Nurse propaganda

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skipdivided said:
This is the whole point though. Yes, an NP may have the ability to learn the physical exam well; this is an art unto itself and certainly takes years to truly master for anyone regardless of degree. However, NPs still don't have the deeper level of understanding of disease processes and/or pathophysiology and/or presentations of diseases, particularly more obscure disorders. So in some cases they don't have an adequate knowledge of what they should be looking for, what exam findings are pertinent, etc. Without attending medical school, it's still more algorithmic than analytic. NPs can go through the same motions of a physical exam as an MD/DO without the deeper level of cognitive evaluation. And there's the problem. Typically it's not the simple bread-and-butter cases that NPs have problems with, it's subtle, difficult-to-distinguish ones that require a more complex understanding. Physicians are seeing the same data points of the physical exam but analyzing them in a different way.
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I think that is where we have to remember that these things can be learned. However, it has to be learned post NP by NP's that actually continue to read/study to learn path etc. Knowledge can be obtained outside of med school it would just take a dedicated NP to do so.

Also this "they don't know what they don't know" statement people keep saying isn't logical. That statement also applies to anybody in any profession.
 
Joebird22 said:
I think that is where we have to remember that these things can be learned. However, it has to be learned post NP by NP's that actually continue to read/study to learn path etc. Knowledge can be obtained outside of med school it would just take a dedicated NP to do so.

Also this "they don't know what they don't know" statement people keep saying isn't logical. That statement also applies to anybody in any profession.
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The reason that "they don't know what they don't know" applies because they are a lesser trained professional trying to market themselves as equivalent or near equivalent. That is the whole point of this thread before the derailment. Remember the OP and the article about the 700 hours of training and being "like doctors in a nurses garb." Which in itself is kind of amusing as they ALL wear the long white coat. More like advanced nurses in doctors garb. We try to avoid confusion with clear, large and color coded IDs. I saw an army of CRNAs hide their identity behind their rank in my time in the military. It was really not right and the command couldn't care less.
 
Joebird22 said:
I think that is where we have to remember that these things can be learned. However, it has to be learned post NP by NP's that actually continue to read/study to learn path etc. Knowledge can be obtained outside of med school it would just take a dedicated NP to do so.

Also this "they don't know what they don't know" statement people keep saying isn't logical. That statement also applies to anybody in any profession.
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Knowledge in almost any field can be learned by people outside the field. I'm not sure there are many people that would dispute that. Preclinically we can debate about the benefits of a cadaver lab but, save that, I can sit down anyone with netters, big Robbins, a micro textbook, a pharm textbook, a neural textbook (and a few other random texts depending on what school you're at) plus an online path slide course and tell them to spend the next two years studying because they'll have a bunch of premade supervised tests to take along the way with a extra big all day test to take at the end. bam you've got the first two years of med school (minus some standardized patient encounters probably but you could reasonably figure out most of that during some kind of clinical rotation anyway).

The problem is actually sitting down and doing that by yourself. Would I take that much time out of my life to do that without someone forcing me? Hell no and I'm pretty sure like 99.9 percent of the population wouldn't either. So it's one thing to talk about "self learning all the medical school stuff"...it's another thing to actually sit down and do it.
 
ChiTownBHawks said:
Not gonna relay my personal story on a public forum. You can PM me if you want to know.
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That's totally cool. I respect that. Just wondering if it was in acute healthcare at busy, university/teaching centers. I have seen a number that don't think that way. In fact in the units where they cover--especially in peds hospitals, everyone pretty much takes a "mother may I approach." It's the nature of pediatrics to tread uber carefully/cautiously with regard to every decision and such. Everything goes through the surgical/medical attendings pretty much no matter what. My experience is that you have to be willing to let go of the autonomy and control you may have had while working in the adult critical care world. People are extra careful about making mistakes and screwing with the treatment recipes for kids. Just my experience, but it is substantial. I would be lying if I said otherwise.

