Nurses vs. Doctors

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MedProdigy

MedProdigy

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Do nurses consider themselves a doctors equal? Or do they know their place?
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Doctors are higher in the food chain, but they are expected to work together with nurses. Especially among newer docs (interns and what not) there is a fair amount of overconfidence, but in "good" environments they get along fine. I wouldn't say they operate as equals, but they definitely each have their zones and rely on each other tremendously, rather than the doc being superior at everything.
 
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They have totally different jobs. Nurses are technicians, meaning they are excellent at following protocols. Their job also includes an intangible "compassionate caregiver" component.

Physicians are more like scientists. They know the science inside and out, and while they often follow protocols as well, their real training shows in the <5% of the cases when **** hits the fan and protocols are thrown out the window and they have to really know whats going on at a cellular level and be able to quickly create a logical solution based on their own knowledge reservoir.

"They know their place" is a pretty crude and disrespectful way to say it, but generally yes, they do. More accurately, they know that they have a very different job than the physicians. A nurses perspective and a doctors perspective can be night and day. A simple analogy would be that doctors are the "coach" and nurses, techs, everyone else are the players. Detroit Pistons = bad model to follow.
 
"They know their place" is a pretty crude and disrespectful way to say it
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Yes...


At any rate, the AANA is pushing equivalence in care between NP/MD pretty hard, but that isn't necessarily representative of many nurses. Similar to APA rx movement and many clinical psychologists.
 
loveoforganic said:
Yes...


At any rate, the AANA is pushing equivalence in care between NP/MD pretty hard, but that isn't necessarily representative of many nurses. Similar to APA rx movement and many clinical psychologists.
Click to expand...

The AANA can push as much as they want. They'll never get the respect that the title of physician carries. Additionally, I doubt very much that anyone bleeding out is going to be asking for an NP.
 
MedProdigy said:
The AANA can push as much as they want. They'll never get the respect that the title of physician carries. Additionally, I doubt very much that anyone bleeding out is going to be asking for an NP.
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Respect isn't really what matters, at least in the sense I think you're using it. Scope of practice + ability to practice without malpractice that outpaces salary + ability to attract patients (the last of which only loosely being related to "respect"). IMO, only way to stop midlevel creep is through legislation - same way they're expanding. To what degree APN should be stopped, I don't know - haven't been both a physician and NP and the equivalency literature out there is pretty lame by and large.

What exactly is your purpose in making this thread? Trollish title, inflammatory one liner body.
 
loveoforganic said:
Respect isn't really what matters, at least in the sense I think you're using it. Scope of practice + ability to practice without malpractice that outpaces salary + ability to attract patients (the last of which only loosely being related to "respect"). IMO, only way to stop midlevel creep is through legislation - same way they're expanding. To what degree APN should be stopped, I don't know - haven't been both a physician and NP and the equivalency literature out there is pretty lame by and large.

What exactly is your purpose in making this thread? Trollish title, inflammatory one liner body.
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Respect
You're at a dinner party and are introduced to a pediatric surgeon and a pediatric np. Who are you going to be more interested in talking to? For me the answer is easy.
 
MedProdigy said:
Respect
You're at a dinner party and are introduced to a pediatric surgeon and a pediatric np. Who are you going to be more interested in talking to? For me the answer is easy.
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Perhaps for you, but I know a handful of people who prefer NPs (or in your case PNPs) to MDs. They think that having been a nurse and getting to care for patients for a longer period of time before learning all of the diagnostics makes for a better practitioner than someone who knows more science but is seen by them to be less compassionate than someone whose job it was day in and day out to make patients feel better in other ways than the medical sense.

Sure, they might not have all of the sciences an MD has, but in most FP or Peds everyday situations, that level is not necessary and NPs practice under an MD so if it were necessary, the MD can step in.
 
MedProdigy said:
Respect
You're at a dinner party and are introduced to a pediatric surgeon and a pediatric np. Who are you going to be more interested in talking to? For me the answer is easy.
Click to expand...

Which is exactly what I thought you meant. If someone has a choice between "equivalent" care between a provider who will see them five minutes and a provider who will see them for fifteen minutes, I don't think "interesting" is high up in the decision-balance. While interaction time hasn't been shown to have an effect on patient satisfaction, at least in literature I'm familiar with, that doesn't mean the expectation isn't there.

Wu - NP scope is regulated by state. Some can practice independently.
 
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loveoforganic said:
Wu - NP scope is regulated by state. Some can practice independently.
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Oh! I was not aware of this fact! Good to know.

