(Serious) Why do 4th year students need supervision but midlevels don't?

[VA Hopeful Dr]

I can agree. I hope med school won't be full of sensitive people. As I always say "f*^% your feelings." But we gotta play ball by the rules here.

It will be

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[Perrotfish]

Americans are the unhealthiest first worlders. Western Europeans, Canadians and Australians live MUCH healthier lives than the average fat lazy fast food shoveling Americans do. Literally almost every single patient I get under the age of 60 either does IV drugs, smokes crack, has a BMI over 40, has a 60 pack year smoking history, abuses alcohol to an extreme, or has uncontrolled HTN in the realm of 250/120 when untreated yet still makes no diet modifications. Very few are traumas with no other history. If they're traumas its "Got hit by a car while strung out on meth and stumbled out into traffic" etc..

Common misconception, not actually true. While we are without a doubt the fattest country in the world, we actually have a slightly below average rate of tobacco and illicit drug use, and an even further below average rate of alcohol abuse. We also exercise more than most countries in the world. Our health shouldn't be dramatically worse or more expensive than other first world nations.

 

[VA Hopeful Dr]

Common misconception, not actually true. While we are without a doubt the fattest country in the world, we actually have a slightly below average rate of tobacco and illicit drug use, and an even further below average rate of alcohol abuse. We also exercise more than most countries in the world. Our health shouldn't be dramatically worse or more expensive than other first world nations.

And it's not actually that much worse.

Cost is a whole other issue.

 

[RNtoMD87]

It will be

That's unfortunate. People's lives don't care about feewlings

 

[sunshinefl]

Medicinez0z- There are an ever increasing number of patients, becoming increasingly sick due to Americans lazy, disgusting life choices. They refuse to take charge of their health, exercise, eat healthy, educate themselves on medications etc.

There are two choices- water down MD education further, in order to push out more MD/DO for a greater patient demand which will be negative to the image of the professsion as a whole and give midlevels a whole new platform to stand on, or allow Midlevels to take up that spot, and know that there is no way they will ever be equal to an MD. Your concern that midlevels will actually compete with MD in the long run is a clue to me that you feel threatened. I don't lose any sleep at night over this, and still want to take the arduous and painful route of becoming an MD over an easier and MUCH cheaper two year route to become an NP simply because I feel this is a midlevel bubble that will burst, and the end result will be disasterous for midlevels, and destructive at best to all nurses.

Apparently this is a false equivalent because they ARE doing what MDs do.

Americans are the unhealthiest first worlders. Western Europeans, Canadians and Australians live MUCH healthier lives than the average fat lazy fast food shoveling Americans do. Literally almost every single patient I get under the age of 60 either does IV drugs, smokes crack, has a BMI over 40, has a 60 pack year smoking history, abuses alcohol to an extreme, or has uncontrolled HTN in the realm of 250/120 when untreated yet still makes no diet modifications. Very few are traumas with no other history. If they're traumas its "Got hit by a car while strung out on meth and stumbled out into traffic" etc.

Americans just aren't a people built for longevity. My copy of "Idiocracy" needs to be moved from my fiction section to the non-fiction section.

I don't care about "right of passage". In the Army it was all about BS traditions and "dog and pony show" stuff like that. I DO have a problem with unqualified people practicing medicine, but it has nothing to do with some "rite of passage" or tradition. I'm a pragmatist.

I can agree. I hope med school won't be full of sensitive people. As I always say "f*^% your feelings." But we gotta play ball by the rules here.

Why are you even a nurse or trying to become a doctor when you look down on patients so much? Keep that same energy at your interviews.

 

[RNtoMD87]

It's not looking down on patients. Its being ashamed of society as a whole. I'm very compassionate with my patients. All doctors and nurses that I've worked with reflect the same feelings of frustration with these populations of patients, but its being frustrated because you feel bad. Like my 92 bmi patient I had the other day that would just cry and cry. On one hand you're thinking "how the f do you let yourself get in that shape?" and on the other hand you feel terrible for them.
And "f your feelings" I'm not talking about the patients. That's a different case. I'm talking about healthcare providers. No ones there to hold hands and make us feel special. Lives are all that matters, not our feelings.

 

[SLC]

See I am at the tail end of my 3rd year right now and just started prepping for Step 2 CK, if you were to take me and a fresh NP grad and make us sit for Step 2 tomorrow and I have to bet on it, I am going to bet my left nut that I am going to outscore that NP or PA. I sound like an arrogant dingus but I have seen them on the wards and it's really no comparison

I sympathize with how you feel. I mean I’ve been there before...

