NPs attack Physicians

[Taurus]

ACNP STRATEGIC PLAN

Adopted February 2005

MISSION

TO ENSURE A SOLID POLICY AND REGULATORY FOUNDATION THAT ENABLES NURSE PRACTITIONERS TO CONTINUE PROVIDING ACCESSIBLE, HIGH QUALITY HEALTHCARE.


CORE VALUES

WE BELIEVE THAT:

- NURSE PRACTITIONERS HAVE THE ABILITY AND RESPONSIBILITY TO POSITIVELY INFLUENCE HEALTH POLICY.
- THE CARE OF INDIVIDUALS, FAMILIES, AND COMMUNITIES IS THE FOUNDATION OF OUR NURSING PROFESSION.
- NURSE PRACTITIONERS PROVIDE HIGH QUALITY, COST-EFFECTIVE CARE.
- INTERDISCIPLINARY NON-HIERARCHICAL TEAM CARE IS THE HIGHEST QUALITY OF CARE.
- ORGANIZATIONAL COLLABORATION AND INCLUSIVENESS IS ESSENTIAL.

VISION

NURSE PRACTITIONERS WILL BE ABLE TO PRACTICE TO THEIR FULL CAPACITY AND WILL BE VITAL AND INDISPENSABLE TO QUALITY HEALTHCARE.

OUTCOMES

- NURSE PRACTITIONERS WILL BE RECOGNIZED AS VITAL AND INDISPENSABLE TO QUALITY HEALTHCARE.
- NURSE PRACTITIONERS WILL HAVE A NATIONALLY RECOGNIZED SCOPE OF PRACTICE AND WILL BE EQUITABLY PAID FOR THEIR SERVICES. THEY WILL BE PRACTICING WITHOUT RESTRICTION IN EVERY SECTOR OF HEALTHCARE DELIVERY.
- THE PUBLIC WILL BE FULLY AWARE OF THE VALUE OF NURSE PRACTITIONERS. CONSUMERS WILL DEMAND AND OBTAIN DIRECT ACCESS TO CARE FROM NURSE PRACTITIONERS IN ALL AREAS OF THE COUNTRY.
- EVIDENCE WILL UNQUESTIONABLY DEMONSTRATE THAT PATIENT OUTCOMES IMPROVE WHEN CARE IS PROVIDED BY NURSE PRACTITIONERS.
- NURSE PRACTITIONERS WILL BE KEY POLICY DECISION-MAKERS IN TRANSFORMING HEALTHCARE.
- ACNP WILL BE THE NATIONALLY RECOGNIZED LEADER IN PUBLIC POLICY ISSUES FOR NURSE PRACTITIONERS, WITH EMINENT INFLUENCE ON POLICY FORMULATION.
- NURSE PRACTITIONERS WILL BE ABLE TO PRACTICE ANYWHERE IN THE UNITED STATES, SO THERE WILL BE NO BARRIERS ACROSS STATES.
- ADVANCED PRACTICE NURSES WILL EXPAND THEIR INFLUENCE IN THE HEALTH POLICY ARENA THROUGH GREATER COLLABORATION; SPEAKING AS A COLLECTIVE VOICE.
- ALL STATES WILL USE SAME CREDENTIALS/TITLE.

OUTCOME ORIENTED GOALS

- PUBLIC POLICY- ACNP WILL HAVE THE CAPACITY TO IMPACT POLICY AND REGULATION AFFECTING NURSE PRACTITIONER PRACTICE.
- HEALTHCARE INDUSTRY INFLUENCE- ACNP WILL BE RECOGNIZED AS AN ESSENTIAL PARTICIPANT IN DIALOGUE ON HEALTHCARE ISSUES.
- LEADERSHIP AND EMPOWERMENT- NURSE PRACTITIONERS WILL HAVE THE CAPACITY AND EXPERTISE TO INFLUENCE POLICY AT ALL LEVELS.
- KNOWLEDGE SOURCE- ACNP WILL BE A LEADER AND PREFERRED PARTNER IN EXPANDING, DISSEMINATING AND TRANSLATING KNOWLEDGE ABOUT NURSE PRACTITIONER ISSUES.
- ORGANIZATION - ACNP WILL HAVE EFFECTIVE STRUCTURES, PROCESSES, RESOURCES, AND CULTURE TO ACCOMPLISH ITS VISION.