Does this mean that they don't even have to be under an MD/DO's supervision indirectly? In the states I'm familiar with, they have to be supervised by MDs but I was never sure if this was directly or indirectly (as in the MD does not have to be onsite when they are)

Also, an aside, how do you address an NP? By first name as you would a nurse?
 
WuMedic said:
Perhaps for you, but I know a handful of people who prefer NPs (or in your case PNPs) to MDs. They think that having been a nurse and getting to care for patients for a longer period of time before learning all of the diagnostics makes for a better practitioner than someone who knows more science but is seen by them to be less compassionate than someone whose job it was day in and day out to make patients feel better in other ways than the medical sense.

Sure, they might not have all of the sciences an MD has, but in most FP or Peds everyday situations, that level is not necessary and NPs practice under an MD so if it were necessary, the MD can step in.
Click to expand...

There are hoards of specialties within pediatrics that NPs will never ever be invited to partake in. Even if invited, they wouldn't be able to complete the program.

So while an NP might able to give a toddler a typical physical, they sure as hell won't have a clue if something looks a bit off in the chart. And guess who will they will be calling if they do suspect something? An NP or an M.D.?
 
WuMedic said:
Perhaps for you, but I know a handful of people who prefer NPs (or in your case PNPs) to MDs. They think that having been a nurse and getting to care for patients for a longer period of time before learning all of the diagnostics makes for a better practitioner than someone who knows more science but is seen by them to be less compassionate than someone whose job it was day in and day out to make patients feel better in other ways than the medical sense.

Sure, they might not have all of the sciences an MD has, but in most FP or Peds everyday situations, that level is not necessary and NPs practice under an MD so if it were necessary, the MD can step in.
Click to expand...


Do people prefer NPs? Yes. People also prefer double cheeseburgers with bacon and extra fries. I agree that everyone wants to be comfortable going to the doctor, but should what the patient wants be the only consideration for medical care? The solution to a truly screwed up system of medical care should not be lowering the standards so patients have more time with the health professional.

The real question is how are people best served for medical care. Sometimes it's not important on an individual basis that you never see a doctor. Other times it can lead to furthering antibiotic resistance or a missed diagnosis.

And I've never met a NP who didn't want to be called Dr. That's part of the problem.
 
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Also doctors who have their own practices clearly state M.D. after their name. All else being equal if my son comes down with a cold and I want to take him to the doc and I see two practices:

Jeff Frank, Pediatrician, M.D.

Judy Wiseman, NP of Pediatrics

Who am I going to?
 
hrandani said:
Do people prefer NPs? Yes. People also prefer double cheeseburgers with bacon and extra fries. I agree that everyone wants to be comfortable going to the doctor, but should what the patient wants be the only consideration for medical care? The solution to a truly screwed up system of medical care should not be lowering the standards so patients have more time with the health professional.

The real question is how are people best served for medical care. Sometimes it's not important on an individual basis that you never see a doctor. Other times it can lead to furthering antibiotic resistance or a missed diagnosis.

And I've never met a NP who didn't want to be called Dr. That's part of the problem.
Click to expand...

Since when do people prefer NPs? I have NEVERRRRR heard any of my friends or family tell me they are going to go to the hospital to be examined by an NP.
 
WuMedic said:
Oh! I was not aware of this fact! Good to know.

Does this mean that they don't even have to be under an MD/DO's supervision indirectly? In the states I'm familiar with, they have to be supervised by MDs but I was never sure if this was directly or indirectly (as in the MD does not have to be onsite when they are)

Also, an aside, how do you address an NP? By first name as you would a nurse?
Click to expand...

http://www.acnpweb.org/files/public/UCSF_Chart_2007.pdf

Good summary on page 3. Completely autonomously to answer your question though.

Mr. / Ms. NP's first name or last name, depending on how they introduce themselves. As far as DNP's... I have no qualms calling someone a non-physician doctorate holder doctor so-and-so in a clinical setting, as long as provider role is clear. If and how that latter part actually happens in theory/practice, I couldn't say, but I think that's really the point of contention in previously proposed legislation holding that only MD/DO's are referred to as doctors in clinical settings (wasn't passed).
 
MedProdigy said:
Also doctors who have their own practices clearly state M.D. after their name. All else being equal if my son comes down with a cold and I want to take him to the doc and I see two practices:

Jeff Frank, Pediatrician, M.D.

Judy Wiseman, NP of Pediatrics

Who am I going to?
Click to expand...

I think you put too much faith in the public to be aware of the difference. Would be an interesting study actually, to investigate public awareness of differences between DNP / physician.
 
