Jump to content
Premed 101 Forums

Nurses acting like physicians


Robin Hood

Recommended Posts

What are you talking about? You mean paid subscription question banks like USMLEWorld? How exactly are those specific to physicians?

 

NPs are quite helpful in certain roles but their clinical skills and knowledge are inferior, mainly because they have vastly less training. It can be as simple as having little to no experience doing a DRE (and in the assessment of BRBPR no less) or not knowing the difference between cholecystitis and cholelithiasis.

Link to comment
Share on other sites

  • Replies 128
  • Created
  • Last Reply
The raison d'être of the NP is to compete directly with the GP. The nurses opportunistically took advantage of the GP shortage so they could expand their territory. The medical establishment, being useless when it comes to collective negotiations, failed to point out the fact that NPs have lower productivity than GPs per taxpayer dollar spent and provide lower quality care.

 

What have medical associations done in response to the primary care shortage? Seems that other professions try to expand their scope to meet the needs of Canadians (rather than just trying to create jobs for themselves, or create some kind of turf war with GPs), and those of the medical paradigm just shoot down all such attempts. Btw do you have a reference for the part about productivity per tax dollar?

Link to comment
Share on other sites

Oh yes, "other professions" are committed to patient care while physicians are just protecting their turf and money. Maybe if nursing programs had fewer fluff courses about "nursing theory" and more basic and clinical science (to say nothing of clinical examination, diagnosis, and management), those of us in the "medical paradigm" would be more inclined to consider NPs as being closer to functioning at the level of a GP.

 

Being a good generalist is really very challenging. You have to be able to diagnosis and manage just about anything, often with little time and myriad stresses. I do not mean *any* disrespect to the nursing profession, but the false equivalency being set up is just that - false.

Link to comment
Share on other sites

Oh yes, "other professions" are committed to patient care while physicians are just protecting their turf and money. Maybe if nursing programs had fewer fluff courses about "nursing theory" and more basic and clinical science (to say nothing of clinical examination, diagnosis, and management), those of us in the "medical paradigm" would be more inclined to consider NPs as being closer to functioning at the level of a GP.

 

Being a good generalist is really very challenging. You have to be able to diagnosis and manage just about anything, often with little time and myriad stresses. I do not mean *any* disrespect to the nursing profession, but the false equivalency being set up is just that - false.

 

My BScN program included biochem, organic chemistry, anatomy, physiology, microbiology, pathophysiology, psychology, physical assessment and courses on top of this that were focused on specifically nursing aspects of all those. We also had clinical placements each year, with 75% of final year in clinical placement. So to say we don't focus on basic or clinical sciences is a bit of an oversight. The "fluff" courses are a very small part of the program. A lot of my classmates, and myself, have HBSc as a previous degree btw.

 

But anyways, I was sincerely asking whether medical associations have done anything significant to address the shortage in primary care. In the end it doesn't really matter why nurses or psychologists want to increase their scope. The reality is that Canadians need more clinicians, especially so in certain healthcare and geographic locations.

 

Personally I would agree that the NP program could be a bit longer. From what I've heard it is a very intensive program, and it also includes a practicum with a GP. But still, an RN with 2 years of experience can go through a one year program to become an NP. It seems that they do fairly well tho.. I mean if patients were dropping dead I would imagine there would be a bit of an outcry. But anyways, I don't think anyone is saying that an NP can fill the exact same role as a GP. But there are certain patients/cases that can be handled by NPs with a physician to consult. For one thing, RNs have been functioning as the only clinician in remote and Northern areas for decades now. No one seems to consider that particularly unacceptable.

Link to comment
Share on other sites

The nurses probobly didnt have access to the ridiculous data base of past questions that all the physicians have access too when writing their exams. Dont talk about having a 50% chance of recieving good health care from nurses, its prob way worse odds for physicians.

 

http://www.cnn.com/2012/01/13/health/prescription-for-cheating

 

Tons more stories like this.

 

What are you talking about? That article is about remembrances used for radiology boards. The poster was talking about the USMLE step 3, a totally different exam for which remembrances are pretty much useless. We all have access to Uworld and kaplan.

