NYT Today: "Nurses are Not Doctors"

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WhippleWhileWeWork said:
But if you take away the studies how will Ph.D and Masters degree seeking Nurses obtain said degrees????
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Write papers on the effects of being wholistic and knowing the patient's spiritual views.
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dadaddadaBATMAN said:
I know you're not really asking, but my explanation would be to milk the most out of group numero three. With more time, they may even get a little better patient compliance.

Not to mention it's an easy stat for a politician to quote, or to distort. "NPs have proven as effective in the management of chronic conditions as......." seems like an easy distortion to use. If questioned, say HbA1C and the phrase "studies havre shown" until the audience tunes out and forgets.
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And it's repeated ad nauseam by politicians, nursing groups, liberal bloggers, etc. I agree the key is to talk about #3 - real endpoints, not stupid HgA1C numbers and BP measurements.
 
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Don't worry guys. The public will figure this out. Just hang in there.

idiocracy.jpg
 
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NeuroSpeed said:
All these Idiocracy posts are killing my study drive! Rawr!
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I am sad to say I've never watched the movie. But now that I've seen clips on Youtube, I will have to get it.
 
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Psai said:
It's a great movie, very true to life. Makes you fear for the future though.
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That's part of the reason I didn't want to see it. My faith in the humanity is already shaken enough as it is. I call them Obamabots.
 
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It's f'n brilliant. I own it. I think I'm due for another viewing.

It's better to put your faith in the true nature of human beings. And in the real processes of evolution. Where extinction is the norm. Things are not always forward and better. In fact, the evidence suggests that in the much longer history of human civilization than was originally thought, we have faced near extinction and been subject to cultural and technological devolution many times.
 
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Nasrudin said:
It's f'n brilliant. I own it. I think I'm due for another viewing.

It's better to put your faith in the true nature of human beings. And in the real processes of evolution. Where extinction is the norm. Things are not always forward and better. In fact, the evidence suggests that in the much longer history of human civilization than was originally thought, we have faced near extinction and been subject to cultural and technological devolution many times.
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Truth and a fascinating reality.
 
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DermViser said:
They use stupid endpoints like HgA1C numbers and BP numbers, instead of real endpoints like mortality or heart attack. I wonder why?
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But they also use things like "patient satisfaction scores" to show they are even better than doctors. They are very quick to point out that they get higher satisfaction scores than physicians because they understand the "humanistic" side of medicine that is not taught in medical school.
 
So, the interesting thing will be when they get the same independence practice rights followed by the same pay. Then comes the same liability, as well as the same practice pressures ( ie seeing a greater number patients in shorter time). I doubt they are going to still be seen as more patient centered when they also have to crank through a patient in 10 minutes. The public is going to see a shift then and won't like it. It's our country yet trying to work around a problem instead of fix it.
 
I remember when journalists actually went and did research so they would know about a topic instead of spamming a bunch of ugly graphics with two lines of garbage along with a random graph affixed in an attempt to appear scientific.
 
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sb247 said:
ugh

http://www.vox.com/2014/6/4/5778848/silly-protectionist-doctors-colds-are-for-nurses
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Posted at the top of the website in bold, highlighted words: "Nurse Practitioners could be fixing this country's health care spending problem."

An excerpt from the "evidence" they cite: "There is limited evidence that suggests that primary care by nurse practitioners is less costly, not only because they earn less, but also because they tend to order fewer tests and expensive diagnostic procedures than do physicians. Recent research, however, does not confirm this hypothesis.

In addition, Medicaid fee-for-service programs pay certified pediatric and family practice nurse practitioners directly, but these rates vary by state. Some states pay nurses the same rates as they pay physicians for some or all services, but more than half of the states pay nurse practitioners a smaller percentage of physician rates. The Affordable Care Act provides for enhanced Medicaid payment for primary care services furnished by physicians, and an Institute of Medicine (IOM) report recommended Congress apply those same rates to nurse practitioners providing similar primary care services."

TL;DR: Nurses cost the gov't less since they get reimbursed less than physicians... but their reimbursements should be increased to match physicians. :confused:
 
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InGen said:
Posted at the top of the website in bold, highlighted words: "Nurse Practitioners could be fixing this country's health care spending problem."

