Robin Hood Posted April 28, 2012 Report Share Posted April 28, 2012 http://www.ama-assn.org/amednews/2011/03/07/prl20307.htm Seriously, if NPs and RNs want to act like physicians, then what's the difference between Nursing and Medicine, and so, wouldn't it be better to make Nursing a medical speciality? Link to comment Share on other sites More sharing options...
MarieJJib Posted April 28, 2012 Report Share Posted April 28, 2012 They don't want to "act like physicians", and I think you really missed the point of the article entirely. I think many current and future MDs are feeling threatened that society no longer sees them as 'God-like'. These days, many people have taken a pro-active approach to their own health care and do not rely entirely on physicians to make medical decisions for them. We are now realizing that RNs, NPs, midwives, nathropaths etc. are more than qualified to deal with many medical issues without being overseen by an MD. This will allow for quicker access to quality health care. Why wait 3+ hours in your family docs office just to get a prescription filled for your child's ear infection? You likely already know what med you need. Medications like these (and many other drugs) are something that pharmacists and other health care providers should be able to prescribe. Link to comment Share on other sites More sharing options...
Robin Hood Posted April 28, 2012 Author Report Share Posted April 28, 2012 They don't want to "act like physicians", and I think you really missed the point of the article entirely.I think many current and future MDs are feeling threatened that society no longer sees them as 'God-like'. These days, many people have taken a pro-active approach to their own health care and do not rely entirely on physicians to make medical decisions for them. We are now realizing that RNs, NPs, midwives, nathropaths etc. are more than qualified to deal with many medical issues without being overseen by an MD. This will allow for quicker access to quality health care.Why wait 3+ hours in your family docs office just to get a prescription filled for your child's ear infection? You likely already know what med you need. Medications like these (and many other drugs) are something that pharmacists and other health care providers should be able to prescribe. Maybe you think that the condition is simple, but you can't know for sure if it's that simple if you can't diagnose. Many diseases can have common symptoms, that's why a diagnostic is important. So if Nurses want to diagnose and prescribe, they should learn about the whole body, and not just get some watered-down medical education. As for pharmacists, they have an interest in selling expensive medication, so allowing them to prescribe can cause a conflict of interest, in addition to the fact that they can't do a diagnostic.As for naturopathy, it's not based on scientific data, so it can't be considered reliable.Also, if auxiliary nurses start infringing on the nursing profession, the nurses wouldn't be happy, and Nursing will start losing value. Link to comment Share on other sites More sharing options...
MarieJJib Posted April 28, 2012 Report Share Posted April 28, 2012 Well you are wrong in assuming that nurses do not learn about the whole body. (In regard to prescribing medication, I am mostly talking about NPs). For you to call the education watered-down is extremely ignorant and it is for this exact reason that people do not want to see doctors anymore (I'm assuming you are a med student). Patients want a say in their health care, they do not want to be told what to do. I certainly believe there needs to be a review of the medical system and the current policies in place, but you would be naive to think that expanding the scope of care that health providers other than MDs can provide would be detrimental or non-successful. Link to comment Share on other sites More sharing options...
Robin Hood Posted April 28, 2012 Author Report Share Posted April 28, 2012 Well you are wrong in assuming that nurses do not learn about the whole body. (In regard to prescribing medication, I am mostly talking about NPs).For you to call the education watered-down is extremely ignorant and it is for this exact reason that people do not want to see doctors anymore (I'm assuming you are a med student). Patients want a say in their health care, they do not want to be told what to do. I certainly believe there needs to be a review of the medical system and the current policies in place, but you would be naive to think that expanding the scope of care that health providers other than MDs can provide would be detrimental or non-successful. NPs can't work independently, and are considered midlevels. Also, MD spend 2 years of intensive basic science learning, 2 years of intensive clerkship, and 2 to 5 years of intensive residency work, while NPs don't get that much training. Link to comment Share on other sites More sharing options...
kpm Posted April 29, 2012 Report Share Posted April 29, 2012 NPs can't work independently, and are considered midlevels. Also, MD spend 2 years of intensive basic science learning, 2 years of intensive clerkship, and 2 to 5 years of intensive residency work, while NPs don't get that much training. I thought that NPs could work independently. They just can't prescribe narcotics. I thought it was PAs who could not work without physicians (MDs). Link to comment Share on other sites More sharing options...
