Wednesday, December 3, 2008

At it again

There is a physician blogger that uses every opportunity that he can to minimize, patronize and belittle the NP role and he is at it again. I refuse to leave a comment on his blog since others who have induce a tirade of back and forth nonsense that gets no where. He can track back to my post and maybe read this blog and maybe gain some relevant insight into NP practice.

I must now return to counting tongue blades since that is as complex as this nurse practitioner gets. One, two, seven....damn!


The Happy Hospitalist said...

Nurse Stephen. If you are going to take my comments out of context, so be it. I have categorically stated I have the highest respect for nurses. For you to say otherwise does your readers a disservice. My post related to the discussion over at the ACP Blog regarding extenders practicing in the medical home model independent of oversight.

That equates to physician level training. I disagree completely with the assertion that extenders can practice internal medicine independently of oversight.

Why you find that offensive is beyond me. I don't take it upon myself to claim I can be a great nurse. It would not occur to me. I never went to nursing school.

I stated if an extender can pass internal medicine boards, then by all means they should be able to practice internal medicine independently of any oversight. Until then, being treated as an equal with less than 1/4 of the training is ludicrous. Why you and others have such a hard time understanding that is beyond me.

Everyone has a role in clinical medicine. And I haven't minimized, patronized and belittle the NP role as you claim. I have put the role in the correct context of patient care.

If you believe you are qualified to manage a medical home independent of oversight, I fear for your patients, unless of course you pass internal medicine boards. Then I say, welcome to the independent practice of medicine. You have tested into that right. Just as all other physicians have in the past century.

Stephen Ferrara, NP said...

Happy: I do believe that you hold respect for nurses. However, I don't think you feel the same towards the advanced practice role. To make a comment about learning how to hold a scalpel, an endoscope and a scalpel, I take that as a slap in the face.

I think the problem you have is the lack of understanding of the NP role. I don't practice medicine nor do I purport to. If I did, that would be considered practicing medicine without a license. My practice focuses on synthesizing nursing and medical care. We focus on the whole person when treating specific health problems and provide extensive health information on the impact of those problems on patients, their families and the community. We work as part of the health care team to care for our patients. New York State has granted me prescription privileges to go along with my nurse practitioner license.

Let me be clear: I don't want to be your "equal." I do want to be respected and valued for the role that I play in healthcare. I also don't want your oversight. I do want to work in collaboration with you so that we can effectively manage that particular patient for that particular condition. Do you not collaborate with your physician colleagues? Why do some in medicine think that they are the owners of health care?

Unfortunately, it doesn't look like you took the time to read through this blog and gain some additional insight into NP practice. I do read and respect your blog and your posts. I wish you would do the same.

Maybe if we recognize we are different and the fact that there are many stakeholders when it comes to patient care, we wouldn't be in the healthcare mess we are today that has come from a century of status quo.

The Happy Hospitalist said...

The whole discussion was predicated on extenders being treated as equal. That was the basis of my discussion as linked to the ACP Advocacy blog. The argument being that there is room for both extenders and physicians to run medical homes independent of each other.

The comment about endoscopes, catheters and scalpels was directed at all health care providers, including physicians, who aren't trained in their use. That includes me as well. It was not meant to be an insult on extenders.

The point being that going to nursing school and NP school is not a substitute for going to medical school and doing a residency.

If medical homes are allowed to be staffed independently as such, then we are saying the education is equal.

All I'm saying is it isn't. You understand that. I understand that. We both agree.

I work all day long with PAs and NP's. Most of the procedural specialists in my hospital utilize them as people to do all the dictations and data gatherers.

Not a job I would ever want to do. But apparently there are some people that will do it.

Other NPs and PAs I work with in the ER do a fine job of taking care of patients, under the support of an MD. I have no problem there as well. They are great at what they do. And they do a fine job.

Going out and managing your own clinic alone with out any back up? Not in a million years.

We are saying the same thing.

Nurse Practitioners Save Lives said...

The Crippen blog does the same unfortunately. He never even responds to most of my comments, even if I happen to agree with him. Oh well..

Murse 53 said...

Where is the research? Where is the literature that shows that the NP scope of practice in this country is unsafe? All the complaints I read seem to be anectodal.