But something about Dunning-Krueger.

 

[Promethean]

It's not looking down on patients. Its being ashamed of society as a whole. I'm very compassionate with my patients. All doctors and nurses that I've worked with reflect the same feelings of frustration with these populations of patients, but its being frustrated because you feel bad. Like my 92 bmi patient I had the other day that would just cry and cry. On one hand you're thinking "how the f do you let yourself get in that shape?" and on the other hand you feel terrible for them.
And "f your feelings" I'm not talking about the patients. That's a different case. I'm talking about healthcare providers. No ones there to hold hands and make us feel special. Lives are all that matters, not our feelings.

But no, really... you might want to dial back that whole F your feelings sentiment.

Lives do matter. So do the people providing the care. Yes, we are to always always always center on the patient, to make it about them, not us. That is, indeed, what the role calls for. But the people providing the care are people, too. Their feelings do actually matter. We can't give the best quality care unless we are engaged and fully human ourselves, and that means that yes, we have to attend to our own inner states as well. Your "F your feelings just do the job" sentiment sounds a bit toxic. I've noticed a lot of people who take that approach end up with seriously dysfunctional coping strategies.

Medical education and training is one of the most harrowing experiences that you are likely to endure in your life. Even when it is good, it is demanding and requires sacrifice. Then, there is taking on the mantle of responsibility that follows it. No one comes through entirely unscathed, and no one gets through it at all without some support along the way. If you don't need hand holding, that is great. But being a good member of your team means being ready to hold a few hands along the way. The value of this skill cannot be overstated.

 

[RNtoMD87]

Im referring to the drama and people crying because "the surgeon yelled at me and cursed me out"

If you're doing something that can jeopardize a life, it's good to have an immediate stress reaction. It makes it stick, and you learn much faster. That's why in basic training the drill sergeants keep the trainees stressed over small details. You remember them and (hopefully) don't get your squad mates slotted.

Tears/sweat now saves blood later.

I had a surgeon yell at me when I was a nursing student. I didn't cry. "Roger that. Won't do it again" and you move on. It isn't about us. It's about the patients.

 

[Chibucks15]

Im referring to the drama and people crying because "the surgeon yelled at me and cursed me out"

If you're doing something that can jeopardize a life, it's good to have an immediate stress reaction. It makes it stick, and you learn much faster. That's why in basic training the drill sergeants keep the trainees stressed over small details. You remember them and (hopefully) don't get your squad mates slotted.

Tears/sweat now saves blood later.

I had a surgeon yell at me when I was a nursing student. I didn't cry. "Roger that. Won't do it again" and you move on. It isn't about us. It's about the patients.

I don't think many people are legit breaking down because they're being yelled at...if they are they shouldn't be in medicine because everyone from patients to nurses to admins are gonna yell at ya. I think what posters are saying here is the "f your feelings"attitude is coming off as your feeling towards your colleagues on here. And they are definitely not gonna enjoy being in class with you my dude when you get fired up. Congrats on being strong and not crying though

 

[VA Hopeful Dr]

I don't think many people are legit breaking down because they're being yelled at...

When I was in med school there was one surgeon who made at least one person cry on every rotation. That's 1/10th of each class...

 

[RNtoMD87]

I don't think many people are legit breaking down because they're being yelled at...if they are they shouldn't be in medicine because everyone from patients to nurses to admins are gonna yell at ya. I think what posters are saying here is the "f your feelings"attitude is coming off as your feeling towards your colleagues on here. And they are definitely not gonna enjoy being in class with you my dude when you get fired up. Congrats on being strong and not crying though

Oh no, I'm the most easy going guy, I just keep my thoughts to myself in real life. I don't give my opinion unless it's asked for. Force of habit. I tend to keep to myself on the unit, chart in the corner while all of the females gossip and cut up, being disruptive. It's much easier to vent online. I don't think any of my family or coworkers know anything about me other than my teddy bear side. I see where you guys are coming from. I've only raised my voice maybe once in two years of being a nurse and it's because some floor nurses about let a patient die by not even initiating CPR and we on the code team were the first to initiate it. I don't get heated easily. I just care about my patients like they're my own family. I've lost a couple buds due to incompetence, and it's something that's stuck with me to this day. You think about them every day, more so on certain days of the year.