No prob with PM. Smart. 🙂
 
IlDestriero said:
The reason that "they don't know what they don't know" applies because they are a lesser trained professional trying to market themselves as equivalent or near equivalent. That is the whole point of this thread before the derailment. Remember the OP and the article about the 700 hours of training and being "like doctors in a nurses garb." Which in itself is kind of amusing as they ALL wear the long white coat. More like advanced nurses in doctors garb. We try to avoid confusion with clear, large and color coded IDs. I saw an army of CRNAs hide their identity behind their rank in my time in the military. It was really not right and the command couldn't care less.
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Marketing that role as physician equivalents is just plain illogical, and certainly this where the line must be drawn. But remember that it is a sub-segment of yahoo-advanced practice nurses that are a part of such rallying. Many NPs are just fine to stay within their scope of practice and go home and call it a day. They aren't marching on DC.

If they want to become physicians, then they have to jump through the same hoops as everyone else. Indeed, there are a number of NPs that have done this and are doing well as physicians.

Besides the extreme AP- political-activists, the others that need to be blamed are the hospitals and centers and such that are hiring NPs or PAs as "fill-ins" for physicians. They are every bit as much to blame, if not more so.

But it's still insane to lump ALL advanced practice nurses into this mentality and behavior.
 
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Mad Jack said:
Totally depends on where you work- my hospital was really great at staffing nurses, but really poor at staffing CNAs, so nurses ended up with a lot of the grunt work. Pay was great though, most nurses with 10 years experience could crack 100k averaging 44 hours a week.
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I mean not every time... but I made sure I was present for two to three changes to check the skin
 
Frazier said:
Had to interact with a particular nurse today that was a real hellborn wench.

That's the end of my story.

This thread is for complaining about nurses, amirite?
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That's not a story that's just tears
 
Psai said:
That's not a story that's just tears
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Yeah, that nurse wishes.

Instead nurse got toneless one-word responses.... and an anonymized bronze plaque for posterity on SDN's 'nurse propaganda' thread in nurse's honor.

Here is to you, angry nurse -- I hope things get better for you.

cheers.jpg
 
Joebird22 said:
I think that is where we have to remember that these things can be learned. However, it has to be learned post NP by NP's that actually continue to read/study to learn path etc. Knowledge can be obtained outside of med school it would just take a dedicated NP to do so.

Also this "they don't know what they don't know" statement people keep saying isn't logical. That statement also applies to anybody in any profession.
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no it doesn't. it's like when you take an impossible test and the kids who didn't study worth crap come out of it like " that wasn't so bad" meanwhile all the people who studied their @sses off are like " zomg I gotta cry"

if you aren't aware of the breadth of content, then things generally seem much simpler than they are. Dunning-Kruger in effect.
 
Frazier said:
Had to interact with a particular nurse today that was a real hellborn wench.

That's the end of my story.

This thread is for complaining about nurses, amirite?
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🤣
 
Frazier said:
Yeah, that nurse wishes.

Instead nurse got toneless one-word responses.... and an anonymized bronze plaque for posterity on SDN's 'nurse propaganda' thread in nurse's honor.

Here is to you, angry nurse -- I hope things get better for you.

cheers.jpg
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Not sure if you are referring to me or not, but I am quite a happy nurse that tries to balance POVs and is moving along her own path. Ey, I'm just looking for the God Particle is all. Can't make it to Geneva right now. 😉

But now I think I am seeing an angry nurse in one of those ice cubes. 😉
 
ChiTownBHawks said:
Sounds like the same people who say MDA to me.
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It's site or hospital specific for anesthesiologists. Bad habit some of us got into. Don't know who started it. It's been around for years, but forgot that some of the newer anesthesiologists in particular don't like it. Apologies to them.

