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But that's what we have been doing and **** isn't working.
I think there's some definition this reminds me of...
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Nursing School Vs Med School, no comparison.
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I think there's some definition this reminds me of...
Too late for that. Maybe a Minister of Rehabilitation.
PC. The great Social Religion, complete with Dogma, minions, and infidels.
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I'm really conflicted on the whole PC thing. I hate the idea of opinions being silenced and I think being afraid to ask questions or state feels because of the "pc" police is bull****
On the other hand, I hate it when people are rude or inflammatory for no other reason than to be hurtful to another person.
On the other hand, I hate it when people are rude or inflammatory for no other reason than to be hurtful to another person.
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I'm really conflicted on the whole PC thing. I hate the idea of opinions being silenced and I think being afraid to ask questions or state feels because of the "pc" police is bullcrap
On the other hand, I hate it when people are rude or inflammatory for no other reason than to be hurtful to another person.
I understand. And agree. The difference as I see it is that the PC opinion is one concerned with the use of words or superficial behaviors whereas intentions and common sense and respect are not necessarily PC. PC culture is one designed to be offended. There are actually people who work this circuit as professionally offended people.
If you say you shouldn't be rude to people. Nobody says you're being a PC fascist.
I'm really conflicted on the whole PC thing. I hate the idea of opinions being silenced and I think being afraid to ask questions or state feels because of the "pc" police is bullcrap
On the other hand, I hate it when people are rude or inflammatory for no other reason than to be hurtful to another person.
The problem with giving everyone the same rights is that some will use those rights in ways that we don't agree with.
Some people dislike that idea so much that they would rather a few people, whom they usually agree with, decide the rights for all the others
Which is why it's important to realize that we don't live in a democracy. The majority don't get to prevail, at least in theory.
*I can't stop editing this...rev #4
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This.
Somewhere in my lifetime there was a change from "I'm offended" to "that's offensive". One being subjective, the other being objective.
How something can be universally and objectively offensive, I have never understood. This generally goes unquestioned though.
So you feel that you could pass the psych board exam today?
As a long-time nurse and soon-to-be medical student, I completely agree.
The real issue in life is not necessarily intelligence, but opportunities for learning and upward mobility. I have met many *****ic physicians and equally *****ic nurses. However, I have also met brilliant nurses who would make fine physicians, if given the desire and/or opportunity.
Nursing school had better not be comparable to medical school, or I'm wasting my time! 🙂 I believe nursing and medicine are two disciplines that seek to promote human wellness from totally different perspectives. I'm grateful for the opportunity to learn both perspectives.
Really-----the nursing vs. physician argument is tired and old because neither discipline could perform their duties effectively without the other!!
I don't know how many more times it needs to be restated that a political struggle for who can get their legislation through and who can block the other profession's legislation for competition in the work force nation wide is not the same thing as don't be a prick to Cindy on 5-East because she's a pedi-onc nurse and saves the children.
But your example is perfect in the context of our PC culture conversation. You....are being a PC nazi. There is a clear difference in average intellectual ability between nurses and docs. It's not self-esteemy chocolate creamy. But it's the real stink of life.
Phd scientists are generally more intellectually gifted than garbage men. You're just gonna have to deal with that fact. If you're offended. It's opportunity for you to see the pointlessness of being so.
I'm not so sure.
The top 10% of my class is incredibly smart. If you are hitting 260s on Step 1 with 4 weeks of studying... I'd like to see some nurses do that.
I don't think nurses understand the amount of info on the Step exams. I've even seen that nurses have had trouble passing our easiest Step exam.
I really doubt you've met *****ic physicians. You might have met some inexperienced interns or doctors that made a mistake but you don't get into medical school while being dumb. But the requirements for nursing school are a lot less stringent from what I've seen.
You know what else isn't PC. The why....
The fact that physicians are largely upper middle class. That, by vast majority, had good nutrition, good role models, safe neighborhoods, good schools with good teachers, and resources for education.
You know what else isn't PC... Overtime these factors also produce differences in intellectual ability...
You know what else isn't PC... Some people genetically will be able to create music better, run faster, jump higher...some people have amazing tits or a big d!ck. There's even global patterns of all these characteristics. We're not all the same. Many of us are just naturally better at stuff.