Robin Hood Posted April 29, 2012 Author Report Share Posted April 29, 2012 I thought that NPs could work independently. They just can't prescribe narcotics. I thought it was PAs who could not work without physicians (MDs). Maybe I was wrong, but it seems NPs work according to protocols set up by the place there working in or the physician, I wasn't able to get a clear answer about this. Link to comment Share on other sites More sharing options...
A-Stark Posted April 29, 2012 Report Share Posted April 29, 2012 NPs can do a lot of work independently, but this is only true of somewhat limited primary care and chronic care. In the acute care sector, they function similarly to housestaff, albeit on a permanent basis without call (call or no call it still sounds like some version of hell unless you're in love with ward paperwork). At Sunnybrook there are NPs involved in the acute pain service too, so it's not strictly true that they cannot prescribe narcotics (probably varies by province). Link to comment Share on other sites More sharing options...
Gaven32 Posted November 2, 2012 Report Share Posted November 2, 2012 I agree these days, many people have taken a pro-active strategy to their own healthcare care and do not depend entirely on doctors to make healthcare choices for them. Nursing staff are more than certified to deal with many wellness problems without being supervised by a doctor. Link to comment Share on other sites More sharing options...
jerkstore Posted November 2, 2012 Report Share Posted November 2, 2012 Nurses acting like Physicians are the scum of the earth:D . I'm definitely in favour of delegating some routine tasks to other professionals. Doctors complain that they work too much and see too many patients, well here's the solution, Jack. Link to comment Share on other sites More sharing options...
seeking1 Posted November 3, 2012 Report Share Posted November 3, 2012 We are now realizing that RNs, NPs, midwives, nathropaths etc. are more than qualified to deal with many medical issues without being overseen by an MD. This statement is not backed up by any evidence whatsoever. In response to your statement, I have looked up the curriculum for RN's and NP's at the University of Toronto. The following links will help us judge the level of expertise of these healthcare workers. Undergraduate BScN curriculum Post-MN NP Diploma MN Degree Requirements Faculty of Nursing Calendar 2012-2013 Where's the focus on pathology? Histology? Neuroscience? Endocrinology? Biochemistry? etc. The division of expertise exists for a reason: because one person cannot reasonably be an expert in everything. On the basis of the education I listed above, nurses are experts in nursing, and physicians are experts in biomedical sciences. Your claim is invalid. Link to comment Share on other sites More sharing options...
leviathan Posted November 4, 2012 Report Share Posted November 4, 2012 Why wait 3+ hours in your family docs office just to get a prescription filled for your child's ear infection? You likely already know what med you need. Common things may be common, but do you know the differential diagnosis for a child with a painful ear or whatever presenting complaint they have that you think is an otitis media? Furthermore, does every child with an ear infection need antibiotics? If not, when do you need to treat an ear infection and at what ages, and what antibiotics are appropriate for each age? What complications might arise from chronic OM and what kinds of further interventions might be required? I'm being overzealous here but just to prove a point. Link to comment Share on other sites More sharing options...
leviathan Posted November 4, 2012 Report Share Posted November 4, 2012 I don't think PhD-level clinical psychologists asking for prescription rights for psych drugs is that much of a stretch. They would probably require a bit of extra training but I think it could be done safely. Definitely a lot safer than naturopaths being allowed to prescribe any drug they want. Link to comment Share on other sites More sharing options...
rmorelan Posted November 4, 2012 Report Share Posted November 4, 2012 I don't think PhD-level clinical psychologists asking for prescription rights for psych drugs is that much of a stretch. They would probably require a bit of extra training but I think it could be done safely. Definitely a lot safer than naturopaths being allowed to prescribe any drug they want. The trouble is how those drugs would interact with all the other potential medication the person may be on plus all the other medical conditions that might be present. In some cases it would be drop dead easy (young, no medical conditions, simple clinical depression) but I have to worry about the more complex stuff. Not to say some system couldn't be worked out but rather (as you know) the problem is never just dealing with what is in your own domain. Link to comment Share on other sites More sharing options...
