Nurse Practitioners (DNP) the new DO?

[clamsauce]

Not really, that's how bad your "data" is.


Of course you would.



NPs are no more likely to practice in crappy locations than MDs.



Does this matter? We used to see stuff NPs missed all the time in the OR, surgery that could have been avoided by timely and appropriate care, or cases that became a lot worse than they needed to be. Let's not even bring up the NPs who will throw a Z pak at anything that sniffles.

Brah Z pak like batra or whatever it's called from Star Wars. Hell its been 10 years since I watched empire strikes back.

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[Mad Jack]

Brah Z pak like batra or whatever it's called from star wars

Bacta dude. We need bacta to stop the NP menace.

 

[jw3600]

Hmmm... I'll bite. If you don't mind, can you tickle my fancy as to why NP's pursue the DNP? After going through *some* physical therapy courses, I learned that the DPT degree was created to take back rights from chiropractors. What is the point of the DNP in your perspective (not what the website states)? Also, if some nurses are wanting the coveted "Dr." title, why not pursue medical school? I'm seriously not trying to be rude. I asked my fellow PT students the same thing.

You are correct. See the face of a PA when you call them a physician's assistant. Literally what their name is and how the field was created. Now they want to be called physician associates and practice independently. Propaganda and word speak is a powerful thing.

 

[clamsauce]

Bacta dude. We need bacta to stop the NP menace.

Yeah that's what it was. I should have googled that **** like nps do for sinusitis treatment

 

[Mad Jack]

Yeah that's what it was. I should have googled that **** like nps do for sinusitis treatment

I basically have a doctorate in Star Wars lore

 

[clamsauce]

I basically have a doctorate in Star Wars lore

Still 10 times better and more useful than DNP.

Maybe np should take computer science class they seemed the worst to instruct when we got new contracts for epic and I had to go there and walk them thru how to click boxes. Everybody else was pretty easy to teach. Guess those long blond bangs and heels got stuck in the mouseball.

 

[DPTinthemaking15]

You are correct. See the face of a PA when you call them a physician's assistant. Literally what their name is and how the field was created. Now they want to be called physician associates and practice independently. Propaganda and word speak is a powerful thing.

Seriously?? Wow. I thought Physician Assistant was the "appropriate" name now-a-days. My wife said it the best "Everyone wants to sit at the big kids table, until they have to take on big kid responsibilities." I'm still not sure what big kid responsibilities are, maybe the dooming thought of mowing the grass or paying a mortgage payment lol.

 

[Lawpy]

Could someone explain to me why at least 70 members believe DNPs will become the new DOs? What does being a new DO even mean?

In any case, an effective strategy to deal with the DNP issue is to grant full independent rights of practice to them. DNPs will accept sole and complete responsibility of health outcomes of their patients, and they will accept all the liabilities and malpractice charges.

 

[DPTinthemaking15]

The NP argument again? I placed this person on ignore a few weeks back for a reason, I can't waste that many hours of my life. I'm just going to let NP practice happen, even hire some myself that are under supervision as part of their contract, then when we've got bad outcomes from independent NPs elsewhere I'll rake in the cash as an expert witness. Why fight it when you can profit from it?

This. Post. I feel like this is 100% me in the future. Go with the flow, but spiteful in the end.

 

[jw3600]

Seriously?? Wow. I thought Physician Assistant was the "appropriate" name now-a-days. My wife said it the best "Everyone wants to sit at the big kids table, until they have to take on big kid responsibilities." I'm still not sure what big kid responsibilities are, maybe the dooming thought of mowing the grass or paying a mortgage payment lol.

Just so we're clear. PhysiciaN associate is perferred (for now lol). Physician'S associate will get you scowls.

 

[DPTinthemaking15]

Could someone explain to me why at least 70 members believe DNPs will become the new DOs? What does being a new DO even mean?

In any case, an effective strategy to deal with the DNP issue is to grant full independent rights of practice to them. DNPs will accept sole and complete responsibility of health outcomes of their patients, and they will accept all the liabilities and malpractice charges.

This is a question I 100% don't understand. Lets say a NP gets sued with their current malpractice insurance. What happens? Please take into consideration I am still a pre-med lol. I mean, do they lose everything? Or do they have to pay the piper and get better insurance? If that is the case, how are they going to afford it with their current salaries. Dang... This can go on forever lol.

 

[clamsauce]

Could someone explain to me why at least 70 members believe DNPs will become the new DOs? What does being a new DO even mean?

In any case, an effective strategy to deal with the DNP issue is to grant full independent rights of practice to them. DNPs will accept sole and complete responsibility of health outcomes of their patients, and they will accept all the liabilities and malpractice charges.