IDK, seriously, I wouldn't be surprised if some nurse started it. Prior to working at some places that didn't have a problem with it, colleagues and I just said anesthesia. Then CRNAs became more and more proliferative, and so at some kiddy hospitals, people clarified and cut anesthesiologist short to ologist. Sounded stupid to me at first too; but when you are in a culture long enough, and others don't have a problem with it, well....you fall into it. It still is dumb though, I agree.
 
jl lin said:
Not sure if you are referring to me or not, but I am quite a happy nurse that tries to balance POVs and is moving along her own path. Ey, I'm just looking for the God Particle is all. Can't make it to Geneva right now. 😉

But now I think I am seeing an angry nurse in one of those ice cubes. 😉
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The odds you are the nurse in the same state, in the same city, in the same system, in the same hospital, on the same floor, in the same department, on the same team, at the same time as I was -- is pretty small.

In all likelihood, I was not talking about you.
 
Frazier said:
The odds you are the nurse in the same state, in the same city, in the same system, in the same hospital, on the same floor, in the same department, on the same team, at the same time as I was -- is pretty small.

In all likelihood, I was not talking about you.
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Was referring to the general tone towards nurses and reaction to any that posted here. People slip in and make under the radar comments and others jump on board. You know how it rolls. No one is losing sleep over it. People can pretty much say what they want.

I was actually frustrated by what I was seeing from nursing yesterday. At least the one nurse had the decency to say, "I'm new to this, so I don't know what you are talking about?" I was surprised; b/c what I was talking about was definitely covered when I went to nursing school.

No offense toward nurses, but I am fearful with regard to even the general caliber of education--or maybe they are making it just too damn easy to get in. Maybe this BS of P/F boards means that more people are just on the edge of passing through licensure. I really don't know. But add to that the ease with which a number of these get into AP programs, with relatively little to no strong clinical practice, and it's frightening. Damn. I am beginning to think they need to revamp everything in nursing from the ground up. I am glad the nurse was nice, but seriously, she was a clueless pill-pusher. Doesn't bode well for nursing.

I totally think I am making the right choice to ultimately move out of nursing. Seems like it used to be that you had to have a decent measure of intellect, curiosity, motivation to be a nurse. It's sad.
 
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Nurses reading biopsies? Sounds dumb as heck to me unless he/she has been an oncology nurse in ONE specialized area for over 50 years.

Unlike most of the folks in this thread, I have a TON of respect for Nurses pre 2005. But these "new school" nurses, with the DNP degrees are something else!
 
NickNaylor said:
In fairness, I don't see many nurses claiming to actually be doctors. Many just want all the trappings of being a physician but are perfectly fine being a "provider" or a "nurse practitioner."

But yes, the irony is palpable.
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That's true.

I don't disrespect nurses. I've learned a lot from several of them, especially in the ICU.

I recently received an email from a "Dr. Whoever, PT, MPT, DPT" and I was just blown away by the pretentiousness that is so prevalent in hospitals. I can barely tell who is who anymore.
 
I actually got my bachelors of science in nursing and made the switch over to medicine. The comparison is laughable. During my nursing school time I heard the instructors (who all had their doctorate and demanded to be called Dr. So and so) essentially harp about how nurses are just as knowledgable and competent as MD/DO's education wise. During my first semester of nursing school I felt this might be true. For the last three semesters it was a joke and a waste of time. The learning was very superficial and focused more on patients social issues a lot of the times more than what was wrong with them. I understand nursing tries to incorporate a social approach as well but I feel some things are more important to learn besides how to pat someone's back the right way (there was literally a question pertaining to this). When I first started taking my pre reqs for medicine it was ridiculous how much more in depth the biology classes, molecular genetics, organic chemistry, etc was compared to the nursing pre reqs. This is just the pre reqs. NPs never have to touch these classes or take an MCAT. My pre reqs for nursing included A&P 1&2, microbiology, and chemistry. These classes were superficially covered and I gurantee you by the first semester of nursing school none of us could have told you what we learned from these classes. My point is, nurses are great and NPs serve a useful function. However, their level of knowledge in hard science is way behind and can be dangerous for a patient. While some people say that nurses don't want to be like doctors, etc, that wasn't the case where I went to school and worked. Many believed they was on the same level knowledge wise and honestly think that they can perform the job as well. This is dangerous thinking. I have spoke to some NPs that wish they had more training in the science area. This would be great and could help benefit them a lot of these nursing organizations would make it an essential requirement.
 