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[pancakesyrup]

Nurse practitioners are useful, but to demand full practicing rights goes a bit too far. After all, they never went to medical school or spent several years in an 80 hr/week residency, so I'm not so sure if they should work without supervision by a physician.

 

[oldManDO2009]

Doctors do not need to do anything but not sign collaborative agreements that put their name on the chart. NPs will fall on their own sword with all of this "we are more holistic nonsense". When they have to see 20-30 (ED) patents per shift with every possible problem and start getting sued left and right with ever increasing malpractice rates and fewer policy options it will be clear that they are not as independent as they claim. All this we are "cheaper to hire", and "spend more time with patients" nonsense just illustrates they do not see the volume of patients I see and nor do those patient's have the complexity.

Any time you want to see the comatose 30 year old hypotensive patient with a failed airway step on up and you can have that train wreck and I will go see the 25 yo female URI (which is really a PE). I am an ED resident an America's new primary care doctor – I would welcome you into my cesspool but when I read comments like this I find it discouraging. I am all about sharing the pain and there is plenty of pain for everyone but I know my place in medicine am I am quick to call a sub-specialist (when appropriate) do not order unnecessary test because it delays my disposition and there are 30 more in the waiting room pissed they have to wait to see a doctor or PA.

I finally know what I don't know and it scare the crap out of me. I shuffle through dozens or routine patients a day and get lulled in to complacency and think I got this and then I get a train wreck and I am quickly reminded that their life is in my hands and I sometimes would like to be elsewhere but we take all comers and I have learned to accept the rotten hours, over whelming tidal wave of patient, and the need to make sure everyone is "happy" and I completed all of my greeting task and all the rest of the minutia so I can get down to business and either piss off the hospitalist or discharge that missed "something"

You want independence then have at it, good luck, but do not expect me to come save you when you are overwhelmed or unsure what to do next. When I graduate one day, no one and I mean no one is coming to save me; they don't want their name on the chart so don't expect it from me. If you work with me then that is a different story and we are in the same sinking boat and we can bail it out together

Why is NP insurance so expensive?
Nurse practitioner premiums should not be considered unusually expensive when you take into account the scope of practice for an NP and the current average premium, and compare them to the NP's counterparts (e.g., a Physician Assistant in Philadelphia County at $7,561; a Physician Assistant in West Virginia at $4,830; a Family Physician in Illinois at $16,000). The premiums charged to NPs are significantly less than the premium charged to healthcare professionals who have very have similar client bases and risk exposures.

Why are NP rates going up?
Nurse Practitioners are being held legally accountable to their scope of practice and now face greater malpractice exposure than ever before, especially in two key areas:
1. Diagnostic Responsibilities - Today a great number of NPs are able to work in a collaborative agreement instead of working for a physician in a complementary role.
2. Prescriptive Authority - Today NPs can prescribe under their own signature in most states.
With the number and severity of claims against NPs on the rise, rates need to change in order to address two important points: first, the exposure to risk that the class represents and second, the yield of financial return so that the program can sustain itself.

Nurses once were, for the most part, outsiders in the physician-led fight to reduce malpractice insurance rates. Sheltered no more, nurse practitioners are finding their annual malpractice costs tripling, nurse-midwives are facing annual premiums as high as $35,000, and only one company is willing to write policies for nurse anesthetists, says Janet Selway, RN, DNSc, CRNP, instructor at Johns Hopkins University School of Nursing, Baltimore.
http://www.nurseweek.com/news/Features/05-03/Malpractice.asp

Analysis of frequency and severity by allegation category
As noted in Table 10, claims occurred most frequently in the three
allegation categories of diagnosis, treatment, and medication. These
top three categories accounted for 81.6 percent of the total claim
allegations. The data indicates that 44.7 percent of the allegations
were included in the diagnosis category. The prevalence of claims
in this category reflects an environment in which nurse practitioners
may be held responsible for the determination of patient diagnosis.
http://www.cna.com/vcm_content/CNA/...cal Services/NursePractitionerClaimsStudy.pdf

 

[unhappyrnstudnt]

ACNP STRATEGIC PLAN

Adopted February 2005

MISSION

TO ENSURE A SOLID POLICY AND REGULATORY FOUNDATION THAT ENABLES NURSE PRACTITIONERS TO CONTINUE PROVIDING ACCESSIBLE, HIGH QUALITY HEALTHCARE.