Some nursing pd clicked it 70 times using her school ISP

 

[Lawpy]

Twin Cities jury awards $20M in malpractice case for woman who died after giving birth

NP in the ER sent a recent postpartum woman home to die of sepsis. Told her she probably had a UTI. 20 Million verdict is the largest wrongful death verdict in state history.

The historically low levels of lawsuits involving inadequately prepared NPs practicing above their true level of competence may be attributable to the fact that, for most of the existence of the NP role, it has been a supervised role. Nurses who have lobbied for greater autonomy are finding that this also means accepting greater liability. Hubris will prove to be expensive, though that may not declare itself until a few more years have passed. But be sure, the hit and miss nature of NP education is no secret to the lawyers who are going to bring those cases, and that is ultimately how you will get your Flexner reform. A few largest ever verdicts gets very pricey and embarrassing real fast. Enough to force the reform that y'all are otherwise happy to talk about as something that would be nice to get around to implementing, you know, someday.

I believe one of the main reasons behind these NP controversies is simply due to physicians supervising NPs and accepting liability. If the NPs experience the sole and direct impact of malpractice lawsuits, the NP encroachment will suddenly collapse and online and/or poor NP programs will be shut down.

I also believe physicians should increase their lobbying efforts to protect their practice rights. But the government and public tend to be largely anti-science and anti-education, so it will take a much larger popular effort to achieve these goals.

 

[FNP_Blix]

The NP argument again? I placed this person on ignore a few weeks back for a reason, I can't waste that many hours of my life. I'm just going to let NP practice happen, even hire some myself that are under supervision as part of their contract, then when we've got bad outcomes from independent NPs elsewhere I'll rake in the cash as an expert witness. Why fight it when you can profit from it?

I missed you buddy

 

[FNP_Blix]

Hmmm... I'll bite. If you don't mind, can you tickle my fancy as to why NP's pursue the DNP? After going through *some* physical therapy courses, I learned that the DPT degree was created to take back rights from chiropractors. What is the point of the DNP in your perspective (not what the website states)? Also, if some nurses are wanting the coveted "Dr." title, why not pursue medical school? I'm seriously not trying to be rude. I asked my fellow PT students the same thing.

Good question. If I decide to further my education, It would either be in law or to go to med school. A PhD in nursing makes sense because they become investigators or professors but the DNP, cant speak to that. If anyone wants to improve their skills as NP then the smartest thing to do is get dual cerified (e.g., FNP + psych NP cert).

 

[FNP_Blix]

Aren't you like the 26 year old nurse?

28 now :-D

 

[clamsauce]

Go to law school and sue nps. Nobody has a doubt that online for profit np education on the increase plus ind practice growing = up coming lawsuits. It's already started in 2017. I'm sure lawyers are already creaming their pants over this

 

[FNP_Blix]

I have a serious question guys. Changing the subject for a sec..Because I seriously dont want to be forced to do the DNP, does anyone know of any schools where I can do my pre-reqs online? Because if it comes down to this, or if the NP profession ever collapses, I want to take my MCAT at the very least so that I can enter into a med school...oh and is there any opportunity during med school where I can pick up shifts like here and there?

 

[FNP_Blix]

Go to law school and sue nps. Nobody has a doubt that online for profit np education on the increase plus ind practice growing = up coming lawsuits. It's already started in 2017. I'm sure lawyers are already creaming their pants over this

You may be right. But data just doesnt show this yet. NPs just dont get sued
Often even in independent practice. But maybe with the proliferation of BS schools and NPs practicing with no experience, this may become a reality in the next decade

 

[FNP_Blix]

I believe one of the main reasons behind these NP controversies is simply due to physicians supervising NPs and accepting liability. If the NPs experience the sole and direct impact of malpractice lawsuits, the NP encroachment will suddenly collapse and online and/or poor NP programs will be shut down.

I also believe physicians should increase their lobbying efforts to protect their practice rights. But the government and public tend to be largely anti-science and anti-education, so it will take a much larger popular effort to achieve these goals.

Eh not that simple. NPs do, and must accept liability. Most physicians drag their Mid-levels down with them, lol are you kidding me. And even if your right, wouldn't be so sudden because most NPs collaborate. Very few actually are independent practitioners. I know I dont want to be until I have years of experience.

 

[clamsauce]

You may be right. But data just doesnt show this yet. NPs just dont get sued
Often even in independent practice. But maybe with the proliferation of BS schools and NPs practicing with no experience, this may become a reality in the next decade

Back in the day though usually only the most intelligent of nurses went back to school for fnp and had to attend one of the new schools for it. Not to mention they were seasoned. Then they were usually trained by the docs who hired them and supervised.