 

[Chibucks15]

When I was in med school there was one surgeon who made at least one person cry on every rotation. That's 1/10th of each class...

well damn haha I haven't seen that as much yet but in my clinical experience I got reamed a time or two

 

[RNtoMD87]

well damn haha I haven't seen that as much yet but in my clinical experience I got reamed a time or two

I got reamed by a forensic pathologist last month for accidentally touching a cranial bullet wound. It happens.

 

[QueenJames]

Im referring to the drama and people crying because "the surgeon yelled at me and cursed me out"

If you're doing something that can jeopardize a life, it's good to have an immediate stress reaction. It makes it stick, and you learn much faster. That's why in basic training the drill sergeants keep the trainees stressed over small details. You remember them and (hopefully) don't get your squad mates slotted.

Tears/sweat now saves blood later.

I had a surgeon yell at me when I was a nursing student. I didn't cry. "Roger that. Won't do it again" and you move on. It isn't about us. It's about the patients.

Are you me?

I think I've finally met my soul sister/brother.

I'm about to cry!

I absolutely DESPISE MANYYYY of my classmates because a majority of them are VERY dramatic. They lack a lot of maturity and perspective.

Always gossiping, lying, and just a bunch of insecure brats. IDK wtf it is.

Always complaining about something or the other like medical school has something to owe them? lol

HONESTLY....

SPEAKING FOR MY CLASS ONLY....

Our class got partitioned in such a way where there are A LOT more females than males this time around...

Each of our small groups is outnumbered and set with a 3:1 female to male ratio.

I really think it is something that happens when you get a bunch of type A people (especially the type of girls OUR school seems to attract) around one another that causes something to change!

I'm all for the increasing amounts of females starting to become physicians and enter medicine.

Some of the SWEETEST and SMARTEST docs and students I have met are females... their bedside manner, their straightforwardness... IDK... something about that just attracts me!

But jesus christ....

I never knew our girls could be this goddamn catty!

But on that note..

THANK GOD FOR ONLINE RECORDED LECTURES.

I only get to see my classmates once a week. We all got one more class before dedicated and it is ADIOS MOTHASUCKAS.

 

[Goro]

I can agree. I hope med school won't be full of sensitive people. As I always say "f*^% your feelings." But we gotta play ball by the rules here.

I've got some students who are so thin-skinned that light passes right through them.

As to closing the thread, the serious discussion stopped on about page 2 or 3. The rest has been toxic dumpster fire.

 

[Perrotfish]

Im referring to the drama and people crying because "the surgeon yelled at me and cursed me out"

If you're doing something that can jeopardize a life, it's good to have an immediate stress reaction. It makes it stick, and you learn much faster. That's why in basic training the drill sergeants keep the trainees stressed over small details. You remember them and (hopefully) don't get your squad mates slotted.

Tears/sweat now saves blood later.

I had a surgeon yell at me when I was a nursing student. I didn't cry. "Roger that. Won't do it again" and you move on. It isn't about us. It's about the patients.

It's a balance. People die when we tolerate mistakes, but they also die when hospitals can't retain good staff. People know.their value, and the ones who stay in a job that makes them feel like **** aren't the ones you want.

 

[RNtoMD87]

Queen James, in glad I've found Someone who feels the same way and understands what I mean. You've helped me realize a better way to explain.

This isn't a macho contest of who cries or gets upset. It's that when I cry over it, it's because I'm either upset over guilt, or the horror that "wow! I could have cost them their life. How could I be so stupid?!"

Not "oh my god, I made a mistake. How dare you yell at me?"

I STILL tear up thinking "could I have done this?" Or "could I have done that" before I realize how futile and pointless such thinking is.

A little self disclosure- on Jan 30, 2011 I worked my last day as a patrol MP. My IT SGT blew his brains out in front of my motor pool SGT and his wife (it was never fully understood what truly happened suicide vs accident for sure), and I was the first responder on the scene. He was alive for an hour and a half afterwards.

I had JUST seen him down at the company maybe two hours prior that evening, doing some paperwork for a young private who had lost control of her motorcycle an gotten in a bad wreck. It's hard not to play the "I wish I had been there/ done x differently" game. He had been dealing with many demons post our deployment in 2008. I never worked the road after this day and instead worked as an armorer until I got out.