CORE VALUES

WE BELIEVE THAT:

- NURSE PRACTITIONERS HAVE THE ABILITY AND RESPONSIBILITY TO POSITIVELY INFLUENCE HEALTH POLICY.
- THE CARE OF INDIVIDUALS, FAMILIES, AND COMMUNITIES IS THE FOUNDATION OF OUR NURSING PROFESSION.
- NURSE PRACTITIONERS PROVIDE HIGH QUALITY, COST-EFFECTIVE CARE.
- INTERDISCIPLINARY NON-HIERARCHICAL TEAM CARE IS THE HIGHEST QUALITY OF CARE.
- ORGANIZATIONAL COLLABORATION AND INCLUSIVENESS IS ESSENTIAL.

VISION

NURSE PRACTITIONERS WILL BE ABLE TO PRACTICE TO THEIR FULL CAPACITY AND WILL BE VITAL AND INDISPENSABLE TO QUALITY HEALTHCARE.

OUTCOMES

- NURSE PRACTITIONERS WILL BE RECOGNIZED AS VITAL AND INDISPENSABLE TO QUALITY HEALTHCARE.
- NURSE PRACTITIONERS WILL HAVE A NATIONALLY RECOGNIZED SCOPE OF PRACTICE AND WILL BE EQUITABLY PAID FOR THEIR SERVICES. THEY WILL BE PRACTICING WITHOUT RESTRICTION IN EVERY SECTOR OF HEALTHCARE DELIVERY.
- THE PUBLIC WILL BE FULLY AWARE OF THE VALUE OF NURSE PRACTITIONERS. CONSUMERS WILL DEMAND AND OBTAIN DIRECT ACCESS TO CARE FROM NURSE PRACTITIONERS IN ALL AREAS OF THE COUNTRY.
- EVIDENCE WILL UNQUESTIONABLY DEMONSTRATE THAT PATIENT OUTCOMES IMPROVE WHEN CARE IS PROVIDED BY NURSE PRACTITIONERS.
- NURSE PRACTITIONERS WILL BE KEY POLICY DECISION-MAKERS IN TRANSFORMING HEALTHCARE.
- ACNP WILL BE THE NATIONALLY RECOGNIZED LEADER IN PUBLIC POLICY ISSUES FOR NURSE PRACTITIONERS, WITH EMINENT INFLUENCE ON POLICY FORMULATION.
- NURSE PRACTITIONERS WILL BE ABLE TO PRACTICE ANYWHERE IN THE UNITED STATES, SO THERE WILL BE NO BARRIERS ACROSS STATES.
- ADVANCED PRACTICE NURSES WILL EXPAND THEIR INFLUENCE IN THE HEALTH POLICY ARENA THROUGH GREATER COLLABORATION; SPEAKING AS A COLLECTIVE VOICE.
- ALL STATES WILL USE SAME CREDENTIALS/TITLE.

OUTCOME ORIENTED GOALS

- PUBLIC POLICY- ACNP WILL HAVE THE CAPACITY TO IMPACT POLICY AND REGULATION AFFECTING NURSE PRACTITIONER PRACTICE.
- HEALTHCARE INDUSTRY INFLUENCE- ACNP WILL BE RECOGNIZED AS AN ESSENTIAL PARTICIPANT IN DIALOGUE ON HEALTHCARE ISSUES.
- LEADERSHIP AND EMPOWERMENT- NURSE PRACTITIONERS WILL HAVE THE CAPACITY AND EXPERTISE TO INFLUENCE POLICY AT ALL LEVELS.
- KNOWLEDGE SOURCE- ACNP WILL BE A LEADER AND PREFERRED PARTNER IN EXPANDING, DISSEMINATING AND TRANSLATING KNOWLEDGE ABOUT NURSE PRACTITIONER ISSUES.
- ORGANIZATION - ACNP WILL HAVE EFFECTIVE STRUCTURES, PROCESSES, RESOURCES, AND CULTURE TO ACCOMPLISH ITS VISION.

