Ontario gives nurse practicioners power to admit, discharge patients.

[ploughboy]

A little late to the discussion but more and more poorly trained folks are getting to do things that people that were highly trained used to do. The nursing home where I do some work at now employs only LPNs with 1 or 2 RNs per shift. The LPNs graduate from some private for profit college, with a 1-2 year diploma and a 3 month practicum, but yet can give medications, receive lab orders, etc.

 

I've worked in the same sort of environment - a ward with two "teams" of 5 or 6 LPNs, each overseen by an RN. It was wonderful...the "team" approach meant nobody knew any of the patients in any detail nor did any one nurse have a sense of responsibility for a given patient, and since they were all LPNs it was darn near impossible to have a sensible medical conversation with them due to their limited training. I wound up saying "Can I talk to the RN please?" a lot. The RNs were great (not being sarcastic, they were really good), but a little bit frazzled given the number of patients.

 

And like at Moo's nursing home, all of this was in the name of cost-saving. I think this particular hospital has actually been written up in the media as an example of ways to cut costs in the medical system. Although I am not aware of any adverse events specifically related to the use of LPNs on the one ward I worked on during the one month I was there, there were enough close calls and "wtf" moments that I'm sure the use of LPNs has resulted in poorer patient care on a hospital-wide basis.

 

But hey, it looks good on a financial spreadsheet, as does the use of mid-levels to do the work formerly done by physicians.

[Islandcrazy]

Some of you guys are ignoring the fact that some IMGs, like myself, are actually Canadian students receiving government money to study aboard. And no I don't mean OSAP, I actually received 3 grants from the governments this year.

[apache]

canadians who go abroad for med aren't what i was referring too, i mean immigrants who do their training abroad

 

Some of you guys are ignoring the fact that some IMGs, like myself, are actually Canadian students receiving government money to study aboard. And no I don't mean OSAP, I actually received 3 grants from the governments this year.

[Slashsev01]

you guys should have read the article of how dal is housing saudi students..i beleive 10 (with total admision number of 60) to study in canada...(but paying a greater tution)...

 

im sure there are students in canada willing to pay 10x more than the saudis to study here...oohh well...

 

u cannot beat a dead horse as they say...

[Renin]

Does that mean that they can do admission summaries and discharge dictations?

 

(if so: YAY!!!!!!!!!!)

 

in reality - there are RN admissions and there are MD admissions. There is a definite difference between the quality (and length) (and depth) of both.

[A-Stark]

NPs definitely dictate discharge summaries, but I cannot imagine the charge nurse let alone a floor RN ever doing them.

[Renin]

NPs definitely dictate discharge summaries, but I cannot imagine the charge nurse let alone a floor RN ever doing them.

 

Booooooooo. They can't do all the fun stuff and leave us the grunt.

[NLengr]

I would imagine that if you are the one with the authority who is discharging the patient, you would be legally required to dictate a discharge summary. At the very least, you would be expected to by the health authority. Plus, it would be foolish from a medico-legal standpoint.

 

The reasons we can do it as clerks and residents is because we are working under the authority of an attending. If there was no clerks or residents, the attending would have to do it.

[Renin]

I would imagine that if you are the one with the authority who is discharging the patient, you would be legally required to dictate a discharge summary. At the very least, you would be expected to by the health authority. Plus, it would be foolish from a medico-legal standpoint.

 

The reasons we can do it as clerks and residents is because we are working under the authority of an attending. If there was no clerks or residents, the attending would have to do it.

 

Of course; what I mean is it seems like all of the things that are given away to NP's are things that have limited amounts of paperwork. I don't mind doing d/c summaries on my own patients, or patients I know of; but I feel that if a NP was doing a d/c then they should do their own summary. Or if a nurse could d/c. Or whomever. It wouldn't really make sense for the physician to do the d/c summary if they didn't do the d/c.