NP performing vasectomy...

[W19]

Oregon nurse practitioners can now perform vasectomies

When/where this s... will end?

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[deleted407021]

On top of this apparently being unnecessary per the evidence, this law seems poorly constructed with no language about even regulating or implementing the new scope of practice it's allowing.

 

[Brahnold Bloodaxe]

Nurse practitioners in Washington state and Alaska have been allowed to perform vasectomies since 1996. In Washington state, it’s up to medical providers and health systems to determine what training and credentialing are required before nurse practitioners can perform the procedures, said Marie Annette Brown, a nurse practitioner and nursing professor at the University of Washington.

Is there any data on how many vasectomies are actually carried out by nurse practitioners in those 2 states? Who in their right mind would elect to go to a freakin' nurse for an operation, let alone one in such a...sensitive..area.

 

[W19]

Is there any data on how many vasectomies are actually carried out by nurse practitioners in those 2 states? Who in their right mind would elect to go to a freakin' nurse for an operation, let alone one in such a...sensitive..area.

Once you wear a white coat and carry a stethoscope around your neck, you are a doc to most people. Most people don't know who is who... and NP is doing a good job in blurring the lines.

 

[Brahnold Bloodaxe]

Once you wear a white coat and carry a stethoscope around your neck, you are a doc to most people. Most people don't know who is who... and NP is doing a good job in blurring the lines.

While I'm sure that is true to a certain extent, nobody gets wheeled to an "emergency vasectomy" at 2AM in the morning and handed off to the first random person in a white coat. Getting that procedure done is a very deliberate decision that people plan out well in advance. Everyone knows the adage "get the best surgeon you can find" for any operation so I find it hard to believe many people would be so completely indifferent to who is doing their vasectomy as to not even know whether its a surgeon or a nurse.

 

[deleted407021]

While I'm sure that is true to a certain extent, nobody gets wheeled to an "emergency vasectomy" at 2AM in the morning and handed off to the first random person in a white coat. Getting that procedure done is a very deliberate decision that people plan out well in advance. Everyone knows the adage "get the best surgeon you can find" for any operation so I find it hard to believe many people would be so completely indifferent to who is doing their vasectomy as to not even know whether its a surgeon or a nurse.

I gather it's being pushed as an "access" issue...despite the data that show NPs are distributed geographically similarly to physicians, so that's just silly.

 

[LutGholein]

I was half expecting a gomerblog post-- this is straight up asinine.

 

[Ho0v-man]

They probably don't even know any d!ck jokes!

In all seriousness, who in their right mind would train them to do this?

 

[zero0]

Is there any data on how many vasectomies are actually carried out by nurse practitioners in those 2 states? Who in their right mind would elect to go to a freakin' nurse for an operation, let alone one in such a...sensitive..area.

Not yet as far as I know, but don't worry they'll fabricate some soon enough, publish it in some halfass journal, and serve it up for the public.

 

[bannie22]

to be honest, i can see why people would go to an NP for a vasectomy. not everyone has the access (geographical and financial) to have a MD do the same job as the NP. heck some would be thankful for anyone to do it. just look at some of the socialeconomically disadvantaged, they dont even come into the hospital until they are near dead.

i think this is very scary tho. but id say if the NP has n number of vasectomies, n being some random number of your liking, i dont see why they cant do an equally good job as an MD. its not like all practicing surgeons are good at all procedures they perform.

of course, this encroachment into the physician surgeon territory is alittle unacceptable given the amount of training they have to go through. but thats another point, residency programs or medical school then can be tailored more accordingly, and perhaps the old question debate about do you really need to do 28 hour shifts every 3 days? when the NP is lounging around making better pay and does the same proceures as u? lol

 

[Cello]

All I know is, you guys need to post more on social media in defense of your profession. The NPs are overrunning Facebook and comments on news articles with their pro-NP propaganda and the public is just lapping it up. The general public seems to have the perception that nurses do all the real work while physicians are just screwing off in a lounge somewhere in the hospital.

