NYT Today: "Nurses are Not Doctors"

[InGen]

A few of you have pointed out the hypocrisy of Big Nursing, so I thought you'd enjoy this. On a All Nurses thread about Nurses taking over respiratory work in hospitals someone said this,

"It's more a matter of "taking back" than "taking over." RT is yet another of those occupations that was spun off from nursing. Back in the day, everything that was done for people outside of actually ordering the medications (physician) was nursing practice, and done by nurses. Over the decades/generations, RT, PT, OT, etc., all got spun off as separate fields. When I started in nursing a long time ago, we had RTs in ICU, but all the respiratory stuff on the floors was done by the RNs. It's not that big a deal. Many of us, over the years, have been concerned about how much of nursing practice we have "given away" to other groups."

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[BamaNicole]

Many of us, over the years, have been concerned about how much of nursing practice we have "given away" to other groups."

 

[BklynRN]

I don't understand the obsession with wanting to become a DNP or NP in nursing. Why is not OK to just be a nurse? I'm totally fine with being a Registered Nurse. It is all a scam, you can make NP money without the school or debt. I know a lot of nurses who pull in between 100,000 to 145,000 a year, the later one being a supervisor on the side at a nursing home but I have also worked with RN's where that is their regular salary a year albeit they are in management but still!!! I personally make 100,000 to 103,000 a year (no two positions just one). I do not think these NP programs put out quality people who can handle complex patients or critically think the way a MD or DO does. They simply do not have the clinical hours or background in advanced science/math to effectively manage such cases. I hear it time and time again, log into your online portal do two response questions a week then take maybe two hard classes pharm/patho then shadow around in clinical and you can take your exam. That is very scary! all I see from NP's are they are referral machines, don't know have blah blah look into it-or order blah blah test, how is that cost effective? that's the major lie, as well.

 

[BklynRN]

Look at the requirements to become specialized in a certain field on nursing. For example, look at needs to be done to be a dialysis specialized nurse to sit and take the test. In my opinion, it is a hell of a lot more strict than an NP program.

 

[NicMouse64]

After following this thread I am just amazed at how doctors have lost the battle over nursing autonomy. How was it allowed to get this far and why aren't there similar lobbying groups that have more sway than the nursing groups? Is part of the problem there are no good studies that give clear evidence that MDs/DOs have better outcomes or am I mistaken?

 

[postbacpremed87]

After following this thread I am just amazed at how doctors have lost the battle over nursing autonomy. How was it allowed to get this far and why aren't there similar lobbying groups that have more sway than the nursing groups? Is part of the problem there are no good studies that give clear evidence that MDs/DOs have better outcomes or am I mistaken?

Too busy getting $%^* done

 

[Member 1337]

I got written up several years ago when asked ( as if I was his mother or his business partner) where the plastic surgeon was (one who had a history of not showing for cases, so I was a bit nervous) and I replied, "How the hell would I know?"

I learned my lesson to keep my trap shut because someone is always out to make a mountain out of a molehill. And to think we have surgeons SCREAMING at OR staff and this is what gets written up.

On a slight tangent, this kind of behavior is interesting to me. I think part of this process is that in the professional fishbowl of hospitals there are a few employees who behave like mean sharks, while most others behave like benevolent sea turtles.

People don't mess with sharks because you know they will attack you, they'll go for blood, try to mess with your life game of thrones style. These are the employees everyone knows are toxic but no one wants to confront because, well, they're sharks, and no one wants to upset a shark. No one wants to upset them because you end up with formal allegations that "must be investigated," taking up your time, energy, resources, and at worst these sharks get obsessed with malicious career/personal sabotage. They tend to get "competent, well rounded" evaluations because their supervisors know honest (critical) feedback will result in being targeted by the shark and having a legal/administrative nightmare to deal with.

Most people are like friendly sea turtles. They're kind and competent and just want to help each other out. But it's easy to mess with a sea turtle and a sea turtle will (usually) not turn around and attack you. The irony is that it is because of this gentle nature that the sea turtle receives the brunt of of workplace criticism, because the organization knows the sea turtle will absorb this criticism without too much backlash (or, at worst, swim away to a different fishbowl). In toxic organizations the most important thing becomes keeping the shark happy, while the sea turtles are expected to put up and shut up.

 

[Ukpremed]

• In most languages they have a word for PhD and MD. English does not make a distinction and has resulted in people like this.

Found this gem of a comment... had the most likes (47) of any comment I saw. lol.

"As an Advanced Practice Nursing student at the University of California-San Francisco and future primary care provider, I am disappointed by Sandeep Jauhar’s limited inquiry into advanced practice nursing and his assumption that nurses want to be confused with medical doctors (clarification: many nurses ARE doctors, having attained Doctorates of Nursing Practice or PhDs). Jauhar’s acceptance of APNs as being more “sensitive to patients’ psychological and social concerns” coupled with his rejection of nurses as competent clinicians suggests an outdated understanding of nursing science, one in which nurses only meet the spiritual/emotional needs of patients. A systematic review of APN practice from 1990-2008 concludes APNs have comparable patient outcomes with MDs (Newhouse, 2008). The 15 yo study Jauhar cites does not, as he asserts, prove NPs “compensate for a lack of training” by ordering excessive diagnostic tests. Rather, the researchers “found a trend toward increased utilization… but for most of these [measures] our study lacked sufficient power to show statistical significance” (Hemani, 1999). The anecdote about a MD diagnosing goiter based simply on a patient’s hoarse voice is quite remarkable considering that an actual diagnosis of goiter would require, at minimum, a physical exam and labs confirming abnormal thyroid hormone levels. Perhaps as long as residents believe primary care requires near mystical powers they will choose specialization over family medicine."