An excerpt from the "evidence" they cite: "There is limited evidence that suggests that primary care by nurse practitioners is less costly, not only because they earn less, but also because they tend to order fewer tests and expensive diagnostic procedures than do physicians. Recent research, however, does not confirm this hypothesis.
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Well, I guess he's at least smart enough to know that the GP will not bother reading the evidence even if it might contradict his claims, just saying "the evidence says/the studies prove" is enough.

Up.Hill.Battle.
 
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WhippleWhileWeWork said:
Well, I guess he's at least smart enough to know that the GP will not bother reading the evidence even if it might contradict his claims, just saying "the evidence says/the studies prove" is enough.

Up.Hill.Battle.
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Sadly, yup. Also, I think the cute picture at the top helps too. They all look so happy, so it must be a good thing!
 
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wholeheartedly said:
It's our country yet trying to work around a problem instead of fix it.
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:clap:

That it is.
I suppose that "do something" looks more impressive if you work forward instead of backwards. Even if the later might actually get to the root/s of the problem.
 
WhippleWhileWeWork said:
:boom:

:diebanana:

No more clicks for Vox and Mr. "Vengeance is mine". I don't know who he's trying to bring his vengeance upon, but it appears to be Physicians.

"Who hurt you, bro? Let's talk about that."
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"Show me on the doll where the PCP touched you when they told you to turn your head and cough."
 
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So apparently the problem is with doctors for practicing medicine and defending medicine from nursing, and not people who go see a physician or a NP because they scrapped their knee or have a cold?
 
One of the scary things about the NP push is what the RNs are currently pushing. Take for example, this anti-science, anti-EBM, anti-math ad currently running in California. Just because RNs don't understand science and algorithms (not to mention the fact that the RN is going to set up a floor to floor transfer instead of calling the physician, or the rapid response team for an unstable patient (arrhythmia with respiratory distress)) doesn't mean that science and math are scary.
 
One of the solutions to getting more nurses into advanced practice, in the article Whipple linked, was to decrease the number of credits needed to become a nurse practitioner.

Please. If anything, there should be more courses that have to do with patho, diagnostics, etc., and fewer courses on management, nursing theory, blah, blah, blah.
 
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WhippleWhileWeWork said:
Which reminds me, we need an OT thread of everyone explaining their screen names. Your's is hilarious, I sing the theme song to myself every time I see it.
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thanks

I'm actually more curious about the avatar from yours, but I'm mostly commenting because "your's" might make me go blind :)
 
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dadaddadaBATMAN said:
thanks

I'm actually more curious about the avatar from yours, but I'm mostly commenting because "your's" might make me go blind :)
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F, I fixed it right before you posted this. Shame.

Et-OH, wreaks havoc on the very limited grammar skills that I try to command.
 
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It amazes me to see how some individuals seem "appalled" by nurses or the nursing profession. At the end of the day, there is nothing that can replace a "doctor." However, one thing is evident........the world of nursing and the world of medicine must learn to get along and respect each for what that profession brings to the table. At the end of the day, it is about the patient.......not your hate or disgust for nursing. You can't compare the educational requirements because they are DIFFERENT professions. Nurses begin their education with hands on experience with patience from day one.......this is what helps build their knowledge base in conjunction with the required academic courses. Working at a teaching hospital, I have witnessed first-hand how residents rely on the information the nurse provides concerning the patient's care and condition. Working in the private setting, the attendings expect the nurse's to understand the patient's conditions and to be able to relate any significant changes observed. It is the nurse that is at the bedside during a patient's illness......not the doctor.

It would be futile for anyone to attempt to argue a DNP being equivalent to a MD........that would be absurd! A nurse who has obtained a DNP is still governed by their states Board of Nursing. If the medical profession did not need the nursing profession........nursing would have phased out decades ago........
 
No one's hating on nursing. Nurses are incredibly valuable. People are hating on nurses that are pretending to be doctors in every way they can. Don't try to practice some absurd watered down version of medicine and then call it "nursing".
 
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TRUTHDIVINE79 said:
It amazes me to see how some individuals seem "appalled" by nurses or the nursing profession.
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What is so surprising that we're appalled over hypocrisy? Nursing continually says that they're equal to physicians (despite a fraction of the education and, compared to a residency trained physician, experience) while mounting nuclear war against any other profession that even begins to "infringe" on nursing. Ever see nursing organizations attack paramedics over such simple things as community paramedicine?