The fact that physicians are largely upper middle class. That, by vast majority, had good nutrition, good role models, safe neighborhoods, good schools with good teachers, and resources for education.
You know what else isn't PC... Overtime these factors also produce differences in intellectual ability...
You know what else isn't PC... Some people genetically will be able to create music better, run faster, jump higher...some people have amazing tits or a big d!ck. There's even global patterns of all these characteristics. We're not all the same. Many of us are just naturally better at stuff.
No, just no.
There are no unintelligent graduates of US medical schools; zero, none, nada. To make it through medical school you have to be at least reasonably intelligent. Meanwhile, there are online nursing programs and pretty much anyone who can get a C in basic level sciences can become a nurse. I don't doubt that there are many intelligent nurses, but being intelligent is not a requisite for becoming a nurse.
Also no, thousands of physicians perform their duties effectively without nurses every single day. I've been to many private practice offices that do not have a single nurse on staff. Office assistants and medical assistants? Yes, absolutely. Nurses? Not necessary in all settings.
Does healthcare in general need nurses? Absolutely. Do nurses need physicians? Absolutely. Do physicians need nurses? Not necessarily.
The implication here is that both are equally footed in their professions and have mutually exclusive tasks. Noted, but wrong.
You seem to be missing the point of the last 12 pages.
Doctors don't want to function as nurses, nurses want to function as doctors. Claiming they are functionally equivalent, wanting some of the ground Doctors are standing on.
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There is little overlap in the breast and penis categories you listed above.
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Haha. Ok. I'm not sure how you mean. My only point was that biological characteristics are not handed out equally according to the desire embodied by certain ideas for all things to be equal or fair or self-affirming. Genitalia I thought merely a useful way of looking at how ego runs counter to what actually is.
I had nothing useful to contribute, but my thumbs had the desire to create words. What I meant is that those with the breasts of which you speak do not tend to also have the penises of which you speak. Although there is some overlap, I suspect, in many of these cases, one or the other has undergone surgical creation or enhancement.
Apparently not, since NPs want to play doctor without needing a physician to be present at all. That's the discussion here. No doctor wants to do nurse work. Many nurses want to be a physician, and a vocal minority want to be a physician without any oversight from actual physicians.
For full disclosure I am a critical care RN who completed the pre-med route and is gunning for PA/DO school but........the crap I am seeing on here from pre-med/med students alike is nothing short of idiocy.
Look most RNs get it, doctors are the pinnacle of the medical hierarchy when it comes to treatment plans and treating the disease process involving the patient. However, it is nurses who are there 24/7 managing that care in normal routine situations or even running a code. The education is not even close to medical school but it is tougher than most college majors (I did Biology in college too which I thought was pretty easy) and there is quite a bit of critical thinking involved that has saved a patient's life millions of times over. From an inpatient viewpoint a lot of what we see is cookie cutter even in the ICU or step down units. Many of the treatment plans for common disease pathways (CHF, COPD exac, Afib RVR, DKA, sepsis, HTN crisis, CVA, ETOH/drug, ARF/CRF, ARDS etc etc) can be broken down into formulaic/flowsheet form or based off of clear imaging/lab results (love dat Harrison's IM doe). Code situations are even more formulaic and most of the time the MD just sits back and nods his head as we do our thing. Obviously there are zebras out there (especially with AMS) and many these common disorders can degrade rapidly even in the most vigilant of situations. Even with the Zebras no one is truly alone even with board cert docs, everyone consults and collaborates., but don't get me wrong I love my intensivists and hospitalists and I love learning everything I can from them. Any RN out there will go the extra mile for a doc who is considerate of our input, actually puts in orders correctly without us fixing them and returns page calls. We have a great repertoire with our doctors and it kind of sickens me to see some of the attitudes on here because I assure you this doesn't reflect the real life work place. Also remember the hospital is usually run by nursing admin or some some other non-clinician form of management....
