Should I fear the growing number of NPs?

[Prncssbuttercup]

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I have no idea what was posted, I was referring to the posts just before my wtf? Post... Anyway, I don't think nurses are incompetent, but I do think that some of the training could be improved and there should be more standardization. About the inappropriate comments, they have no place in any work place. Not just in medicine...

 

[Prncssbuttercup]

I am mobile right now, so I can't see what it is... I guess for me it depends on the context. I also think if it is 'bad' you can always report the post...

 

[DocEspana]

See, okay. This is the type of thing that makes me want to vomit. Perhaps it's that my wife is a nurse, so every time I see someone make sexual and misogynistic comments about nurses on these forums, I just imagine that you're making them about my super hot wife, and so I get really defensive as I'm a man and that's my woman and I imagine you checking out her ass. I will give you that. BUT, SEXISM and MISOGYNY have no place in medicine. No place at all. 1) Nurses are people. They are not objects for your sexual fantasy or for your groping pleasure. 2) Many of them are actually NOT hot. Many of them are quite old and obese, with mustaches. 3) 95% of RN's would rather cut off their own arm than see your genitals. This according to my wife, who would definitely report any MD/DO/med student who hit on her. So, let's stop this woman-hating nurses-are-only-good-for-T&A fest. OK? Thanks.

Also, about the stethoscope. You may not be aware of this, but on the Littman Cardiology III, the "bell" that you refer to has multiple interchangeable heads to it. You can switch out the "bell" for a pediatric diaphragm. Bam! You've got an adult stethoscope and a pediatric stethoscope in one. 😱 Shocking, yes. But true story.

Its the second image that comes up when you google search "nurses." You explained your gut reaction well, but my comment was neither misogynist as i clearly dont hate women (misogyny is an *incredibly* misused term), sexist as it never implied nurses are inherently women nor dismissed them for such, nor judgemental at all beyond the fact that I wanted to point out this was the second hit on google images for the totally non-descript term of 'nurses.'

On the other half, I'm totally aware of the cardiology III and the ability to turn the pre-equipped pediatric diaphragm into a bell. 😉 Perhaps my knowledge of which one it comes pre-equipped with shows you how well i do know it. My point was that nurses dont need that $250 stethscope. And i was very clear with that. I'm not sure what you were getting at with your comment. But the cardiology III is $230-280 more expensive than any stethoscope a nurse ever needs unless they work on, and only on, cardiology patients. Why the google image search also showed so many nurses with cardiology III's blew my mind since one look at a real life hospital shows that nurses aren't going to be carrying around a cardiology III (or II or any such stethoscope with a bell) since the nurse stethoscope (yes thats its proper name) is $12 for adult size and $20 for adult and child interchangeable diaphragms.

P.S. I understand your defensiveness, but dont assume that because i posted a picture where the nurses are not wearing hospital issue clothing means I'm perpetuating anything other than humor at how absurd the top hits on google images is

P.P.S.: BAM! (sorry. I'm juvenile when someone does something silly like that, i'm gonna get echolalia)

 

[JaggerPlate]

SEXISM and MISOGYNY have no place in medicine. No place at all. 1) Nurses are people. They are not objects for your sexual fantasy or for your groping pleasure.

What? Did anyone else know about it??? Final straw - camel's back broken, I'm doneski.

If I can't roll into an ICU, open velvet shirt, mustache flowing, and slap SOMEONE's ass amidst a see of winks and giggles, then WHAT has this whole thing been about???!!????

2) Many of them are actually NOT hot. Many of them are quite old and obese, with mustaches.

Confused, I thought you said they WEREN'T hot???

95% of RN's would rather cut off their own arm than see your genitals.

PROVE IT!!!!

Also, about the stethoscope. You may not be aware of this, but on the Littman Cardiology III, the "bell" that you refer to has multiple interchangeable heads to it. You can switch out the "bell" for a pediatric diaphragm. Bam! You've got an adult stethoscope and a pediatric stethoscope in one. 😱 Shocking, yes. But true story.

The bell changessss? Does it come with an instruction pamphlet? Whaaaa???


Happy April Fool's Runner.

 

[Prncssbuttercup]

That's funny... Do I get to slap male nurses on the ass too? That way it goes both ways... 😛 😉

 

[emjayel]

BUT, SEXISM and MISOGYNY have no place in medicine. No place at all. 1) Nurses are people. They are not objects for your sexual fantasy or for your groping pleasure.

Damn. Well I'm out. Guess I'll be switching over to dentistry for the hygienists




I kid, I kid.

 

[JaggerPlate]

That's funny... Do I get to slap male nurses on the ass too? That way it goes both ways... 😛 😉

Only if you grunt and 'cat call' when you do it.

