Nursing Notes

October 5, 2011

Nurses Don’t Want To Be Doctors

Here is an interesting article about the discord between nurses with graduate degrees and physicians.  This is a “hot topic” right now as the ANA encourages more and more nurses to pursue higher education as a means of advancing the practice of nursing.
Physicians have a point, I guess.  But mostly I think that they have missed the point. Nurses do not want to BE physicians, they want to be nurses.  But they want to be the best nurses they can be.  Receiving your doctorate in nursing only means that you value the profession and you want to pass on to your patients the benefit of you learning.  Nurses are much more global thinkers than physicians.  We are trained to look at the whole picture and then figure out the way the symptoms are affecting the persons health.  Doctors are symptom driven and deal with specifics.  Have you ever gone to the doctor with a complaint of, “I just don’t feel right” and gotten a concerned and interested response.  The usual response would be to send you for a million tests to rule out things.  Nurses will get inquisitive and ask lots and lots of personal questions until they have an “ah-ha” moment.
This article is from HealthLeadersmedia, which I have used before.  I really love this site and hope that you will click over to finish reading this great article.  Leave us both a comment about your take on this issue, won’t you?
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Rebecca Hendren, for HealthLeaders Media, October 4, 2011

As a child addressing thank you notes for birthday gifts, I was perplexed by the one relative whose address began “Dr. and Mrs. John Doe.” I knew he was not a Doctor and yet he was called doctor. My mother explained he was a doctor, but not a “Doctor,” and you can imagine the emphasis on the second doctor.

This was my first introduction to the confusing world of honorifics and it hasn’t become any simpler since.

We all know that the title “doctor” refers both to physicians with medical degrees and to people who have been awarded a doctorate in a certain subject. These days patients often visit “the doctor” and are seen by a nurse who has an advanced practice degree and whose title includes the right to use the honorific term doctor.

Physician groups have been voicing concerns that the growing numbers of nurses who are also doctors are confusing for patients. Nurses are concerned that advanced practice professionals who have received doctorates in their field are afforded the proper respect and receive the designation that advanced study and knowledge is usually afforded in other fields.

Patients are left in the middle. Most patients grasp the differences between a physician and a nurse practitioner (or a physician assistant). Where many patients become confused is when the advanced practice nurse is referred to as doctor. As in, “Hello Mr. Green, I’m your nurse, Dr. Blue.”

Nurse practitioners who use the title with patients in care settings makes some physicians apoplectic. Their reaction leaves advanced practice nurses fuming. It leaves me perplexed. Why would any nurse want patients to think he or she was a medical doctor?

Nurses don’t want to be doctors. Advanced practice nurses could have chosen medical school if they wanted to become doctors. Instead, they chose to expand their study of nursing through advanced practice programs such as anesthesia, nurse practitioners, or the rapidly expanding doctorate in nursing practice.

Choosing further study in the nursing profession is a commitment to the nursing model, which emphasizes holistic patient care. Nurses approach their profession in a very different manner than physicians approach theirs and both are valuable and necessary to the overall provision of care in this country. Indeed, given the physician shortage, particularly in rural areas, the only way to meet the country’s needs for primary care is through advanced practice nurses.

So advanced practice nurses are necessary, vital, and supported by the public. Study after study has shown equal, or in some cases better, outcomes in patient care from advanced practice nurses. A study in the northwest last year revealed patients found nurse practitioner care just as good as physician care and the nurse…[read more]

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April 19, 2010

Nursing our way out of a doctor shortage

Here’s an article that talks about the physician shortage currently looming and the way nursing can help fill the empty spaces to provide basic care and free up the physicians to see the patients that really need them.  Nurses could care for simple things like colds, fever, stomach upset, check-ups and send seriously ill patients to the physicians.  Just thought I’d post this article here to see what you think about this topic.

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Give non-physicians more freedom to help patients.

Steve ChapmanApril 18, 2010

Thanks to health care reform, millions of previously uninsured Americans will have policies enabling them to go to the doctor when necessary without financial fear. But it’s a bit like giving everyone a plane ticket to fly tomorrow. If the planes are all full, you won’t be going anywhere.

There are not a lot of doctors sitting in their offices like the Maytag repairman, playing solitaire and wishing a patient would drop by. Most of them manage to stay plenty busy. Nor is there a tidal wave of young physicians about to roll in to quench this new thirst for medical care.

On the contrary. The Association of American Medical Colleges says that by 2025, the nation could be 150,000 doctors short of the number we need. Meanwhile, the number of med students entering primary care, the area of greatest need, is on the decline.

It’s hard to quickly boost the supply of physicians, since the necessary training usually takes at least seven years beyond college. The result, as an AAMC official told The Wall Street Journal: “It will probably take 10 years to even make a dent into the number of doctors that we need out there.”