While these are probably still a slight majority I think we can all agree on the proliferation of direct entry, no experience, online for profit, NPs teaching NPs, and independent practice all mixed together is probably not going to end well. Too many stars align in the wrong direction. Hence why after I got my rn I got a bs in computer science, worked a few years for epic while taking med prereqs and decided on the long route instead. Can't take a profession seriously that has an educational background with as many gaping holes in it as the brain of some poor kid in Africa with neuroscisterocosis cheese brain from drinking ****ty water

 

[DPTinthemaking15]

I have a serious question guys. Changing the subject for a sec..Because I seriously dont want to be forced to do the DNP, does anyone know of any schools where I can do my pre-reqs online? Because if it comes down to this, or if the NP profession ever collapses, I want to take my MCAT at the very least so that I can enter into a med school...oh and is there any opportunity during med school where I can pick up shifts like here and there?

UNE online! I was going to do the same thing with a few of my pre-reqs, but you need to check with the programs you are applying to. Some are okay with them and others don't like them at all. As for the shifts, not a clue.

 

[FNP_Blix]

UNE online! I was going to do the same thing with a few of my pre-reqs, but you need to check with the programs you are applying to. Some are okay with them and others don't like them at all. As for the shifts, not a clue.

Yea im gonna slowly plan for this and when im 32 or 33 years old Ill be ready to make that jump if i need to

 

[DPTinthemaking15]

Yea im gonna slowly plan for this and when im 32 or 33 years old Ill be ready to make that jump if i need to

It's a good move. My two friends who are NP's just started their first year as medical students and apparently they are loving it.

 

[clamsauce]

Yea im gonna slowly plan for this and when im 32 or 33 years old Ill be ready to make that jump if i need to

Took my prerequisites at a community college. It's so cheap. Since I ran out of scholarship money since I had a bs already. Of course that is if there is one near you. If not then do what above guy said.

 

[FNP_Blix]

Back in the day though usually only the most intelligent of nurses went back to school for fnp and had to attend one of the new schools for it. Not to mention they were seasoned. Then they were usually trained by the docs who hired them and supervised.


While these are probably still a slight majority I think we can all agree on the proliferation of direct entry, no experience, online for profit, NPs teaching NPs, and independent practice all mixed together is probably not going to end well. Too many stars align in the wrong direction. Hence why after I got my rn I got a bs in computer science, worked a few years for epic while taking med prereqs and decided on the long route instead. Can't take a profession seriously that has an educational background with as many gaping holes in it as the brain of some poor kid in Africa with neuroscisterocosis cheese brain from drinking ****ty water

Lol yea the majority are really good and train under physicians (like me!). But unfortunately the sad reality is that every freaking new grad nurse wants to go directly into NP schools and many schools allow this. Ive been an RN for almost 6 years now so im not really in that category. I work in MSICU now

 

[neoevolution]

Lol yea the majority are really good and train under physicians (like me!). But unfortunately the sad reality is that every freaking new grad nurse wants to go directly into NP schools and many schools allow this. Ive been an RN for almost 6 years now so im not really in that category. I work in MSICU now

I met a nursing student with no prior nursing training or experience who was in a 3.5 year NP program. And that time includes the basic prerequisites for the RN as well. It's insane, it's the equivalent of letting an M3 practice alone

 

[FNP_Blix]

I met a nursing student with no prior nursing training or experience who was in a 3.5 year NP program. And that time includes the basic prerequisites for the RN as well. It's insane, it's the equivalent of letting an M3 practice alone

It depends on the program. If its a great school, like Georgetown University or something , then okay, maybe it's okay. But keep in mind that most NPs know its career suicide (potentially) to practice independent right out of school. Just stupid really.

 

[Deecee2DO]

absolutely not.

 

[themoonman2]

I second the community college for pre-reqs suggestion. It's not as prestigious as some other routes, but very cheap and can get you into med school so long as your MCAT is up to par.

 

[clamsauce]

All I'm gonna say about those nursing to MD equivalency studies is that if big tobacco companies sponsored a study on the effects of smoking the conclusion would prob say it cures cancer, helps asthma, and makes your bird grow 6 inches. One cup size increase for the ladies just to keep it kosher

 

[FNP_Blix]

All I'm gonna say about those nursing to MD equivalency studies is that if big tobacco companies sponsored a study on the effects of smoking the conclusion would prob say it cures cancer, helps asthma, and makes your bird grow 6 inches. One cup size increase for the ladies just to keep it kosher

lmao come on man thats such a stretch

 

[FNP_Blix]

Harvard has pre med online at 1500$ a course (course by course for those with bachelors degree already)

 

[clamsauce]

lmao come on man thats such a stretch

It would be a stretch if it was true. 6 more inches. Ouch

 

[Mad Jack]

I second the community college for pre-reqs suggestion. It's not as prestigious as some other routes, but very cheap and can get you into med school so long as your MCAT is up to par.