 

[Drrrrrr. Celty]

to be honest, i can see why people would go to an NP for a vasectomy. not everyone has the access (geographical and financial) to have a MD do the same job as the NP. heck some would be thankful for anyone to do it. just look at some of the socialeconomically disadvantaged, they dont even come into the hospital until they are near dead.

i think this is very scary tho. but id say if the NP has n number of vasectomies, n being some random number of your liking, i dont see why they cant do an equally good job as an MD. its not like all practicing surgeons are good at all procedures they perform.

of course, this encroachment into the physician surgeon territory is alittle unacceptable given the amount of training they have to go through. but thats another point, residency programs or medical school then can be tailored more accordingly, and perhaps the old question debate about do you really need to do 28 hour shifts every 3 days? when the NP is lounging around making better pay and does the same proceures as u? lol

A vasectomy isn't a burning fever of 104 where anyone is better than no one. You can schedule an appointment and you can drive for 30-45 minutes to a FP or Urologist and get it done without having to worry about whether or not your stan smith vasectomy works.

 

[Perfect Hair Day]

Once you wear a white coat and carry a stethoscope around your neck, you are a doc to most people. Most people don't know who is who... and NP is doing a good job in blurring the lines.

Last year for one of my rotations I spent a week working in a high school nurses office - it was staffed by an ARNP, and I explained to one of the high schoolers that I was a medical student and that the nurse would be in to see this patient shortly. I got so much lip about calling her a "nurse" - who in their right mind would expect a high school student to know the difference between someone with a BSN, NP, LPN, etc. It seemed really uppity of them to assume I was being disrespectful rather than simplfying the language for a high school aged child.

This needs to stop though.

 

[W19]

Last year for one of my rotations I spent a week working in a high school nurses office - it was staffed by an ARNP, and I explained to one of the high schoolers that I was a medical student and that the nurse would be in to see this patient shortly. I got so much lip about calling her a "nurse" - who in their right mind would expect a high school student to know the difference between someone with a BSN, NP, LPN, etc. It seemed really uppity of them to assume I was being disrespectful rather than simplfying the language for a high school aged child.

This needs to stop though.

Physicians have dropped the ball, and I think it's already too late.

The other thing that need to be discussed is that: Do physicians need that much schooling? (4+ 4+ 3+)... One can argue that a system of 3+3+2+ can also produce competent physicians. Do GI docs really have to spend a whole 3 years in internal medicine instead of 2? What is the difference b/t an EM doc who did a 3-year residency vs. 4-year?

 

[LutGholein]

Last year for one of my rotations I spent a week working in a high school nurses office - it was staffed by an ARNP, and I explained to one of the high schoolers that I was a medical student and that the nurse would be in to see this patient shortly. I got so much lip about calling her a "nurse" - who in their right mind would expect a high school student to know the difference between someone with a BSN, NP, LPN, etc. It seemed really uppity of them to assume I was being disrespectful rather than simplfying the language for a high school aged child.

This needs to stop though.

Was she expecting you to tell the high schooler that the "advanced registered nurse practitioner" will see them soon?

Nurse is in the name-- it's not disrespectful-- they are nurses! No amount of alphabet soup acronyms will change that primary role as a nurse.

 

[Goro]

Oregon nurse practitioners can now perform vasectomies

When/where this s... will end?

Ok, my computer is updating windows and so I'm stuck on my phone waiting for it to reboot. So I'm bored and feel like playing Devil's Advocate.

If a combat medic can pull a bullet or shrapnel out, and tie off a severed artery plus treat multiple penetrating injuries, why can't a nurse practitioner be trained to do a vasectomy?

 

[Staphylococcus Aureus]

If a combat medic can pull a bullet or shrapnel out, and tie off a severed artery plus treat multiple penetrating injuries, why can't a nurse practitioner be trained to do a vasectomy?

Horrible analogy. And the dexterity/physical act of a procedure is not the reason you need a surgeon's expertise and training.

 

[Goro]

Horrible analogy. And the dexterity/physical act of a procedure is not the reason you need a surgeon's expertise and training.

Doesn't tying off a spurting artery require a surgeon's expertise and training??

 

[ACSurgeon]

Oregon nurse practitioners can now perform vasectomies

When/where this s... will end?

It will end when we stop training them to do our job. When we stop being greedy. When the public wakes up.

So never.

 

[Staphylococcus Aureus]

Doesn't tying off a spurting artery require a surgeon's expertise and training??

I should've said not the only reason. But if you're putting blinders on and seeing it as just a spurting artery then yes you could teach a child tying, that's not the point. Why stop at NPs? Goro you should find an EMT to do your vasectomy, they'll do a better job of patching you up to your expectations.

 

[Goro]

I should've said not the only reason. But if you're putting blinders on and seeing it as just a spurting artery then yes you could teach a child tying, that's not the point. Why stop at NPs? Goro you should find an EMT to do your vasectomy, they'll do a better job of patching you up to your expectations.