MedProdigy said:
Also doctors who have their own practices clearly state M.D. after their name. All else being equal if my son comes down with a cold and I want to take him to the doc and I see two practices:

Jeff Frank, Pediatrician, M.D.

Judy Wiseman, NP of Pediatrics

Who am I going to?
Click to expand...

It depends on if you have a preference for type of practitioner, but for you, I'm guessing you'll be seeing the MD. But answer this question: The MD is booked today, would you see the NP or have your son wait a day?
(There is actually no right answer here, just a personal preference. Some people would NEVER see an NP, just as some would ALWAYS choose an NP if given a situation)

MedProdigy said:
Since when do people prefer NPs? I have NEVERRRRR heard any of my friends or family tell me they are going to go to the hospital to be examined by an NP.
Click to expand...

I'm sorry that your life experiences are limited in this regard. Please come back after you conduct some research and write a term paper on the subject of alternative (alternate to MD, including DO, NP, ND etc.) medical practitioners and their role in the American society.
 
loveoforganic said:
http://www.acnpweb.org/files/public/UCSF_Chart_2007.pdf

Good summary on page 3. Completely autonomously to answer your question though.

Mr. / Ms. NP's first name or last name, depending on how they introduce themselves. As far as DNP's... I have no qualms calling someone a non-physician doctorate holder doctor so-and-so in a clinical setting, as long as provider role is clear. If and how that latter part actually happens in theory/practice, I couldn't say, but I think that's really the point of contention in previously proposed legislation holding that only MD/DO's are referred to as doctors in clinical settings (wasn't passed).
Click to expand...

Oh, that chart is handy! I didn't realize that 11 states give them autonomous authorities!

I can see why the public might be confused if you start calling nurses who have doctorates doctors! In some countries, dr. and Dr. (note case) are differentiated between clinical doctors and doctorate degree holders...
 
MedProdigy said:
Also doctors who have their own practices clearly state M.D. after their name. All else being equal if my son comes down with a cold and I want to take him to the doc and I see two practices:

Jeff Frank, Pediatrician, M.D.

Judy Wiseman, NP of Pediatrics

Who am I going to?
Click to expand...

As it is, in most of the country advanced practice nurses cannot have their own practice, so this argument is pretty pointless. The only exception I know of off-hand is CNMs, but they still need an Ob/Gyn to refer their patients to if they become high risk or need a C-section.

MedProdigy said:
Since when do people prefer NPs? I have NEVERRRRR heard any of my friends or family tell me they are going to go to the hospital to be examined by an NP.
Click to expand...
So what if someone that seems a group prefers an allied health practitioner to the doctor in the practice? Oh God, the horror.

I don't even know why I'm responding to you, though. I'm sure you're trolling.
 
WuMedic said:
Also, an aside, how do you address an NP? By first name as you would a nurse?
Click to expand...

In my hospital, the NPs and PAs are always addressed by their first name.

MedProdigy said:
Respect
You're at a dinner party and are introduced to a pediatric surgeon and a pediatric np. Who are you going to be more interested in talking to? For me the answer is easy.
Click to expand...
The nicer one. :idea:
 
Geekchick921 said:
I don't even know why I'm responding to you, though. I'm sure you're trolling.
Click to expand...

Well this is actually a great opportunity, given that you're a mod. I've been keeping an eye on this turd farmer and his overwhelming number of threads started. They were merely inane to start, but are getting progressively more offensive.

Poise ban hammer.
 
medzealot said:
Well this is actually a great opportunity, given that you're a mod. I've been keeping an eye on this turd farmer and his overwhelming number of threads started. They were merely inane to start, but are getting progressively more offensive.

Poise ban hammer.
Click to expand...

You aren't the only one, trust me.
 
superiority complex....


strange_men_051.jpg



edit: lol @ probationary status
 
MedProdigy said:
Also doctors who have their own practices clearly state M.D. after their name. All else being equal if my son comes down with a cold and I want to take him to the doc and I see two practices:

Jeff Frank, Pediatrician, M.D.

Judy Wiseman, NP of Pediatrics

Who am I going to?
Click to expand...

Considering that neither one can do anything for a cold, it doesn't really matter.
 
Parts Unknown said:
Considering that neither one can do anything for a cold, it doesn't really matter.
Click to expand...

Use a humidifier at night. Call us again if they get worst or the cough doesn't go away in a week. *Fork over $20.*

^ 90% of pediatric sick visits.
 
I studied in Nursing school for two and a half years or so, and yes nurses are taught that they are "almost" as equivalent to doctors in some aspects while in others they are superior.

