

I never said that we should not also look at them in a scientific and medical knowledge.
You don't think that DNP/NP are educated with scientific and medical knowledge?

 

[DNPDoctor]

Delete.

 

[RGMSU]

I was talking about the preventative measures and normalization.

There are frequently preventative measures in the management of depression psychologically speaking. Not really sure how normalization plays a role here. I think this viewpoint belies the fact that geriatric psychiatry is frequently much more complicated than simply situational analysis. While I will agree that geriatric psychiatry is frequently multi-factorial with elements that are not always medically approachable, biochemical interventions have often proven to be helpful, so there are often medical elements to the situation that you would be doing a disservice to the patient to ignore.

 

[DNPDoctor]

Okay guys.
Take out the word "depression" from my post and try to see the point that I'm making.

I understand what you guys are talking about, and yes, it's important to implement medical interventions as well.

Let's get back to the main issue on hand.
I just don't understand the hatred and disrespect that some of you guys are showing towards NP and DNP.

 

[deleted87716]

Reading comprehension fail. hehe

To be fair, I deleted my post prior to your reply.

Reason?

It's. Just. Not. Worth. It.

 

[RGMSU]

I never said that we should not also look at them in a scientific and medical knowledge.
You don't think that DNP/NP are educated with scientific and medical knowledge?

I didn't say that, but you seem to be skirting around the medical to grasp for something far more nebulous in your discussion of managing a chronically ill patient. Then we get back to the original point of this thread - what is the comparison between DNPs and MDs with reference to scientific and medical knowledge? And, are DNPs willing to admit a limitation if they perceive there is one? Granted, there will be personal variations here. Some DNPs will be much better than others, and some MDs will be quite poor at what they do. Generally speaking, though, I would still expect to see and be more comfortable seeing more MDs walking around the ICU than DNPs. Not a slap at DNPs. I just don't view it as being as rigorous of a medical education compared to the MD, and that can be a problem when the bottom starts to fall out. For the record, I never said I was opposed to DNPs or NPs. I said I had a problem with independent practice. This thread is intentionally confrontational by the title "NP vs MD," so I'm just addressing the differences that I see.

 

[DNPDoctor]

To be fair, I deleted my post prior to your reply.

Reason?

It's. Just. Not. Worth. It.

Exactamundo.

I'm not sure how to delete mine.
I'll just edit it.

Sorry.

 

[RGMSU]

Okay guys.
Take out the word "depression" from my post and try to see the point that I'm making.

I understand what you guys are talking about, and yes, it's important to implement medical interventions as well.

Let's get back to the main issue on hand.
I just don't understand the hatred and disrespect that some of you guys are showing towards NP and DNP.

It's not hatred. I respect NPs and DNPs and am willing to work with either. I just think they should be cautious about limitations, as we should all be. If I were an FP, I wouldn't expect to go parading around the cath lab stenting people. We all have limitations. NURSES ARE JUST AS IMPORTANT ON THE MEDICAL TEAM AS PHYSICIANS. The optimal practice arrangement with NPs and MDs is a collaborative one, but if you guys insist on independence, it becomes very hard to be collaborative.

I don't take any of this personally. I'm just a debater. My primary academic training was liberal arts (history and political science) before medical school.

 

[DNPDoctor]

It's not hatred. I respect NPs and DNPs and am willing to work with either. I just think they should be cautious about limitations, as we should all be. If I were an FP, I wouldn't expect to go parading around the cath lab stenting people. We all have limitations. NURSES ARE JUST AS IMPORTANT ON THE MEDICAL TEAM AS PHYSICIANS. The optimal practice arrangement with NPs and MDs is a collaborative one, but if you guys insist on independence, it becomes very hard to be collaborative.

I don't take any of this personally. I'm just a debater. My primary academic training was liberal arts (history and political science) before medical school.

I agree. Np should be cautious about the limitations. I think that many of them know of the limitations as well.
Believe me, I want to see a lot of improvements for DNP program.
I think that in the future, they need to add more science courses, increase the clinical hours, be required to do the residence, and pass all of USMLE tests.
I see a good number of np and physicians working together and collaborating with each other in the health clinics.
They are independent in the sense that the physician's license is not on the line for the mistakes that they make, if any.

 

[J1515]

Our education is sufficient for the role that we are partaking.

The role you are currently partaking, yes. The role that DNPs want to partake in? No.

I don't know of any NP saying that he or she is equivalent to a physician.

That Mundinger lady (Resigned) does not represent all/most of us or how we feel.