The real question is how much training Oregon's NPs will have in being able to do these procedure?

I agree with the BloodAxe that I don't think guys are going to be be running in off the street to have an NP do such a delicate procedure. But there seems to be a lot of hysteria in this thread that newly minted NPs will all of a sudden start doing procedures.

So where is the OR state medical association in all this, anyway? And see LazyMed's post above yours....which represents a vital choke point idea.

But if a combat medic can be trained to the level of doing a specific vital surgery, why not an NP?

 

[Staphylococcus Aureus]

how much training Oregon's NPs will have in being able to do these procedure?

If history is any indicator, then none or almost none

 

[Goro]

If history is any indicator, then none or almost none

There is where the discussion needs to be centered. I see too many posts that harp on competition for $. If you make the discussion about patient safety, you have a very large rock to stand on. But the "Midlevels are taking our jobs" meme won't get you any traction or sympathy with legislators or the general public.

 

[Ho0v-man]

Ok, my computer is updating windows and so I'm stuck on my phone waiting for it to reboot. So I'm bored and feel like playing Devil's Advocate.

If a combat medic can pull a bullet or shrapnel out, and tie off a severed artery plus treat multiple penetrating injuries, why can't a nurse practitioner be trained to do a vasectomy?

Because if the medic does nothing, that person with the spurting artery will likely die very quickly. That's patchwork. It'll still need to be addressed by a surgeon later, much like the complications of having an elective surgery performed by someone with an online degree will need to be addressed by a surgeon as well.

 

[Goro]

Because if the medic does nothing, that person with the spurting artery will likely die very quickly. That's patchwork. It'll still need to be addressed by a surgeon later, much like the complications of having an elective surgery performed by someone with an online degree will need to be addressed by a surgeon as well.

But the need of the procedure isn't the issue. It's the skill set here. My point still is if a medic can be trained t do X, why can't an NP be trained to do Y?

And you guys keep harping on this online degree crap. Let it go. You really think that NPs are going to go directly from their computer screen to making incisions?

 

[DokterMom]

Last year for one of my rotations I spent a week working in a high school nurses office - it was staffed by an ARNP, and I explained to one of the high schoolers that I was a medical student and that the nurse would be in to see this patient shortly. I got so much lip about calling her a "nurse" - who in their right mind would expect a high school student to know the difference between someone with a BSN, NP, LPN, etc. It seemed really uppity of them to assume I was being disrespectful rather than simplfying the language for a high school aged child.

This needs to stop though.

If an "advanced practice nurse practitioner" is offended at being called a "nurse" -- Well, that shows you pretty clearly where the problem lies.

There is where the discussion needs to be centered. I see too many posts that harp on competition for $. If you make the discussion about patient safety, you have a very large rock to stand on. But the "Midlevels are taking our jobs" meme won't get you any traction or sympathy with legislators or the general public.

Exactly! Make the discussion all about education, training and patient safety and hit the social networks loudly and frequently advocating to set/raise the training requirements for medical providers (NPs, PAs and potentially even MDs in other fields) such that unqualified 'providers' won't be licensed to perform procedures for which they're unqualified. You can pour all sorts of verbal appreciation for nurses and PAs all over your message, but keep the focus on patient safety.

 

[Ho0v-man]

But the need of the procedure isn't the issue. It's the skill set here. My point still is if a medic can be trained t do X, why can't an NP be trained to do Y?

And you guys keep harping on this online degree crap. Let it go. You really think that NPs are going to go directly from their computer screen to making incisions?

Yet they're advocating for the right to do this based on a need that is largely fabricated.

As for the skill set, tying off an artery and performing surgery are two very different things. Your argument is like saying "since the guy who mows my lawn can drive a riding lawn mower, why can't a truck driver be trained to fly a jet?" The article cites that the rate of complication is extremely low. That doesn't necessarily imply that it's stupid easy and just anyone can do it. It means the people doing it have been extremely well trained to do it. It also means they have a background in understanding what surgical complications a patient is at risk for and how to manage or preempt them. An NP does not.

In regards to your last paragraph, yes they absolutely could. I've seen too many NPs in the ER suture for the first time. I don't mean on their first pt. I mean the first time period. Never even simulated in school or performed in clinicals. Same with chest tubes, paracenteses, central lines, etc.

I absolutely think any NP could be trained to be a surgeon...by going to medical school. Thats the safe way to go about it. I want my surgeon overtrained. Furthermore, this is an elective procedure. People aren't dying because they can't get vasectomies. This law takes a huge risk to meet a fabricated demand for a non-emergent elective surgery.

