I am a CNA.
I can assure you that no nurse is trying to take over your future practice as a physician. If you learned to actually utilize your nursing staff properly you would understand this. Nurses enjoy what they do, they want to help people and they way they do this is fundamentally different from what physicians do.
Ok. As a
paramedic who works with nurses on a nearly daily basis, I think this is naively generalizing an entire group of professionals.
Sure, plenty of nurses enjoy what they do; however, there is an inherent underlying push-pull between the nursing and medicine professions. Nursing theory is, in my opinion, dramatically different than the medical model taught to paramedics, physician assistants, and physicians. For many years the subservient nature of nursing was taught, even indoctrinated I dare say, into many nursing graduates. Then they get out and start to practice and it gets old, fast. Nurses get tired of the "high and mighty doctor." It's made worse by the fact that
some nurses haze new MDs in residency and new MDs remember this and return the favor in spades (I understand this goes both ways). For every caring, good natured nurse who enjoys their station in life, there are certainly a few who would like nothing more than to turn the tables on 100 years of history. I get the feeling that many nurses see themselves as a disenfranchised class of people with a
right to practice independently, not a profession seeking to advance themselves toward
proving a right to independent practice.
This idea that nurses have a sole license over "holistic care" is itself protectionist, yet it is perpetuated at the bedside of patients everyday. I couldn't count on my hands the number of times I've heard a nurse (or other allied health provider) say, "Listen, if you need something, ask me. The doctors just are not in touch with what you need" or some other undermining comment like this. Patients are trained to seek relief and care through their nurse, not the physician.
In their defense, this is actually true all too often. This is where physicians have failed. I recently had a family member undergo some fairly serious care. The physician who came to speak with my family was texting and checking Facebook while he spoke with my mother. When he left my mother said, "Thank God for the nurse. How unprofessional! If you ever act like that I'll slap you." The physician actually did do his job. He asked all the pertinent questions relevant to the emergent condition, performed a brief back and forth differential with the family, and left. He just did it without one ounce of compassion or concern for the family members. The rest of the visit the nurses established themselves as the patient advocates and the doctors as the big bad enemy. Numerous people left that hospital with less respect for physicians than they had when they entered the hospital.
I don't believe the idea of DNPs is a problem, really. I think the problem is physicians are not actively advertising themselves as a meaningful part of the healthcare system because they assume, wrongly in my mind, that they are protected by thousands of years of tradition. That's shortsighted. The development of the DNP degree is a disruptive innovation and physicians would be smart to mobilize their significant financial resources to remind the public of the unique service they provide.
Finally, I should clarify that I appreciate the service nurses provide. I'm not even opposed to nurses, should they adopt a similar standard and model for education, eventually producing physicians. If DNPs want to take the MCAT, apply to nursing medical schools, complete residency, and pass a licensing exam of similar rigor to physicians, then they have done nothing less than what osteopathic physicians did so many years ago and should be recognized as "separate but equal." If, on the other hand, society as a whole comes to find the training of primary care physicians to be "overkill," then society, in consultation with physician organizations, should amend the requirements to enter that particular part of the profession, not create a new class of provider. If advanced practice nursing, with it's relevant educational attainment, is a safe way to provide primary care then maybe we should look at three year MD/DO programs (I think LECOM and NYU already have this) and shorter residencies for those professionals interested in this type of medical practice.
So, no its not true. I didnt think it made much sense either. But, maybe I had missed some arbitrary rule somewhere... You never know.
