“Nurse Practitioners are DUMB AND I HATE THEM” | A Doctor's Uncensored Take
Вставка
- Опубліковано 19 жов 2017
- The eternal struggle over the scope of practice of nurse practitioners reaches a new low when a doctor attacks online and all hell breaks loose. Here's my uncensored take.
Your support makes what we do possible! Join the SuperPac and get exclusive content, live discussions, and other crazy perks:
UA-cam: / zdoggmd
Facebook: / zdoggmd
Patreon: / zdoggmd
Website: ZDoggMD.com
Podcast: ZDoggMD.com/podcasts
Facebook: / zdoggmd
Newsletter: eepurl.com/gD8_D1
Twitter: / zdoggmd
Instagram: / zdoggmd
Send Us Email: zubin@turntablehealth.com
Send Us Hate Mail:
1025 Alameda De Las Pulgas #218
Belmont, CA 94002 - Наука та технологія
Im a paramedic and ER Tech.... i know where i stand in the healthcare hierarchy. I just dont appreciate when everyone looks down on us. We all strive to make a difference in our patients lives and we also suffer our own tragedies
Have all techs walk out one day.... see how well the docs do. I wouldn't be able to do my job without techs.
Always amazed that paramedics can intubate and manage a code single handily with just them in the back of a moving vehicle (air/ground) then at the hospital they usually aren't allowed to start IVs just vital signs.
jeremy rinner thank you. Its so funny that you say that. In NY, there was a time we were not allowed to take a blood sugar because we were not trained to as a ER tech but as a Paramedic i can do far more. But i was ok with it, 1 less task i will be bombarded with.
Shane Sanders thank you shane. We are all here to improve healthcare and improve pts outcomes and lives. If you remove 1 thread, the fabric will not be as strong and unified.
That’s why I love Indiana. It’s basically no scope. I can do whatever as long as my medical director trains us on it. We have medics that do chest tubes here. The nurses can’t get away with that “higher scope” BS in Indiana.
As a physician, I would say we ALL have to know our limits, strengths and weaknesses, not point fingers based on the initials after our name. In our group, the PA who worked in a GI group, is better at hepatic disease than I am. So she gets those patients. The name of the game is the PATIENT.
Love this comment!
I do applaud your honesty and humbleness. I miss the times of working with physicians in which we as nurse practitioners work as a team. We can bring our skills together for optimal patient care. I have never wanted to be a physician as I love bedside nursing. I'm returning to school for my doctoral degree so that I can become an educator. DNP does not mean that I am a physician but rather can become a professor or work in an organization in which I can assist with innovations, contribute to practice change projects, etc.
This comment is amazing!
Well said ❤️
You got that right doc. The name of our game is patient first.
Im a nursing student and a server. And I served a table of paramedics. I was excited to tell them I was studying nursing and they told me to please not be mean to paramedics when I become a nurse. I was so surprised that this was an actual thing and that nurses were mean to paramedics. Im really surprised by the hostility between health care workers. Its disappointing.
I worked in hospitals for more than 30 years, and those were the best years in my life. Once the nurse got the license to prescribe and labelled as "Independent Nurse Practitioners / consultants and Prescribers", I found them to be worst people to work in healthcare. Majority of them think they are doctors, why? because their initial ambition was to be a doctor, but due to reasons I can't say, they did not get selected to qualify and so they choose nursing. This is the fastest rout to work as a doctor in hospitals now. Sad. Good nurses like you will be crushed by them.
It's my understanding that NPs are being churned out with little to no clinical experience. I have not looked into this, but as a nurse with 12 years of experience in a wide variety of settings I have to say that this frightens me.
I have the utmost respect for all levels of caregivers but I do feel that experience counts for a lot and there is a wisdom that is gained through experience that one does not get by attending an online course.
Nurses are mean to aides. And anyone below them
90% of nurses were mean and condescending when I was in medical school.
Nurses are major bitches in general.
Thank you for this post! One of the primary reasons I no longer use my NP license is because profit-driven practice managers continually pushed me to practice beyond my ability and outside of my specialty so they could “serve” more patients. These practice models also did not lend themselves to allowing me to get an MD’s opinion when I was clinically in over my head.
OMG! my thoughts exactly! i am exhausted and really wanting to leave the NP profession. Collaborating physician not present, wont answer call or text or email, and you're trapped with the patient and decide on your own.
I am looking forward to pursue DNP so I can teach BSN/ADN.
Scope creeping is a major problem. I'm seeing it a lot even as a patient. Thank you for being one of the good ones.
I’m a nurse Practitioner. I don’t think I am or pretend to be a doctor. The most important thing to me is: know what I know. Know what I don’t know. Be honest with patients about that. And know when to refer.”
I mean why would any nurse practitioner feel like they need to manage cases unsupervised? Why open yourself to that kind of liability and stress? If it is beyond your scope of duties, and you still will get paid a good salary, then just leave the doctors deal with the responsibility and stress. I wouldn't want to put myself more work and worry more than I have to. I would happily leave it to the MDs deal with it.
Every physician refers when it's out of their scope of practice too. An ER physician wouldn't perform neurosurgery. At least it's not a good idea.
@@MCendan What do you mean an ER doc wouldn't perform neurosurgery? They do it all the time on Dr. House! :D
I agree I’m not a nurse practitioner but I have a seen lots of them some of them are fantastic the same thing with doctors and PA some I really like some I didn’t it all who you are comfortable with
That's what I was taught in nursing school!
I would like to premise this by saying I respect EVERY healthcare worker. I was unfortunately in an abusive relationship, and after a pretty rough situation, I went to the ER to have part of my tongue sewn back together. The ER doctor was discharging me as a Nurse(RN) came in and refused him. The doc was furious, but luckily she noticed I had some weakness-as I was getting dressed to leave, mind you-and she demanded a CT. The doc refused to order it, and she basically begged for an X-ray. The doc agreed, only to prove her wrong. I had 5 fractured vertebrae from C-6 to T-4(T-1 escaped somehow..) and 9 broken ribs. Thank god for that nurse, and thank God for the doctor, before I left the X-ray room he was at my side and had already called a neurosurgeon. He was absolutely able to admit his mistake and he thanked the nurse in front of me for saving my life.
Amelia Deloach God bless you
where do you live the doctors( where i live) and Nurses can careless about giving good quality service haha
I hope you find the love you deserve
Now that's good medicine and good care. Even with the disagreement, the ego was put aside to provide you the best care.
Amelia Deloach - That is the first and only good thing I have heard about an RN! Most of them are horrible people!
makes sense.
"stay in your lane." dont pretend you know what you haven't learned.
be the best md. be the best np. be the best paramedic.
I am unclear what stay in your lane means. I understand that NPs and docs have different levels of education but if you completely stay in your lane you will miss a bunch of things that only nurses will see and capture. So don't really stay in your lane, your patient need you to step up and get out of your lane and question those who believe you should not move outside of your lane
@@ewtordella1 Staying in your lane is doing everything you can within your scope of practice. Nothing wrong with doing all you can within that region.
Medical doctors misdiagnosed me for three years until a Nurse practitioner correctly diagnosed me. In my opinion, nurse practitioners are much more attuned with the patient and are able to care for them holistically. Medical doctors aren’t able to do that. From my own experience as a patient and from what I see in the ICU I work in as a nurse.
This entire debate seems so logical to me. Even amongst physicians, there are varying levels of expertise. Could you imagine a primary care physician insisting on performing a heart transplant on his patient, simply because he believed he was as good as a cardiac surgeon? It's insane. The problem is ego, and we all need to check it at the door, and put the patients best interest first.
soltafari yes!!!! ❤️❤️❤️
AMEN!!!