I for one am not a huge fan of the way the NP education model is heading which is why I am going after the medical route but even when I try to bash NPs somewhat with my physicians they have nothing but good things to say about them oddly enough. Yes, they do a lot of the scut work but they also play a large role in primary care. Coming from a military background I know that 80%+ of the anesthesia used in the military is done by CRNAs in COMBAT and stateside with just as efficient results as the docs. They really knew their **** and it showed when I worked with them.
tldr: Most good nurses know docs are the head honchos in healthcare but it is the smart docs who realize the value in RNs/APRNs and their respective roles. I don't know the OPs beef or what his/her experience as an RN was but it seems odd they are keen on bashing their former profession. Pre-meds/med students don't form biased opinions until you get your feet wet as senior residents or attendings, many people on here are just shooting from the hip with what they think is valid commentary.
Look most RNs get it, doctors are the pinnacle of the medical hierarchy when it comes to treatment plans and treating the disease process involving the patient. However, it is nurses who are there 24/7 managing that care in normal routine situations or even running a code. The education is not even close to medical school but it is tougher than most college majors (I did Biology in college too which I thought was pretty easy) and there is quite a bit of critical thinking involved that has saved a patient's life millions of times over. From an inpatient viewpoint a lot of what we see is cookie cutter even in the ICU or step down units. Many of the treatment plans for common disease pathways (CHF, COPD exac, Afib RVR, DKA, sepsis, HTN crisis, CVA, ETOH/drug, ARF/CRF, ARDS etc etc) can be broken down into formulaic/flowsheet form or based off of clear imaging/lab results (love dat Harrison's IM doe). Code situations are even more formulaic and most of the time the MD just sits back and nods his head as we do our thing. Obviously there are zebras out there (especially with AMS) and many these common disorders can degrade rapidly even in the most vigilant of situations. Even with the Zebras no one is truly alone even with board cert docs, everyone consults and collaborates., but don't get me wrong I love my intensivists and hospitalists and I love learning everything I can from them. Any RN out there will go the extra mile for a doc who is considerate of our input, actually puts in orders correctly without us fixing them and returns page calls. We have a great repertoire with our doctors and it kind of sickens me to see some of the attitudes on here because I assure you this doesn't reflect the real life work place. Also remember the hospital is usually run by nursing admin or some some other non-clinician form of management....
I for one am not a huge fan of the way the NP education model is heading which is why I am going after the medical route but even when I try to bash NPs somewhat with my physicians they have nothing but good things to say about them oddly enough. Yes, they do a lot of the scut work but they also play a large role in primary care. Coming from a military background I know that 80%+ of the anesthesia used in the military is done by CRNAs in COMBAT and stateside with just as efficient results as the docs. They really knew their **** and it showed when I worked with them.
tldr: Most good nurses know docs are the head honchos in healthcare but it is the smart docs who realize the value in RNs/APRNs and their respective roles. I don't know the OPs beef or what his/her experience as an RN was but it seems odd they are keen on bashing their former profession. Pre-meds/med students don't form biased opinions until you get your feet wet as senior residents or attendings, many people on here are just shooting from the hip with what they think is valid commentary.
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Hurrr duuuuur I am not going to insult your intelligence but surely you know the difference in outpatient vs inpatient. RNs in outpatient are by in large not using their skillset, hence the MAs. I firmly believe most people on here talk like they have nursing figured out and what all of our roles entail when in reality couldn't be farther from the truth. There are no online RN programs, only RN to BSN which consist of mostly research/non-clinical work for starters....
You are right docs don't need nurses, they can manage the patient every day 24/7 on the floor. However, I bet your rebuttal is any layperson can fulfill an RN role. Ok lets try that and see what happens to patient outcomes..
The general ignorance regarding nursing by future doctors on here is astounding regardless of their views on NPs encroaching on doc turf.
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What specifically is idiotic?
Because it seems there is not that much disagreement about the key issues of professional competition. The educational basis of the NP clinical route is nursing. And it seems you would agree with us this is a very weakened and compromised foundation for independent clinical work.
The military model has enormous strengths. But the fact that an active service members can't file suit against an officer in charge of their medical care is not a small factor in who is allowed to treat independently.
I think if you took a 3rd year medical student and placed them in a team setting and forced them to learn quickly on the job you could produce a reasonably competent clinician in a couple years of work. If you had captive american public being actively invaded by hostile military forces and you might be able pull it off at scale.
The purpose, at least the purpose of my argument, is that the public is jamming a policy of equal practice rights down our throats and is forcing us to train our competition. The response of actively attacking the mythos of nursing education as a sound foundation for independent clinical practice is the game being played.