Nurse practitioners are useful, but to demand full practicing rights goes a bit too far. After all, they never went to medical school or spent several years in an 80 hr/week residency, so I'm not so sure if they should work without supervision by a physician.

This NP statement is misleading (not the OP...the actual statement). Maybe manipulative is a better word? Can't phrase what I'm thinking, but I'm gonna explain anyway. The first practice rights declaration states "Nurse practitioners will be able to practice to their full capacity." This sounds like a nice statement, assuming it actually means what it sets forth at face value. Nurses have their own scope of practice, which is NOT medical (duh). A nurse practitioner, being an advanced nurse, would hypothetically have extensive experience/practice/knowledge WITHIN THAT MODEL. That should also include not assuming duties that go beyond what the nursing science education is limited to. If NPs behaved in the manner of staying within their profession and scope of practice, I could find this statement understandable.

The problem (and the misleading part - if you don't read closely, you won't catch the two sides) is a statement in the outcomes section. The goal regarding their practice rights is "nurse practitioners will be practicing without restriction in every sector of healthcare delivery." Um, what? If they were to stay within their own scope of practice, that would be fine. But with NPs pushing so hard to have more prescribing powers and more duties of an MD, though WITHOUT the education, I don't trust this statement AT ALL. I think the very nature of nurses being "caring" (which is supposedly their primary function) makes the group a target for patients pulling the wool over their eyes. If they did have full prescribing power, how would they be able to say no to anyone crying for pain medicine? In my nursing school (not sure about any other RN school or medical school) we are taught that while not completely standardized, we should for all intensive purposes consider pain to be the 5th vital sign and ALWAYS ask patients their level of pain during our initial assessment. I tried to ask how the professors handled addicts, and every single one of them cut the conversation very short with "if the patient is in pain, you MUST get them pain medication." I get the impression that I'm supposed to believe the statement "I'm in pain" is true in the case of addicts, maybe due to detox. I don't know. But I have had very close personal experience with addicts (not myself - Xbox is my drug of choice, lol) to know that they will go to any length to get the drug they are looking for. They become skilled actors/manipulators. These people will spot a cushy, sappy kind of person from miles away and feed off of them. Nurses have that extra sappiness that could really screw a lot of people over if they are given restriction-free practice rights.

Oh, not to mention, I don't want a nurse ANYWHERE near me with a scalpel. I used to see NPs at my PCP, but never again. Since the start of school, I trust them less every day. Oh! Also think about neurology. Pretty much all of these are severe. Nurses definitely don't have the scientific background to definitely contribute to the neurology field! WTF.

 

[zenman]

Hospitals increasingly use NPs to meet patient demand
The shortage of primary care providers, limits on the work hours of medical residents, a surge of baby boomers and an expansion of coverage under the health care law are driving hospitals across the U.S. to rely more on advanced practice nurses, experts said. In Ohio, Akron Children's Hospital set up a resource center to oversee recruitment, orientation and training of advanced-practice providers, while the Cleveland Clinic system built a low-acuity, patient-centered clinic staffed by advanced-practice providers. Akron Beacon Journal (Ohio) (10/30"

These hard cold facts make it difficult for anyone to throw NP's under the bus. My malpractice insurance, if I had to pay it myself, runs a few dollars over $1,000 a year. I work in an independent practice state. My clinic supervisor stopped meeting with me after a few visits as we thought alike in our treatment of patients. However, I have no problem stepping the 6 feet or so into the psychiatrist's office next to mine and chatting about a patient. Most of the time we think alike or he can think of nothing else to do. And this weekend I interviewed at a hospital that wants to add a mid-level. I also get so many job offers it clogs up my email. I think some of you hard core guys are just butting your heads against the wall...which not only hurts but is a waste of your valuable time that could perhaps be better spent with patients.

