You experience with nurse practitioners in [pediatric] hemo oncology?

[Poetic Silence]

I'd like the input of resident physicians and practicing physicians on this subject.

Let me give you a little information on my situation. As of now, I'm entering my second year of pre nursing studies and general education for a bachelors of science with a major in nursing. I'm doing quite well in school and even have my professional rescuer's certification. I help out with first aid and wound care at an inner city homeless shelter. I intend to earn my CNA and CNA2 (acute care) as I work on my studies. The only reason I'm telling you all of this is so that you don't think of me as a total n00b to the world of healthcare. The bottom line is that I intend to work someday down the road in a pediatric hemo oncology unit as both an RN and a NP (PA is still a possibility.)

So here's where you lovely ladies and germs come in. What has been your experience working with NP's in this specialty? Has it been good or bad? Do you feel the NP plays an important role in his or her own right? I understand the collaboration agreements between the NP and the charge physician. Quite frankly, I wouldn't have it any other way. I feel strongly that the collaboration between a NP and his or her charge physician allows the NP to practice to his or her fullest potential. With that said, how involved is the NP in planning patient care? How often do they get to use their prescription authority? How much of a role do they play in the interpretation of Xrays and other diagnostic imaging procedures? What procedures do they routinely perform in this unit? I know of bone marrow aspirations, lumbar pushes, and pre bone marrow transplant cell injections. What else? I can imagine the NP's biggest role is patient education, pre and post surgery follow ups, and other duties of similar nature. I'm all for that.

Answers to my questions and any additional constructive feedback would be highly appreciated.



Thank you for your time,




Poetic Silence

P.S., Mods, if you feel it necessary to move this thread to the pediatrics residency forums, I won't argue. But I feel pediatrics or adults, the general duties would be about the same. Thanks.

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[Poetic Silence]

Now, now, guys. No need to all post at once.

 

[Poetic Silence]

That was like a suicidal teen begging for help at a MyChemicalRomance concert. Of course no one answered me. *Roll eyes*

 

[smq123]

That was like a suicidal teen begging for help at a MyChemicalRomance concert. Of course no one answered me. *Roll eyes*

Maybe it's because you posted a thread about working in PEDIATRIC heme onc in the INTERNAL MEDICINE forums. *Roll eyes*

IM physicians do not see anyone under the age of 18. Most pediatricians only see people under the age of 18 (although exceptions are sometimes made).

Sorry, but the decision to post a question about working in a pediatric subspecialty in the adult medicine forums *does* make me think that you are a total n00b to the world of healthcare.

(And I don't have any personal experience with peds heme-onc NPs so I can't answer your question. My experience with NPs in other fields has been that they do not play a big role in planning patient care, they rarely know how to read their own studies, and they don't do many procedures, leaving those for the attendings and residents. But your attitude and sense of entitlement is getting irritating.)

 

[truth617]

I had replied a few days ago, but my post was deleted by an admin because it had a link for the signature, much like the post above me. To see the work that I put into a post deleted, rather than just the link edited out, leaves a bitter taste. My time is precious enough as it is.

 

[Poetic Silence]

Maybe it's because you posted a thread about working in PEDIATRIC heme onc in the INTERNAL MEDICINE forums. *Roll eyes*

IM physicians do not see anyone under the age of 18. Most pediatricians only see people under the age of 18 (although exceptions are sometimes made).

Sorry, but the decision to post a question about working in a pediatric subspecialty in the adult medicine forums *does* make me think that you are a total n00b to the world of healthcare.

(And I don't have any personal experience with peds heme-onc NPs so I can't answer your question. My experience with NPs in other fields has been that they do not play a big role in planning patient care, they rarely know how to read their own studies, and they don't do many procedures, leaving those for the attendings and residents. But your attitude and sense of entitlement is getting irritating.)

Someone's all high and mighty here, but it isn't me. For your information, the pediatrics subspecialty was optional. All I needed to know could be applied to any adult oncology unit. The key words here are "oncology" and "unit". Pediatrics was only backup information on my preferences.