At the end of the day, there is nothing that can replace a "doctor." However, one thing is evident........the world of nursing and the world of medicine must learn to get along and respect each for what that profession brings to the table. At the end of the day, it is about the patient.......not your hate or disgust for nursing.
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Nursing's hate for medicine and physicians is perfectly fine though, right? After all, we're the ones who have to meet you guys, not the other way around.

You can't compare the educational requirements because they are DIFFERENT professions. Nurses begin their education with hands on experience with patience from day one.......this is what helps build their knowledge base in conjunction with the required academic courses.
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1. If they're different then why does nursing keep trying to compare equivilance?
2. If they're different, then why does "advanced practice" nurses keep trying to do what, if described accurately, would never be mistaken for anything else but the practice of medicine?
3. If physicians don't get hands on experience from day one, how come I was working in primary care clinics starting my first semester of medical school?

Working at a teaching hospital, I have witnessed first-hand how residents rely on the information the nurse provides concerning the patient's care and condition. Working in the private setting, the attendings expect the nurse's to understand the patient's conditions and to be able to relate any significant changes observed. It is the nurse that is at the bedside during a patient's illness......not the doctor.
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1. ...and I've seen attendings take time to teach nursing students? How about we compare attending physicians to nurses?
2. Wait, you mean that the person who's job is to implement medical orders, monitor the patient, and assist the patient with basic human needs (not that there's anything wrong with that, because nothing gets a nurse all hot and bothered than mentioning the importance of cleaning and feeding a patient) knows more about the minute by minute course of the patient than the person who's job is to guide the medical course for that patient, while taking care of 3-4 times the number of patients (or more depending on the unit) that the nurse is taking care of?
3. Emergency physicians and surgeons aren't present during the majority (and most important) part's of the patient's illness? I'll make sure to let them know that resuscitation and surgery isn't important.

4. Can you explain why so many people who hate nursing goes on to become nurses and then bemoan that they're actually supposed to be nurses and practice nursing? Because, you know, a lot of this paragraph really comes off as "I really don't like my job, even though I should have known that this is the job I was being educated to perform during my 2-4 years of college." It really is surprising that so many nurses act like martyrs for being expected to do their job.


It would be futile for anyone to attempt to argue a DNP being equivalent to a MD........that would be absurd! A nurse who has obtained a DNP is still governed by their states Board of Nursing. If the medical profession did not need the nursing profession........nursing would have phased out decades ago........
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Every nursing organization that is promoting autonomy for NPs practicing medicine under the thin veil of "nursing" (if nursing diagnosed and prescribed medicine, why do they page physicians for colace orders and potassium of 3.4?) is disagreeing with you.
 
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TRUTHDIVINE79 said:
It amazes me to see how some individuals seem "appalled" by nurses or the nursing profession. At the end of the day, there is nothing that can replace a "doctor." However, one thing is evident........the world of nursing and the world of medicine must learn to get along and respect each for what that profession brings to the table. At the end of the day, it is about the patient.......not your hate or disgust for nursing. You can't compare the educational requirements because they are DIFFERENT professions.
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When nurses practice medicine, they cease to be DIFFERENT professions. We're familiar with your talking points.
No one is appalled by the nursing profession, we're appalled when nurses decide they can and should practice medicine but pretend it's still nursing.

TRUTHDIVINE79 said:
Nurses begin their education with hands on experience with patience from day one.......this is what helps build their knowledge base in conjunction with the required academic courses.
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And, what does that mean exactly?

TRUTHDIVINE79 said:
Working at a teaching hospital, I have witnessed first-hand how residents rely on the information the nurse provides concerning the patient's care and condition.
Working in the private setting, the attendings expect the nurse's to understand the patient's conditions and to be able to relate any significant changes observed. It is the nurse that is at the bedside during a patient's illness......not the doctor.
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No one here has a problem with nurses and the job they do when functioning as a nurse.
TRUTHDIVINE79 said:
It would be futile for anyone to attempt to argue a DNP being equivalent to a MD........that would be absurd!
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Absurd? Tell that to the DNP champion Mary Mundinger

" Truly comprehensive care requires both medical and nursing skills, and nurses with a clinical doctorate have that complement of abilities."

"Once patients move beyond the common bias that only doctors of medicine can provide top-flight care, they typically come to appreciate these added benefits. Most important, research has demonstrated that DNPs, with their eight years of education and extensive clinical experience, can achieve clinical outcomes comparable to those of primary-care physicians."

" By allowing DNPs to take this test, the medical establishment will give patients definitive evidence that these skilled clinicians have the ability to provide comprehensive care indistinguishable from physicians."



