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Stop the nurses before it's too late


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I'm with you on the Naturopaths. In our ENT room we recently had a child who needed extensive surgery b/c the parents had opted for a Naturopath to treat what was a simple ear infection. But apparently Cipro isn't considered as good as "flower remedies"...Not to mention a PA I worked with in Afghanistan who couldn't do an ABG to save his life (or more accurately, the patients)!

You're right also about the anecdotes, just venting.

I agree with you about several things, and Ian Wong's posting certainly gave me a pause.

I have had many positive experiences with NPs though and I maintain that they do have a place within our healthcare system.

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It is an insult to GP's, especially from the government who are being hypocrites if they support this.

 

On one hand, they urge medical students to become GP's to fulfill the need for doctors.

 

On the other hand, they are sending out the message that someone who has far less clinical/medical training can do the exact same job without the rigor/competition/extensive # of years and hard work and will be competing for their jobs. Okay, so what exactly are medical students/GP's supposed to think?

 

It's like having an actual teacher with a B. Ed. and someone who did 2 years of college and some "extra training" and now they are both somehow qualified to teach high school students? Even if a rural school was lacking teachers, it's not fair to just push this other person with less training/knowledge over and say "Here, they can do the same job now." Either you need a certain level of training to do a job or you don't. You can't have both running parallel together, it doesn't work that way. If the government thinks you don't need that much training, then I challenge them to completely get rid of GP's and run a new program where all NP's replace the role of GP's then. It's an all-or-none thing, you can't have your cake and eat it too.

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So....the drs at your office defraud OHIP? That's great. No sarcasm here, nope none at all....

 

NPs in Canada are prepared at a Masters level, so I doubt if they'll be called doctors anytime soon. Nor should they want to be.

I think all the negative comments being posted about nurses are extremely disrespectful. I for one got great grades in high school, and after some time in an intense science program at a well-known university, opted to enter a profession where I was guaranteed patient contact and a good salary (not 'cos I flunked out either :P ). Hospital nurses are at the pt's bedside 24/7 and will know the patients and their families better then you ever will. I hope those of you who are in medical school gain some appreciation of your colleagues. And most staff physicians at my facility ask the nursing staff their opinion of the med students who are applying for residencies there.

But seriously- enough with the profession bashing. There are poor examples in any health care field (Such as the GP hospitalist who prescribed T3s to the pt with the codeine allergy...which was found out by a nurse...after the drugs had been dispensed by a pharmacist). NPs are a reality in our health care system, as are other mid-level practitioners.

 

there was also a recent tragic case this past summer when a med student mixed up intravenous NaCl with KCl... not pretty. Everyone can make mistakes, and there are black sheep in every profession. mildoc1, you certainly are awesome if you're in med now, but on average, the people in nursing are not anywhere near the level of medical students, and to afford them the same privileges is silly. Even arbritrarly, nurses may graduate with a 60%, while in med, a pass is at least 70%. A better solution might be to reserve several spots in med school for the brightest nurse practioners.

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Reading through the thread I see a lot that I agree with when it comes to an expanded medical role for RNs and NPs. Precisely because they are not trained in medicine (formally) I take issue with them practicing medicine. When it comes to PAs, however, I think this is a whole different issue. One cannot lump PAs and NPs together. PAs study medicine, just less of it. Their programs teach them medicine in a fashion similar to how m.d./mbbs degree programs teach medicine. Looking at the documents here http://umanitoba.ca/faculties/medicine/departments/opas/paep/curr_student/3884.htm or the outline here http://registrar.mcmaster.ca/calendar/current/pg1257.html shows that.

 

What is more, the standard for admission to these PA programs is, in itself quite high and admissions are highly competitive as well.

 

From what I understand, the main thing that MD/MBBS students get more of than PA students is the detailed underlying basic science of things, thus making them better qualified to handle complexities.

 

Upon graduation from a PA program, PAs write licensing exams and then function in a way very similar to a PGY1. They practice medicine under the guidance and supervision of physicians. And, in so doing, extend the practice.

