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Well it started off with the first post being delusional.
Nursing School Vs Med School, no comparison.
Started by Critical Mass REACHED
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Well it started off with the first post being delusional.
Have a good time and be careful.
Lol no need to be careful really. All my break will consist of is eating and sleep....and sleep.....and sleep.
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Sir, how would you like me to do that since I'm already doing it in practice?
You may -think- you practice as well as a physician, but you cannot know how much you don't know, because you have not gone through medical school and residency. By passing the same board exams as physicians, you are showing that you have as much knowledge as a physician, and thus can practice at the same level as one. When 80% of Columbia's GRADUATING NP class, who are fully ready to practice independently, can't pass a simplified version of the USMLE Step 3, the basic step for a physician to begin training, I must say there is a serious knowledge disparity between physicians and nurses. Your skills will leave you at a loss when it comes to many complex situations that deviate from your particular discipline and the algorithms you have learned to follow. The broad training of a physician allows them to pick up on things that would otherwise be missed, such as a psych patient coming in with problems that are stemming from a disease that they might have seen in their IM rotations. Do you honestly believe you have as much clinical knowledge as a physician, and that no harm will ever come from practicing independently versus a physician that is invested in his patients and profession?
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You know, I reread my post and realized it came across kind of bitchy. I just want to clarify to you that wasn't my intention. I have a lot of respect for anyone who is serving our veterans and I know there is a huge psychiatric need in that population. Thank you for your service.
The part of your posts that have russled my jimmies is when you say that you are doing the exact same job as a psychiatrist. Because that's just not true. That doesn't mean that what you are doing isn't important or that you don't have a cool life story, but you are not doing the exact same job as a psychiatrist.
I think I missed this. Actually, I'm pretty well liked, much more so than in high school, because I have a personality, and suffer from genetic hilarity. I will admit I’m a smart-a** also but so is our group practice manager so that is a plus. The Chief of Psychiatry is a current Jeep guy like me and my civilian boss used to race Jeeps in the desert. How well do you think we get along, eh?
In my field this is important. You may not care that your surgeon is a dick as long as he is good, but bedside manner means a lot in psychiatry. Soldiers here can switch from any provider, psychiatrist, social worker, psychologist, etc. after first talking with that provider about wanting to switch. I get quite a few because, and mark this down for future reference as these are some actual reasons for switching, "Dr. Blank has the personality of a tree." "Dr. Blank just kept interrupting me.” “Dr. Blank put me on pills and never would change the dose even when I told him they weren’t working.” “Dr. Blank told me he knew what was best for me.” And a dependent I saw in the ER couple weekends ago told me she thought her civilian psychiatrist was documenting on his computer as she talked but at one visit he forgot to turn the volume down and she caught him playing a game! BTW, I am the only prescriber here that doesn’t sit across a desk from a patient.
You are welcome to come visit anytime to see for yourself.
Not an issue but thanks. I'll get back to you and mad jack as soon as I can talk with my boss. He's an old guy so has been around a long time. Recently took his boards again, which he said was a waste of his time and money.
Agree with this, although to be fair I believe that the pass rate was 50% initially, and that it has improved in subsequent years.
Zenman - I used to believe that for NPs to practice independently, they should have to pass Step 1, 2, and 3. However, I realize I am softening my stance slightly to 'For NPs to practice independently, they should have to pass Step 3'. If it's that easy for your boss, and since you two are pretty much equal, it should be a piece of cake for you as well, right?
It was 50% for the watered down USMLE at Columbia. To give you an idea of how watered down it was (with these nurses still failing):
"According to the NBME, the DNP certification exam draws on portions of the USMLE Step 3 that test skills and knowledge related to patient management. It does not include assessments of fundamental science, clinical diagnosis or clinical skills included in the other two portions of the physician test."
So it has no questions about clinical diagnosis, clinical skills, or fundamental science, ONLY patient management, and STILL only 50% can pass it?!?! If that doesn't say poor preparation, I don't know what does. I would imagine that practically none would pass a test with actual clinical skill components.
http://www.amednews.com/article/20090608/profession/306089978/1/
I always thought Step 3 was viewed as a joke by most physicians anyways.
Step 1 - 2 months
Step 2 - 2 weeks
Step 3 - bring a number 2 pencil
If NPs can't even pass the easiest board exam, why on earth should they be practicing independently???
Step 1 - 2 months
Step 2 - 2 weeks
Step 3 - bring a number 2 pencil
If NPs can't even pass the easiest board exam, why on earth should they be practicing independently???
It's not a joke, it just doesn't take the same kind of "sit down and do questions/read books in preparation" preparation since MS3/4 and the beginning of residency, if completed prior to exam, should be all the studying needed.
makes sense. Thank you for the clarification.