There isn't a day that goes by that I don't think about him and the boys we lost in Iraq. We had a company commander so incompetent, that we toyed many times as a whole unit with the idea of shooting him ourselves, because he was so callous, and even made snide comments about putting us in harms way so he could get his "cookie". He had little care when people died for these BS missions, that he only organized for the purpose of hoping to get attacked to pad his OER. He was finally relieved of command and we got a much better commander who actually took care of his men.

I've seen first hand what happens when these arrogant, sociopathic, ego fueled megalomaniacs are in charge. People die, and they could give two sh**s about it.

 

[762513]

Queen James, in glad I've found Someone who feels the same way and understands what I mean. You've helped me realize a better way to explain.

This isn't a macho contest of who cries or gets upset. It's that when I cry over it, it's because I'm either upset over guilt, or the horror that "wow! I could have cost them their life. How could I be so stupid?!"

Not "oh my god, I made a mistake. How dare you yell at me?"

I STILL tear up thinking "could I have done this?" Or "could I have done that" before I realize how futile and pointless such thinking is.

A little self disclosure- on Jan 30, 2011 I worked my last day as a patrol MP. My IT SGT blew his brains out in front of my motor pool SGT and his wife (it was never fully understood what truly happened suicide vs accident for sure), and I was the first responder on the scene. He was alive for an hour and a half afterwards.

I had JUST seen him down at the company maybe two hours prior that evening, doing some paperwork for a young private who had lost control of her motorcycle an gotten in a bad wreck. It's hard not to play the "I wish I had been there/ done x differently" game. He had been dealing with many demons post our deployment in 2008. I never worked the road after this day and instead worked as an armorer until I got out.

There isn't a day that goes by that I don't think about him and the boys we lost in Iraq. We had a company commander so incompetent, that we toyed many times as a whole unit with the idea of shooting him ourselves, because he was so callous, and even made snide comments about putting us in harms way so he could get his "cookie". He had little care when people died for these BS missions, that he only organized for the purpose of hoping to get attacked to pad his OER. He was finally relieved of command and we got a much better commander who actually took care of his men.

I've seen first hand what happens when these arrogant, sociopathic, ego fueled megalomaniacs are in charge. People die, and they could give two sh**s about it.

Thanks for sharing your story. I think we had the same Commander. My deployment was rough too, and you can’t explain to a civilian what’s its like seeing a corpse of someone you know who’s dressed identically to you. Good luck finishing your semester.

 

[RNtoMD87]

Thanks for sharing your story. I think we had the same Commander. My deployment was rough too, and you can’t explain to a civilian what’s its like seeing a corpse of someone you know who’s dressed identically to you. Good luck finishing your semester.

Or what it's like being in a convoy, and having one of your vehicles completely disabled with an EFP and losing everyone inside and wondering "why wasn't that just any of us? What made me so special that I deserve to make it out of here?" (This is why I feel like I have to help others. I haven't earned the right to come home like many of my brothers were denied. I literally bawl every time I see the ending of Saving Private Ryan, because it's so relatable.)

Or seeing your buddy who got hit by an IED and was the sole survivor of the vehicle who has a TBI and is now mentally a 4 year old, and you tear up every time you think about how he will never have a family, and that he doesn't even understand why we all hold him in such high praise. And how hard it is to read his mothers blog online, but you feel like you owe it to him to understand his story and know the struggle he is fighting,

Or your other battle, who left 4 kids behind at the age of 27 after being shot under his arm by some piece of sh** in the desert and they will never know what a great man their father was or his personality. And how his sense of humor would light up the room.

But please princess, tell me about how hard being a student doctor/nurse/ whatever is. I'm totally compelled by how hard life is.

It makes me want to bang my head against the wall repeatedly.

 

[QueenJames]

Queen James, in glad I've found Someone who feels the same way and understands what I mean. You've helped me realize a better way to explain.

This isn't a macho contest of who cries or gets upset. It's that when I cry over it, it's because I'm either upset over guilt, or the horror that "wow! I could have cost them their life. How could I be so stupid?!"

Not "oh my god, I made a mistake. How dare you yell at me?"

I STILL tear up thinking "could I have done this?" Or "could I have done that" before I realize how futile and pointless such thinking is.

A little self disclosure- on Jan 30, 2011 I worked my last day as a patrol MP. My IT SGT blew his brains out in front of my motor pool SGT and his wife (it was never fully understood what truly happened suicide vs accident for sure), and I was the first responder on the scene. He was alive for an hour and a half afterwards.