Strong awareness of the difference between a PhD and an MD

 

[Kaustikos]

On a slight tangent, this kind of behavior is interesting to me. I think part of this process is that in the professional fishbowl of hospitals there are a few employees who behave like mean sharks, while most others behave like benevolent sea turtles.

People don't mess with sharks because you know they will attack you, they'll go for blood, try to mess with your life game of thrones style. These are the employees everyone knows are toxic but no one wants to confront because, well, they're sharks, and no one wants to upset a shark. No one wants to upset them because you end up with formal allegations that "must be investigated," taking up your time, energy, resources, and at worst these sharks get obsessed with malicious career/personal sabotage. They tend to get "competent, well rounded" evaluations because their supervisors know honest (critical) feedback will result in being targeted by the shark and having a legal/administrative nightmare to deal with.

Most people are like friendly sea turtles. They're kind and competent and just want to help each other out. But it's easy to mess with a sea turtle and a sea turtle will (usually) not turn around and attack you. The irony is that it is because of this gentle nature that the sea turtle receives the brunt of of workplace criticism, because the organization knows the sea turtle will absorb this criticism without too much backlash (or, at worst, swim away to a different fishbowl). In toxic organizations the most important thing becomes keeping the shark happy, while the sea turtles are expected to put up and shut up.

Yeah.....
I'm a hippo. I look friendly, but don't **** with me or you'll see your entire boat/crew capsized by my attack.

But seriously, since when are sea turtles nice? You obviously don't know much since sharks, in the wild, don't mess with them.

More seriously: anyone that writes someone up for "how the hell am I supposed to know" deserves to be metaphorically beaten to death with the blunt force of the common courtesy and sense bat. The very same bat used against people who write someone up for wearing red shoes.

My point is: replace shark with snake, weasel or whatever conniving animal that exists.

 

[criticalelement]

I personally make 100,000 to 103,000 a year (no two positions just one). l.

Really? Where do you work? Brooklyn? and what do you do? That is insane that an RN can make 100K per year as a nurse where pediatricians in tNYC are making 125k

 

[Nasrudin]

Really? Where do you work? Brooklyn? and what do you do? That is insane that an RN can make 100K per year as a nurse where pediatricians in tNYC are making 125k

This is how nursing unions operate. The same in California. They don't get a sweet deal they strike. And the public, for some inexplicable reason, supports them way more than they do teachers. Its quite amazing actually. Nursing unions are crafty as F.

 

[Kaustikos]

Really? Where do you work? Brooklyn? and what do you do? That is insane that an RN can make 100K per year as a nurse where pediatricians in tNYC are making 125k

Uh .. So, I have heard of how nurses can make bank and it's not that difficult from a planning perspective: You work a 3-4 day shift of 12 hours at one hospital. Means you have 4-3 days to compensate. Legally, some hospitals won't let you work more. HOWEVER, You work at another hospital outside the prior ones "system" and you're rolling in more cash. Basically, if you're fresh out of nursing school with enough energy, you could easily work a 5-6 day 12 hour schedule and make 100k+. Better yet if you're a 'floating nurse' outside your regular schedule.
I have definitely seen these nurses make this kind of salary. It's not impossible. Hell, it's very easy. And the ones that do it (and succeed at it) have their schedule/planning so well done that they don't burn out.

In the end, nurses can moonlight.

 

[delco714]

Here's a question...are NPs better than PAs considering some NPs are doctors and the only initial after a PA's name is "C"? Or, are PAs more reliable and capable since they strive to support and work WITH their physician colleagues?

 

[Psai]

Here's a question...are NPs better than PAs considering some NPs are doctors and the only initial after a PA's name is "C"? Or, are PAs more reliable and capable since they strive to support and work WITH their physician colleagues?

They say that there are no such things as dumb questions but I'm beginning to question that aphorism

 

[Kaustikos]

Here's a question...are NPs better than PAs considering some NPs are doctors and the only initial after a PA's name is "C"? Or, are PAs more reliable and capable since they strive to support and work WITH their physician colleagues?

Oh Jesus Christ. Come now and end this thread.

 

[TooMuchResearch]

Oh Jesus Christ. Come now and end this thread.

I dub that the SDN prayer.

Substitute in any Deity that suits you.

 

[Jabbed]

So this is back. Kewl.

 

[nowanmd]

So what do we learn from this
1) you must specialize
2)states like new york and oregon are hostile to doctors they should be avoided
3) President Obama said why do drs earn so much money I ask why community organizers do
4) Although I'm a registered democrat the only states run rationally have republican governors

 

[loris]

.

 

[BklynRN]

Really? Where do you work? Brooklyn? and what do you do? That is insane that an RN can make 100K per year as a nurse where pediatricians in tNYC are making 125k

I do visiting nursing- 3 patients a day.... and no I'm not unionized, that is just the salary being offered nowadays... one major reason the salary is high is because you work in the roughest/dingiest projects of NYC on a daily basis... you run a high risk of contracting bed bugs... I have never had a problem thank God just need to use simple precautions.. also see all your patients before 1PM then go home and do paperwork before the gang bangers wake up... on the plus side you are kind of your own boss, just need to meet your case load and get paperwork in one time... no dealing with other nurses or hospital drama.. I will never go back.. plus hospitals do not pay and or stable- this one closing down every 3 years here in NYC...