Why most nurses' subconscious groupthink prevents them from dealing with arguments such as these separately from how they feel about themselves and their colleagues has always puzzled me. It has such zombie like power that via the PC enforcement apparatus of our own institutions it has taken over the minds of many of our colleagues here.
Not content with this. You or your constituents will not stop your mantra of Bad Doctor Better be Nice to Nurses despite the fact that that is simply not what what is at issue here. Nobody here that I read is just excited to go kicking nurses in the shins (metaphorically) for no reason.
We're talking about active political battles to see who will control the clinican market. With the sort of huge effort and sacrifice of which you haven't begun to get an inkling of at stake.
I am not even talking about NPs, you and I both know the curriculum and rigor is just not up to snuff to produce an independent provider. The ANA is huge lobbying force in healthcare and eventually the dribble quality being produced by these for-profit and lackluster NP programs will rear it's ugly head sooner or later. Hopefully the nursing QC organizations will be to stick it to the ANA and start policing their accreditation but probably not....
But that's isn't my main beef.
My main beef as stated above is the the total disregard and knowledge deficit of pre med and medical students regarding what we as RNs actually do. I had a kid in my Orgo 2 class who literally thought being an RN was a 4 week course and another med student who was doing rounds with some attendings thought we just answer call lights and push drugs. It's this kind of crap that bothers me. I am totally with SDN regarding their views on NPs but I can't get behind this frivolous belittling scattered through posts on here especially by people who have 0 tangible experience in healthcare.
The get the sacrifice probably more so than 99% of pre-meds on here after being in healthcare for a few years and gutting out o-chem and biochem after pulling 4 12 hour night shifts in a row while most med students had the luxury of getting in the traditional way.
Most of the people commenting here are 3rd and 4th year medical students. They have plenty of clinical experience and understand what RNs do. We work with them everyday.
Well, ok. I get why it might be difficult to hear your knowledge base being attacked when what you see are new medical clerks as an experienced ICU RN while also dealing with premeds on your off time. I'd probably be saying something similar to you, most likely more vociferously.
What I can say is that just like animals on the African savanna looking at a squishy human baby, you could easily think what a useless ball of ****. And of course for pragmatic and immediate survival in your specific context you'd be right. But what you will gain an appreciation for as you progress is that, that useless baby clerk, has the proper foundation for the development of much more advanced means of operating. Which take much longer to come on line in a fully developed way.
So yes, we survive at your mercy for the interim in the work place. And of course respect for this process should be present in our minds at all times, if we are wise.
However, these powerful forces you allude to are using the RN background as a means to go end around on our profession in the work place. And this has to be dismantled. The bar has to higher for us intellectually. If you're a ICU RN going premed I suspect the challenge of that proposition is what attracts you.
Yes, I understand that nurses are necessary in an inpatient setting. The post I was replying to said that "physicians could not perform their duties effectively without nurses" and that's clearly inaccurate given the large amount of outpatient and private practice facilities. There may not be any online RN programs, but "RN"s are not the only "nurses." Are there not LPNs and ADNs wandering the wards as nurses?
What exactly is ignorant about SDN med student opinions on nurses? I don't claim to know the exact day-to-day role of a nurse, but I know that the big picture is they assist in patient care. The physician leads the team, while the nurses assist.. That's the heirarchy. I understand that nurses go through education and training just like anyone else does for their chosen profession. So is my rebuttal that "any layperson can fulfill an RN role"? No, definitely not. My rebuttal is that most any layperson can be trained to be a nurse and eventually fulfill the role of "nurse" in a patient care setting. The same cannot be said for training to become a physician.
Edit: I don't think anyone on SDN is saying that nurses have an easy job. There are certainly many skills that nurses are more proficient in than physicians, but you don't see physicians getting all defensive about it.
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But those other three days of the week you had off were awesome, amirite?
When I wasn't getting called back in or trying to get some sleep? Remember working nights kind of limits when you take class unless you literally can function with zero sleep for years on end. I did these same courses in undergrad and it was by far easier (been a few years that's why I was retaking) when I was a full time student and I think most non-traditional students would agree. The only difference was in undergrad I did ROTC which took up ass loads of time, it would have been a lot easier to direct commission into the Army but I didn't want that AMEDD officer rep that get's cast down from ROTC/OCS/Westpoint grads.