That, of course, is assuming that the new health insurance system doesn’t drive aspiring or existing doctors out of medicine, which is entirely possible. Regardless, there seems to be no doubt that it will get harder to find someone to treat you, it may cost more and you’ll spend two hours in the waiting room instead of one.

Or maybe not. What people with medical problems need is medical care, but you don’t always need a physician to get treatment. You might also see a different sort of trained professional — say, a nurse practitioner, physician’s assistant, nurse or physical therapist.

Not every ailment demands Dr. McDreamy, any more than every car trip requires a Lexus. If you have a sore throat, earache or runny nose, you probably don’t absolutely require a board-certified internist to conduct an exam and dispense a remedy.

But it may not be up to you to decide who is suited to provide the care you want. Different states have different rules on what these clinicians may do. In many places, a nurse practitioner has to be under the supervision of a doctor. In others, she may not prescribe medicines or use the title “Dr.” even if she has a doctorate (as many do).

Medicare typically reimburses nurse practitioners at a lower rate than physicians. In Chicago, an office visit that would bring $70 to a doctor is worth only $60 to a nurse practitioner.

But the need for more primary care is forcing a welcome reassessment of these policies. So 28 states are reportedly considering loosening the regulations for nurse practitioners, on the novel theory that any competent professional health care is better than none.

Private enterprise is already responding to what consumers want. Walgreens, for example, has established more than 700 retail health clinics staffed by nurses, nurse practitioners and other non-doctor professionals. CVS has its own version. The number of these facilities is expected to soar in the next few years.

You might fear that this sort of treatment is inferior to what you’d get from your personal doctor. Your doctor might agree. The American Medical Association, reports The Associated Press, warns that “a doctor shortage is no reason to put nurses in charge and endanger patients.”

But put your mind at ease. A 2000 study published in the Journal of the American Medical Association found that where nurse practitioners have full latitude to do their jobs, their patients did just as well as patients sent to physicians. Other research confirms that finding, while noting that retail clinics provide their services for far less money than doctors’ offices and emergency rooms.

Obviously, if you wake up with crushing pain in your chest or fall out of a second-story window, you’d be well-advised to see a specialist. But for common ailments that are mainly a nuisance, a physician may be a superfluous luxury.

Obama’s health care reform rests on the assumption that expanding access demands a bigger government role. But even its supporters should be able to see that sometimes, it helps to get the government out of the way.

Steve Chapman is a member of the Tribune’s editorial board and blogs at chicagotribune.com/chapman

schapman@tribune.com

Here’s the link to the original article

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March 18, 2010

Myths About Nurses Perpetuated by Hollywood and Other Uninformed Media

As promised, here is part two of this article.  The debunking of the persistent myths about nursing.  I enjoyed reading this and hope you will, too.  Please feel free to comment at any time.

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1. Physicians are nurses’ superiors in the hospital hierarchy- nurses “work for” physicians.

Not true. Nursing is a separate, autonomous profession. We work with, not for physicians. We have our own leaders, and we regulate, license, and manage ourselves. Nurses decide what nurses do, not physicians.

2. Nursing doesn’t require much education.

Nursing education is highly specialized, intense, and rigorous, because nursing itself is a profession grounded in science. Many people, if they believe nurses go to college at all, think that most nurses attend a brief 1- or 2-year program. In fact, 58% of nurses presently have a bachelor’s degree or higher, a number that is growing every year. The “2year” nursing program doesn’t really exist – the associate’s degree in nursing requires prerequisites even before entering the nursing program, making it essentially a 3-year program. And in many areas, new graduate nurses undergo extended fellowships in the clinical setting that greatly increase their education and skill in nursing as they enter the profession.

3. Nurses mainly “fetch things” for physicians.

Nursing is a practice that is unique and distinct from medicine. Nursing is the protection, promotion, and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, communities, and populations.[2] Nursing’s focus, and what sets it apart from medicine, is the whole person, not just the specific, presenting health problem, and nursing encompasses both actual and potential health problems. Nursing’s scope of practice has been shown in numerous studies to save lives and improve health outcomes.

4. Nurses are those who aren’t smart enough to get into medical school.

This might be the most irritating myth of all. It presupposes that nursing is just a tiny subset of medicine, a fallback for people who can’t quite make it up the ladder. However, nursing is a different profession, not the same profession watered or dumbed down. Many nurses go on to earn advanced degrees at the master’s or doctoral level, but they are still practicing nursing (note that nurse practitioners and other advanced practice nurses may share some of the same functions as physicians in their specialties, but they are philosophically nursing-oriented in their approach to patients). And research shows that care provided by these advanced practice nurses is equal to or better than that provided by physicians.[3-6]

To be continued………………………………

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