 

[unhappyrnstudnt]

Hospitals increasingly use NPs to meet patient demand
The shortage of primary care providers, limits on the work hours of medical residents, a surge of baby boomers and an expansion of coverage under the health care law are driving hospitals across the U.S. to rely more on advanced practice nurses, experts said. In Ohio, Akron Children's Hospital set up a resource center to oversee recruitment, orientation and training of advanced-practice providers, while the Cleveland Clinic system built a low-acuity, patient-centered clinic staffed by advanced-practice providers. Akron Beacon Journal (Ohio) (10/30"

These hard cold facts make it difficult for anyone to throw NP's under the bus. My malpractice insurance, if I had to pay it myself, runs a few dollars over $1,000 a year. I work in an independent practice state. My clinic supervisor stopped meeting with me after a few visits as we thought alike in our treatment of patients. However, I have no problem stepping the 6 feet or so into the psychiatrist's office next to mine and chatting about a patient. Most of the time we think alike or he can think of nothing else to do. And this weekend I interviewed at a hospital that wants to add a mid-level. I also get so many job offers it clogs up my email. I think some of you hard core guys are just butting your heads against the wall...which not only hurts but is a waste of your valuable time that could perhaps be better spent with patients.

It's not that NPs exist, but their increased demand for wider advanced practice responsibilities without a standardized DNP education requirements. What I have said in prior posts has been in part an emotional manifestation of my frustrations with my educational institution and faculty. While I still firmly stand by NPs needing to reign in the demand for more responsibilities and use of the title "doctor," that is not to say advanced practice nurses are useless.

I also firmly stand by the idea that DNP education needs restructured. Or just structured. Maybe some programs require more extensive coursework is physiology/pathophysiology/etc, but I don't think that's all programs. Extending responsibilities to the profession as a whole assumes that the profession as a whole is qualified for them. And truthfully, online programs are not demanding enough to qualify extended responsibilities.

My nursing professors have repeatedly told us our knowledge will increase most dramatically once we get into clinicals and in practice. While this may be the case, it is not a valid reason for glazing over information without a giving any kind of clue to what's important and what's not. It's an attitude of "learn by doing," which is discomforting to me. I understand that medicine in general is very much "practice" and action oriented in the clinical setting, but the lack of focus on why we are doing certain things concerns me. Like breath sounds, for example. We quickly glazed through these once in lecture, with no explanation of what the sounds clinically indicate/signify. Our clinical instructors (a different set of nurses from the lecture faculty) started quizzing us on the sounds a week later, after we are told not to worry about the breath sounds (we were told we could "fake it" during our physical assessment check-offs). A few weeks later, we review them once more, though again with no explanation of indication...and again later being questioned on the sounds in lab. And while I don't have a problem with anything in the chapter being fair game, the professors aren't consistent with when to follow the book, when to follow the lectures, and what their idea of "the best answer" among a set of multiple choice answers are. So my physical assessment grade came with a "student needs to build confidence" side note, which honestly really pisses me off. Lectures build no base for understanding/practice due to the lack of consistency, so of course I won't be confident. And I'd follow the book, but the book has it's own problems. Not only is the physiology fluffy and uninformative, but the information is disjointed. Not to mention the insane amount of typos (not just spelling errors, such as a 'z' in place of 's,' but things like "antacids increase stomach acid").

From what I've read, this is common among many nursing programs. I think part of the problem is that nursing professors aren't paid at all what they can make as an RN, so it's either a side gig for a lot of them and/or the good ones are just really freakin' hard to find.

So yeah...it would be easier to have a little more respect for NPs if the education proved they could handle the things they demand, but it doesn't.

 

[zenman]

It's not that NPs exist, but their increased demand for wider advanced practice responsibilities without a standardized DNP education requirements. What I have said in prior posts has been in part an emotional manifestation of my frustrations with my educational institution and faculty. While I still firmly stand by NPs needing to reign in the demand for more responsibilities and use of the title "doctor," that is not to say advanced practice nurses are useless.

I also firmly stand by the idea that DNP education needs restructured. Or just structured. Maybe some programs require more extensive coursework is physiology/pathophysiology/etc, but I don't think that's all programs. Extending responsibilities to the profession as a whole assumes that the profession as a whole is qualified for them. And truthfully, online programs are not demanding enough to qualify extended responsibilities.