You didn't direct commission did you? 😉
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If you have been here long enough people will spout random ill thought out hate towards nurses at all levels from the freshman pre-med to attending doc for no rhyme or reason. I am an RN that is an ally to your guys viewpoint but even so people as evidenced above get all up arms and can't use reading comprehension or see the big picture in my posts.
LPN are rarely in an inpatient and function under the supervision of an RN, ADNs are RNs but have an associates and not a bachelors
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I agree with you, it just irks me when people whose XX hours as a volunteer, shadowing a physician, EMT -B course (glorified transporter),scribe or other trivial HCE in the grand scheme of things start acting as the all-knowing god of healthcare roles.
You would be correct and that is why I am pursuing med school, the only reason I commented was to provide a counter point to show not all RNs (while playing a devil's advocate) are like those many on here describe and to educate those who may be unfamiliar with out role because even though 3/4th years round a **** ton most of their time is spent in rounds/classes
I have no idea what the heirarchy within nursing is (clearly) except maybe that NPs are at the top.
Anyway, I think there's blind hate both ways. You can't get far on allnurses without seeing someone bashing a doc. For those that dislike the other group I would guess it's for these reasons: Nurses resent doctors because doctors often get all the credit. Doctors resent nurses because nurses are often perceived to overstep their education/training. Of course getting all the credit is a double-edged sword for docs. If a nurse messes up nobody sues the nurse, they sue the attending.
Obviously there are people in both groups that are reasonable and don't get caught up in all this drama.
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Bro I know this nursing admin animal that you speak of and staff RNs dislike them just as much but there are just as many doctors who pull similar crap (especially surgeons) that make life/work unbearably difficult for no reason. SOme are great managers/leaders but not all. Quoting a well known internal medicine books suddenly makes me think I am pretending I have more education when I have been agreeing with you guys the whole time about NPs? Woah that's a hasty backhanded quip at being defensive. I apologize for reading a book that was given to me as a gift by one of the attendings who was excited to see me pursue med school.
Nurses can get sued and many carry malpractice insurance albeit a lot less than a doc. If we give a med that was scripted and approved by pharmacy even though it was wrong and we gave it without challenging the order we are at fault. Seen this happen twice both resulted in law suits against the nurse and hospital.
I avoid allnurses like the plague
I liked the part where you say we're hating on nurses without knowing anything about their role and then out of nowhere you take a crap on emts.
Come again? I functioned as an EMT in school.....we give oxygen and transport I know the role very well. EMT-Ps do pretty much everything
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Which is why I said a lot less . The money wasn't issue I was discussing I was just saying RNs CAN get sued. These suits can also be civil/personal and not via the hospital. Obviously the physician and to an extent the pharmacist who verifies everything are at more of a risk but they are also compensated more for that risk. In my area hospitalists pay is around 210-275k a year and if they are employed by the hospital the insurance is obviously covered
Competition is lovely for the guy who doesn't have to work for or invest a fraction of what we do for a space on the board huh? I give zero f@cks for your trade commission report. FYI.
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I hate to agree with this but it't true.
The fact that physicians have had no competition the last 50+ years is why medical education is such a crappy product.
How many medical students believe the education process is highly effective, efficient, economical, and overall a great product? It's not.
Are nurses training some fields in 20% of the time as we are? Yes. Are they as good? Probably not. But look at this practically, if an iPad cost $2,500 and an Amazon Kindle costs $400, then everyone would buy the Kindle. 5 times more expensive (or longer in medicine's case) is too much. But an iPad costs around $500 or $600, and that's why Apple is profitable. Better product? Sure. But also subject to tons of competition, so they can only increase the gap so much.
Medicine is trying to train some specialties in 8 years when nurses aim for 2 years post undergraduate years. Medicine hasn't attempted to change this paradigm much in the past 6 or 7 decades (stagnating anyone?). We are partly victims of our success. Yes, surgeons take 10 years to train, but we could improve Family Medicine training down from 7 years after an undergraduate degree (or even scrap the undergrad degree requirement). Today with college it takes 11 years to train to become a family medicine doctor. There is a faster and better way, but there's been no necessity to make one.
And this is unfortunately a deal breaker for physicians. We can't possibly compete with nurses if they play by a different set of rules.