I had JUST seen him down at the company maybe two hours prior that evening, doing some paperwork for a young private who had lost control of her motorcycle an gotten in a bad wreck. It's hard not to play the "I wish I had been there/ done x differently" game. He had been dealing with many demons post our deployment in 2008. I never worked the road after this day and instead worked as an armorer until I got out.

There isn't a day that goes by that I don't think about him and the boys we lost in Iraq. We had a company commander so incompetent, that we toyed many times as a whole unit with the idea of shooting him ourselves, because he was so callous, and even made snide comments about putting us in harms way so he could get his "cookie". He had little care when people died for these BS missions, that he only organized for the purpose of hoping to get attacked to pad his OER. He was finally relieved of command and we got a much better commander who actually took care of his men.

I've seen first hand what happens when these arrogant, sociopathic, ego fueled megalomaniacs are in charge. People die, and they could give two sh**s about it.

Damn.

sorry to hear that homie.

I'm a "civilian" as you service folks refer to us and I'm not the one to bring up politics or anything, but I honestly wanna say thank you for your service.

You guys have seen, been through, and done some s hit that definitely not everybody can handle man.

This country (despite wtf is going on in politics and the reality TV show that everything is becoming on a daily basis) is blessed to have folks like y'all that make a huge sacrifice and do what you guys are supposed to do... no questions asked.

Major respect.

I'm sure you'll do great in med school bro.

Just keep your head down, do your work, and eff what anybody else has to say.

Keep it up homie!

One thing I'm sure you'll agree with is that life is all about perspective.

Sadly... most of these princesses and brats have been raised by mommy and daddy with a huge frickin' silver spoon..... and the hardest decision they have had to deal with is whether or not to stay at a resort hotel that ONLY has a pool or a chain hotel down the street that also provides free breakfast.

It's people like these that piss me off on a daily basis because they literally think anything and everything is "beneath them".

These are the same students who will literally talk about patients outside of the door and judge them constantly.

Homeless patient who abused drugs before? They'll be like "OMG.. WHY would anybody do that?"

Umm.. idk Princess... maybe because he's been through some crazy crap and didn't live on a golf course with mommy and daddy and went to private schools his whole life and wasn't afforded the right opportunity to be around the same people you were blessed to be around...?

ARGHH... it pisses me off writing about this as I'm typing it.

Long story short man...

Just keep doing your thing.

Being a good, understanding person is a lot more valuable than being a douchebag doc who knows every treatment and fact out of some stupid boards review book.

 

[sunshinefl]

Or what it's like being in a convoy, and having one of your vehicles completely disabled with an EFP and losing everyone inside and wondering "why wasn't that just any of us? What made me so special that I deserve to make it out of here?"

This is why I feel like I have to help others. I haven't earned the right to come home like many of my brothers were denied. I literally bawl every time I see the ending of Saving Private Ryan, because it's so relatable.

Or seeing your buddy who got hit by an IED and was the sole survivor of the vehicle who has a TBI and is now mentally a 4 year old, and you tear up every time you think about how he will never have a family, and that he doesn't even understand why we all hold him in such high praise. And how hard it is to read his mothers blog online, but you feel like you owe it to him to understand his story.

Or your other battle, who left 4 kids behind at the age of 27 after being shot under his arm by some piece of sh** in the desert and they will never know what a great man their father was or his personality. And how his sense of humor would light up the room.

But please princess, tell me about how hard being a student doctor/nurse/ whatever is. I'm totally compelled by how hard life is.

It makes me want to bang my head against the wall repeatedly.

So now you have regressed back to this attitude. Sigh. Not everything has to be a comparison. People can have struggles without being killed in military duty. Since you were troubled by your commander’s suicide you would think you would be more sensitive to the fact that anxiety, depression, and suicide occur at much higher rates in medical students, residents, and doctors.

 

[RNtoMD87]

Thanks Queen James. I was Army though not marines. I just did what I had to do, the ones who didn't make it back physically or mentally are the ones who deserve all of the praise.

Sunshine he wasn't my commander, he was my IT Sergeant. The point is he wasn't dealing with issues because someone was a big meanie butt to him. It was because he LOST PEOPLE under him, and it drove him down a very dark path. He was guilty over events that weren't his fault. I have been down that same mental road, but I look at the big picture and realize even though I feel like I could've done more, it isn't how life works.

I just wish medical professionals would realize- it's not about YOU. You are a servant- it is about the patients, especially the children, handicapped, and elderly. I'm tired of this need for hand holding and ass kissing. If a surgeon or other attending yells at you, it's probably for a good reason.