First please be aware that I'm very invested in my patients and profession. I am a little stumped now after this last 22 yr old female with 5 week hx of fatique. CBC w/diff, Met panel, TSH, Folate RBC, Vit B-12, ESR were all WNL. Depression controlled with Venlafaxine ER 225. Not pregnant. Thought there might have been some restrictive lung problem due to DOE but that was ruled out. She's has to meet ARMY fitness standards so she's in decent CP state. Possible allergies. Sending her to primary care before I do anything else. What do you think?
This is the way I lean vs being a "brainiac."
The February issue of Current Psychiatry featured an editorial by Dr. Henry Nasrallah; he is Professor and Chairman of the Department of Psychiatry and Neurology at St. Louis University, and said that psychiatrists who were not speaking the new language of the “neuroscientification” of psychiatry would soon be rendered obsolete.
Henry says that we are at the tipping point in psychiatry, giving up the primitive notions that have guided the profession for the past century. We are moving toward explaining our successes and failures in terms of microglial activation, inflammatory markers, aproptosis, S100B, and NOTCH 3. Those who talk about ego strengths, defense mechanisms, resilience,, the unconscious mind, and the human spirit are “clinical dinosaurs”.
Henry speaks for most psychiatric academicians today, who believe the best way to understand the complexity of the human condition is to explain it in terms of neurotransmitters, genomics, and MRI’s. But the truth is that no matter how much we know about the brain, the mind will always have a mind of its own. The language of science can’t adequately explain the mystery and awesomeness that are an essential part of the human experience.
I was introduced to an old Hopi medicine man many years ago who, upon learning that I was a psychiatrist, asked me what I knew about the mind (The Dancing Healers, 1988). At the moment, I couldn’t come up with a brief, pithy, summation so I said that what I knew about the mind I couldn’t tell him in a short time. He responded that if I couldn’t explain what I knew about the mind in a short time, that I didn’t know it. I asked him what he knew about the mind, and he said he could tell me in one word; it was he said “mysterious”.
Brain researchers tell us that the brain is hardwired for mystical experience. We are biologically programmed to experience awe, transcendent states that allow us to see the familiar from a new perspective, to experience the awesome. It matters less how we explain the mechanics of the mysterious, than it does to know it’s important.
To all my academic colleagues who herald in the ‘neuroscientification’ of psychiatry, I say let’s not take ourselves too seriously. Awe is the mechanism by which we tame the ego, and lift our spirits.
P.S. I wrote to Henry and told him I would be in St. Louis in late April and would come free of charge to present to his Department the memoirs of a clinical dinosaur, perhaps entitle it, The Magic and Mystery of Mind Healing.
Carl Hammerschlag, MD
Source: http://healingdoc.com/
The February issue of Current Psychiatry featured an editorial by Dr. Henry Nasrallah; he is Professor and Chairman of the Department of Psychiatry and Neurology at St. Louis University, and said that psychiatrists who were not speaking the new language of the “neuroscientification” of psychiatry would soon be rendered obsolete.
Henry says that we are at the tipping point in psychiatry, giving up the primitive notions that have guided the profession for the past century. We are moving toward explaining our successes and failures in terms of microglial activation, inflammatory markers, aproptosis, S100B, and NOTCH 3. Those who talk about ego strengths, defense mechanisms, resilience,, the unconscious mind, and the human spirit are “clinical dinosaurs”.
Henry speaks for most psychiatric academicians today, who believe the best way to understand the complexity of the human condition is to explain it in terms of neurotransmitters, genomics, and MRI’s. But the truth is that no matter how much we know about the brain, the mind will always have a mind of its own. The language of science can’t adequately explain the mystery and awesomeness that are an essential part of the human experience.
I was introduced to an old Hopi medicine man many years ago who, upon learning that I was a psychiatrist, asked me what I knew about the mind (The Dancing Healers, 1988). At the moment, I couldn’t come up with a brief, pithy, summation so I said that what I knew about the mind I couldn’t tell him in a short time. He responded that if I couldn’t explain what I knew about the mind in a short time, that I didn’t know it. I asked him what he knew about the mind, and he said he could tell me in one word; it was he said “mysterious”.
Brain researchers tell us that the brain is hardwired for mystical experience. We are biologically programmed to experience awe, transcendent states that allow us to see the familiar from a new perspective, to experience the awesome. It matters less how we explain the mechanics of the mysterious, than it does to know it’s important.
To all my academic colleagues who herald in the ‘neuroscientification’ of psychiatry, I say let’s not take ourselves too seriously. Awe is the mechanism by which we tame the ego, and lift our spirits.
P.S. I wrote to Henry and told him I would be in St. Louis in late April and would come free of charge to present to his Department the memoirs of a clinical dinosaur, perhaps entitle it, The Magic and Mystery of Mind Healing.