My nursing professors have repeatedly told us our knowledge will increase most dramatically once we get into clinicals and in practice. While this may be the case, it is not a valid reason for glazing over information without a giving any kind of clue to what's important and what's not. It's an attitude of "learn by doing," which is discomforting to me. I understand that medicine in general is very much "practice" and action oriented in the clinical setting, but the lack of focus on why we are doing certain things concerns me. Like breath sounds, for example. We quickly glazed through these once in lecture, with no explanation of what the sounds clinically indicate/signify. Our clinical instructors (a different set of nurses from the lecture faculty) started quizzing us on the sounds a week later, after we are told not to worry about the breath sounds (we were told we could "fake it" during our physical assessment check-offs). A few weeks later, we review them once more, though again with no explanation of indication...and again later being questioned on the sounds in lab. And while I don't have a problem with anything in the chapter being fair game, the professors aren't consistent with when to follow the book, when to follow the lectures, and what their idea of "the best answer" among a set of multiple choice answers are. So my physical assessment grade came with a "student needs to build confidence" side note, which honestly really pisses me off. Lectures build no base for understanding/practice due to the lack of consistency, so of course I won't be confident. And I'd follow the book, but the book has it's own problems. Not only is the physiology fluffy and uninformative, but the information is disjointed. Not to mention the insane amount of typos (not just spelling errors, such as a 'z' in place of 's,' but things like "antacids increase stomach acid").

From what I've read, this is common among many nursing programs. I think part of the problem is that nursing professors aren't paid at all what they can make as an RN, so it's either a side gig for a lot of them and/or the good ones are just really freakin' hard to find.

So yeah...it would be easier to have a little more respect for NPs if the education proved they could handle the things they demand, but it doesn't.

I can see you're frustrated but I'm wondering how you managed to find such a crap program. I still remember being ripped apart because I couldn't tell an instructor if the patient had a freckle at 3 o'clock on their rectum after I did a physical assessment!

If everyone can get over the people (in any field) who are impressed with their own doctorate, you might look at the DNP in another way. There used to be combined MSN/MBA programs. Now, with the DNP you're going to have NP's "forced" to take classes that give them a business sense. I'd be less inclined to give a whit about who wanted to be called doctor and instead consider that there's going to be DNP's setting up programs, clinics, and other types of health care businesses...and money talks.

i also think you're wrong about online classes. I did a post-masters at Rush University, mostly online with actual weekends for patient interviewing and physical exams. I already had graduate degrees in nursing and business from brick and mortar schools. I never care to do anything but online again. There's good research behind it if you check it out. Interesting also that some of our course requirements were to look at online coursework from several medical schools. Even though Rush had clinical sites you could chose from, I set up my own in order to get the experience I wanted, one on a Marine base in Okinawa and a VA mental health clinic in Texas. I started the program while living in Bangladesh and Thailand, and finished in the states. When I graduated I acted like my first jobs were still clinical and got ones to give me the experiences I wanted. It was perfect and I could never had done in at a brick and mortar school.

If you don't think my NP education didn't prepare me for the job, I can certainly show you some physician references, one from a physician who managed over a 100 physicians and said I'm in the top 10 of them. Not bragging; just saying you can't make blanket statements. Your education is what you make of it...and it never ends. I mainly don't care for the DNP as I already have the business courses. I would like to see more clinical courses but I'll get what I need on my own.

 

[Dharma]

Nurse practitioners are useful, but to demand full practicing rights goes a bit too far. After all, they never went to medical school or spent several years in an 80 hr/week residency, so I'm not so sure if they should work without supervision by a physician.

 

[Top Gun]

Nurse practitioners are useful, but to demand full practicing rights goes a bit too far. After all, they never went to medical school or spent several years in an 80 hr/week residency, so I'm not so sure if they should work without supervision by a physician.

You know, the other day, a patient ended up transferring to me from the nurse practitioner she was seeing, due to personality conflicts. When I talked with the patient, I found out that this NP was giving steroids to treat her gastritis!

How can NP's expect to be allowed to practice without supervision, when there are gaps like this in their medical education?