It isn't PERSONAL, it's BUSINESS.

 

[RNtoMD87]

Damn.

sorry to hear that homie.

I'm a "civilian" as you marine folks refer to us and I'm not the one to bring up politics or anything, but I honestly wanna say thank you for your service.

You guys have seen, been through, and done some s hit that definitely not everybody can handle man.

This country (despite wtf is going on in politics and the reality TV show that everything is becoming on a daily basis) is blessed to have folks like y'all that make a huge sacrifice and do what you guys are supposed to do... no questions asked.

Major respect.

I'm sure you'll do great in med school bro.

Just keep your head down, do your work, and eff what anybody else has to say.

Keep it up homie!

One thing I'm sure you'll agree with is that life is all about perspective.

Sadly... most of these princesses and brats have been raised by mommy and daddy with a huge frickin' silver spoon..... and the hardest decision they have had to deal with is whether or not to stay at a resort hotel that ONLY has a pool or a chain hotel down the street that also provides free breakfast.

It's people like these that piss me off on a daily basis because they literally think anything and everything is "beneath them".

These are the same students who will literally talk about patients outside of the door and judge them constantly.

Homeless patient who abused drugs before? They'll be like "OMG.. WHY would anybody do that?"

Umm.. idk Princess... maybe because he's been through some crazy crap and didn't live on a golf course with mommy and daddy and went to private schools his whole life and wasn't afforded the right opportunity to be around the same people you were blessed to be around...?

ARGHH... it pisses me off writing about this as I'm typing it.

Long story short man...

Just keep doing your thing.

Being a good, understanding person is a lot more valuable than being a douchebag doc who knows every treatment and fact out of some stupid boards review book.

You're absolutely right. So many nurses i work with are 24-33 and still have mommy and daddy paying all of their bills. I've been on my own since I was 16.

 

[QueenJames]

You're absolutely right. So many nurses i work with are 24-33 and still have mommy and daddy paying all of their bills. I've been on my own since I was 16.

It's all about playing the cards you were dealt.. you feel me?

Keep doing your thing mane!

 

[RNtoMD87]

You too brother. The world needs more doctors like you.

 

[cbrons]

The question in thread title is stupid because neither of those groups should be unsupervised.

 

[762513]

Queen James, in glad I've found Someone who feels the same way and understands what I mean. You've helped me realize a better way to explain.

This isn't a macho contest of who cries or gets upset. It's that when I cry over it, it's because I'm either upset over guilt, or the horror that "wow! I could have cost them their life. How could I be so stupid?!"

Not "oh my god, I made a mistake. How dare you yell at me?"

I STILL tear up thinking "could I have done this?" Or "could I have done that" before I realize how futile and pointless such thinking is.

A little self disclosure- on Jan 30, 2011 I worked my last day as a patrol MP. My IT SGT blew his brains out in front of my motor pool SGT and his wife (it was never fully understood what truly happened suicide vs accident for sure), and I was the first responder on the scene. He was alive for an hour and a half afterwards.

I had JUST seen him down at the company maybe two hours prior that evening, doing some paperwork for a young private who had lost control of her motorcycle an gotten in a bad wreck. It's hard not to play the "I wish I had been there/ done x differently" game. He had been dealing with many demons post our deployment in 2008. I never worked the road after this day and instead worked as an armorer until I got out.

There isn't a day that goes by that I don't think about him and the boys we lost in Iraq. We had a company commander so incompetent, that we toyed many times as a whole unit with the idea of shooting him ourselves, because he was so callous, and even made snide comments about putting us in harms way so he could get his "cookie". He had little care when people died for these BS missions, that he only organized for the purpose of hoping to get attacked to pad his OER. He was finally relieved of command and we got a much better commander who actually took care of his men.

I've seen first hand what happens when these arrogant, sociopathic, ego fueled megalomaniacs are in charge. People die, and they could give two sh**s about it.

If you want to talk to another vet just message me, battle.

 

[RNtoMD87]

If you want to talk to another vet just message me, battle.

Same here man. Gotta look out for one another, most will not.

 

[MedicineZ0Z]

The question in thread title is stupid because neither of those groups should be unsupervised.

Well... I mean I did sort of say that like 20 times this thread. lol. I assumed everyone knew how ridiculous it was for students to be unsupervised. Hence, it's even more ridiculous for a fresh NP to be alone.

