Or…Oh no you didn’t….
The shift has mercifully ended, and as always, I return to my drafty castle to check once more on the world before I leave for dreamland. My trusty hellhounds at my feet as I read my twitter feed to see that a Doctor that I follow on twitter is using her feed to discuss how DNP nurse practitioners only have 3% of the education of MDs, yet refer to themselves as Doctors, and she has issues with this practice. Good for her I guess. Yours truly would never present himself as a “Doctor”, because quite honestly, I am not that impressed with doctors (even DNPs).
Oh yeah, shots fired right across the bow. Nursie poo must have had one hell of a night if it’s starting like that today. Well, no. Honestly, everyone needs to cop a chill and do their thing. First, let’s start with me as an NP. I am a Family Practice NP with a master’s degree. I spent 3 years in school, killing myself by working full-time nights on a lovely post-surgical floor to obtain the degree. I did clinical rotations at three different sites and endured all the studying and pain involved in sitting for a board. Just so you know, when I did my boards, I was 1-week post op and still had kidney stents in. I couldn’t move without having to pee and then bled like a stuck pig every time I did. I hurt, and I passed. The last part makes the point that I really had to have a good grasp on the information if I am going to make it with that kind of handicap. I am allowed to see, assess, diagnose, and prescribe for patients without supervision (that is the part that upsets doctors most about nurse practitioners). Some states do have tighter restrictions on NPs requiring MD supervision, but NPs do have the ability and knowledge to fly solo.
The original development of the NP came, not from nurses wanting to be Doctors, but from taking the experienced nurse and giving them a higher level of practice. I have been a nurse for a long time and was a medic before that. I have shepherded residents and doctors through numerous patients and caught mistakes. Most are at least thankful, but a good many more doctors are extremely arrogant when confronted with their humanity (More so when a CNA catches their mistake and takes them to task for it like Igor has). I am not sure why, but it is not about their ego or mine, but to protect the patient and to function as a team to facilitate healing. Slipping a decimal on some medications is pretty lethal. Or medications that are known to interact that are prescribed by a half-awake resident who is asking you, the RN, what you would prescribe. I always shudder when I think what I carry with me as an NP to help me when I am at a loss to prescribe. I have no problem consulting another NP if I am stuck, and to be honest, if I make a mistake and I am caught, I am always thankful, even if the person is a nurse who literally just graduated from school.
Those more experienced nurses who moved to an NP have been practicing a few years, 18 here, and were already aware of a great deal about medicine. What happened with many NP programs is that they are clogged with folks who have their RN 2-3 years and then move on to what they view as the next step. Let Nursie tell you a few things, 2-3 years does not make a person experienced as an RN, and not experienced enough to move and practice independently. The basis of a good NP is one who has nursing experience before they go to school. Once you are an NP, you are still a nurse, and there is a lot of things that you do that are still related to nursing such as holistic care plans and community and/or population-based health. So, different focus. Yeah, prescribe and treat is not the only thing I do. A DNP has a doctorate and a heavier research focus. Yeah, Nursie poo does not like research, just ask Nikki and Melanie. You can keep it. If you are a doctor, it is because you have a doctorate, which technically means you can be called the doctor (Igor plans on becoming a doctor too, just like the professors who trained him in Literature and English). Hell, when I was a medic, I got called doc…whatever.
The exalted doctor who tweeted out is upset by this and the implication that a lowly nurse could rise to do a position without her 93% more training, that sounds like it might have skipped bedside manners, humility, and compassion. I have her 93% wrapped up in 18 years of clinical care along with 5 years as a field medic. I also am damned good at leading people in tough situations. So, other than her fancy degree and her learning from the nurses around her to be a doctor….
I got nothing on her. Yeah, have a nice day. The hellhounds are dragging me to the coffin, and at least I can sleep without my ego yelling at my id about the lowly DNPs trying to rise to the ranks of an educated equal to help heal the sick and wounded.