 

I just wanted to point this out since, for some reason, PAs keep getting lumped-in with NPs despite the fact that they are two totally different professions with entirely different training and function.

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all you have to do is let the secretary know you'd like to book a "counselling session" with the doctor, which by law is supposed to be half an hour and OHIP pays your family doc more for it. even without the counselling

 

Sounds like fraud to me. I'm also basing my opinion on my experience. If I knew more Naturopaths maybe I'd feel differently. As it is I work with CF PAs on a regular basis. Often these practitioners last formal schooling was high school (and you only need Gr12 biology, not even graduation). Although now they've raised the standards and they are getting a correspondence degree from Nebraska.....

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there was also a recent tragic case this past summer when a med student mixed up intravenous NaCl with KCl... not pretty. Everyone can make mistakes, and there are black sheep in every profession. mildoc1, you certainly are awesome if you're in med now, but on average, the people in nursing are not anywhere near the level of medical students, and to afford them the same privileges is silly. Even arbritrarly, nurses may graduate with a 60%, while in med, a pass is at least 70%. A better solution might be to reserve several spots in med school for the brightest nurse practioners.

 

That's news to me!

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If this "war" goes on, the CMA should be fighting back. I can see the ads now...

 

"Dear Canadian patients, you have in front of you two choices. To have you and your family members treated by the cream of the cream of our society- our M.D.'s. Or you could choose a nurse. An MD has a doctorate in medicine, and a Nurse Practitioner has a masters in Nursing. Both would cost you the same- zero out of your pocket. It's basically like giving you the choice of driving a Porsche vs a Camry-and both are FREE! Its a clear choice. I know I'll have the Porsche. Thanks for listening to your friendly CMA."

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there was also a recent tragic case this past summer when a med student mixed up intravenous NaCl with KCl... not pretty.

 

Every hospital that I have every worked in, from downtown Toronto to the boondocks where there are hitching posts on main street for horses, has stocked bags of normal saline pre-mixed with 0 or 20 or 40 mmol/L KCl to prevent such an occurrence...

 

Citation, please.

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because doctors cost more to hire and train. NP will save the government money...

 

Until the point when NPs have achieved some sort of clinical parity with MDs. Then the argument will be "we are doing the same work that physicians are doing, therefore we deserve the same compensation."

 

Mark my words, 5-10 years from now this line of reasoning will be advanced by NPs and their ilk in their negotiations with the government.

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Maybe if you weren't so freaking condescending and rude I'd be more inclined to apologize.

So sorry, I did misread your sentence.

I do respect the doctors I work with, but I don't have such a kind view towards wannabe med students who cr@p all over my profession.

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I don't think anyone is attacking nursing as a profession. In fact, most people greatly value the role of nurses and teamwork in healthcare. It's when boundaries start getting unclear between different roles that puts the patient at risk. Just because people are skeptical about giving NP's the same role as GP's doesn't mean they are disrespecting nursing.

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I'm applying to medicine because I want to become a surgeon. I've had a great career as a nurse, but I want to do and learn more. As a nurse I've worked across the country in CCU, ER, palliative care, gen surg, pediatrics, and most recently in the OR. As a military nurse I've been to Afghanistan and Haiti. My deployments convinced me that medicine was what I want to do. I was lucky enough to be part of amazing teams, both times, and I really had an incredible opportunity to be mentored by some fantastic docs.

 

On this thread I certainly wasn't trying to bash physicians, just point out that there are mistakes made by every health care worker. I do believe that NPs are valuable members of the team, but I do not believe they should be given equal pay or scope of practice to physicians. For other mid-level practitioners, I have a limited frame of reference.

 

I did misread dreamers' post and for that I apologize! I also feel the response and the personal insults were totally out of line. As for the nurse bashing- people on this thread have stated that some nurses aren't even university educated (if it's less expensive then university and you come out with the same credentials why wouldn't you go to college?), that the standards for marking are lower (I though most med schools had gone the "pass/fail" route), and compared NPs to Toyotas (and not a word if it was pre or post recall :) )

So why are you applying?