TheTao said:
Nurses reading biopsies? Sounds dumb as heck to me unless he/she has been an oncology nurse in ONE specialized area for over 50 years.

Unlike most of the folks in this thread, I have a TON of respect for Nurses pre 2005. But these "new school" nurses, with the DNP degrees are something else!
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56981285.jpg
 
jl lin said:
I was with you right up to the point about competence. If an NP is taught how to do a physical exam by a physician and becomes competent in completing them by experience and such, this is an area where both a physician and NP may well be equally competent. I know that I am better than some docs at hearing heart sounds, b/c I have become experienced and learned and practiced in heart sounds. It takes time and some people are better at it than others. It doesn't mean I am a competent cardiologist though for God's sake. But there are skills and didactic insight and such in which the PA, NP, and physician may or may not be more or less competent.

And there are less competent physicians, where in fact, some NPs or PAs are a sight better--b/c they have expanded their knowledge and just really give a damn to build their level of competence. There indeed are physicians, where, regardless of their education and residency, just aren't that good at what they do and are not competent practitioners. Are they more competent than those experience and continually learned NPs and PAs that do actually give a damn about what they are doing and are bright and committed? No.

Bill made some good points. But some of this stuff is just about a pissing contest, which really isn't a pissing contest, b/c on the whole, physicians have the advantage, hands down. So why all the NP and/or PA hate?

End of the day, it is up to each practitioner to be as competent as possible--from a professional standpoint and from an ethical one.
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In case any premeds are reading this nonsense, none of it is true. I've only been on the wards for a little while but I have not read a single note where mid levels are picking up subtle findings. Physicians don't go out of their way to teach mid levels how to do a physical exam and to really do a proper one you need to have a good differential diagnosis in mind to know what to look for. You don't have that with a nursing education. Just another clueless nurse spouting equality nonsense couched in political correctness. I'm looking forward to what she says if she ever makes it into medical school.
 
Psai said:
In case any premeds are reading this nonsense, none of it is true. I've only been on the wards for a little while but I have not read a single note where mid levels are picking up subtle findings. Physicians don't go out of their way to teach mid levels how to do a physical exam and to really do a proper one you need to have a good differential diagnosis in mind to know what to look for. You don't have that with a nursing education. Just another clueless nurse spouting equality nonsense couched in political correctness. I'm looking forward to what she says if she ever makes it into medical school.
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A while back there was a poster on SDN who went through nursing school and some NP school before deciding it was malarky and going to medical school- schultzhand or something like that. It was no comparison and it was scary to him/her how much nursing propaganda there was in nursing school. Note there is none of that in medical school directed at nursing and if anything there is the opposite- you are told to trust an experienced nurse. It was also scary how little they knew and how little they realized how little they knew.

Having gone through 6 years of post-graduate training after 4 years of medical school at very reasonable institutions, I am still in fear of what I have not seen and what I might not know.
 
Psai said:
In case any premeds are reading this nonsense, none of it is true. I've only been on the wards for a little while but I have not read a single note where mid levels are picking up subtle findings. Physicians don't go out of their way to teach mid levels how to do a physical exam and to really do a proper one you need to have a good differential diagnosis in mind to know what to look for. You don't have that with a nursing education. Just another clueless nurse spouting equality nonsense couched in political correctness. I'm looking forward to what she says if she ever makes it into medical school.
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Nearly all of the PA/APN notes that I see are 99% templates with little no useful information added and very little to no modification of plans. I respect PAs more as their education follows the medical model, but APNs effectively act (at least in my medical center) as a resident with a lower quality of training. Sure, there are some great APNs out there, but in my experience they are the exception and not the rule, which in itself is fairly telling.
 