Carl Hammerschlag, MD
Source: http://healingdoc.com/
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Sounds like diabetes or a broken arm to me (see linked video below for context)
Just to let you know, I believe it is against site policy to ask medical advice. This probably includes consults on actual patients. Even if I had a real opinion, I wouldn't post it.
Mr. Nurse, please go to your forum called Nurses.com, I'm tired of you posting on this thread. Maybe we should call SDN, Student Physician Network. You were entertaining at first, but now you are as painful as an external hemorrhoid. You had your chance to make your point, but it's clear that the nurse practitioner you see for your psychiatric issues placed you on the wrong drug regimen, and now you have relapsed into a severe psychotic state.
Second if you would like a CONSULT from a real doctor, you must formally lay out a PROPER H&P. I'm guessing you skipped that online course on how to properly do an H&P.
moderator please, "PLEASE" kill the troll. He's cluttering cyberspace at the moment.
Obviously she needs to be treated for Lyme Disease.
I've been enjoying reading this thread but haven't really engaged because I am sick of the pissing match between NPs and MDs. I honestly do not care what a bunch of med students on the internet think about nursing or NPs. Angry SDNers have absolutely zero to do with me or my career, so why engage in the vitriol? Rage on, med students!
I will say that this thread is a brilliant example as to why docs are losing the PR fight with the public and lawmakers. I mean seriously, just look at some of the personalities on display in this thread.
I've been well, otherwise. Getting through my program one day at a time. We are getting placed for our main clinical sites in a few months, so it's a somewhat stressful time. I'm currently at a psych emergency room and it's been a great experience, though I do not plan on practicing in such an acute setting, since I prefer to follow up with patients and manage their illness over a longer period. They psychiatrists are great (for the most part) and good teachers. It's an excellent place to hone one's assessment skills. I am very excited about the 6 figure light at the end of this tunnel. I can't stop thinking about graduating next year and beginning my professional career. I'm seeing jobs posted for psych left and right. All in all I can say is that I am 100% certain I made the best career decision possible for myself. So if people want to hate NPs, I say go for it. The need for psych NPs is massive and there are jobs a plenty. If I get sick of psychiatry someday then I can go back to school and practice in an entirely separate field, go into research, or teach. Being an NP offers flexibility + good pay + excellent quality of life... so I am more than satisfied.
You'd be mad too if you've been working hard your whole life just to have someone telling you that they're better than you at your own job.
Oh, semantics. I'll keep in mind that the doc who works in student health treating STDs and prescribing ZPacks all day has a "career" and that the PhD nursing professor who teaches NP, pharmacy, and even (gasp!) med students, does genetics research in her lab, publishes alongside the MDs, etc., has a "job". Whatever makes you feel better.
This thread, yikes. Good luck changing the public's perception of physicians as NPs continue to expand their power. Really, I think you're gonna need it.
I'll make sure to push for Psychologist to also have prescription rights, seeing how they also have been pushing for the doctor title. When was the last time an NP nurse discovered some fancy protein or new therapy? Oh, that right they are to busy doing research on comparisons between doctors and nurses funded by the ANA. Doctors are too busy with treating patients (appropriately) and doing research on things that matter. When the day comes that we need to lobby congress, trust me, you will feel it.
If you think Obama Care had people enraged, just wait until doctors starts exposing nurses that are practicing dangerously independent. We are are not at that point yet. You can point to all the studies you want, but the brand of MD matters to the patient. I don't see any shows on the network called NP-OZ, or the NP-House Call, etc. When the patients start to decide, we shall see who they prefer. Enjoy your rotation, I hope it goes well.
We just can't compete with the amount of hugs you NPs are able to dish out. Patients love hugs.
Nurses do not teach MD students anything. Unless she/he has a PhD in pharm&nursing. If a nurse has something useful to say during rounds, I'm respectful enough to listen to her speak. That just means that I was polite and decided to listen to her speak in regards to some cool fact she found on wiki. That is not teaching, so don't confuse the two. Please tell the name of the institution that has nurses teaching academic session to MD students, so I can promptly contact the LCME.
So maybe us med students should just quit while we're ahead and save ourselves the embarrassment? You guys can take over all surgical specialties this second anyway right? I could care less about NP's, PA's, MD's.....whatever. In the end we all share a responsibility in treating patients. The only thing that tics me off is how hard you NP's get about the "growing power" you have over MD's. Is that really what this is all about? Thats pretty sad.
I think we need NP's. I also think we need physicians. It seems like some of you NP's are so hard pressed to state your superiority / equality that you are willing to push your agenda at all costs, even to the patient. Doesn't this go against what we are all taught in the first place?
You'll always have a job. Plain and simple. As an MD, so will I. It doesn't matter if NP's take over the world. Why? Because there will always be that 1 person, or 2 people or 3, that will only see you as a nurse. Do I see you as that? Nope. But there are people that do and no amount of PR will change that. Shoot, we still have people that won't see a D.O. Even though they are licensed physicians. Its a bias. It sucks, but its there and it will be for quite sometime.