 

[Staphylococcus Aureus]

Judging by his medic analogy posts, and with all due respect, it's apparent Goro either doesn't understand anything about NP training/scope or why their lack of knowledge/expertise is bad for patients.

 

[SterlingMaloryArcher]

This reminds me of a proposed bill in Hawaii allowing PhD clinical psychologists to take a class allowing them to dispense drugs to expand psychiatric care in across the islands. There is a very interesting deliberation on YT. Anyways, many many many psychologists themselves said they would not opt into this program because they themselves knew they don't have the background to feel comfortable with that. Hopefully nurses will be responsible and react the same way but that's doubtful.

 

[deleted407021]

This reminds me of a proposed bill in Hawaii allowing PhD clinical psychologists to take a class allowing them to dispense drugs to expand psychiatric care in across the islands. There is a very interesting deliberation on YT. Anyways, many many many psychologists themselves said they would not opt into this program because they themselves knew they don't have the background to feel comfortable with that. Hopefully nurses will be responsible and react the same way but that's doubtful.

I wonder where this difference in confidence between the two professions comes from.

 

[SterlingMaloryArcher]

I wonder where this difference in confidence between the two professions comes from.

Well Freud would say it's penis envy.

 

[dr zaius]

I'm not sure what combat medics are tying off vessels unless you are referring to tourniquet application. Medics aren't out there throwing figure of eights into stumps or blindly into bleeding wounds. They can do things like crics as a very last resort for airways, but they also train extensively prior to deployment. This is a very different situation than a vasectomy.

Vasectomy is a relatively simple procedure. Things can go wrong quickly and unexpectedly, though, and you can't just cauterize your way out of it without a real potential for possible testicular loss. What if they cut the vas and lose it in the scrotum before cauterizing the ends, and a hematoma forms right before their eyes and they have no idea how to stop it? The same can be said for FPs doing vasectomies to a lesser extent, but most of the ones performing vasectomies are more procedurally inclined and do skin biopsies, EIC and lipoma excisions, etc so have a basic idea of tissue handling and hemostasis.

I'd be interested to see the training program they implement. More importantly I hope they keep track of complications and compare them to the reported incidence. If the demand is there (which seems sketchy based on the article) and they can perform it safely...sure. Go for it. There should be a caveat that they can't immediately refer to urology for post vasectomy pain and they also have to come in and see the patient when they show up in the ED with a hematoma at 2AM. Part of mastering a procedure is understanding the complications. I'd wager you don't fully understand them/how to prevent them until you see those complications and work through the management which I guarantee is not a part of their plan.

 

[857770]

If an "advanced practice nurse practitioner" is offended at being called a "nurse" -- Well, that shows you pretty clearly where the problem lies.



Exactly! Make the discussion all about education, training and patient safety and hit the social networks loudly and frequently advocating to set/raise the training requirements for medical providers (NPs, PAs and potentially even MDs in other fields) such that unqualified 'providers' won't be licensed to perform procedures for which they're unqualified. You can pour all sorts of verbal appreciation for nurses and PAs all over your message, but keep the focus on patient safety.

It gets worse: PAs now have a program were they can become a DMS ("doctor of medical science"). This is supposed to be a second path to becoming a doctor, when there should only be one: medical school.

 

[857770]

Yet they're advocating for the right to do this based on a need that is largely fabricated.

As for the skill set, tying off an artery and performing surgery are two very different things. Your argument is like saying "since the guy who mows my lawn can drive a riding lawn mower, why can't a truck driver be trained to fly a jet?" The article cites that the rate of complication is extremely low. That doesn't necessarily imply that it's stupid easy and just anyone can do it. It means the people doing it have been extremely well trained to do it. It also means they have a background in understanding what surgical complications a patient is at risk for and how to manage or preempt them. An NP does not.

In regards to your last paragraph, yes they absolutely could. I've seen too many NPs in the ER suture for the first time. I don't mean on their first pt. I mean the first time period. Never even simulated in school or performed in clinicals. Same with chest tubes, paracenteses, central lines, etc.

I absolutely think any NP could be trained to be a surgeon...by going to medical school. Thats the safe way to go about it. I want my surgeon overtrained. Furthermore, this is an elective procedure. People aren't dying because they can't get vasectomies. This law takes a huge risk to meet a fabricated demand for a non-emergent elective surgery.

Holy F. That is terrifying!!!!!

 

[DokterMom]

I wonder where this difference in confidence between the two professions comes from.