 

[762513]

Well... I mean I did sort of say that like 20 times this thread. lol. I assumed everyone knew how ridiculous it was for students to be unsupervised. Hence, it's even more ridiculous for a fresh NP to be alone.

Nah. You said the typical NP, not the fresh NP. Nice revision tho.

 

[RNtoMD87]

Yeah NOONE would ever argue against a new NP practicing independently. I don't know how any nurses honest to themselves could support a new NP being independent

 

[762513]

Yeah NOONE would ever argue against a new NP. I don't know how any nurses honest to themselves could support a new NP being independent

The OP is trying to tell everyone he didn’t say what he said, and is only making himself look more foolish. If he conceded that he phrased his question wrong, the conversation would immediately be over with immediate group consensus, but he can’t do that apparently. Pride, maybe?

 

[rg2o3]

If you want to talk to another vet just message me, battle.

+1

 

[MedicineZ0Z]

Nah. You said the typical NP, not the fresh NP. Nice revision tho.

Shouldn't you technically be ready to go fresh or not? Attending day 1 of the job doesn't have his mistakes forgiven in court and his patient's body certainly won't be forgiving because the attending is "fresh."

 

[dpmd]

Shouldn't you technically be ready to go fresh or not? Attending day 1 of the job doesn't have his mistakes forgiven in court and his patient's body certainly won't be forgiving because the attending is "fresh."

Attending day 1 of the job often still has someone looking over their shoulders (proctoring requirement for procedural specialty, not sure what the medical specialties do)

 

[RNtoMD87]

Attending day 1 of the job often still has someone looking over their shoulders (proctoring requirement for procedural specialty, not sure what the medical specialties do)

NP isn't ready independently no, but they should be ready to work under a physician day one, just like a resident does.

 

[dpmd]

NP isn't ready independently no, but they should be ready to work under a physician day one, just like a resident does.

I can't tell if you are agreeing with me or saying they SHOULD be ready but are somehow not?

 

[RNtoMD87]

I'm saying they should be ready to practice under a physician day one, but why are we comparing day one NPs with residents/attendings?

I'm saying medicinez0z is saying "shouldn't an NP be ready to practice day one?"

Yes they should. But their role is different from an attending. He isn't required to be near perfect like an attending, just like a resident isn't expected to be free from mistakes or lack of knowledge areas.

NPs and physicians, you can't even compare them. Like someone said, if a student doctor should be as "free" in their job as a NP because of their classroom knowledge, a 2 year RN student in a bachelors program should have more freedom than a fresh 1 year LPN graduate. But this is ridiculous. Until the product is finished, it is not ready to be unleashed upon the world.

 

[Goro]

I'm saying they should be ready to practice under a physician day one, but why are we comparing day one NPs with residents/attendings?

I'm saying medicinez0z is saying "shouldn't an NP be ready to practice day one?"

Yes they should. But their role is different from an attending. He isn't required to be near perfect like an attending, just like a resident isn't expected to be free from mistakes or lack of knowledge areas.

NPs and physicians, you can't even compare them. Like someone said, if a student doctor should be as "free" in their job as a NP because of their classroom knowledge, a 2 year RN student in a bachelors program should have more freedom than a fresh 1 year LPN graduate. But this is ridiculous. Until the product is finished, it is not ready to be unleashed upon the world.

I'm beginning to think that a few of the unteachable posters (not you, RNtoMD) in this thread are, like my 15 year old, arguing for the sake of arguing.

 

[MedicineZ0Z]

Attending day 1 of the job often still has someone looking over their shoulders (proctoring requirement for procedural specialty, not sure what the medical specialties do)

NP isn't ready independently no, but they should be ready to work under a physician day one, just like a resident does.

Okay so next natural step of this argument --> NPs shouldnt be unsupervised, and everyone here agrees. So why then, aren't NPs outraged that they keep gaining independent practice rights state by state? And that there's constant ongoing legislation to rid them of any supervision? Shouldn't NPs unify and push back to prevent these laws from passing? Or could it be they secretly think they're just as good and love the ego/income boost.

 

[dpmd]

Okay so next natural step of this argument --> NPs shouldnt be unsupervised, and everyone here agrees. So why then, aren't NPs outraged that they keep gaining independent practice rights state by state? And that there's constant ongoing legislation to rid them of any supervision? Shouldn't NPs unify and push back to prevent these laws from passing? Or could it be they secretly think they're just as good and love the ego/income boost.