Took the words right out of my mouth, well said mate.
soltafari Someone with common sense
Yet I've had primary MDs order genetic tests that they don't know how to interpret, give patients incorrect info about the gene and give surgical advise based on that as if they are geneticists or surgeons... some don't know the limits of their scope of practice regardless of the field, but there aren't as many checks and balances on what doctors can do as there are on the other providers.
I'm a Nurse Practitioner working full-time for 12 years...I completely agree with practicing within the scope of your training and working as a team to provide great care to all of our patients!
Not any of us should practice outside our scope of practice. But this means that we practice in a way in which we limit lawsuits. For me to stay in my lane means that I ignore things outside of my lane and, sometimes by doing so I place the patient in harms way or I get the patient the care they require. In my lane with bad outcome when I know better breaks my heart so and so. So how to get past this, insist, insist and insist. Document, document, document. Outside the lane? You bet. No one gives great patient care by staying inside their lane. If the docs don't respond, send it up the chain, and up that chain until the patient's needs are met.There are as many dumb docs as dumb nurses. Keep the ball rolling.
ditto!
Which means you can basically do nothing but nursing
Love this Doctor. I’m an NP and I work in collaboration with an amazing surgeon. I’m not a MD, and she’s not a RN/NP, but we work as a team to provide good well rounded care for our patients.
he called you dumb
perfectly said.. TEAM
Well said!
Yep this is how you do it, I’m in pathology far away from the people with my microscope. Just do your job well and don’t be shitty, leave the shitty part of you at the door 😅
PHYSICIAN, not doctor. dr is a title, not an occupation. joke's on us tho, as they're not really even physicians. just the dope connect and sometimes body mechanics.
I’ve been a NP for 25+ years and wouldn’t even consider working independently without a physician to consult with. If I wanted to be viewed as a physician, I would have gone to medical school. I started with a BSN and then wanted to advance my skills as a NURSE. I’ve been very content, and supported, by the physicians I’ve worked with as a pediatric Hospice and palliative care NP. I wanted this choice because I wanted more time to be able to raise my children. The physicians I’ve work with haven’t been able to have that “off switch” like I am able to do.
My husband was a paramedic and I always said that he surpassed all my skills when it came to starting a IV or provide critical crisis care.
We should be “complimenting” each other’s skills (as team members) and not trying to compete and/or insult.
Great video. Thanks! I’m glad UA-cam placed this on my recommended page. I’ve subscribed.
Amen! I’m an NP and I don’t understand these other midlevels wanting to be able to work without a supervising physician. I’m not a doctor, I’m an extension of the doctor. Especially now since anyone can get their NP online. It’s so dangerous.
If you did not get adequate training, that is ok. Don't project your lack of capability on the rest of us.
@@christinawells2024 You do realize that our NP organizations came out years ago agains the term "midlevel". It's very derogatory. Are regular RNs "low level" then?
Nope! I hear it used everyday. I do not say it in a derogatory way either. I am an NP. It does not offend me one bit. And you’re the one who said RNs are “low level”. I’m glad that’s all you got out of this discussion.
@@christinawells2024 So our organizations say not to use it. Many other NPs take offense to it but you don't so it's ok? Then you try to twist my words to make it seem like I called RNs low level. Pretty sad.
So as a family doctor even I know my scope of practice. Just because I'm a doctor doesn't mean I'm going to go do a surgery but I will recognize when people need that consult ;)
abeed87 Can’t argue with that. The most important part is recognizing when people need that consult.
I'm a NP and totally agree. I know my limitations and I work alongside my MDs as a team. Don't be an asshole is the perfect way to put it.
P H Bitch shut up. It all comes down to how a provider presents themselves.
P H Ok so the doctors who don't wear white coats they need to stop that shit because they are fooling pts right?
Devon B he is right you know. It supposed to signify the physician
P H And again they should wear those long white coats all the time right and never take them off in your opinion
P H If a doctor is mad about a long white coat then they have to much time on their hands. The doctors I know dont have time to care about something so petty. They want to do their job and go home to their family
I have been working for 7 years as a NP ,the bullying is real ,not just from the MDs but also the way the NPs are demeaned by the practice managers and idiotic staff saying “the real doctor won’t be available till next week ,that is just a NP “ . You are right ,it’s the insecure people who do that .
I am grateful for MD opinions and consults that I seek for very complicated patients. But I am fully aware of my contribution to patient care .
The term "Doctor" is misused in our country. Doctor literally refers to the level of education earned. I think we should get in the habit of using more accurate terms, like physician. Of course getting the general populace to play along would be hard.
Hey Ison, I agree. Doctor is misused and "nurse" is misused as well. If we could get Hollywood to use the right words and show roles accurately I think we could begin to get the public on the right page. The other thing we could do would be to get M.D.'s to practice at the top of their training they could work more in the consulting and supervisory role instead of feeling threatened by those coming in to do the day to day work in primary care. I worry though that some of this is because the medical field is still dominated by males and the Nurse Practitioner field is dominated by females, and I hear ZDogg saying much of what he says with a gender-based assumption in many ways.
Wow, this is SO WELL said in such a concise manner!! 💕💕💕
Fools, sheeple many be as they believe...
@Roy_Thousand Ego you suffer from my dear...
So in my town there’s an acupuncturist and a chiropractor that call themselves physicians. Everybody wanna be a doctor, nobody wants to lift heavy ass books.
This must be a big city thing. The doctor’s out here love NPs because it’s more rural and the NPs are complementary to the MD.
I’m an RN, and I’m a firm believer that NPs and MDs are different- but both important. No NP I know feel they’re like doctors. In fact a good friend of mine has had to go to her boss many times because she felt she was being expected to practice with patients who were too acute for her level of training, and that they need to be seen by an MD. I think in nursing, no matter the level of training, should be aware of the scope of practice for their license, and practice in that scope.
Rebekah Snyder agree. I am an RN also and agree with your comment
Ive been an icu nurse and now im an np.. i actually do see alot of np and pa who thinks theyre physicians..its a difference in people encounter
I’m an MD, and agree with you. No one is the master of everything. If I’m unsure I call a specialist, and often they call a super-specialist. Everyone must know their limits. Also, I ask the ICU nurses for their opinion often...helps a lot.
@Ann Igoe, no need for the lengthy specifics, but I guess you feel better letting off steam through this medium. I've been a nurse for over 20 years and I have seen errors from all disciplines in health care. You are required to report any unsafe practices you witness, or else you are culpable, if all you have written were true. Get your facts together and contact the person above the NP, Doctor, Nurse, or whomever. No need to lose sleep if you do the right thing. NPs are needed for a reason and you shouldn't down the profession. Nobody knows it all, and I would guess you've messed up sometimes, but if you are squeaky clean, then I hope you never mess up. Good luck.
WIth all due respect, you can't speak for everyone. There are definitely some NP's and PA's that dole out the attitude or show their insecurities by power tripping and making work seem like hell for everyone else.
How did doctors all of a sudden become too busy to see their own patients. I am 72 and can remember when the doctor actually came to your house. Remember housecalls..you probably don't. You do all the research to find a doctor that you think is capable and go to your appointment and see a nurse practitioner. Doctor are going the way of the dinosaur or a magicians assistant, you employ them ....then they DISAPPEAR.
I remember house calls. Those were the days.