 

[Makati2008]

I can see you're frustrated but I'm wondering how you managed to find such a crap program. I still remember being ripped apart because I couldn't tell an instructor if the patient had a freckle at 3 o'clock on their rectum after I did a physical assessment!

If everyone can get over the people (in any field) who are impressed with their own doctorate, you might look at the DNP in another way. There used to be combined MSN/MBA programs. Now, with the DNP you're going to have NP's "forced" to take classes that give them a business sense. I'd be less inclined to give a whit about who wanted to be called doctor and instead consider that there's going to be DNP's setting up programs, clinics, and other types of health care businesses...and money talks.

i also think you're wrong about online classes. I did a post-masters at Rush University, mostly online with actual weekends for patient interviewing and physical exams. I already had graduate degrees in nursing and business from brick and mortar schools. I never care to do anything but online again. There's good research behind it if you check it out. Interesting also that some of our course requirements were to look at online coursework from several medical schools. Even though Rush had clinical sites you could chose from, I set up my own in order to get the experience I wanted, one on a Marine base in Okinawa and a VA mental health clinic in Texas. I started the program while living in Bangladesh and Thailand, and finished in the states. When I graduated I acted like my first jobs were still clinical and got ones to give me the experiences I wanted. It was perfect and I could never had done in at a brick and mortar school.

If you don't think my NP education didn't prepare me for the job, I can certainly show you some physician references, one from a physician who managed over a 100 physicians and said I'm in the top 10 of them. Not bragging; just saying you can't make blanket statements. Your education is what you make of it...and it never ends. I mainly don't care for the DNP as I already have the business courses. I would like to see more clinical courses but I'll get what I need on my own.

I bolded the part that was a little displaced....maybe it was a slip or maybe it is how you really feel. You will never be a Physician equal(I say this as a PA and I know I am not a MD/DO equal as of yet)

 

[zenman]

I bolded the part that was a little displaced....maybe it was a slip or maybe it is how you really feel. You will never be a Physician equal(I say this as a PA and I know I am not a MD/DO equal as of yet)

No, it's not displaced; it's on a reference which I recently obtained after interviewing for a hospital position. I can easily produce that reference and others if needed. By the way I got hired based on what I know, not what I don't know. I personally don't feel the need to have pissing contests. I'm confident in what I know and don't know and I don't have an emotional attachment to much of the same crap other posters here do. I work in tandem with physicians not in trying to be equal. However, please remember this. I have training in some areas you don't so don't whine about that please.

 

[Makati2008]

No, it's not displaced; it's on a reference which I recently obtained after interviewing for a hospital position. I can easily produce that reference and others if needed. By the way I got hired based on what I know, not what I don't know. I personally don't feel the need to have pissing contests. I'm confident in what I know and don't know and I don't have an emotional attachment to much of the same crap other posters here do. I work in tandem with physicians not in trying to be equal. However, please remember this. I have training in some areas you don't so don't whine about that please.

That is all I am asking you to admit that you work WITH Physicians not AS a Physician and it seems like you admitted in a roundabout way. I still think that comment is a very dangerous one(maybe I am stuck on the wording who knows) that you made earlier. And your little smart comment goes both ways Zen. You definitely don't have training in areas that I do either

 

[zenman]

That is all I am asking you to admit that you work WITH Physicians not AS a Physician and it seems like you admitted in a roundabout way. I still think that comment is a very dangerous one(maybe I am stuck on the wording who knows) that you made earlier. And your little smart comment goes both ways Zen. You definitely don't have training in areas that I do either

Oh so that's what you're asking. I admit I work with physicians, not as a physician. How's that? Actually, I've never thought I was a physician, especially since I never trained as one.

Now which comment do you think was dangerous?

It was a smart little comment (I am a smart*****), and for fun I like to ask other providers what can they do if all their equipment was taken away and the electricity turned off. Now go treat that office full of patients.

Let me clarify now that I'm awake. When I say I work "with" physicians, it's not that I work "under" one. I'm independent and have my own caseload, but sometimes we see each others patients when one of us is away. One got behind the other day and I saw a couple of his patients. We work together as team partners. All of us are under a clinic supervisor who can look at our notes anytime he wants.