Tacrolimus Posted November 5, 2012 Report Share Posted November 5, 2012 N/A Link to comment Share on other sites More sharing options...
leviathan Posted November 5, 2012 Report Share Posted November 5, 2012 The trouble is how those drugs would interact with all the other potential medication the person may be on plus all the other medical conditions that might be present. In some cases it would be drop dead easy (young, no medical conditions, simple clinical depression) but I have to worry about the more complex stuff. Not to say some system couldn't be worked out but rather (as you know) the problem is never just dealing with what is in your own domain. This is the only reason that I would say it is difficult to sign off on. But it's definitely possible that they can learn about all the drugs they're using and which other drugs they interact with, the contraindications etc. Link to comment Share on other sites More sharing options...
futureGP Posted November 5, 2012 Report Share Posted November 5, 2012 Well you are wrong in assuming that nurses do not learn about the whole body. (In regard to prescribing medication, I am mostly talking about NPs).For you to call the education watered-down is extremely ignorant and it is for this exact reason that people do not want to see doctors anymore (I'm assuming you are a med student). Patients want a say in their health care, they do not want to be told what to do. I certainly believe there needs to be a review of the medical system and the current policies in place, but you would be naive to think that expanding the scope of care that health providers other than MDs can provide would be detrimental or non-successful. well i think you're ignorant in that doctors think they're God-like and want to make decisions for their patients... this is the 21st century, and people make decisions about what they want themselves. We are just consultants to their needs. If they don't want to, we never force them to and this is being emphasized in medical school greatly. yeah, i certainly believe there needs to be a review of the medical system too. Let's make health-care free-for-all and see whose method is better. Let's give everyone prescription rights and see who the patients prefer to see. actually, why don't we go back to the 1800s when there were no regulations? that sounds about right Link to comment Share on other sites More sharing options...
thebouque Posted November 5, 2012 Report Share Posted November 5, 2012 [quote=MarieJ Why wait 3+ hours in your family docs office just to get a prescription filled for your child's ear infection? You likely already know what med you need. Medications like these (and many other drugs) are something that pharmacists and other health care providers should be able to prescribe. You already know what med the child need if he has a painful ear? In a lot of cases he wouldn't need any, even with a proven otitis media... Link to comment Share on other sites More sharing options...
aaronjw Posted November 5, 2012 Report Share Posted November 5, 2012 well i think you're ignorant in that doctors think they're God-like and want to make decisions for their patients... this is the 21st century, and people make decisions about what they want themselves. We are just consultants to their needs. If they don't want to, we never force them to and this is being emphasized in medical school greatly. yeah, i certainly believe there needs to be a review of the medical system too. Let's make health-care free-for-all and see whose method is better. Let's give everyone prescription rights and see who the patients prefer to see. actually, why don't we go back to the 1800s when there were no regulations? that sounds about right AtomSmasher and Brooksbane would be in favour I think lol Link to comment Share on other sites More sharing options...
apache Posted November 6, 2012 Report Share Posted November 6, 2012 well, even missing sleep apnea for add or daytime drowsiness, potential interactions between certain anti-consulsants... honestly, i think medical psychology could just be a grandfathered in specialty that provided greater breadth in terms of the strong biological background shrinks are expected of having, plus knowing multiple modalities in terms of psychotherapy, knowing greater epidemiology, social factors.... as well as skill in clinical conditions which fall outside of the more biological treatment (fibromyalgia, cfs, severe personality disorders, depersonalization/dissociation, adhd (which has important bio interventions, but so many lifestyle, ecological and other changes most shrinks are clueless about)... that was you get the best of both worlds, like yeah, it's honestly redundant having one claim the body and psyche (speaking superficially of course), when we can invest so much more in an individual... whose understanding of numerous factors allow them to better make comprehensive treatment plans. The trouble is how those drugs would interact with all the other potential medication the person may be on plus all the other medical conditions that might be present. In some cases it would be drop dead easy (young, no medical conditions, simple clinical depression) but I have to worry about the more complex stuff. Not to say some system couldn't be worked out but rather (as you know) the problem is never just dealing with what is in your own domain. Link to comment Share on other sites More sharing options...