I fell on this episode by accident and am so glad that I did. Z, you said so many things that I've said in the past. Thank you! I've been a paramedic for 27 years, a nurse for 7 and now am in NP school. I TURNED DOWN A MED SCHOOL ACCEPTANCE! At the time it was a tough choice that didn't fit in with so many things going on in my new family. My family is older now, and working as an NP is what I've chosen. I have always been terrified of people in their chose field not admitting that they still have something to learn. They don't know what they don't know. Some of the best physicians I've worked with have been happy to have me on their team and some of the worst discounted my contribution. Health care is better for EVERYONE when the team concept is acknowledged with people consulting each other for a better outcome. I hope to be an amazing NP working with amazing counterparts. Thanks for a great episode!
I am a PA - i am not a doctor - i dont want to be a doctor- i enjoy my role as supporting cast. I help doctors be better doctors. I correct patients if they call me doctor.
The IQ statement is stupid - I was accepted to med school.
Stephanie S ,,,, Nurse practitioners are smart not stupid,in the lease. Who call another one stupid, is not so smart himself ..
Nurse practitionner in Canada gotta do a master in uni, so no theyre not stupid at all
I really respect PA's and I catch myself calling them doc because I feel that have that somewhat level of training in a way....just my opinion, but I use to work with a NP who allowed her patients to call her Doctor, I never said nothing because she thought she was GOD, I have no respect for ppl like that...thanks for all you do
@@fkhan96 yeah if you don't have the fortitude, don't do med school. It's a lot and will bring you to your emotional depths and feel stress you've never experienced.
fkhan96 no disrespect to the previous commenter... but she is delivering a faulty impression. As someone who is nearly done with my BSN and having spent years as part of multiple hospital care teams, I can tell you it’s all tough. Nursing school is far from a picnic. I believe I understand what you meant when you said you were seriously considering it and should you join us, i would welcome you to the profession. To be clear, I do not mean to say that becoming an RN is harder than becoming an MD but becoming a nurse demands a type of fortitude that doctors do not require. In my humble opinion, med school is likely more taxing, but our profession can be more all-around demanding.
If I might give you some unsolicited advice? If you go NP, spend at least 5-7 years as an RN so you can be a full nurse first rather than jump straight to Doc Talk. Without the nursing experience, I do not believe you can add nearly as much to the team as you do with it. Thanks for reading!
Totally agree. I've been a NP for 25 yrs and I have no desire to be a doctor! I function within a team and love it! And you're right - that wanker's comments are a reflection of his own level of pathetic insecurities!
Really appreciate this perspective! I’m going for my BSN right now and eventually want to be an NP. Looking forward to being part of a collaborative healthcare team. I 100% agree that NP’s aren’t the same as doctors, but are an important piece of helping patients.
NPs can be better than doctors. I see plenty of it. Don't do us a disservice.
@@jeremybludau185 Very, very rarely, but vast majority of the time? Absolutely not. If they were, they’d be doctors.
I work as a paramedic in an ED that utilizes a lot of NPs and PAs who all do an amazing job. In my many (well, 3 or 4) years in the ED, I don't think I've heard any NPs or PAs calling themselves "doctor". Now patients will call them doc, but I think they let it go uncorrected because in that moment it's fairly unimportant given the things that brought them to the ED.
Levels of care mean a division of labor. Np's are another layer of the healthcare continum. Team work makes the dream work.
Love the Slogan!
Well said.
mike that's a real good slogan too bad that it doesn't work in the real world.Wait till you get a np that thinks they are the world's gift to medicine, and they really don't know crap.My ex np almost killed me!!!
john gartin cause your not worth saving
YES!!! Exactly! We are a TEAM from the CNA (me) to the MD/DO. 💙
This made me feel so much better. I’m a freshman nursing student, I’m aiming for Psych NP. All I’ve ever wanted to do is help people. It hurts so much to see people on the internet demean NPs, even going as far as calling them low IQ. It’s disheartening, thank you for this video. It means so much coming from an MD :)
You are right. I had my daughter in a midwifery center in NYC even with choice hospitals all around. The Mid-Wife NPs were amazing and I'll always be grateful to them. Nursing is a calling and it's not the same as a medical doctor and I love it. All the best to you!
If you're young (under 30), I'd highly suggest you becoming a Psychiatrist instead of an NP. There's a huge need for competent mental health providers in the US, please don't take the easy way out. I know medical school sounds scary but if you can pass nursing school then you can pass medical school!
@@aahsimovieprojectsit doesn’t matter the age. If still breathing go for it!!!!!
I actually saw an NP when I was living in the rural south and she was always quick to correct when someone called her doctor. She also worked along aside a doctor but I never met the MD.
A Nurse Practitioner underdosed me on my thyroid meds by 30mg for 4 years!!! When I finally, 4 years too late, went in with a bullish attitude armed with the information to advocate for myself and raised my voice, she yelled at me saying, "I'm not a doctor and I don't know this stuff." She sent me to an endocrine Dr that immediately upped my dose 30mg.
I think it has to do with hospitals here just wanting to pay the lowest salaries possible and they do not care that it compromises care.
I’m an NP in the hospital, I work with lots of other NPs. None of us think we are doctors, we don’t even debate this ever.
I'm training to be an DNP, and I think the biggest weakness of any practitioner (DNP or MD) is not knowing what we don't know. Having a big head and not consulting others with more or different clinical experience kills patients. Arrogance makes people stupid.
I am curious - in what scenario/aspect would a DNP exhibit arrogance? Would it be with the emphasis on holistic care they are trained with? Or are you referring specifically to arrogance on the part of MDs?
DNPs, just like any practitioner, can think they know more than anyone else. They can ignore or belittle RNs or anyone else on the healthcare team. The absolute worse thing (IMHO) a health care worker can do is discount/ignore the opinions/observations of other professionals, the patient, and/or family members of the patient.
Why not go to medical school instead? I switched over from nursing school and have been doing the pre-reqs for MD and DO admissions.
I think there is a big difference between those two and that statement. One went to md school and has large background in many fields and the science component including pathophysiology is different. Residency is not only about gaining hands on experience but you still have to self pace in studying pathophysiology. So yes while the statement applies to both there is a big difference. Md at least should know what they are dealing with but don't have the experience to handle a particular case.
P H what's that?
I have had good nurse practitioners and PAs. I have also had a PA tell me that its not possible to overdose on Vit D (WRONG). I have had good doctors and I have also had bad ones. I had a Pulmonary doctor tell me there is no such thing as cold induced asthma. (ALSO WRONG). I think it is dangerous and common in the medical field for clinicians to be overly confident in their knowledge and when coupled with the arrogance (not listening to their patients), can lead to dangerous situations. No matter what their scope, education or experience.
Cardiac RN here and I would like to shine the spotlight on another part of this conversation that I think was missed entirely. The anesthesiologist (and I'd hate to stand up for someone who sounds like an a-hole) said the NP doesn't correct the patients when they call them doctor - he didn't say they call themselves doctor. That brings me to what I deal with on my unit when I walk into a room and my patient said someone wast just in their room talking to them about something like a procedure or their diagnosis and it could've been any consult MD, any of the NPs, the cleaning techs, nutrition, or our floor techs/PCAs. By the process of elimination, the conversation usually goes like this: "Someone was just in here? Were they wearing green scrubs (our PCA/floor tech colors)? No? Did they have on a white coat (an intern/resident/fellow most likely, but not always an attending, consult, or NP/PA)." The process continues until I can figure it out or I give up, because we all know physicians for SOME REASON are free from having a dress code in the hospital (which I think is stupid, honestly because it causes a lot of confusion to everyone and is a security risk). IF the person in the room was wearing scrubs that weren't my color or the color of the PCA/techs, but spoke to them about their procedure, they were most likely a doctor or np/pa. THE DIFFERENCE TO A PATIENT is none. We don't learn about NPs and PAs in high school. We don't learn about our healthcare in our education systems. The general public doesn't know what a normal blood pressure or blood sugar reading range is, so how do you expect anyone to know the difference in roles between a nurse practitioner, physician assistant, and physician? All roles can enter medicines, all ask the same questions, all get consents and assess the patients, all do rounds, and explain to the patient what is going to happen. To the patient, the role of their healthcare provider, regardless of the title, is whoever that one person is they see the most rounding in their room - and I can tell you, it's going to be the NP or PA rounding more often than the MD.