Link to comment
Share on other sites

The nurses probobly didnt have access to the ridiculous data base of past questions that all the physicians have access too when writing their exams. Dont talk about having a 50% chance of recieving good health care from nurses, its prob way worse odds for physicians.

 

http://www.cnn.com/2012/01/13/health/prescription-for-cheating

 

Tons more stories like this.

 

LOL. There aren't any question banks made up of old exam questions for any other test out there, right? Kaplan and Princeton Review manage to come up with all those wonderful questions that are so much like the real MCAT questions on their own, right? USMLE World is full of their own unique questions too, right?

 

This is utter bull. They are just picking on one specialty when everybody does the same sh*t for any exam. You're telling me that nobody in high school/university ever went over old exam questions to help prepare for an upcoming exam?

 

So ridiculous.

Link to comment
Share on other sites

My BScN program included biochem, organic chemistry, anatomy, physiology, microbiology, pathophysiology, psychology, physical assessment and courses on top of this that were focused on specifically nursing aspects of all those. We also had clinical placements each year, with 75% of final year in clinical placement. So to say we don't focus on basic or clinical sciences is a bit of an oversight. The "fluff" courses are a very small part of the program. A lot of my classmates, and myself, have HBSc as a previous degree btw.

 

This is only my own opinion, but I think those are still fairly "light" science courses. I believe, I did all of those courses in less than two years in undergraduate, along with other courses like molecular genetics, protein biochemistry, psychopharmacology, histology, biophysics, etc. Courses in my junior and senior years were quite a bit more specialized (embryology, biochemical pharmacology, genomics, pathogenic microbiology, etc). Of course, I never doubted nurses took science courses, but I don't think they achieve the same level of depth. However, I could be wrong, and I would graciously apologize if that were the case..

Link to comment
Share on other sites

This is only my own opinion, but I think those are still fairly "light" science courses. I believe, I did all of those courses in less than two years in undergraduate, along with other courses like molecular genetics, protein biochemistry, psychopharmacology, histology, biophysics, etc. Courses in my junior and senior years were quite a bit more specialized (embryology, biochemical pharmacology, genomics, pathogenic microbiology, etc). Of course, I never doubted nurses took science courses, but I don't think they achieve the same level of depth. However, I could be wrong, and I would graciously apologize if that were the case..

 

Your undergraduate background is not necessarily a reflection of the courses most medical students have taken during their undergrad. While I do not doubt that not everyone takes "bird courses", to say it is the norm for pre-meds to have a transcript full of rigorous courses is a little generous. Many students don't even have a science degree before medical school. There's a reason you're in the MD/PhD stream... :P

Link to comment
Share on other sites

This is only my own opinion, but I think those are still fairly "light" science courses. I believe, I did all of those courses in less than two years in undergraduate, along with other courses like molecular genetics, protein biochemistry, psychopharmacology, histology, biophysics, etc. Courses in my junior and senior years were quite a bit more specialized (embryology, biochemical pharmacology, genomics, pathogenic microbiology, etc). Of course, I never doubted nurses took science courses, but I don't think they achieve the same level of depth. However, I could be wrong, and I would graciously apologize if that were the case..

 

I have heard this quite a few times from HBSc students, some of whom seem to be experts on nursing classes somehow. But you are right that nursing courses don't achieve the same level of depth, mainly for sake of time and in consideration of necessity. For example I don't think nurses nor MDs use their organic chemistry knowledge on a daily basis (unless you're directly involved in drug discovery or other such research). HBSc students need those courses in case they end up doing research in a certain field, in which case they will likely only use a very small part of knowledge they gained during the UG (this is what I've been told by friends who did a MSc). I'm sure taking basic science courses helps during med school, but mainly because it makes the applied material easier/faster to learn, rather than actually needing to know the characteristics of molecules that are strong nucleophiles or whatever. As docmm mentioned some students come from social science backgrounds or even fine arts and make fully capable physicians.

Link to comment
Share on other sites

Your undergraduate background is not necessarily a reflection of the courses most medical students have taken during their undergrad. While I do not doubt that not everyone takes "bird courses", to say it is the norm for pre-meds to have a transcript full of rigorous courses is a little generous. Many students don't even have a science degree before medical school. There's a reason you're in the MD/PhD stream... :P

 

Quite a few of us don't have science degrees. I would say that my honours BA (well, +BSc with an extra year) was if anything more rigorous than taking umpteen memorize-and-regurgitate biology courses. Though nothing really compares to PDEs or Analysis. I'm just glad I completely avoided any higher-level chem courses.