rswim Posted November 20, 2012 Report Share Posted November 20, 2012 Speaking of nurses who think they are doctors - how about the CRNA debate? I apologize for posting this in two different forums but I feel like its relevant to this discussion: CRNAs can be beneficial if they have the correct attitude. Like nurses in other fields, they should be there to assist the anesthesiologist. Things get dangerous when people think they can do more than they are trained for. A good CRNA will know that he/she is not an anesthesiologist, the same way a ER nurse knows they are not the same as an emergency doctor, a dental hygienist is not the same as a dentist, and a flight attendant is not the same as a pilot. Flying an airplane and Anesthesia are often compared. 99% of the time it is smooth sailings and things are on autopilot. Does this mean that we can turf the pilot and let the flight attendants run the show? Perhaps on sunny days with a calm forecast we should forgo having a pilot? Good luck operating an airline on that premise. Anesthesia is the same way, 99% of the time there isn't that much to it, but you need to have a fellowship trained anesthetist (13 years of post graduate education 9 since starting medical school) there for that 1%. Furthermore, we don't merely want patients to survive their surgery, we want them to have the best possible experience and highly trained specialists with thorough understanding of physiology and pharmacology are required to get the best possible results. CRNAs shouldn't threaten anesthesiologists, and should be seen as a welcome addition to the team to assist the anesthetist the same way scrub nurses assist the surgeons. What scares me is this attitude that a CRNA is any different from any other specialized mid level provider. Link to comment Share on other sites More sharing options...
jerkstore Posted November 20, 2012 Report Share Posted November 20, 2012 Speaking of nurses who think they are doctors - how about the CRNA debate? I apologize for posting this in two different forums but I feel like its relevant to this discussion: CRNAs can be beneficial if they have the correct attitude. Like nurses in other fields, they should be there to assist the anesthesiologist. Things get dangerous when people think they can do more than they are trained for. A good CRNA will know that he/she is not an anesthesiologist, the same way a ER nurse knows they are not the same as an emergency doctor, a dental hygienist is not the same as a dentist, and a flight attendant is not the same as a pilot. Flying an airplane and Anesthesia are often compared. 99% of the time it is smooth sailings and things are on autopilot. Does this mean that we can turf the pilot and let the flight attendants run the show? Perhaps on sunny days with a calm forecast we should forgo having a pilot? Good luck operating an airline on that premise. Anesthesia is the same way, 99% of the time there isn't that much to it, but you need to have a fellowship trained anesthetist (13 years of post graduate education 9 since starting medical school) there for that 1%. Furthermore, we don't merely want patients to survive their surgery, we want them to have the best possible experience and highly trained specialists with thorough understanding of physiology and pharmacology are required to get the best possible results. CRNAs shouldn't threaten anesthesiologists, and should be seen as a welcome addition to the team to assist the anesthetist the same way scrub nurses assist the surgeons. What scares me is this attitude that a CRNA is any different from any other specialized mid level provider. You make a good point about "we don't want patients merely to survive the surgery", look at all the studies out there about the effects of anesthesia on the brain etc. Just because someone survived doesn't mean they were not damaged in some menial way. Link to comment Share on other sites More sharing options...
concernedmedstudent Posted November 20, 2012 Report Share Posted November 20, 2012 I agree - if a nurse wants to become an anesthetist he/she should get a university degree (if they haven't already) apply to medical school score among the top of the class and complete a 5 year anesthesia residency +/- an fellowship. It would only take them 9-15 years depending on their undergrad education and desire for fellowship. Although I guess he/she could learn the same amount with additional two year program at community college would be equivalent?? And nurses/other healthcare professionals often say doctors are arrogant? Link to comment Share on other sites More sharing options...
kortezjoe Posted November 21, 2012 Report Share Posted November 21, 2012 what do you think about this link http://drugstore24hour.sc-specialhost.com/ Link to comment Share on other sites More sharing options...
laladeedee Posted November 21, 2012 Report Share Posted November 21, 2012 what do you think about this link http://drugstore24hour.sc-specialhost.com/ woah an online drug store.. ? Is that safe? Link to comment Share on other sites More sharing options...
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