The patients often slip and call the NP or PA their doctor and I would correct them and tell them it's their NP or PA but correcting patients and educating them on the difference when you can't even educate them on their meds or their illness is a bit overreaching. They don't care about the job title. They really mean "whoever the fuck is my healthcare provider rounding on me, because you all switch every shift and it's too complicated to keep track of what all of your names are." They don't even get MY name right, and it's WRITTEN IN FONT 200 IN FRONT OF THEM ON THE BOARD. Practically, that's it in a nutshell.
The NP the anesthesiologist is talking about is probably just tired of correcting her patients. She laughs when they call her doctor because she's probably told them she's an NP a billion fucking times and they STILL don't know the difference and don't give a damn and use the word doctor in place of NP because it's easier to say. No one prefers saying Physician over Doctor because Doctor is easier to say. Honestly. The NP isn't trying to piss off the a-hole, but he obviously has no idea what it's like talking to patients, and why would he besides putting them to sleep or getting consents (if he doesn't send the CRNA to do that, too)?
What I'm trying to reiterate here is that it's not a MD vs NP or PA thing, it's a lack of education in the general population on what the role differences are and that no one cares when they're sick and in the hospital and if there was a way to say "my healthcare provider" in any simpler form that sounded easier to say than the word "doctor," they would use it. I know I get tired of correcting the patients on which doctor or np is which and who is on what team. I grab my scrubs and plainly say I AM YOUR ONLY NURSE. NO ONE WEARING THESE COLORS LIKE ME SHOULD BE IN YOUR ROOM TAKING CARE OF YOU TODAY BUT ME. That is how I tell the hardheaded patients who their nurse is when they don't understand for the 3rd time who I am or why I am writing my name on their board, lol.
I’m a nurse, and my health provider is an NP. I saw her originally out of necessity, but it was the best thing that ever happened to me. That holistic approach you talked about is working for me. I’m getting healthier, and so thankful for her knowledge and skill. As for Paramedics and EMTs, I am so totally in awe of what they do. I will never save as many lives as some of the ones I know, and they totally deserve to be paid more! I’ve never witnessed the mistreatment probably because several nurses I work with moonlight as EMS, and they would never put up with it.
Even when I'm done with my NP I'd prefer to have a MD to learn on and bounce things off of and learn and adapt. I agree with y'all. Let's get along and be a team.
I’m an NP but started as a “lowly” paramedic. Thank you for addressing this on behalf of everyone in healthcare!
As an NP for the past 7 years and now in private practice, I’ve seen how MDs degrade NPS and visa versa. Even with my success as an NP and now preparing for my MCAT, not because I am not proud to be an NP but because that was my original plan and dream to be a physician. However I find it very sad and just plan disrespectful that MDs are almost always referred to as Dr. so and so. However a Nurse Practitioner is almost always not acknowledged at NP so and so. It’s Bob, Mary, SAM. Some people don’t even know their doctor’s first name, all because they are DOCTORS, they get that respect, whether qualified or not. An first year resident will get more respect than an experienced NP. We all deserve respect, NP, PA, DO, and MDs.
Hi came across your comment today. I know it’s been 5 years. I am curious whether you got into med school and if there is any change in your opinion after 5 years
@@user-mi8xf8tq1z My opinion still remains the same. We all deserve respect no matter the title. I took my MCAT, got into DO school and decided not go. I know my purpose and love my career. Title wasn’t going to change that. To my self in debt and start from the bottom to do the same thing I’m doing now…I’ve been an NP for 13 years now and for the past 6 years in private practice independently. I’m fulfilled and happy with my choice to continue my work as a NP.
@@BriSlayAkaTheBeautyPlug
Omg, out replied 😊😊
Thanks. I wasn’t sure if you’ll see a reply on a post from 5 years ago.
@@BriSlayAkaTheBeautyPlug SMART. A lot of doctors are leaving...and why put yourself in huge amounts of debt.
I am a proud nurse practitioner. I am not a physician. I went that route because I didn’t think I had medical school in me. I also collaborate with a team of other NPs, PAs, and my surgeon. I know what I am capable of, and so does everyone else. One of my jobs is to treat patients, but to also protect the other members of my team. Let’s not forget the first rule of being a doctor. Not to do no harm. But to not piss off the nurses.
P H wow
Stephen Johnson S young Black, male NP!! Kudos to you. Would love if you guys were more visible; should begin vlogging, actually.
Indeed without nurses we can function properly as a health team.
Patients will ALWAYS come first, not any of you, remind yourself of that while you're busy power tripping.
Say that! Not an NP, but Public Health Nurse. First off, people choose their careers for a reason. Exactly, MD ZDogg said, it’s decisive. We aren’t going beyond our scope. We are a team and ancillary staff are the cogs. Let us walk out, then what?!
A sincere PA or NP are way more valuable and beneficial for most patients than an arrogant MD
Agree!
For sure!
So true
I’m a PA and I love what I do! Love working with physicians and recognize their tremendous efforts in their education and training as well as NPs. All play a role and to assume roles that are out of your scope of expertise is dangerous regardless of your position in healthcare.
Fight for independent PA practice
I love this commentary. As an RN and a new NP who went to an NP/PA program where our program director was an MD in this particular program, I actually gained a lot of appreciation for the collaboration between MD's and NP's. I have seen the attitude that nurses have and it's definitely not helpful. I think it is best that at the end of the day, that we work together for better patient outcomes instead of trying to fight each other. Thank you for bringing this hot topic into light Z-dawg! Hoping and praying for a healthcare system that focuses on collaborative care!
In NP school right now. Love my doctors and totally agree with you Z!
ShivaDance Do you work in addition to attending NP school?? I'm thinking about going back to school but i work full time.
I work 2 jobs because I am trying not to take out any loans! You can do it!
I always tell everyone that we are all doing the same job, just different parts of it. All the parts together add up as a whole.
I just had a very negative experience with a nurse practitioner. I had no idea she was not a medical doctor. She called herself a neurologist not an APRN. This person waited until I was in her office to inform me that she was cancelling the appointment! Then I got a text from her office three minutes before my appointment time. We parted ways with no resolution. There was not attempt to fix things. No more techs for me.
Even this video is 5yrs old, everything covered in it still applicable at the present. As a very new NP who is practicing in adult primary care for over a year now, I still need my supervising physician to assist me with complex/complicated patients. However, most of the time, I find it hard for them to really help me like basically ignoring me so my last resort is to use uptodate and/or call a seasoned PA or NP for help. I believe that if collaboration needs to be structured between PA/NP and a Physician, practices/offices/corporations should stop letting the mid-level practitioners/APPs be on their own in an office with the so-called "collaborating physician" is in another location or hundred miles away. Kudos to this big private practice that models collaborative relationship very well, where a physician is always in the same office as the APPs- and they will run the office with at least one physician in the office. I hope all practices are doing this. In fact, I feel safer when there's an MD/DO in the office with me.
As of the "doctor" terminology, in my own experience, even just for over a year being an NP, I'm about to give up correcting my patient and educate them that I'm not a doctor, and they can just call me with my first name. But most of them just cant stop calling me "doctor". What can I do? When I arrive in the office first thing in the morning with patients in the lobby waiting, and they greet me "good morning doctor", should I always correct them? There's even some patients who responds like "but you are doing the same thing when a patient comes in the office" and I will just like say "yes, but doctors are DOs/MDs". There's one even argued, how about those Doctor in Psychology who wants to be addressed as "DRs". I think the issue here is the "bad seed" as what has been mentioned in the video, as well as insecurities.