I did half of my prereqs at community college, as well as taking biochem online at UNE. Ended up with a 35 on the MCAT, so clearly good enough to excel without breaking the bank.

 

[Mad Jack]

All I'm gonna say about those nursing to MD equivalency studies is that if big tobacco companies sponsored a study on the effects of smoking the conclusion would prob say it cures cancer, helps asthma, and makes your bird grow 6 inches. One cup size increase for the ladies just to keep it kosher

And they'd say it was unbiased because it was conducted by convenience store owners, who don't make tobacco so clearly it's legit since they're an unbiased third party (even though they stand the second most to gain from tobacco sales).

 

[clamsauce]

I did half of my prereqs at community college, as well as taking biochem online at UNE. Ended up with a 35 on the MCAT, so clearly good enough to excel without breaking the bank.

Haha yeah that's what I made on new version. Better to spend time reading teh review books and questions then overload on class based science prereqs. God mcat score is a good investment. Lets us get into even more debt and argue about DNPS

 

[Mad Jack]

Haha yeah that's what I made on new version. Better to spend time reading teh review books and questions then overload on class based science prereqs. God mcat score is a good investment. Lets us get into even more debt and argue about DNPS

Another thing that likely helped was that I took my prereqs immediately before the MCAT, which made it infinitely easier. I can't imagine how much it must suck studying several years out.

 

[FNP_Blix]

Haha yeah that's what I made on new version. Better to spend time reading teh review books and questions then overload on class based science prereqs. God mcat score is a good investment. Lets us get into even more debt and argue about DNPS

The nice thing is im an NP already already practicing medicine and making good money. I think that will be advantageous if I decide to go to med school (@ the very least financially)

 

[clamsauce]

Another thing that likely helped was that I took my prereqs immediately before the MCAT, which made it infinitely easier. I can't imagine how much it must suck studying several years out.

Yeah for real who wants to learn organic chemistry twice. Once is enough. Even though there was barely any orgo on the new one mostly biochem with tons of knock out mice.

 

[FNP_Blix]

I did half of my prereqs at community college, as well as taking biochem online at UNE. Ended up with a 35 on the MCAT, so clearly good enough to excel without breaking the bank.

How much was UNE

 

[Mad Jack]

How much was UNE

$1,385
UNE Online Tuition

 

[AnatomyGrey12]

I have a serious question guys. Changing the subject for a sec..Because I seriously dont want to be forced to do the DNP, does anyone know of any schools where I can do my pre-reqs online? Because if it comes down to this, or if the NP profession ever collapses, I want to take my MCAT at the very least so that I can enter into a med school...oh and is there any opportunity during med school where I can pick up shifts like here and there?

UNE online is good like was mentioned above. A lot of schools have rules where you cannot work during school outside of work-study opportunities, but not all of them. Honestly I wouldn't plan on working in medical school because it is so time consuming. If you have that time do something else like research.

lmao come on man thats such a stretch

Not really. I'm not kidding when I say the "research" that shows NP=MD is an absolute joke. The study design alone is enough to completely ignore it, let alone actually consider it efficacious and on top of that the bias involved is glaringly obvious. The big issue is that a good study designed to actually pit NP against MD would never happen because it would be unethical.

 

[FNP_Blix]

UNE online is good like was mentioned above. A lot of schools have rules where you cannot work during school outside of work-study opportunities, but not all of them. Honestly I wouldn't plan on working in medical school because it is so time consuming. If you have that time do something else like research.

Thanks for the info.

Not really. I'm not kidding when I say the "research" that shows NP=MD is an absolute joke. The study design alone is enough to completely ignore it, let alone actually consider it efficacious and on top of that the bias involved is glaringly obvious. The big issue is that a good study designed to actually pit NP against MD would never happen because it would be unethical.

Can't honestly say that I agree. Please don't take this as, "I think NPs should replace physicians altogether", but I find the studies actually quite compelling. Can you honestly sit there and tell me that the studies out there in medicine and healthcare in general are without bias or limitations? Most studies out there can be shred to pieces and I think you know that. Also, can you reference any studies that disproves that NPs are not capable of practicing independently? I haven't really seen any good studies that disprove my position. All I'm saying is that in the right setting, NPs can do just fine on their own. I know most of you on here will disagree but there is a wealth of data out there that would agree with this position, not to mention, 21 US states and D.C.