Fair enough. So then what's the point of the DNP degree besides calling oneself Dr Nurse? An NP would be a lot more valuable to the world of healthcare if she spent that time on the floors seeing patients and learning through experience rather than taking bs classes like "nursing theory".

Looks like the physicians don't look at the holistic approach and whole body after all.
You and I both know that there are many diseases in the elderly and other people that cannot be treated.
They have to live with chronic illness.
If they can't find a way to cope with the disease and normalize their current status, they will end up costing the health care system a lot more (example: depression).
You have to find a preventative measure and promote health.
In order to do that, you have to look at the person in a holistic manner.

Lets be real. Look at the descriptions of those classes. They use big words to try to sound sophisticated and important. "Normalization"?? Basically in these classes you are learning about patients with chronic diseases. Stop with the nonsense.

 

[DNPDoctor]

The role you are currently partaking, yes. The role that DNPs want to partake in? No.

Have you worked with any?
Don't put words in their mouth.

Fair enough. So then what's the point of the DNP degree besides calling oneself Dr Nurse? An NP would be a lot more valuable to the world of healthcare if she spent that time on the floors seeing patients and learning through experience rather than taking bs classes like "nursing theory".

Good question. Many NP are satisfied with the masters. It was imposed on us.

Lets be real. Look at the descriptions of those classes. They use big words to try to sound sophisticated and important. "Normalization"?? Basically in these classes you are learning about patients with chronic diseases. Stop with the nonsense.

I'm sorry, but we should use a grade 5 word and be educated at that level because we're inferior and stupid right? sir?

Thank you for your maturity. No need to dismiss our education. No education is a waste.

 

[RGMSU]

I think that in the future, they need to add more science courses, increase the clinical hours, be required to do the residence, and pass all of USMLE tests.

These goals sound good, but this would be a difficult degree to market, I suspect. To pass all elements of the USMLE, the programs would be forced to compete for students with MD/DO programs. Whether such students could be convinced to pursue the DNP or whether they would have the nursing background would be questionable.

 

[J1515]

Have you worked with any?
Don't put words in their mouth.

Yes I have. I have personally seen one actually fight with a nephrology fellow and insist that a patient needed to be dialyzed immediately because their creatinine was 8. N=1, but still, I have worked with them.

I'm sorry, but we should use a grade 5 word and be educated at that level because we're inferior and stupid right? sir?

You are the only one who is bringing up this whole inferiority thing. Talking about "normalizing" patients doesn't making you sound any smarter than saying "coping with chronic illness" or "palliative care". Similar to how DNPs practice "Comprehensive Care." I have a feeling if you told a patient with ESRD that you were going to normalize them they'd probably call the police on you.

 

[DNPDoctor]

Yes I have. I have personally seen one actually fight with a nephrology fellow and insist that a patient needed to be dialyzed immediately because their creatinine was 8. N=1, but still, I have worked with them.

Nice. From your experience, you can automatically deduce that tens of thousands of nps think like that particular individual.

You are the only one who is bringing up this whole inferiority thing. Talking about "normalizing" patients doesn't making you sound any smarter than saying "coping with chronic illness" or "palliative care". Similar to how DNPs practice "Comprehensive Care." I have a feeling if you told a patient with ESRD that you were going to normalize them they'd probably call the police on you.

A classic case of superiority complex.

 

[J1515]

Nice. From your experience, you can automatically deduce that tens of thousands of nps think like that particular individual.

You asked me if I ever worked with NPs or DNPs. I responded. Which part of N=1 didn't you understand? I admitted it was one person. The entire purpose of the DNP movement is to get NPs equal practicing rights with MDs/DOs. If you disagree with the whole idea, then great. I would have no problem working with you. That doesn't mean that there arent others pushing for this whole "doctor nurse" idea.

A classic case of superiority complex.

I have no clue what you're talking about. Have a nice day.

 

[DNPDoctor]

I have no clue what you're talking about. Have a nice day.

You have a nice day too.

 

[pianoman511]

I agree. Np should be cautious about the limitations. I think that many of them know of the limitations as well.
Believe me, I want to see a lot of improvements for DNP program.
I think that in the future, they need to add more science courses, increase the clinical hours, be required to do the residence, and pass all of USMLE tests.
I see a good number of np and physicians working together and collaborating with each other in the health clinics.
They are independent in the sense that the physician's license is not on the line for the mistakes that they make, if any.

DNP + more science + more clinical + residency + USMLE = medical school.... so why not just go to med school ?

It's great to postulate about improving programs in the future, but the nursing establishment is advocating for independent practice rights with the current curriculum. That's (i think) what many have issue with.