Same reason doctors don't lobby to extend med school or limit autonomy during residency or afterward. We prefer to trust the process will keep people safe and would rather police ourselves (perhaps at times not that well) rather than have more rules. So your "natural" next step is pretty unnatural. How much effort do you put into lobbying against independent practice laws?

 

[Perrotfish]

Yes they should. But their role is different from an attending. He isn't required to be near perfect like an attending, just like a resident isn't expected to be free from mistakes or lack of knowledge areas.

The majority of midlevels I have worked with are working a role that is equivalent to an attending physician. They are diagnosing and treating for patients who leave the clinic before a physician reviews their charts. The 'supervision', when it exists, usually does not exceed the rare/random chart reviews that most physicians go through as well. If they are being licensed to practice, and cannot fill that role safely, then their licensing process is unsafe and broken.

The only midlevels I have seen doing a true 'midlevel' job are hospitalist NPs and PAs working with a subspecialty service. They really are in a kind of permanent resident's role: doing the scut of writing notes and doing consults, but a physician does ultimately round on all of their patients every single day. But that's a small percentage of the midlevels I have seen in practice.

 

[RNtoMD87]

Okay so next natural step of this argument --> NPs shouldnt be unsupervised, and everyone here agrees. So why then, aren't NPs outraged that they keep gaining independent practice rights state by state? And that there's constant ongoing legislation to rid them of any supervision? Shouldn't NPs unify and push back to prevent these laws from passing? Or could it be they secretly think they're just as good and love the ego/income boost.

Many NPs are the very ones pushing for independent practice rights. It's the experienced ones that want this ability. I am not experienced enough to even give my opinion on what level of independence an advanced NP should have. I just know that a brand new NP should definitely be watched closely.

 

[RNtoMD87]

The majority of midlevels I have worked with are working a role that is equivalent to an attending physician. They are diagnosing and treating for patients who leave the clinic before a physician reviews their charts. The 'supervision', when it exists, usually does not exceed the rare/random chart reviews that most physicians go through as well. If they are being licensed to practice, and cannot fill that role safely, then their licensing process is unsafe and broken.

The only midlevels I have seen doing a true 'midlevel' job are hospitalist NPs and PAs working with a subspecialty service. They really are in a kind of permanent resident's role: doing the scut of writing notes and doing consults, but a physician does ultimately round on all of their patients every single day. But that's a small percentage of the midlevels I have seen in practice.

As an ICU nurse the only NPs that I have any experience of are CCMS and impress me with their knowledge and confidence, and usually have a CCMS attending available. When I call CCMS, I usually get one of three equally impressive NPs or one of 2 PAs, and the attending is usually busy putting in a chest tube or doing some other procedure. When my patients have been pretty bad off, they both usually come round together when the attending is free. This is why I don't have any problem with the system, based on my personal experience so far.

 

[MedicineZ0Z]

Many NPs are the very ones pushing for independent practice rights. It's the experienced ones that want this ability. I am not experienced enough to even give my opinion on what level of independence an advanced NP should have. I just know that a brand new NP should definitely be watched closely.

And what do independent rights mean? When you push for that - you're literally saying that you're as good as a doctor.

 

[762513]

And what do independent rights mean? When you push for that - you're literally saying that you're as good as a doctor.

Literally no one is talking about an independent NP except you. You keep retreating to that statement to cover your stubbornness in admitting you’ve lost the debate. About 6 people have told you this. I wish someone would lock the thread.

 

[Chibucks15]

I cannot fathom why this thread is still going. This has to be some kind of record

 

[MedicineZ0Z]

Literally no one is talking about an independent NP except you. You keep retreating to that statement to cover your stubbornness in admitting you’ve lost the debate. About 6 people have told you this. I wish someone would lock the thread.

So you oppose what the nursing union is doing aka achieve more and more independency?

This whole midlevel vs. physician thing is a classic case of false equivalency.

 

[RNtoMD87]

So you oppose what the nursing union is doing aka achieve more and more independency?

This whole midlevel vs. physician thing is a classic case of false equivalency.

I agree. They couldn't be more different. But not being equivalent doesn't mean there isn't a reason for NPs to ever function independently.

Should there be a high standard? Yes. Should they need YEARS of experience first? Yes.

But I'd rather patients see a NP/PA rather than not be able to be seen. And especially in rural areas, it can be difficult to be seen. I've experienced this myself. For primary care in my hometown of 1,200 people (called officially a "Village", your only real option for a PCP is a nurse practitioner unless you want to drive 45 mins or so.