 

[neoevolution]

It depends on the program. If its a great school, like Georgetown University or something , then okay, maybe it's okay. But keep in mind that most NPs know its career suicide (potentially) to practice independent right out of school. Just stupid really.

Even HMS students don't get to skip residency and just go into practice, and they have undergrad preregs + 6mo of grad school over whatever the direct programs offers. And their clinical hours per week are far fewer than what a med student does.

I understand that most won't practice independently immediately, but the fact that they're legally fully licensed to do so is dangerous.

 

[FNP_Blix]

Not really. I'm not kidding when I say the "research" that shows NP=MD is an absolute joke. The study design alone is enough to completely ignore it, let alone actually consider it efficacious and on top of that the bias involved is glaringly obvious. The big issue is that a good study designed to actually pit NP against MD would never happen because it would be unethical.

Forgot to also mention that the studies are not saying that NP=MD. What they are saying is that, in the outcomes being measured (which are significant) NPs are performing, in practice, just as well (and in some cases scoring better) than physicians. No NP that I have ever met will claim they have equivalent knowledge or breadth of study under their belt as a physician. But to fulfill the duties they are meant to fulfill, they are usually well prepared. I prefer to work under a physician because I'm still new. But I have met amazing, seasoned NPs that are completely able to practice solo.

 

[FNP_Blix]

Even HMS students don't get to skip residency and just go into practice, and they have undergrad preregs + 6mo of grad school over whatever the direct programs offers. And their clinical hours per week are far fewer than what a med student does.

I understand that most won't practice independently immediately, but the fact that they're legally fully licensed to do so is dangerous.

I know, there is a lot of inconsistency in nursing. It really bothers me too. However, I think most NPs will choose to stay in a team based setting and serve as an adjunct or extender. The one's that are practicing independently I believe are highly experienced, and know their limitations. Also, most schools require undergrad prereqs plus nursing experience. Half of my clinical practicums were under physician supervision, and we do 1000 clinical hours. Most NPs have 10-11 years of RN experience too (though this may be changing over the next decade), which I think plays a big role, because of the experience we bring to the table. Again, you don't have to like this rationale, but this is the reality...I'm just going to hold out, and if the ball ever drops, I'm going to med school. But this has been a topic of debate for years and nothing has really changed. Maybe, by at least requiring a DNP for minimum standard admission, it will weed out unmotivated students and keep our numbers down.

 

[clamsauce]

At least you have reason behind your reasoning. Hell its like chewing on burned out light bulbs what they say over on allnurses. If all the docs quit and walked out they would prob think they could run the hospital themselves including spine surgery.

 

[clamsauce]

There was one licensed as an fnp working in psychiatry who thinks she can do everything a psychiatrist can do.

"We are the only mental health clinic around blah blah and we only see low acuity.

Ok so if your the only clinic around what do you do send the high acuity people down the street to the non exsistant psych center.


Lmfao

 

[AnatomyGrey12]

Can you honestly sit there and tell me that the studies out there in medicine and healthcare in general are without bias or limitations?

No, but the "NP studies" are so bad they don't even compare.

Most studies out there can be shred to pieces and I think you know that.

Yes there is lots of biased, problematic research and they do get shred to pieces on a consistent basis.

Also, can you reference any studies that disproves that NPs are not capable of practicing independently?

That's not how this works at all, and you not understanding that is a big problem. Medical doctors are the gold standard for healthcare, and anyone (i.e. NPs) who wants to claim that their skills or comparable is the one who carries the burden of proof. And no I'm not talking about studies where the NPs are managing grandma and her HTN meds and the docs are doing that and also seeing an additional 15 patients with more comorbidities. To show equal competence you need to take the NPs and give them the same acuity patients as physicians in the same time frame and see the outcomes of each. This kind of study will never happen because it is unethical due to NPs lacking the skills to handle those types of patients and patients would suffer.

I haven't really seen any good studies that disprove my position

See above.

know most of you on here will disagree but there is a wealth of data out there that would agree with this position, not to mention, 21 US states and D.C.

No there isn't, all there are a bunch of shoddy studies done by nursing lobbyists or even the nurse groups themselves with terrible n values and high school level study designs. Also appealing to a bunch of lobbyists and politicians who only care about the bottom line isn't the best appeal to authority and does nothing to prove your point.

What they are saying is that, in the outcomes being measured (which are significant) NPs are performing, in practice, just as well (and in some cases scoring better) than physicians

Lol no. What outcomes measured are "significant"? Your going to need to cite some sources to show NPs performing better and I don't want to see a study comparing patient satisfaction surveys.