Dunning-Kruger! Alive, well, and running rampant.

Dunning–Kruger effect - Wikipedia

 

[WaterIsGood]

I decided to do some research on what a doctor of medical science means.

Came across this forum The Online Doctor of Medical Science - A New Type of Physician

An excerpt:

"I got a response from LMU this morning"

Currently the DMS is only an academic degree. Because this is a brand new concept, there is currently no legislation or scope of practice beyond that of a PA. Accreditation standards prevent a “bridge” to the current DO, MD therefore the new program design. Thus, until legislators, third party payers, patients, etc have a chance to understand this new program (similar to PA, CRNA, etc history), the result is a very well trained PA. The University hopes to start addressing this at the state levels very soon. So, in answer to your question, outside of the enhanced relationship with your supervising physician, your advanced medical knowledge and competency, there are currently no new scopes of practice that coincide with this training. As such, this is a pioneer program.
So, for now the degree is purely academic, although it does look like they are going to start working to change laws. There is precedent for this, like when the nurse practitioner programs were developed back in the 60s. LMU's response still didn't answer my question about whether the program was intended to create some sort of super PA or be a bridge to physician program. Perhaps they are being intentionally vague.


Yikes


Sent from my iPhone using SDN mobile

 

[backside_attack]

I decided to do some research on what a doctor of medical science means.

Came across this forum The Online Doctor of Medical Science - A New Type of Physician

An excerpt:

"I got a response from LMU this morning"

Currently the DMS is only an academic degree. Because this is a brand new concept, there is currently no legislation or scope of practice beyond that of a PA. Accreditation standards prevent a “bridge” to the current DO, MD therefore the new program design. Thus, until legislators, third party payers, patients, etc have a chance to understand this new program (similar to PA, CRNA, etc history), the result is a very well trained PA. The University hopes to start addressing this at the state levels very soon. So, in answer to your question, outside of the enhanced relationship with your supervising physician, your advanced medical knowledge and competency, there are currently no new scopes of practice that coincide with this training. As such, this is a pioneer program.
So, for now the degree is purely academic, although it does look like they are going to start working to change laws. There is precedent for this, like when the nurse practitioner programs were developed back in the 60s. LMU's response still didn't answer my question about whether the program was intended to create some sort of super PA or be a bridge to physician program. Perhaps they are being intentionally vague.


Yikes


Sent from my iPhone using SDN mobile

So interesting. My mother recently graduated from a master's program in nursing (not NP -- nurse management) and at her graduation ceremony the dean of the school was going on about how the school was growing and was starting a DMS program. Knowing I am in medical school, my family turned to me and asked "Is that like what you're doing?" and I honestly had no idea what the degree was but it seemed pretty fake based on the vague language of the dean.

 

[Staphylococcus Aureus]

That DMS program is in no way a bridge. I believe it's two years ONLINE AND PART TIME, in what way does that + PA school equate to a physician? If PAs want to become a physician they should go to medical school then residency, it's a sad world where people refuse to put in the work for anything and will allow fake doctors. A bridge would be maybe letting PAs test out (if the could) of MS1 or accelerate 4th year, not a few online classes as a maliciously vague titled online degree.

 

[Gilakend]

Not even in med school so I won't try to jump in on the argument, but am I the only one who thinks it weird that NPs can pretty much do more than an actual doctor can with the less training? For example: A med school grad with no residency or just an intern year. Are they not just as qualified or more qualified than an NP? But I feel like they don't have nearly as many privileges. I remember a thread a few years ago saying that a state (Missouri I think?) just passed a law that let doctors without residencies do primary care in rural areas and that was a big deal but NPs can do vasectomies? Maybe my data is outdated and things are much more progressive now but it's still crazy to me.

 

[cbrons]

Not even in med school so I won't try to jump in on the argument, but am I the only one who thinks it weird that NPs can pretty much do more than an actual doctor can with the same training? For example: A med school grad with no residency or just an intern year. Are they not just as qualified as an NP? But I feel like they don't have nearly as many privileges. I remember a thread a few years ago saying that a state (Missouri I think?) just passed a law that let doctors without residencies do primary care in rural areas and that was a big deal but NPs can do vasectomies? Maybe my data is outdated and things are much more progressive now but it's still crazy to me.

An np degree is NOT the "same training" as medical school and intern year.

 

[Gilakend]

An np degree is NOT the "same training" as medical school and intern year.