Poor analogy. Med school admissions is still a $2500 iPad as evidenced by the increasing competition.
Also, this may not be a widespread thing but I know of at least 3 schools who are currently working towards a 1.5yr pre-clinical curriculum. There is also a big LCME change in the works, though I'm not too keen on the details.
Oh, I don't think the analogy matters. The idea is we take 11 years after high school to train a family doctor. That's a long time and midlevels can capitalize on things like that.
This thread has gone on for a very long time but I'll say this: the question is not whether individual midlevels are capable of performing as independent providers. The question is whether or not the current system in place inspires enough confidence such that every midlevel is capable of performing as an independent provider without any kind of residency or potentially any kind of clinical nursing experience (now a lot of people are going straight from getting their RN to getting an MSN with no clinical work in between). Because that is what these changes will result in. Right now, every single graduate from the #1 to the #200 ranked MD or DO medical school is competent to enter residency in any field, and provided they complete that residency and pass all their boards they are competent to independently practice medicine. We work very hard to maintain very high admissions standards and have a rigorous accreditation process to ensure all our medical schools, residencies, and fellowships are up to snuff. The nurse practitioner/anesthetist model completely bypasses all that, which is fine if they are always going to be a monitored by an appropriately trained physician who is just going to tell them what to do anyway, but not fine if we are going to let them go off on their own. People need to keep this in mind as they bring up these isolated examples of the really nice, super experienced NP who taught them something/saved a life/etc etc.
I see.. You can't just "scrap" the undergrad requirement or the duration of medical school just for family medicine.. First of all, most people don't know for sure what specialty they'll end up in until the middle of M3 and second of all I'm not so sure there is a significantly faster way to train FMs or any other physician.
Sure, shorten preclinicals, but that's only a half a year faster. You want to shorten the clinical years? Residency?
If you shorten medical education you are only creating more for midlevels to "capitalize on"
.
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1. Because only nurses are all knowing gods of healthcare roles?
2. I love how you find it necessary to take a dump on other fields ("glorified transporter"? I'm not going to defend the
Well in the interest of consistency. If the EMT was trying to do the nurse's job without the training. Claiming that he trained in the paramedicine model. He doesn't want to be equal. Just different. But doing the same job. All cutesy like.
Well then. Cut that bastard and his whole treasonous tribe down.
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You mean... like the concept of community paramedicine? Having paramedics assigned to fly cars doing things like post discharge checkups on patients who are at high risk for readmission? Yea, NP : Physician::Community paramedic:RN. Except, of course, the community paramedics aren't asking for independent practice rights.
That's interesting and new one on me. I didn't know EMS systems were utilizing paramedics in the community like that. That's how you learn about health care roles. By working in it and talking to people. Something an associates degree at a CC doesn't make you better or worse at.
Yep, if they did try to take nursing jobs, then just like any potential adversary of nursing laterally or from below they would be crushed. And yet nobody seems to attribute the same negative descriptors to them when they do it. For them it's always about patient safety and advocacy somehow.
They're like PR puppies, they can **** everywhere, and still be adored.
Well when I have done both I can make that claim right? Besides even when there wasn't a huge push for NP autonomy this forum ( this doesn't happen in real life mind you only on SDN) made a statement in ****ting on nurses for the most trivial of matters. So I find you your disgust regarding me taking a dump on another career path pretty laughable especially when I said a post later that I have been in the field. EMTs-Bs are essentially transporters, does that make you mad?
I'm am--was rather--an EMT-B. I'm also avid collector of other's experience. An amateur student of labor history. And consider mysef, given my various vantage points, an impeccable marksman for characterizing the political agenda of your profession. I'm also exquisitely well-informed on the tactics of the CNA, having friends involved on both sides of it's masterful political gamesmanship.
It doesn't make me mad that you call me a transporter. How do you think I got around my hospital talking curiously to everyone. It's just that your conclusions are more representative of Zombie groupthink than anything else.
Reading this lengthy discussion, and knowing my med school class, I'm afraid there isn't much fight in the lot of us to defend our territory. We have too many touchy-feely, PC loving folks in our midst. The same goes for how we respond to healthcare legislation. It seems that anything the oval office dishes out, we grab with open arms and endorse. Because it wouldn't be PC to reject it.