Also, it is concerning for some schools who does not require bedside RN experience prior entering the NP program. I believe the original logic of creating the NP profession is the fact that it is based on the actual bedside/nursing experience, and hone it, use the nursing model plus this experience to the diagnosing and treating part of the healthcare delivery. I hope this will change in the near future.
Also, NPs should practice on the specialty they were trained for. Acute NP should practice in the acute settings (There's a lot of Family NPs who work as an Acute NP), a Primary Mental Health NP should practice in psychiatry (There are some FNPs who practice as psych NPs), and so on. NP program is specifically designed according to specialty: Womens health, Midwifery, Anesthesiology, Adult-Gerontology, Family, ER, Acute, etc. This is where PA program is different, since they are trained in different specialty with their PA program.
I have seen the hell of med school, all the tests, studying, late nights, early mornings, Doctors rock, nurses rock and all the specialties, sub fields and care givers that support them rock!
Doctors treat diseases...nurses treat patients. I've been an RN for over 20 years. I work in an ICU at a level 1 trauma hospital. I've been a nurse longer than any of our NP's, but I know my scope and my place and totally respect their further education than my own. Some of them have their doctorate in nursing, but they NEVER EVER allow patients to call them Doctor. But, there are times they will come to ask me about something from my years of experience and that lets me know they respect me too. Our teams work very well together. I also know NP's and PA's who are quite scary because, as you said, they don't know what they don't know!
NP here. This is an amazing exploration of the issues. Thank you for a thorough, albeit ranting, perspective on this complicated topic. I found myself nodding and smiling repeatedly. I love my NP colleagues. I love my physician colleagues. I love to consult and explore cases with wise physicians. So glad you decided to move on this topic and take on the multitude of facets contained within this unfortunate professional war. I am happy to report that in my 34 yrs as an NP I have never worked with an NP who claims to be a physician equivalent. The world needs us all for what we bring to the patient.
About to get attacked and I say this as a Mom of an MSN, when a NP becomes a DNP, they still aren't called "Doctor" unless in a University setting. They don't have the same training and they know it.
That said, I've had 3 heart attacks, lupus, factor 5, I'm complex and it's always been Nurse Practitioners who diagnose the weird stuff and give me relief because they have epic hands on, think outside the box, and have more of a whole body approach.
That's a bunch of bullshit. Anybody who claims to be more "holistic" is blowing smoke up your ass
Even phd degree holders are not allowed to call themselves “Dr.” In a clinical setting.
Only a physician is a “Dr.” in a clinical setting.
@@user-mi8xf8tq1z Exactly. Patients hear “doctor”, they expect a real doctor.
Thanks zdoggmd!!! Im an adult acute NP student at upenn and thank you for laying out the lay of the land, encouraging all of us to work together more!! I agree with everything you say, and will start to use your arguments more in conversations about this with my classmates and colleagues. I am embarrassed to say that this negativity goes both ways - there are a number of NPs who equate themselves to MDs, and who attack physicians in the same unproductive way - it’s not right, this type of language needs to be changed.
What more to say? I've worked my way through the medical hierarchy to a place that I am happy with. I have been the EMT who was told to just go drive, the paramedic who tried to describe a patients home to an RN that dismissed me as an ambulance driver, the nurse who has had been asked by a doctor "so what do you want to do, because I don't see a problem", and the NP who has had the discussion with a PA about how we're not doctors and cannot complain that MDs/DOs get paid so much more than we do. She couldn't believe that I would never feel comfortable working in a rural ER without a physician being available/present. I've seen the shit we can give each other and those who we consider "inferior" because their training is different. I am happy and content as an NP. I take care of the patients that I can and I hand off those that I cannot. I ask for help when something doesn't fit the picture I was expecting to see and I am confident when I recognize something I've seen before. Because of this I couldn't care less what any dipshit doctor has to say about my level of licensure or training. That's not to say I am not open to learning more or to constructive criticism so I can better take care of my patients. I am always looking for the next thing I can experience or learn. I have found that many of the physicians I work with are also looking for that next thing that can learn. We all are here to do the best we can taking care of patients. Instead of focusing on our small differences we should embrace everyone at the highest level of their training because there are more than enough patients to go around for all of us. Asshole doctors can try to dismiss and belittle NPs all they want, it really doesn't matter. NPs are a thing and we're not going away. The public is on our side, the majority of state legislatures are on our side. That isn't to say we shouldn't be having conversations about scope of practice and what NPs can and can't do with or without collaboration, but dismissing us outright will likely leave an asshole doctor away from the table when that discussion is had.
WIth all due respect, I think there is a large gap within your "hierarchy" with regards to the nature of the job of doctors in contrast to Nurses / Paramedics / Techs. Yes, you have experienced working as well as work politics with being an EMT/Para/RN/NP.. but the large disconnect is the level of education.
For NPs, it is common, even expected for this "evidence based" experience to build up towards the practice of RNs/NPs... but for doctors, it's a whole different beast altogether. I started out as an EMT during college, and I have a host of RNs and a few NPs in my family. Even as an EMT, my colleagues all had big dreams. Some wanted to be firefighters, some ultimately, RNs/NPs/CRNAs and MDs. Where the paths diverged differed, but it was clear to me that going the paramedic route was clearly more of an advantage if I was going for nursing or firefighting. The training of a doctor on the other hand, is much more academic. Like ZDogg stated, it isn't about IQ in most cases, but preference. People pursue what they choose.
During medical clerkship now, I directly work with many in the healthcare team.. and it is just clear to me during rounds, and with the level of understanding and thinking physicians have to do to reason out their decisions regarding the data of charts combined with the information they've gathered from the rest of the healthcare team.. that there is just no way this line of thinking (that we do) can be born out of that thread of education / training (EMT--> NP). It is very different, but pretty much useless if the team wasn't all there working together. Physicians can't / aren't trained to handle things out on the field (EMT's/Paramedics), nor would they be able to / tolerate half the things RNs have to deal with.. and vice-versa across the board. There will be overlaps in scopes of practice, where I think these conflicts arise.. but in the end I think it all boils down to common sense and respect for one another as a healthcare team.
As I said above I never claimed to be an MD/DO nor equal to one. What I pointed out is that all of us within the healthcare field can throw shade at another career within the field that we feel is beneath us. The size of the disparity in education, pay, respect, or perceived importance isn't what is in question. I do take to task that there is "just no way this line of thinking (that we do) can be born out of that thread of education / training". There is a seismic jump between RN and NP in the thought process of how we care for our patients. Yes it is under a different model, nursing instead of medical, but the change is still present and huge. An RN that must look at a patient, make a nursing assessment, and compare received orders and make sure they fit the patient in front of them. As an NP I must assess the patient, take in all the history I can gather, consult with their previous providers if available, review lab work/imaging, and sift through all this information to arrive at a diagnoses I intend to treat. There have also been multiple articles in multiple scholarly journals (would you like me to list them for you?) that have concluded that NPs provide just as good of care for patients in primary care as physicians do -- often times with higher patient satisfaction scores (we can include PAs in this discussion as well). Yes there are complex cases in primary care that require physician management. What NPs and PAs can safely do is take the run of the mill patients off of the physicians plate, leaving them more time for the truly sick patients, and we do not need oversight or collaboration to do so safely. Furthermore many NPs work in "collaboration" with a physician that does very little actual collaboration. These NPs work as independently as any other provider. Now in an acute care setting I do feel the need for collaboration is much greater. With that being said in the ER I am just as capable of taking care of an ankle sprain or a 20 year old with a viral URI as a physician is. When I care for more complex cases then I welcome, and generally seek, physician involvement. I've said many times there are more than enough sick people to go around for all of us. Instead of trying to defend each of our own little piece of the pie we should instead accept one another for their strengths, all work together on our weaknesses, and take care of as many patients as we can safely and efficiently do so.