 

[calvinhobbes]

I'm someone who wants to go into IM and now won't be starting medical school until 2013, but all throughout these forums are concerns that the growing number of NPs will significantly stifle the growth of Internal Medicine positions. Some, however, point out that with growing retired populations, as well as the addition of 30 million new patients to the ranks of the insured, that this will create significant demand that necessitates the growing number of NPs and expanding Physician classes. Additionally, many docs will be retiring by 2020, but I just wanted to see what you guys' opinions are.

As someone who is in the health care field currently, I know the situation.

The NP's will replace the FAMILY Medicine docs, not the IM's, because they are cheaper to higher by hospitals.

Don't even get me started on the DNP or whatever that doctorate for nursing degree is. 🙄

 

[JaggerPlate]

As someone who is in the health care field currently, I know the situation.

The NP's will replace the FAMILY Medicine docs, not the IM's, because they are cheaper to higher by hospitals.

Don't even get me started on the DNP or whatever that doctorate for nursing degree is. 🙄

Just curious, are you planning on going into IM?

 

[StudyShy]

I was in nurse midwifery school last fall, and I can tell you it was a joke. They had open book exams and group papers. They taught from day one that doctors are essentially evil and that they hurt women by doing unnecesary procedures and interventions. They also taught at orientation that they are better than physicians. It is true that they view themselves slightly different from other "mid-level" nursing groups. They become highly offended if you call a CNM mid-level as I had done without even knowing that was taboo.

Should we be afraid of nursing groups? Heck yeah. Nurse practitioner degrees are everywhere. A lot of them are online. They are relatively easy and quick to get through. Anyone can become an NP. All you have to know is APA and even that is challenging to most of them.

The Runner's wife seems intelligent, and I'm not trying to disrespect you. Physicians have their own list of downfalls.

 

[StudyShy]

Where were you in Nurse Midwifery school, if you don't mind me asking? Very curious. 😉 You can PM me if you want. Schools with open book exams should lose their accreditation. No excuse.

and group papers. Yep, I'll PM you.

 

[StudyShy]

Very true. But, unlike a workplace, this forum is littered with misogynistic comments about nurses- and no one ever calls anyone else out on it. That's one of the first things I noticed about SDN- the misogyny. And I was really perplexed by it because I would think that there are enough women on this forum to get a little PO'ed about it, but apparently no one cares. But for me, a modern man who recognizes women as existing for more than merely my sexual pleasure, it's truly disgusting. Just my 2 cents. 😉

I think it is more that those on SDN view nurses as miles below them. Even the females in th forum have this view so they go along with it even though they should probably defend themselves more.

Fortunately, I do not really see this IRL in the hospital setting. Nurses and physicians get along fairly well. Hell, some of the physicians forgo their free lunch in the lounge to eat lunch with the lowly social workers and case managers.

 

[JaggerPlate]

I was in nurse midwifery school last fall, and I can tell you it was a joke. They had open book exams and group papers. They taught from day one that doctors are essentially evil and that they hurt women by doing unnecesary procedures and interventions. They also taught at orientation that they are better than physicians. It is true that they view themselves slightly different from other "mid-level" nursing groups. They become highly offended if you call a CNM mid-level as I had done without even knowing that was taboo.

Should we be afraid of nursing groups? Heck yeah. Nurse practitioner degrees are everywhere. A lot of them are online. They are relatively easy and quick to get through. Anyone can become an NP. All you have to know is APA and even that is challenging to most of them.

The Runner's wife seems intelligent, and I'm not trying to disrespect you. Physicians have their own list of downfalls.

Thank you for essentially confirming my suspicions 100%.

 

[Prncssbuttercup]

I don't see nurses as beneath me, what I think is beneath me is the education. I have a BS in biotechnology, it requires everything 'premed' (advanced A/P, ochem, 1 full year of gen chem, biochem, physics, & calc, + histology, pharma, parasitology, and immunology). I have seen the nursing curriculum for BSNs, it requires 200/2000 level A/P, not 400/4000, and none of the rest. So, they take pharma, and have no real understanding of the physiological principles at work. Then, they treat me as if I'm the one with inferior intelligence because THEY are a nurse, and I work in biotech. They also want to treat docs as if they know nothing, when inherently even in my undergrad education I had more medical classroom training than they did. I said this before, the 200/2000 level A/P is the ONLY A/P they'll ever have, and as an NP they are in charge of peoples health. Additionally, biochemistry is never required even to get an NP, so they are RXing drugs which they have no physiological/biochemical understanding of.... But I am the one with the inferior education??? The AA RN who freaked out that we all hated her and thought less of her because she has an AA, or whatever her reason was should know, is that sorry, but you aren't inferior as a person, but your education is inferior to people with BS/MS/MD/DO/PhDs. So it isn't that I think nurses are inferior because that is a personal judgment, I think the training is inferior to be in charge of peoples lives....