That was poorly typed, I meant to say with equal or less training. I was trying to say I feel like a medical school + intern year doctor has at minimum equal to or more training than a NP but a NP can do more. Maybe I am ignorant to how well NPs are trained though. I'll switch the wording in my post.

 

[IlDestriero]

But the need of the procedure isn't the issue. It's the skill set here. My point still is if a medic can be trained t do X, why can't an NP be trained to do Y?

And you guys keep harping on this online degree crap. Let it go. You really think that NPs are going to go directly from their computer screen to making incisions?

Medics are trained in critical damage control techniques. Suggesting they're competent in "procedures" is a stretch.

The NP isn't going to go from the computer screen to the OR, she's going to a weekend long CME course first.


--
Il Destriero

 

[Stagg737]

All I know is, you guys need to post more on social media in defense of your profession. The NPs are overrunning Facebook and comments on news articles with their pro-NP propaganda and the public is just lapping it up. The general public seems to have the perception that nurses do all the real work while physicians are just screwing off in a lounge somewhere in the hospital.

The problem is that when a doctor comes in and comments, even if it's reasonable and polite, they are so outnumbered that the mass of nurses jump in screaming how we're just a-holes sitting back and being overpaid while they do all the real work. I've had it happen to me more than once when nurses were making obviously false statements. I ended up looking like the bad guy instead of a voice of reason. The problem isn't just lack of vocalization, it's a volume issue as well. In our modern society the most reasonable voice isn't the winner, the loudest voice is and due to sheer number of nurses they will always be louder.

But the need of the procedure isn't the issue. It's the skill set here. My point still is if a medic can be trained t do X, why can't an NP be trained to do Y?

And you guys keep harping on this online degree crap. Let it go. You really think that NPs are going to go directly from their computer screen to making incisions?

An NP could be trained to do it, but the training they get through the NP degree is inadequate. You don't teach someone to grill a burger for a day or two then tell them to run the grill at a party of 50 people the next day. It's not an issue of "can they", it's an issue of "should they".

Yes, some NPs are going straight from the computer screen to incisions/clinic. I've worked with at least 2 or 3 NPs who did exactly this and walked around like they were running the department.

 

[Goro]

An NP could be trained to do it, but the training they get through the NP degree is inadequate. You don't teach someone to grill a burger for a day or two then tell them to run the grill at a party of 50 people the next day. It's not an issue of "can they", it's an issue of "should they".

Yes, some NPs are going straight from the computer screen to incisions/clinic. I've worked with at least 2 or 3 NPs who did exactly this and walked around like they were running the department.

Sounds like it's time for the state AMAs/AOAs to start talking to the politicians

 

[Goro]

Medics are trained in critical damage control techniques. Suggesting they're competent in "procedures" is a stretch.

The NP isn't going to go from the computer screen to the OR, she's going to a weekend long CME course first.


--
Il Destriero

OK, then the question is: what are you guys going to do about it? Wait for patient safety data to be published?

 

[NYCdude]

Wasn't the whole argument for NP's that they're trying to help the primary care physician shortage?

There are way too many cardiac NP's, neuro NP's, and orthopedic NP's if you ask me lol.

 

[Lawpy]

Oregon nurse practitioners can now perform vasectomies

When/where this s... will end?

I'm likely lost somewhere but what is stopping NPs from being completely independent and taking full and sole responsibility of patient outcomes (since there wouldn't be anyone supervising them)? Isn't that what NPs want? And wouldn't that ultimately end the NP encroachment?

 

[857770]

I'm likely lost somewhere but what is stopping NPs from being completely independent and taking full and sole responsibility of patient outcomes (since there wouldn't be anyone supervising them)? Isn't that what NPs want? And wouldn't that ultimately end the NP encroachment?

Even with full independent practice rights, some clinics and hospitals are taking on some of the liability of NPs. This is due to not trusting the training that NPs get. And they shouldn't trust their training.

 

[IlDestriero]

OK, then the question is: what are you guys going to do about it? Wait for patient safety data to be published?

What am I doing about it?
I don't lecture/sim/etc. at CRNA conferences.
I give to our PAC.
I wouldn't support independent practice at our hospital. (It would never happen here anyway.)
That's all I'm going to do.
We can work together, but the other fields have to fight their own battles. They're not helping us by supervising their own salaried CRNAs for procedures and taking the billing profits for themselves.

--
Il Destriero

 

[857770]

OK, then the question is: what are you guys going to do about it? Wait for patient safety data to be published?

I won't hire a midlevel nor participate in training them (especially NP students).