Kinoons buu
I’m a retired healthcare provider, my concern, my whole career was why (in my hospital) did it take 3 to 6 months to orient a newly graduated RN? What’s wrong with nursing schools that they can’t put out a product that’s ready to go with a couple of weeks of orientation.
Great video. Love the emphasis on the importance of the collaborative nature between these professionals in order to practice the best medicine. And you're so right about how a lot of these divisive comments bring out the worst in people - the most negative, least confident docs and NPs. Especially when people can hide behind anonymity. Thanks for making this video!
forget being a doctor or NP I want to be a millionaire! 😬
Then perhaps televangelism is for you ?
Then become and mba and health care administrator. Lol
Do you have a podcast??? This is amazing, you're hilarious while being so well articulated. Health care providers for the win!
You have a great outlook for the system and everyone involved. Keep up the great work! People like you create a better future. I hope to work with more Doctors like you!
As a nurse, I totally feel like you put everything eloquently ♡ wish we all understood the importance of each person's role in the Healthcare team, what our scope of practices entail and the fact that we are a TEAM.
Love you! I’m an NP and we all need to be a team. We are all better together as a team! We all should be taking care of the patients! Glad you are so realistic!
I have been a NP for 23 years. After so many years of practice I don't ask for much help. But every now and then I collaborate with my MD and sometimes he knows what it is and sometime he tells me to send them to the specialist. I have had the best mentors, who empower me, give me autonomy and understand that if I need help, I will always ask. And this is what I tell my students. If you don't know, say so, ask your M.D., learn, and move on.
Belinda Godfrey thanks for the comment.
Awesome comment! I've also seen less experienced MDs ask MORE experienced MDs in the same practice. Collaboration is collaboration, period. -a future FNP
Belinda Godfrey All of us need another set of eyes and a brain at times!
I totally agree Belinda Godfrey. I've consulted my MD collaborator and often times he/she agrees with me that it's a problem that needs to be referred to a specialist or that my suspicions were well founded and correct. Sometimes I actually learn something new from them and appreciate the knowledge and graciousness.
My biggest problem is everytime I go to a specialist now I never see the Drs anymore. I went to a Neurosurgeon and they scheduled me again but with no Dr after a MRI. She wanted me to go to physical therapy before I even got my test back. This is total BS. Where are the Drs. They only are at the office 2 days a week too.
Very important conversation. I am an FNP student about to graduate and have trained with MDs, DOs and NPs in my program. Hands down the MDs AND DOs have a depth of clinical knowledge that NPs do not. I completely agree that NPs can be excellent providers but must recognize limitations of their knowledge and ask questions, seek knowledge and refer out.
There are competent doctors and incompetent doctors and there are competent nurse practitioners and incompetent nurse practitioners. There seems to be an ongoing thing with training and licenses. I've experienced similar things between RNs and LPNs with LPNs feeling that their training is equal and that therefore, they should be licensed to do the same things an RN is licensed to do and that they should not be supervised by an RN. Not understanding differences in training and scopes of practices and respecting that there are differences, that level of blind arrogance doesn't help the patients.
Disgusting, I left my terrible physician for a Family Nurse Practitioner and he is amazing. He doesn't pretend to be a doctor.. He is amazing, caring, and stays within his scope of practice!
Hear hear !
Javier Aget same here. I was actually killed by my old PCP. It was complete idiocy when it happened. My NP has been a Godsend!!
My Np is amazing, and has great bedside manner. He does NOT pretend to be a MD
Doctors and nurses have different roles in the healthcare system and can't function without each other. Both should be respected. I'm with Tom's wife. I want to be a nurse, not a doctor. They are different things.
Hands down realest talk I’ve heard in a long time. Definitely a sub!!
Thank you for saying this!!! I'm a PA student and some of the stuff I read online regarding MD/DO vs NP/PA can be super discouraging at times....
Yup. Bunches of conflicts arise where there is a lot of practice scope overlap. It's even happening between OD's and Ophthalmologists.
PAs are great. NPs... well...
P H can you color within the lines too. You seem to be a bright one.
P H you’re the type of people that creates these kind of divide. Do everyone a favor ... don’t go into healthcare
it really is I was thinking of going into nursing school as a highschool student and now I'm re thinking because of the people degrading nps and nurses
Oh good lord, this is funny to me. I’m in NP school right now, and if a doc thinks I’m stupid so what. My caring will be patient centered. Best way to earn respect is be good at what you do and I plan on just that. This stuff is childish.
No one overestimates there own intelligence more than MD's, except Donald Trump.
I am a PA, worked in the ER @ night. I got so tired of explaining my education, almost everyone would say doctor so I gave up. At night, when crisis after crisis would happen, I would show up and help where I could. Mostly doctors with lacerations, which took a lot of time, so I became a tailor. PA’s need a sign off on some drugs, but trust is everything in the ER. NP’s are fine. I trained with NP’s and PA’s. NP now requires a MA. The best way to learn is the old, see one, do one, teach one. You should either call out this anesthesia guy or forget about him.
Love it! Can't we all just get along, do our part, be good seeds, appreciate each other and work as a team.
I love working with NPs. They’re great! In a busy ED department it really helps the work load :) we work as a team with our NPs and it’s great! Let’s all work together to give patients the best care we can give :D
❤️❤️❤️
I'm just an ADN working and going to school. I can relate however because of the medical assistance in physician offices being called nurses. For example, children go in for a "nurse visit" to get their immunizations and weighing. The MA's actually introduce themselves as nurses in many cases and have no idea how much they have not learned.
I would have a talk with your employer because that is serious and is actually illegal. If you are not a licensed nurse (i.e., LPN, RN, APN) no one should be introducing themselves as such.
That happens all the time and it so annoying. If you’re in a position be proud of how hard you’ve worked to get there and appropriately state what your title is and continue to improve and learn. It drives me crazy as a nurse to see that.
And people wonder why doctors get upset about others calling themselves doctors.
mike zappulla yes they get upset but if you have a clinical doctorate then you are technically and legally (in most states) allowed to introduce yourself as such in a clinical setting where physicians are present, as long as it’s made clear you are not a physician. This is a lot different from the MA calling herself a nurse because she has not earned the title to be called such, just like nurses are not to call themselves physicians. Actually, no one can call themselves a physician (unless the are an MD or DO). But there are many clinical doctorates and they are in fact doctors in their respected field (e.g., physical therapy, nursing, pharmacy, medicine). I hope you see the distinction here.
“Just an ADN”? What?! What you are is a NURSE. ADN, BSN, diploma..we all take the same boards. What’s important is how you care for your patients. Don’t let ANYONE make you think you are “just” anything!!
Zdogg I love how you address healthcare as a team! Our priorities are patients not who is better at providing care! 💕
Amazing content. Not taking a side, explaining it from a logical unbiased standpoint. Subscribed right after you said you will not defend NPs just for the sake of defending. Looking forward to future content
Yes, I feel the same. I want to be a neonatal nurse practitioner and I just want to have a larger scope of practice. I would never compare a two year program to medical school, if I wanted to be a doctor I would have but I don’t want to know everything I just want to be able to be better able to help my patients. Doctors are on another level not to say there aren’t amazing nurse practitioners like I plan to be lol
Interestingly enough, the public often think nurses are some kind of “stunted doctors”. I often explain to people that nurses and doctors have very different training and roles in medical care. We work together to take care of patients.