 

[Prncssbuttercup]

Yes, BUT, like I said, you can't put all of them in "boxes". Once again, my wife graduated with a B.S. in Biology from a top notch state school with a very respectable and DO worthy GPA. There are many reasons why some people choose to go the path of NP or CNM. There are some very intelligent and very well educated CNM's out there.

I challenge anyone on this thread to listen to this podcast from the Academic OB/GYN: http://academicobgyn.files.wordpress.com/2011/02/gyn-31.m4a

This woman is a CNM. And she's one of the leading researchers in delayed cord clamping in the US, which is a major thing right now in the OB/Neonatal world. Listen and weep your tears of shame.

And your wife (and this woman) may be the exception, not the rule, or she may be like 50% of the rest, I am not sure. Your wife isn't the one in question, but there are some (like my friend who is a psych NP, and the one getting the Ortho NP) who didn't have a college biology degree (both had previous non-science degrees, the psych turned it into a BSN, the ortho got an AA and is now getting a MSN)...

I have skimmed over the research on delayed cord clamping, I am friends on FB (yes I said that) with two doulas, they post stuff all the time about the benefits of it. However, when I looked into it, there are still pros/cons to doing it. If done improperly, it can be very detrimental, and it greatly increases the risk of jaundice, but it does provide additional red blood cells and additional nutrients, potentially making the child more resilient in the early days of life. I'm going to stick with the WHO studies and say the jury is still out on this one...

 

[StudyShy]

Yes, BUT, like I said, you can't put all of them in "boxes". Once again, my wife graduated with a B.S. in Biology from a top notch state school with a very respectable and DO worthy GPA. There are many reasons why some people choose to go the path of NP or CNM. There are some very intelligent and very well educated CNM's out there.

I challenge anyone on this thread to listen to this podcast from the Academic OB/GYN: http://academicobgyn.files.wordpress.com/2011/02/gyn-31.m4a

This woman is a CNM. And she's one of the leading researchers in delayed cord clamping in the US, which is a major thing right now in the OB/Neonatal world. Listen and weep your tears of shame.

I love academic OB/GYN! 😍

 

[Prncssbuttercup]

Hyperbilirubinemia and clinically significant jaundice represent two separate diagnosis. This is an important distinction.

Curious as to what you mean by "done improperly"? Are you referring to holding the baby above the level of the placenta? The idea of the baby transfusing the placenta is a myth. It's essentially impossible for this to happen due to the physiological processes in the cord after the birth. The muscular outer layer of the umbilical arteries spasm after the birth due to being outside of the warm womb. This shuts off blood flow in the umbilical arteries, thereby preventing backflow.

You might be interested to know that the WHO's definition of "early clamping" is somewhat different from the definition of "early clamping" used here in the US. In fact, the WHO advocates waiting at least 30 seconds to cut the cord. Studies here:

http://apps.who.int/rhl/pregnancy_childbirth/childbirth/3rd_stage/cd004074_abalose_com/en/index.html
http://apps.who.int/rhl/pregnancy_childbirth/childbirth/3rd_stage/jccom/en/index.html
http://apps.who.int/rhl/pregnancy_childbirth/childbirth/3rd_stage/jcguide/en/index.html
http://apps.who.int/rhl/pregnancy_childbirth/childbirth/3rd_stage/cd003248/en/index.html

Also of reference would be the editorial and study in the February edition of the Green Journal. If you have access to this edition, the page numbers are p. 203-204 for the editorial and p. 205-211 for the study. Interesting quote: "Delayed clamping of the umbilical cord has been known for decades to confer benefit to term infants by increasing their hemoglobin mass and iron endowment with no apparent adverse effects, except a modest increase in hyperbilirubinemia."

ETA: That would be the February 2011 edition, sorry. And by the "Green Journal" I mean "Obstetrics and Gynecology", the official journal of ACOG. If anyone would like a copy of the articles in question, feel free to PM me.

I guess I'm not thinking above the mother, but below. I was trained that the infant being too low is worse, that they can have too much blood pushed into their system, causing distention/distension. That may however be the point. As an EMT I remember being taught that 30sec-2min is the 'normal' amount of time to clamp a cord. So I guess that was my assumption on the WHO study, and that longer than 2 min would be considered "delayed" cord clamping... About the bilirubin vs jaundice, the studies I found specifically stated Jaundice, and that the infants were treated with UV light exposure. I was at work, and it was several weeks ago, so I can't tell you what the sources were... sorry 😳 but, I'm sticking with my answer, some kids it's a wonderful thing, others it may not have been the best... I have seen for preemies that it is usually a greater benefit than harm, and I'm all for those little guys getting any help they can...

 

[Prncssbuttercup]

I had a feeling it was so... Suddenly he seemed to know an awful lot about having babies 😉 hehe, You could do what Edlongshanks wife did, and start your own account as MrsTheRunner 😉