TRUTHDIVINE79 said:
A nurse who has obtained a DNP is still governed by their states Board of Nursing. If the medical profession did not need the nursing profession........nursing would have phased out decades ago........
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Don't muddy the waters. Nurses functioning as nurses are highly valued members of the team. A DNP is not functioning as a nurse.
 
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Psai said:
I remember when journalists actually went and did research so they would know about a topic instead of spamming a bunch of ugly graphics with two lines of garbage along with a random graph affixed in an attempt to appear scientific.
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Those were the days. Now any blogger living in Mom's basement can create "news".
 
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TRUTHDIVINE79 said:
It amazes me to see how some individuals seem "appalled" by nurses or the nursing profession. At the end of the day, there is nothing that can replace a "doctor." However, one thing is evident........the world of nursing and the world of medicine must learn to get along and respect each for what that profession brings to the table. At the end of the day, it is about the patient.......not your hate or disgust for nursing. You can't compare the educational requirements because they are DIFFERENT professions. Nurses begin their education with hands on experience with patience from day one.......this is what helps build their knowledge base in conjunction with the required academic courses. Working at a teaching hospital, I have witnessed first-hand how residents rely on the information the nurse provides concerning the patient's care and condition. Working in the private setting, the attendings expect the nurse's to understand the patient's conditions and to be able to relate any significant changes observed. It is the nurse that is at the bedside during a patient's illness......not the doctor.

It would be futile for anyone to attempt to argue a DNP being equivalent to a MD........that would be absurd! A nurse who has obtained a DNP is still governed by their states Board of Nursing. If the medical profession did not need the nursing profession........nursing would have phased out decades ago........
Click to expand...

Tell that to Mary Mundinger who has said that NPs can and should replace Primary Care doctors.

http://observer.com/2009/12/the-nursecrusader-goes-to-washington/
For her part, Ms. Mundinger readily concedes that there are some things nurses are not educationally equipped to do: oncology, surgery, things that call for medical specialists. But she argues that, if anything, primary care physicians are overeducated. “I spoke to the Federation of State Medical Boards, the people who run all board certifications, and a primary care physician stood up and said, ‘Are you saying I wasted my time going to medical school?’” recalled Ms. Mundinger. “I wanted to say, yeah.”
==================

As far as your examples of nurses providing info. to residents and to attendings. I don't think you really understand the importance of those examples. Residents/attendings don't just have 3-4 patients they have to monitor on a shift.

You're right, medicine and nursing are entirely DIFFERENT professions. And yet, it is nursing that is specifically trying to increase its scope of practice by grassroots lobbying of politicians at the state level to change scope of practice laws, to specifically undertake tasks that have always fallen under medicine. It has nothing to do with caring for patients. It has to do with wanting to be paid more. Which is also why NPs are fighting for Medicare and insurance companies to reimburse them at the same level of Physicians. It's why they're also going into subspecialty care (while telling politicians that they're the solution for primary care). It's essentially a way to "professionalize" your profession (see the DNP when a Master's degree has been perfectly fine) for more tuition $$ at the university level --- a.k.a. degree creep.

A DNP is not acting as a nurse, esp. when they want to be called "Doctor" in a healthcare setting, and you and your AANP organization saying it is nursing (so you can say that Medicine has no right to comment) doesn't make it so.

Also it's patients not patience.
 
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LoudBark said:
But they also use things like "patient satisfaction scores" to show they are even better than doctors. They are very quick to point out that they get higher satisfaction scores than physicians because they understand the "humanistic" side of medicine that is not taught in medical school.
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Yes, and they also know that patient satisfaction scores can be gamed to cover up medical incompetence: http://www.forbes.com/sites/kaifalkenberg/2013/01/02/why-rating-your-doctor-is-bad-for-your-health/
 
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WhippleWhileWeWork said:
" By allowing DNPs to take this test, the medical establishment will give patients definitive evidence that these skilled clinicians have the ability to provide comprehensive care indistinguishable from physicians."
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And then when they take the test and 50% fail - they say it shouldn't be a requirement, that one test can't truly encompass the education of a DNP, and the medical establishment has no right to judge their standards bc they're nursing. Right before they stomp off in a temper tantrum.
 
Why would they take a difficult test like a watered down step 3, the easiest standardized test to become a physician according to many when politicians can make them physician-like with just the stroke of a pen? Competency be damned!
 
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