BTW, I agree with you. I have tremendous respect and appreciation for physicians. Especially the ones I currently work with. They also respect my skills and what value I bring to the patients.
Agree. At times, the nurse vs doctor pathway is simply a matter of a "stunted" or disadvantaged background and not the innate IQ. If your daddy is a wealthy doctor, you are less likely to become a nurse. Can't ace the MCAT? The daddy will pay for a Caribbean medical school.
Elton Bright Better, daddy or mommy will donate a huge sum of money to the med school so that you can get into an ivy league med school without even interviewing.
Yes it's differ care but with 1 goal ^_^
@@soniatsui7606 This is Bill gates daughter
RN student here. Do you think NPs should be allowed to practice general/family health care in private practice, but be aware of their limitations and know when to refer the client out?
@ZDoggMD D to the Jizzle! You crack me up bro! You are my spirit animal bro! Facts, honesty, hating on stupidness. All of my values wrapped up in one vlog.
Same issues between scrub nurses and Operating room techs
I agree with a team approach. Research shows competence of NP Primary Care Providers time and time again. I’m an FNP student and I’m not gunning for any Physicians job, don’t call me Doctor, don’t call me Physician. Just tell me what’s wrong with you and I’ll deal with it to the best of my ability.
I have always enjoyed your videos. Thank you always for the information and laughs. As a person who has been in medicine for over 30 years as an EMT, ER RN, and nurse practitioner. YOU are SO correct! I do believe everything you have said here today. I do believe, even now, after all these years, I love having a very knowledgeable physician that I collaborate with to give the best care to my, his, and our patients. I think we all (RN, NP, MD, DO, PA, EMT, Medics) start with knowledge and our experience makes us better clinicians. I believe spending our time lifting each other up and educating others will allow us all to give the best care.
I am both RN and MD, and I know to be on both sides. Practices are totally different, yet the same goal. We need to care for our patients only, and not what other people say.
CNA, studying for my RN. Thanks for articulating the "lol what about med school?" response
Good luck! Keep up the studying colleague ! :)
- Ranbir Singh M.D.
I love the ending to this video. "They love it when we fight". My doctor colleagues are amazing and I think the world of them. They do things I cant even imagine doing. I'm a nurse, not a doctor. I know what I know, but I also know I don't know a lot. Doctors have illuminated so many interesting things that I had no idea about and that has made me a better nurse.
Where is the 'vid' on PA's, I'm a PA-C now for 24 years- still practicing
Loved the episode! Looking forward to watching more. Healthcare 3.0 is the biz yo! Thank you
Peace be to you Doctor! I'm a new subscriber! You raise alot of great points! I really enjoy working with both NPs and MDs.
Omar Abdul-Malik DHEd, MPAS, PA-C When I go too an ER, I think I desserve to see a Dr. I have had good and bad experience with them.
I waited in a hospital waiting room for 3 to 4 hours. Just to see a bitchy, nasty NP. That is lucky I didn't go home and kill mysrlf.
She was down right insulting and knew absolutely nothing about my condition.
NYEagles1 Scout Yeah and that was 1 Nurse Practioner. You honeslty could of just as easily had an Er Doc who was just as nasty
A lot, its "a lot".
Zdogg & beasty backup boys~
Obviously missed this episode when it first appeared...Well said on a “difficult” mine-field-of-a-topic! I ain’t givin’ ya no Sh-t-I feel like I am hearing my own echo...’cept the message is rebounding with a whole helluva lot more F-bombs🤬🤣 Long live the Team; Vive le différence amongst the team members;
God Bless Us All, Everyone!
Omar Abdul-Malik DHEd, MPAS, PA-C hello. Im looking for healthcare professionals to assist me in closing the gaps between Practitioners and patients. Within the African American community , we are experiencing very dangerous trends in healthcare which are worsening. I’m not sure where or who else to reach out to for assistance in having these difficult conversations. I felt led to message you. If you’d like to get specific questions that I have , feel free to inbox me . Kham2479@gmail.com
I work in the hospital with tremendous people of every discipline. It's all about humility and compassion.
Patients die from not working together- that's the bottom line- a failed patient is the fault of both professionals. We are all human and things are missed, we should be working as a team to support each other to provide the best care for patients!
Lol. You are hilarious. I am an acute care nurse practioner and guess what I'm not a doctor. I work in an ICU in collaboration with the intensivist and other physicians and I agree there can be no comparison in the training!! Thank goodness for up-to-date . Agree with this vlog wholeheartedly.
Using the term "supervisor" and the legal restrictions that accompany that language is the problem. One could even argue that scope and training are problematic. Here are the facts.
1. Many NP programs are sub-par and graduates need to work harder to perform at the same level of even the worst residency prepared physician. The type of nursing experience gained before NP school greatly influences competency.
2. An NP with 10 years of RN work in an intensive specialty like ER or ICU and then 5 years of inpatient work as an NP.... Does not need to be "supervised" by a physician 3 weeks out of a family medicine residency. Yet this Is the law. It creates only an illusion of supervisory safety and control.
3. No matter your credentials... The most dangerous medical provider is the one who does not recognize their limitations and know when to ask for help. I have seen both MD and NP exercise such ignorance. The former however has legal protection and state condoned authority to do so.
Anyone think it's a good idea for a family medicine trained physician of 20 years to attempt placing an emergency pacemaker at a rural emergency department. Despite having only practiced the procedure once in residency training 2 decades ago? Of course it's a bad idea but I have seen this and many other rediculous scenarios play out. Yet despite my training and experience as a flight nurse, with hundreds of intubations logged. In my new role as NP I would place my license in peril assisting a difficult emergency intubation while rounding hospital.
My point is that instead of arguing false metrics like hours of training and legal scope. Which are poor if not irrelevant predictors of patient safety, quality and outcome (as more and more studies clearly demonstrate).
It would benefit ALL parties to reconsider how we measure our value and role in medicine. Not in the context of a hierarchy but as team with each member having a unique and valuable skill set. The value of direct actual experience and proven competency is not even being considered in these arguments... Yet it's probably the only thing that actually matters.
Ugh, let’s all just be friends
Dunn AMEN!
When I was an ER nurse studying to be a NP, I had a med student tell me that NP need to know their boundaries, they shouldn't pretend to be doctors and if I became a NP to know my place.
That's when I found out about this hostility, why?
I am a NP now and I don't think I am a doctor. Not even close. But I am a good NP because I know my strengths and weaknesses and when to ask for help.
If I am not confident in what I am doing, I consult.
I just don't understand the hostility. Are we a threat?
If an MD is threatened by a NP that says a lot about that MD.
If you think job security is threatened by NPs then that just sad.
What are your thoughts on ER nurse practitioners vs ER Doctors?
I graduate from my BSN nursing program in April and have been considering acute care gerontology nurse practitioner school with a year emergency medicine certification.
I keep on hearing that they have similar or the same treatments and responsibilities.
I have so much to say about this. I am an icu Nurse, and when I first graduated nursing school I thought about going back to be an NP. I visited several schools and researched the curriculum. I saw some of my co workers working as new NP’s and felt that they were expected to make medical decisions that were out of their scope of practice. One of them works with one of our cardiologists and comes to the icu and makes decisions that I don’t think she’s educated on. I hope no one takes offense to this, because I think NP’s are a great addition to the team! But long story longer, I realized that being an NP is not something in my journey for so many reasons. But I wouldn’t feel comfortable treating patients in an outpatient or inpatient setting the way that MDs do, who went to school for a really long freakin time! But that’s MY decision. I also started the pre med path before going to nursing school. Then I had my daughter and realized that nursing was a better situation for my family life, on a personal level. I don’t believe that nurses become nurses because we can’t get into med school. That’s such a false statement. My husbands dad is a doctor, and he specifically became a nurse because he wanted to work in healthcare but wanted a better work life balance compared to what he had growing up with his dad. So much respect for everyone in our field! Everyone is needed! Everyone has a different journey! Thank you for your honesty and this bad ass channel!