In the future let's not be difficult.

 

[Poetic Silence]

I had replied a few days ago, but my post was deleted by an admin because it had a link for the signature, much like the post above me. To see the work that I put into a post deleted, rather than just the link edited out, leaves a bitter taste. My time is precious enough as it is.

Reminds me of my time at allnurses. They moderate the crap out of a toilet. Nonetheless, if you'd be so kind as to repost your response and answers to my questions without including what caused your post to be removed, I'd be very grateful.


Thanks,



Poetic Silence

 

[smq123]

Someone's all high and mighty here, but it isn't me. For your information, the pediatrics subspecialty was optional. All I needed to know could be applied to any adult oncology unit. The key words here are "oncology" and "unit". Pediatrics was only backup information on my preferences.

In the future let's not be difficult.

No, it's not only an optional piece of information.

For your information, NPs in different fields and different settings tend to have different responsibilities. Heck, even NPs in different hospitals tend to have different responsibilities!

For all you know, a pediatric NP, even in an onc unit, may have completely different responsibilities from an IM NP in an onc unit.

 

[Poetic Silence]

No, it's not only an optional piece of information.

For your information, NPs in different fields and different settings tend to have different responsibilities. Heck, even NPs in different hospitals tend to have different responsibilities!

For all you know, a pediatric NP, even in an onc unit, may have completely different responsibilities from an IM NP in an onc unit.

If you're going to be difficult I'll simply agree with you in hopes you'll calm down.

 

[VanDiemen]

There are pretty big differences between peds onc and adult onc:

1. The number of children who need to see heme/oncs is WAY smaller than the number of adults who do.

2. In peds, the overall five year survival rate is much higher than it is in adult onc.

3. Peds Onc, as far as I know, is only practiced in large tertiary care centers by academic physicians. Adult onc work can be found in community hospitals as well as academic centers.

As for your question, sorry that no has helped yet. I'm just a med student, but from what I've seen on rotations the NPs do have quite an important role. I have never seen any of them utilizing their prescribing authority, however.

Here are a couple of links to published articles about the role of NPs in oncology:

http://jop.ascopubs.org/content/6/1/2.full

http://www.communityoncology.net/journal/articles/0203218.pdf

This is actually a pretty hot topic nowadays for some oncs.

 

[Tarabara]

I'm sorry but being a PRE-nursing student who PLANS on getting a CNA license doesn't make you 'seasoned' in the health care field. you are a noob. which is fine we all start somewhere but I think you should think before calling others 'high and mighty'. I'm also confused as to why you're inquiring about the role of a NP on a doctor forum. Sure doctors may work with them but wouldn't it be best to ask an actual NP?

 

[staup]

What an NP or PA does day to day is very dependent on the practice setting and place of work. I have seen emergency, IM, and surgery NPs and PAs do everything: almost all major decision making, all procedures, and just present to an attending when all the data and/or final diagnosis is there. I have also NPs and PAs function as glorified medical students who are just super helpers. I have also seen NPs function in a primary care setting and never speak to an attending all day.

It is widely variable, and not super consistent in specialties from place to place.

In other words, I have seen NPs and PAs do everything you can imagine to very little. There is no consistent work model to follow. They help an attending do their job, and in some cases, do 99% of the job themselves.

As a final example, in my hospital, a hospitalist NP functions under an attending and speaks to the attending about patients every day, but the attending is never required to actually see the patient unless it is on the admission day for a patient. Some attendings see every patient every day, some attendings only see sick patients when needed, but unless it's the admission day, the NP can function and bill pretty independently.

 

[Paseo Del Norte]

Hey poetic, you do realise "paediatric" is part of the title of this thread? While I'm not the brightest bulb, the probability that there is in fact a profound difference between paed and adult appears to be rather high to me.

Regardless, this appears to be an overall fail as there is an entire section on this site dedicated to NP's, PA's and so on.

Also, pissing off a mod who correctly calls you out may not be the brightest thing to do. Unless you planned on a short tenure...