 

I have heard this quite a few times from HBSc students, some of whom seem to be experts on nursing classes somehow. But you are right that nursing courses don't achieve the same level of depth, mainly for sake of time and in consideration of necessity.

 

As far as I know, nurses take quite comparable intro-level courses to other undergrads, but (and this is something quite apparent in the clinical setting) their basic science and pathophysiology knowledge is really not comparable to MDs or even CC3s. The volume of material in undergrad for anyone simply doesn't compare. Nursing clinical placements are very different from a medical clerkship and it is not an exaggeration to say that observation is a big component. Nursing students also get subjected to numerous fluff courses on "nursing theory" which I gather do not have great relevance for practice.

Link to comment
Share on other sites

Just thought I'd chime in (didn't read the entire thread). But was this exam a requirement for entry-to-practice?

 

It's very possible that a lot of NP's just wing'd it to see how they would do because their licences were not depending on it (as it does for MD students trying to match into competitive residencies). That would make the study flawed... just an opinion

Link to comment
Share on other sites

Your undergraduate background is not necessarily a reflection of the courses most medical students have taken during their undergrad. While I do not doubt that not everyone takes "bird courses", to say it is the norm for pre-meds to have a transcript full of rigorous courses is a little generous. Many students don't even have a science degree before medical school. There's a reason you're in the MD/PhD stream... :P

 

;)

 

I have heard this quite a few times from HBSc students, some of whom seem to be experts on nursing classes somehow. But you are right that nursing courses don't achieve the same level of depth, mainly for sake of time and in consideration of necessity. For example I don't think nurses nor MDs use their organic chemistry knowledge on a daily basis (unless you're directly involved in drug discovery or other such research). HBSc students need those courses in case they end up doing research in a certain field, in which case they will likely only use a very small part of knowledge they gained during the UG (this is what I've been told by friends who did a MSc). I'm sure taking basic science courses helps during med school, but mainly because it makes the applied material easier/faster to learn, rather than actually needing to know the characteristics of molecules that are strong nucleophiles or whatever. As docmm mentioned some students come from social science backgrounds or even fine arts and make fully capable physicians.

 

I can only speak from personal experience here, but yes, I agree that taking "basic science courses," probably, doesn't result in better physicians. However, I think that students who have taken advanced courses in the medical sciences can add a great deal to their respective specialties. Of course, I'm not suggesting every student take advanced courses, but I've definitely seen a positive difference in the students who have taken them versus the students who haven't.

 

Quite a few of us don't have science degrees. I would say that my honours BA (well, +BSc with an extra year) was if anything more rigorous than taking umpteen memorize-and-regurgitate biology courses. Though nothing really compares to PDEs or Analysis. I'm just glad I completely avoided any higher-level chem courses.

 

As far as I know, nurses take quite comparable intro-level courses to other undergrads, but (and this is something quite apparent in the clinical setting) their basic science and pathophysiology knowledge is really not comparable to MDs or even CC3s. The volume of material in undergrad for anyone simply doesn't compare. Nursing clinical placements are very different from a medical clerkship and it is not an exaggeration to say that observation is a big component. Nursing students also get subjected to numerous fluff courses on "nursing theory" which I gather do not have great relevance for practice.

 

I can't say I agree with the majority of your points, but that's okay. :)

Link to comment
Share on other sites

  • 2 weeks later...

Lot's of nurse bashing going on here. :confused:

 

I'm a 3rd year BscN student and I think nurse practitioners aren't trying to replace GP's but instead relieve some of the stress on our healthcare system. Besides MD's are educated with the medical model whereas NP's use I'd say 50% nursing theory and 50% medical model in their practise. You also have to realize NP's don't usually deal with complex cases. Either way I think the government is taking the NP route as it has been shown to be successful in a number of different cities in the country. A lot of people here seem to be disgruntled that the physician isn't seen as the only gatekeeper these days in terms of diagnosing and prescribing.. Not sure why that's a bad thing as healthcare should be a collaborative effort.