I don't see why docs get so riled up over the fact that NP's are taking over the profession. It will never happen. Will NP's become even more prominent? Yep. Will I be working around them? Depends on their push into surgery, and if they are competent I won't care. However, I doubt we'll see the day where an NP introduces themselves to a patient as "their neurosurgeon".
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Maybe you don't care, but many of us do. Imagine if your wife gave birth and it was a midwife delivering the baby, nurse anesthesia provider behind the curtain, and a nurse in the room with NO oversight from an MD? That is what the ANA is practically fighting for. It should make you furious that they are claiming equivalency while you busted your rectum for years sacrificing your life to save others. Now they parade through with easy curriculums and degrees online claiming to be equally trained with no measurable difference.
You're right that what we know about neuroscience is likely only scratching the surface of the complexities of the brain. Even so, what little we do know is still way more than you can know as an MD (unless you're a neurologist or neurosurgeon) and especially more than an NP knows.
When my wife gave birth I hand picked everybody in the room. Nurses, docs, you name it. I went with competency. A CRNA did her epidural. I picked him because he was good. Plain and simple. Would I want him dumping isoflurane into my body and maintaining me under general? Maybe, with supervision. But he did a great job with my wife's pregnancy.
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Key words there, "supervision." Which is the premise of this thread. Supervision because physicians know best, and when fecal material hits the fan, I want a MD/DO
I don't knock DO's, yes they still hold on to that holistic approach and body manipulation, but they are Physicians. Their structure of training is as intense as allopathic medicine, and comparable. If NP's decided to implement the same standards and rigorous training, then I would not have a problem with independence or even equality.
Let me ask you, seeing how you just got accepted to medical school osteopathic, "how hard was it to apply to both, and get accepted?" I applied to 50 allopathic and 10 osteopathic years ago, and received about 10 interviews between both, despite having a great MCAT, and Nursing background. The selection process selectively seeks out the best! I can tell you the standards to be accepted into NP school is pretty much based on your Credit score and eligibility of getting student loans. I don't want any joe blow running the show alone, without the careful watch of a physician.
Im an allopathic student bro. Not sure where you got that I attend a D.O school.
He might have been thinking of me
Exactly how did you determine if a CRNA was "good"? Frankly, I doubt you or any medical student has the capacity to judge something like that.
I saw the guy put over 150 people under anesthesia. Unsupervised. He was good. This is completely beside the point.
Well yeah.....why not post on osteo threads?
Easy on him, he's just starting med school.
Lol I'm so hurt bro. You're the one getting all bent out of shape about some midlevel taking your job
Just like all the other PhDs who lecture MS1s...there's nothing special about that however much it might stroke your nursing ego.
I don't mean to offend, but I think they know exactly how this feels. This entire thread is dedicated to saying that we are better than they are.
It seems to me like all the residents and attendings stopped commenting on this a while ago. I am going to start imitating that behavior.
I think the thread is saying that nurses are not physicians (and physicians are not nurses). The fact that physicians have more autonomy, education, and perceived prestige makes the jump to "nurses are not as good as physicians" an easy one. That's apples to oranges though. Nurses have a job to do, just like physicians have a job to do. The problem arises when an NP thinks they are as capable as a physician at doing what physicians do.
Are physicians better than nurses? No. Are physicians better at being a physician? Yes.
The whole point of this thread is "you don't know what you don't know", and a medical student thinking he knows how to judge the quality of anesthetic delivery is beside the point?
They mostly can't even pass a simplified version of the simplest physician exam. Hence, NP education is a joke.
Edumacate me then great one. How should I judge the quality of anesthetic delivery? Or is patient outcome not good enough?
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Shoot how does any patient really determine quality of a provider? Aside from word of mouth there isn't much to go off of
See thats what I'm saying. That or they go to vitals.com 😉
A good patient outcome is about as good a measuring stick as you can get.
Unless the guy trolling me is a gas resident or attending then his opinion on the matter means about as much to me as the baked potato I just ate for dinner.
Anyway, why in the world are there pre-meds in this forum? Did Allo just stop being moderated altogether or what?
Complete rubbish. OMM is ascientific garbage - a holdover from the early part of the last century that fools will not let go (mostly in order to justify their "uniqueness" among the guild of physicians. Many if not most DOs know this and the vast majority of them don't even use it. But never forget the harm that so-called OMM has done to American medicine in the form of spawning new quackery (i.e. encouraging harmful rubbish like chiropractic). As a great American hero once (HL Mencken) once said:
I beg to differ, I respect DO's. Yes, their history spawned from quackery, but so has the entire field of medicine. They have evolved, and just like evolution they have adapted to the changing times.