NickNaylor said:
Nearly all of the PA/APN notes that I see are 99% templates with little no useful information added and very little to no modification of plans. I respect PAs more as their education follows the medical model, but APNs effectively act (at least in my medical center) as a resident with a lower quality of training. Sure, there are some great APNs out there, but in my experience they are the exception and not the rule, which in itself is fairly telling.
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The absolute worst are the ED notes where it's painfully apparent that they just clicked buttons. "The duration is ___" "The onset was ____" I'm like what the **** is this? Not only is it useless, it's a waste of space in the EMR
 
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Although I see the same from ED physicians. Although usually the diffy and plans are better, that's where the real CYA/medicine is anyway.
 
Psai said:
The absolute worst are the ED notes where it's painfully apparent that they just clicked buttons. "The duration is ___" "The onset was ____" I'm like what the **** is this? Not only is it useless, it's a waste of space in the EMR
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As the resident above me said, ED physicians often use the same Powernote templates. The notes are a pain in the ass to read, and are about the least efficient way to learn about a patient if you're, say, on an admitting team.
 
What will surgeons do when NPs and PAs are granted the right to practice surgery?

You are a world class fool if you don't think this will eventually happen by the way.

"THIS CASE COULD NOT HAVE BEEN PERFORMED WITHOUT THE EXCELLENT ASSISTANCE OF BOB JOHNSON, PA-C."
- Quote from EMR from one patient's arthroplasty by ortho surgeon that I read very recently (name made up).
 
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cbrons said:
What will surgeons do when NPs and PAs are granted the right to practice surgery?

You are a world class fool if you don't think this will eventually happen by the way.

"THIS CASE COULD NOT HAVE BEEN PERFORMED WITHOUT THE EXCELLENT ASSISTANCE OF BOB JOHNSON, PA-C."
- Quote from EMR from one patient's arthroplasty by ortho surgeon that I read very recently (name made up).
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That's such nonsense. It's already starting to happen with first assist PAs and nurses. It is having a hugely negative impact on medical student education, not sure how much of an effect it has with residents. I do know of a surgeon who prefers to work with the mid-levels that they have trained themselves because those people do the same procedures over and over which would be slowed by a resident. These midlevels do things like greater saphenous harvests for cabgs
 
DokterMom said:
Stereotype much? :nono:
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Re: the poster to whom you replied. 🙂

It's a bit of an older thread, but here is a sad reality. Nurses behavior towards other nurses, often, not so much about "worship" at all. It's more about undermining and underlying insecurities. I have worked quite long enough and in a enough places that I have to be honest and say my n=1 equals a lot more than some realize. Yes, there are those that stick together, but not in the general, work-a-day sense. I wish I could only count on one hand all the nurses that were too eager to throw another nurse under the bus. I honestly do.
 
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cbrons said:
What will surgeons do when NPs and PAs are granted the right to practice surgery?

You are a world class fool if you don't think this will eventually happen by the way.

"THIS CASE COULD NOT HAVE BEEN PERFORMED WITHOUT THE EXCELLENT ASSISTANCE OF BOB JOHNSON, PA-C."
- Quote from EMR from one patient's arthroplasty by ortho surgeon that I read very recently (name made up).
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Some PAs harvest saphenous veins and such in the OR, but what they do often is not much beyond that. Yes, there are some exceptions, but surgeons that go through the whole trying pathway to become surgeons will continue. Geez, people get nervous enough about having procedures done at teaching hospitals, where they know the surgeon will allow the residents and fellows to do some of the surgery. There are some interesting stories. OTOH, rightfully so, a good number of surgeons that are worth anything are utter control freaks--thank God.
 
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chipwhitley said:
What doctors should do is refuse to work with NPs and let them demonstrate just how capable they are on their own and completely on their own.
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I don't care what they put me through as a NP. Hell if I would do surgery without the proper medical and post-graduate training--and even then a strong fellowship. It's not worth it, and those people that take the path to become surgeons know it's is UTTERLY ball-busting. Sure, if they like it, it's cool for them; but it's still very grueling.
 
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