Link to comment
Share on other sites

  • 4 weeks later...
Lot's of nurse bashing going on here. :confused:

 

I'm a 3rd year BscN student and I think nurse practitioners aren't trying to replace GP's but instead relieve some of the stress on our healthcare system. Besides MD's are educated with the medical model whereas NP's use I'd say 50% nursing theory and 50% medical model in their practise. You also have to realize NP's don't usually deal with complex cases. Either way I think the government is taking the NP route as it has been shown to be successful in a number of different cities in the country. A lot of people here seem to be disgruntled that the physician isn't seen as the only gatekeeper these days in terms of diagnosing and prescribing.. Not sure why that's a bad thing as healthcare should be a collaborative effort.

 

I agree wholeheartedly! This is a team sport! Having nurses enhance their skills and move into mid-level positions will only serve to relieve some of the strain on physicians and improve efficiency. Physicians can't function without nurses the same way nurses can't function without physicians!

 

It is important that everyone works together to the best of their ability.

 

It simply doesn't make sense for a physician who has cost the gov't over $600 000 to train and who has anywhere from 10-14 years of high level top tier post secondary education to be spending their time with sniffly kids or taking blood pressures etc.

 

It makes sense for people to practice within their limitations but also to continue to enhance their skills! There is nothing wrong with hierarchy but change can happen from the bottom up and the stronger the base the better higher the peak!

Link to comment
Share on other sites

Maybe you think that the condition is simple, but you can't know for sure if it's that simple if you can't diagonize. Many diseases can have common symptoms, that's why diagnostic is important. So if Nurses want to diagonize 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 to med 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.

 

Pointless argument man. You won't win.

Link to comment
Share on other sites

I agree wholeheartedly! This is a team sport! Having nurses enhance their skills and move into mid-level positions will only serve to relieve some of the strain on physicians and improve efficiency. Physicians can't function without nurses the same way nurses can't function without physicians!

 

It is important that everyone works together to the best of their ability.

 

It simply doesn't make sense for a physician who has cost the gov't over $600 000 to train and who has anywhere from 10-14 years of high level top tier post secondary education to be spending their time with sniffly kids or taking blood pressures etc.

 

It makes sense for people to practice within their limitations but also to continue to enhance their skills! There is nothing wrong with hierarchy but change can happen from the bottom up and the stronger the base the better higher the peak!

 

The problem is, a nurse on steroids is still not a doctor. They can only learn so much without actually going and getting an MD. The doctor is still the end of the line.

Link to comment
Share on other sites

No offense but I would feel safer trusting a physician's diagnosis with a pharmacist's prescription than just a physician doing it all. Pharmacist's are like special drug doctors, they know way more about the specific interactions between drugs than a physician could dream of knowing. I think it would be best if the physician and pharmacist collaborated for the patient, but this really doesn't happen.

Also, nurse practitioners have enough training to do basic diagnoses. If they are unsure what it is, they can always ask a physician to perform a double-check of necessary. I don't see the issue. It helps the government save money to leave simple patient and prescription renewals to NPs.

I would never trust an RN diagnosis. Not enough training, experience can't teach everything.

Link to comment
Share on other sites

What do you call an doctor who graduated with C's?. A doctor. No one is trying to get nurses to replace doctors, We're all fallible regardless of how long we went to school for. Suggesting that NPs can treat minor and routine medical issues is not a stretch at all.

 

M.D. = 4 years undergrad + 4 years medical school + 2/3 years residency

NP = 4 years undergrad +3 years graduate school + 2 years work experience

Link to comment
Share on other sites

What do you call an doctor who graduated with C's?. A doctor. No one is trying to get nurses to replace doctors, We're all fallible regardless of how long we went to school for. Suggesting that NPs can treat minor and routine medical issues is not a stretch at all.

 

M.D. = 4 years undergrad + 4 years medical school + 2/3 years residency

NP = 4 years undergrad +3 years graduate school + 2 years work experience

 

 

 

actually at my school, you'll get kicked out if you have an average of c.

 

just sayin

Link to comment
Share on other sites

Archived

This topic is now archived and is closed to further replies.


×
×
  • Create New...