The New Doctors in the House

I find it appalling that you can even comment that a "nurse" is a "physician" or aka "the new doctors". It is insulting to a profession that exudes a skill level, commitment and knowledge base unparalleled to many... Most college graduates cannot even enter the MCAt steps let alone achieve a score worthy of acceptance. I am not even addressing the financial commitment. The process begins with a 4.0 in college, then MCATs, then community service and extracurricular excellence, then medical school, then USMLE scores above the 90th percentile, then residency from the minimum of 3 years to 9 with and without research at times. A nurse has his or her valued place. Now please recognize the place of a physician.

Anesthesiologist of CT 2:44PM December 14, 2011

To Dr. Nurse - That is great that you felt the need to be a doctor of medicine. NP's are not doctors and most do not want to be doctors. NP's are limited to non-complex patient care, so I don't know why you have such a problem with the classification. The field of doctors wanting to take care of patients that don't require a specialty is dwindling and we are facing a shortage especially in rural and underserved areas.

This is where the NP role is flourishing. A competent NP will know when he/she is in over her head and will refer those most difficult patients to the proper physician. Being a NP allows nurses to take care of their patients at a more thorough level than they ever could do at the bedside. Many NP's are above the age that would permit them to attend medical school as you did and so settle to work under-appreciated as nurses always do.

I am sorry that you feel that way about your former colleagues. Why don't you help out and spread some of your new found knowledge our way to help the situation improve patient care, rather than belittling what the rest of us do to take care of the patients you don't have time for?

As society progresses and patient numbers continue to escalate - their will always be a need for underlings to advance to the next level. We have seen this in nursing; hence the roles of LPN and CNA's. Now we have med aides who are not even nurses that pass meds - how do you feel about that? It is the way society responds to necessity. When tasks become too much for one group to handle, a new group is created to ease the burden. This is what has happened in medicine and who more qualified to ease it than advanced degree nurses who are used to the system? I would rather it be a nurse than a non-medical person trained to work solely under a doctor! This just seems to be about a lot of over-blown ego's who can't stand it when someone else has the opportunity to utilize their knowledge and skills. If NP's begin to fail, then perhaps they will offer more rigorous training in the future. But since that hasn't happened yet, they must be doing something right!!

S. Williams of IA 9:46PM October 01, 2011

I will give you a little bit of my background before I enter into this mess of a debate. I am a physician who used to be a nurse before I entered medical school. I will be brutally honest... I chose to go to medical school even after being a nurse because as nurses we are simply not trained at the rigor of a physician in order to understand pathophysiology, pharmacology, clinical decision making, evidence based medicine, and much much more. I realized that the amount of hours of training I would receive as an NP would be FAR FAR less than that of any MD. As a nurse I received my BSN, and I could get my masters that would allow me to PRACTICE on patients in two and a half years. That's 6.5 years of training. "On the job training" as an RN is a crock honestly. As an RN I know a LOT of things that doctors do not... how to run IV's, insert foleys, draw blood, dispense meds, wound care... things that docs don't get trained on and don't have time to spend doing. Doctors would never be able to give their care without nurses, but we don't learn to do what they do. We don't learn how to think through complicated presentations and pathology, DIFFERENTIALS (nurses don't know how to do a differential to save their life). I learned how to do all of those things in medical school, and residency. Let's be honest here... the average NP spends 2.5 years of training post-bacc in order to practice, and the average MD spends 7-10 years post-bacc in order to practice, and many of those years they are working 60-80 hrs a week and taking 30hrs of call at a time. The amount of hour difference is astronomical. Who would you rather have your family member be treated by?

Dr. Nurse of 4:09AM June 27, 2011

Having NP's gives the public more options. I am pursuing my NP and am in an MSN program currently. I will have an additional year and a half after this to take just NP classes. With my 30 plus years of nursing experience and my 10+ years of education, I will feel quite competent to handle the care for routine and non-complex medical conditions that I will come across. I will never call myself a doctor if I decide to obtain my doctorate as will be required in 2015. I know there is a huge difference between the two. But, you make it sound like only doctors are able to have knowledge that is beyond anyone else's scope of ability. I look forward to having MD's to call on for additional expertise.

I want to learn all I can from them (and possibly you), but it is complete arrogance to say "Nurses are not or should not be "treating patients" they should be caring for patients". Part of caring is treating. Nurses treat wounds on a daily basis, we treat our patients with kindness when they are dying; how many physicians stay at the bedside of a dying patient and hold their hands? According to Webster's Dictionary, to treat, means "to care for or deal with medically or surgically". NP's just want to increase their realm of "treating" to include being a more involved health care provider; one that can utilize our patient care experiences with our medical knowledge to provide and improve healthcare that is limited in availability today.

Family practice physician's are few in number and most are getting into specialized practice and will not work in areas where NP's are doing so (underserved/poor, and rural)- D.O.'s were also started to help alleviate a physician shortage, and operate under the same principles as NP's (focusing primarily on holistic medicine, wellness and prevention), thank you for pointing that out.

I am left to believe that it is your ego that is keeping you from wanting to let nurses enter into your realm of doctor-dom. Nurses have been fighting this battle for decades, and we are finally winning; people like you just cannot stand it when faced with the reality that nurses can be just as smart as you and you have to share your locker room with us. In the end it all comes down to our patients. They will get the best that we can give them. There is good and bad in all professions - we need to let society choose whom they prefer.

S. Williams of IA 4:28PM March 16, 2011