Very well said. It really is all about experience. When I first started as an NP, I was scared to death. I’ve been an NP for 7 years now, I just transitioned from cardiology to primary care. I was very nervous before starting, I just want to take care of my patients and do the right thing. I am very comfortable in what I’m doing, I feel I am well within my scope of practice. My supervising physician is always available to me if I need him. I fully believe NP’s should always have a supervising physician. I am not there to replace the doctor, I am there to help him get things done and take care of the things that are within my scope.
@@christinawells2024 You're lucky that you have a good collaborating physician who is willing to work with you. The first time I worked as a Nurse Practitioner, my collaborating physician was a total a**hole to me. He treated me like s**t and when the patients started to treat me warmly, he started to get verbally and emotionally abusive with me; he wouldn't answer my questions, he wouldn't discuss patient care with me, he never gave me any feedback, he was truly demonic. Needless to say, I left there quickly. I went back to the hospital to work in the ICU just for the health insurance, oh yeah, my collaborating physician didn't give me any health insurance either, I was so traumatized by this physician that I'm really not that anxious to get another job as a Nurse Practitioner. For now, I'm fine with working in Critical Care, I don't HATE the bedside and I appreciate the benefits the hospitals give. I will probably work as a Nurse Practitioner again but only with a collaborating physician who cares to work in a truly COLLABORATIVE practice. To all new nurse practitioners, don't just take any position, carefully research the physician that you are going to work with. Most physicians have EGO and they love to put down Nurse Practitioners, you just have to find the right one. BTW, ICU nurses have a lot of knowledge and they are to be commended.
Laurin, I am a Nurse Practitioner but I still work in Critical Care also, please read my post below, I talk about my experience as a new Nurse Practitioner. I just wanted to tell you that it's fine to want to be an ICU nurse at the bedside. ICU nurses are extremely knowledgeable and they should be commended and recognized as the caring and compassionate healthcare professionals that they are.
My pals baby is now tube fed because an NP didn’t want to treat his acid reflux until he started vomiting blood
So sad. : (
Thank you so much! When I read the title of the video, I must admit I wasn't sure about what I was getting into! I'm a new grad NP and I thought I was just in for a good old-fashioned bashing! I couldn't have been more wrong and more pleasantly surprised! I 100% agree, we have to know what we don't know, stay within our scope and support one another! Thanks, ZDoggMD!
Thank you for making this video. My sister is finishing up nursing school. Starting this coming fall she plans to become a nurse practitioner. Unfortunately, she's doubting her decision because of the way many doctors seem to perceive nurse practitioners. Thank you for trying to make life easier for people like my sister.
Just a inoffensive comment passing by before hell breaks loose in the section comment. I'm an architect and I see this conflict between Architects and Engineers all the time, assholes gonna be assholes in every profession man.
WORD
So which one is better?! 😏
I appreciated the fuck out of this lol.
anarchy0209 There's a big disconnect between most doctors too.
ENT's and Gastro Dr's totally disagree with 1 another. They refuse too work together. They actually undermine one another.
Our health care system is a joke, unless ur rich.
I completely agree! Sorry, this is gonna be a novel! I'm currently a LPN, getting ready to graduate my ADN program this December. Additionally, I'm planning on obtaining my BSN and FNP. I'm well aware of the NP role in medicine and firmly believe that it is not that of a MD. Each member of the medical team is extremely valuable, from nursing aids all the way to MD. Each branch has their own specialty and training that make the patient experience, care, and healing very high quality when done correctly and cohesively.
The main reason I want to practice as a FNP is due to the fact that I see so many patients and families complaining of feeling uninformed and uneducated due to the doctor's lack of time with them and/or horrible bed-side manner. As a nurse, I feel education is my priority and obligation. It makes me feel so much more accomplished knowing that I did my absolute best at educating a patient and family and giving them a foundation of knowledge about whatever disorder they may be dealing with. Don't get me wrong, I'm well aware there are many reasons for time constraints and that not every family or patient cares or wants to know very much. But being able to bridge that gap, whenever possible, is very important to me. In my experience, NP's typically get more time allotted to them when seeing patients, which then gives the NP more time to explain conditions and educate accordingly as well as plan a course of treatment that should be overseen by a MD. Doctors are more focused (appropriately) on treating the condition with hopes of full recovery.
Just the other day, I was doing a CC clinical for school, and the person who was admitted in ICU was being scheduled for an EGD due to extensive GI bleeding and also had several other co-morbidities. The patient had had several bags of blood throughout the night and his H&H were 9.8&34 :( . The docs and nurses were doing whatever they could to make him comfortable and stable.A little later, the wife was at the bedside when the doc came in to explain the scoping and obtain consent. He quickly rambled the information, while standing over her with his hand on his hips. He asked her if she had any questions at the same time he pulled his phone out and began looking at messages. The wife, with tears in her eyes stuttered and stammered, stated she didn't know what to ask and "I guess you must have covered everything." The doctor told her it was all routine and "things should be fine." The staff nurse I was with came over with the consent form and the wife signed it as the doctor walked out of the room. My heart started aching. This poor wife. Her husband was laying in bed right next to her sleeping due to exhaustion from his condition, and all she can really think about and see is the NG tube that is on intermittent suction draining the blood from his stomach.
Luckily, since I'm a student in that situation, I had a little more freedom with my time since her husband was my only assigned patient that day. I told her I would be right back, ran to my book bag and grabbed my textbook. I came back in, opened the book up to the GI section and started a mini tutorial on what his condition was and what the EGD was for. The staff nurse kept close just in case she was needed and let us be. The wife became engaged and started asking questions. The 2 questions that I didn't have an answer for, I took to my instructor and the Intensivist who then came in to talk to the wife. After everything was settled, the wife asked me if she could give me a hug. She stated that no one had ever taken the time to sit down and explain things as well as I did and asked why I didn't choose to become a doctor, "since you're so caring and knowledgeable." I told her that my calling is to be a nurse and that I like being able to have a more one-on-one (staffing ratio permitting) interaction with patients.
Love this story. As a patient care associate I have had the opportunity to be 1:1 with med hold/ psych patients with medical needs, meaning I am with the patient for every interaction from housekeeping to surgeon and have been able to relay important information to family members as well as physicians and nurses. Ive seen how breakdowns in communication cause severe delays in care. Being able to take the time to explain to the patient/family what is happening with their care and seeing them get it is so rewarding
I'm an NP with 20 years experience in urgent care and ER medicine and I AGREE 100% with ZDogg. I AM NOT a physician and I absolutely think NPs should be in collaboration with physicians to practice. That being said, I've also had physicians consult with me on things. I've also seen MANY new NPs who think because they have a doctorate that they're all that and they don't know shit in many cases.
jdfnp most cases.
Thank god, you’re not the one deciding if there are NPs or not and what they are allowed to do. I am a NP, specialised in infectious diseases. How many patients are referred to our department by lets say family doctors, and primarily treated wrong? They are not specialised in infectious diseases. It’s fine that they do mistakes. That’s why specialisation is great. But it’s not important to be treated by a MD or NP. The key is to be treated by someone that knows what he/she is doing. I don’t know what’s your motivation. But the way you do it is terrible, and absolutely destructive. Just terrible.