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and i must say it's quite classy of you to not apologize after making an immature statement. you are fuelling the very stereotype that you are trying to disprove; that nurses will use any opportunity to bring down doctors. in no way did my post indicate my bosses were committing fraud, instead it was the total opposite, but i guess it's all about this filter you have in your head that only lets through things you want to think/hear. anyways, i'm done with this grade 1 type argument. i hope YOU can gain some respect for doctors some day. and then you can hope that others respect you just as much. bye.

 

I'm in nursing, and I appreciate it if you don't label nursing as an evil and greedy profession that wants to "bring down [the] doctors".

 

I work with many great physicians, and we value and respect each other's work.

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I don't think anyone is attacking nursing as a profession. In fact, most people greatly value the role of nurses and teamwork in healthcare. It's when boundaries start getting unclear between different roles that puts the patient at risk. Just because people are skeptical about giving NP's the same role as GP's doesn't mean they are disrespecting nursing.

 

This is exactly the point, I would say the same stuff if family docs wanted the rights to perform heart surgery. If you dont have the training, stay out of that area

 

You're a gigantic douchebag. You were also wrong. WRONG. I'm not sure if you understand the concept. It's like when you give a patient the wrong medication (which I'm sure you've done, many times) but you refuse to apologize because that patient was a **** to you.

 

I have nothing to say about your profession. But.. *pulls down pants and drops a big one*... here's one for you, ya worthless piece of sh*t.

 

/this post will soon disappear so enjoy it while you can, kids! :D

 

Oh come on, mildoc is also in med school, so there is no logical reason to think this, right? we are just have a nice relaxing debate. As intellectuals, no reason for this to degenerate into flame wars...

 

I'm in nursing, and I appreciate it if you don't label nursing as an evil and greedy profession that wants to "bring down [the] doctors".

 

I work with many great physicians, and we value and respect each other's work.

 

well, you do understand your boundaries and current limitations... and thats why YOU are cut out to be a doc someday. If I may quote alexander pope, A little learning is a dangerous thing; drink deep, or taste not the Pierian spring: there shallow draughts intoxicate the brain, and drinking largely sobers us again. The problem is that some nurses dont understand/respect their lack of knowledge, and may think that a few years of clinical experience has taught them enough too properly take care of their patients... that's what i'm scared about for the future patients of Canada...

 

and dreamer? e-HUG!!!

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As for the nurse bashing- people on this thread have stated that some nurses aren't even university educated (if it's less expensive then university and you come out with the same credentials why wouldn't you go to college?), that the standards for marking are lower (I though most med schools had gone the "pass/fail" route), and compared NPs to Toyotas (and not a word if it was pre or post recall :) )

So why are you applying?

 

Perhaps the manner some of these ideas were articulated could've been better, but that's no reason to completely ignore the truth. There are college-level nurses and combined programs. The standards ARE lower than medical school in terms of knowledge base, that has nothing to do with whether both are pass/fail or not. As for the last one, lol, well it's too bad you don't like humor, but really, the point is that GP's > NP's at doing the job they WERE trained for. Good point UTPEOPLE, it really has nothing to do with nurses vs. doctors, it's more about the specific role. You'll hear as much uproar if family doctors started to challenge the idea of doing open heart surgery.

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Perhaps the manner some of these ideas were articulated could've been better, but that's no reason to completely ignore the truth. There are college-level nurses and combined programs. The standards ARE lower than medical school in terms of knowledge base, that has nothing to do with whether both are pass/fail or not. As for the last one, lol, well it's too bad you don't like humor, but really, the point is that GP's > NP's at doing the job they WERE trained for. Good point UTPEOPLE, it really has nothing to do with nurses vs. doctors, it's more about the specific role. You'll hear as much uproar if family doctors started to challenge the idea of doing open heart surgery.

 

I would run for the hills...

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