Example: nurses are expected to follow a doctor's order and diagnosis, however if the nurse sees that the diagnosis is misplaced they are also expected to talk with the doctor. Same with medication. If a doctor orders medication for a patient who already has 20, nursing training requires nurses to call the doctor and ask for medication to be replaced, removed, etc.

Nurses see themselves as patient advocates, and will make sure to let the doctor know that.

So there. 🙂
 
MedProdigy said:
Respect
You're at a dinner party and are introduced to a pediatric surgeon and a pediatric np. Who are you going to be more interested in talking to? For me the answer is easy.
Click to expand...

assuming they are female, the one who is hotter (srs)
 
sc4s2cg said:
Example: nurses are expected to follow a doctor's order and diagnosis, however if the nurse sees that the diagnosis is misplaced they are also expected to talk with the doctor.

Nurses see themselves as patient advocates, and will make sure to let the doctor know that.
Click to expand...

True. Doctor writes orders; Nurse wakes doctor with 3:00 am phone call to verify. This does not happen the other way around.

Not debatable who has more autonomy in patient care. Definitely debatable who has more "power."
 
also, it tends the be the older nurses who are uppity and carry a chip on their shoulder, similar to how some old docs can be hard-asses and annoying. The younger generation of both are less disgruntled and both groups more pleasant to be around (with many exceptions)
 
patel2 said:
also, it tends the be the older nurses who are uppity and carry a chip on their shoulder, similar to how some old docs can be hard-asses and annoying. The younger generation of both are less disgruntled and both groups more pleasant to be around (with many exceptions)
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I'd like to see a p value on this tendency :laugh:

I'd also like to see the trends separated by gender...I've heard more about murses with stuff to prove than older ladies but I've always found these stories a little suspect.
 
patel2 said:
also, it tends the be the older nurses who are uppity and carry a chip on their shoulder, similar to how some old docs can be hard-asses and annoying. The younger generation of both are less disgruntled and both groups more pleasant to be around (with many exceptions)
Click to expand...

Personally I've seen opposite. The older nurses (by which I mean RNs, NPs are a whole other thing) trained and learned to work in an era in which nurses reported directly to a physician. Even though it's not true any more, a lot of the oldest nurses often seem to have problems shaking the subordinate mentality. The newer generation of nurses was trained in the modern era, where nurses report to nursing coordinators and the nursing staff deals with physicians the same way that physicians deal with physicians on other services: by frequently consulting them, somtimes arguing with them, and always complaining bitterly about them. If you're looking for a support network they're not the ones to talk to. There are, of course, a ton of exceptions to this rule.

I'd also like to see the trends separated by gender...I've heard more about murses with stuff to prove than older ladies but I've always found these stories a little suspect.
Click to expand...

Again, I've always seen the opposite. I've never had a single bad experience with a male nurse.
 
medzealot said:
Weak troll gets served.

Nice job you two.
Click to expand...

If you're correct in thinking that the OP is trolling, the only "serving" being done on this thread is by the OP because he got your attention. Now, be quiet and let interesting threads continue.
 
Mizoodles said:
If you're correct in thinking that the OP is trolling, the only "serving" being done on this thread is by the OP because he got your attention. Now, be quiet and let interesting threads continue.
Click to expand...

but this isn't an interesting thread...AND getting someone's attention isn't "serving" someone fyi
 
MedProdigy said:
Since when do people prefer NPs? I have NEVERRRRR heard any of my friends or family tell me they are going to go to the hospital to be examined by an NP.
Click to expand...
Happens all the time. NPs usually spend more time with patients, which is often the one thing the patient really notices.
 
Mbeas said:
but this isn't an interesting thread...AND getting someone's attention isn't "serving" someone fyi
Click to expand...

if it wasn't an interesting thread, you wouldn't be coming back to it. and yes, when it comes to trolling, the entire point is to get a response! Duh! U mad?
 
Nurses vs doctors?

Well let's just say doctors aren't the ones trying to get people to think they are nurses, while nurses are trying to get people to think they are doctors via DNPs.
 
I give nothing but respect to the nurses that are taking care of my patients. I always introduce myself and I always ask them how the patient is doing. If there is a question about something not getting done, I always ask questions that leave the nurse open to correct the mistake while saving face, even if it makes me look a little dumber or disorganized (ie, I will often ask, "I think the intern just ordered X for the patient, sorry for the last minute order!") If you make working together the path of least resistance, the system is very beneficial for everyone. As a medical student, I am able to facilitate that system because I'm expected to be wrong and mistaken about everything.
 
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