A Nurse Practitioner's View

Just wanted to update anyone following me as I am finishing up the DNP (graduation is May 2011!) The work is intense. Trying to juggle school, work and family life, is a challenge. However I know that it is already worth it. My perspective on my practice has changed for the better and I now incorporate evidence-based practice and culturally competent care in all of my interactions. My group of four are knee deep into the data analysis/synthesis of our systematic review. The statistical portion is mind numbing after looking at all of these clinical trials and trying to synthesize them into something that will make sense. We are also incorporating non randomized controlled trials (RCTs) into our write up which brings additional challenges in answering our clinical question (focused on diabetes and group medical visits). We have been busy reading and re-reading clinical studies, crunching numbers, e-mailing study authors (many who don't actually write back to you), making forest plot...

I recently ordered an ECG along with routine blood work for a patient who needed a pre-op workup. I received the ECG results today with the interpretation by the cardiologist. I thought it was funny and sad that he felt the need to cross out the default "Dr." preceding my name on the report. Of course, I am not a "doctor" as in physician, nor do I ever purport to be. I will soon have my doctorate in nursing practice (7 months to go!) but that will have no impact on how I interact with my patients or colleagues. I wish reports, and even prescription bottles for that matter, correctly referred to the credentials of the ordering clinician. Our patients should be able to identify their clinician without further confusion. But until then, I guess providers will self enforce who gets to be called "Dr." I can't help but to imagine a rogue pharmacist crossing out the "Dr." on every prescription label for prescriptions that are written by non-physicia...

With the recent increased media attention regarding nurse practitioner practice, I've noticed many inconsistencies and misconceptions in the media. Here are some of my own clarifying points: Nurse Practitioner practice is not brand new. The profession has been around since the mid 1960's. Therefore, all of these intimations that we are doing something (or looking to do something) new is inaccurate. There is a 40-year history of NP practice. NPs are not individuals who one day arbitrarily started writing prescriptions. There is a standardized education , training, licensure, and certification process that allows us to perform in that capacity. There are differences in each State practice act that sets the standard for what we can (and can't) do in each state. Note that the majority of State acts have these regulations that haven't been updated to reflect current education and training. The Doctor of Nursing Practice (DNP) degree is often linked to these conversations but...

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!

Benjamin Brewer, M.D. writes a regular column in the Wall Street Journal entilted, "The Doctor's Office." Yesterday, he wrote the article, " Primary Care Has Rewards Despite Hassles ." I suppose the article is intended to give you the warm and fuzzy's about what it should be like being a primary care physician today - he talks of saving lives and delivering babies. However, I guess Nurse Practitioners are among the "Hassles" that he speaks of: "The future competition from retail clinics, various physician extenders and the opening of 200 Ph.D. nursing programs that will churn out "doctor nurses" is just a symptom of our health system's ills, not necessarily a cure for them." By the way, those programs are Doctor of Nurse Practice (DNP), not PhDs. I don't believe any of those "hassles" purport to be the cure-all for the ills of the healthcare system. They are however, an attempt to address many of today's dy...

Here is a comprehensive article written in the Physician's News Digest entitled, " Growing role of nurse practitioners ." This balanced article gives a synopsis of the current state of the profession and where we might be headed. Also written this past week was an article about nurse practitioner-staffed retail clinics in Atlanta.

Today's Wall Street Journal Health Blog reports on nursing schools awarding Doctor of Nursing Practice degrees to already advanced practice nurses & nurse practitioners. This is certainly a hot topic within the nurse practitioner ranks and has stimulated discussions of the pros and cons. Of course, the article is not without the obligatory unsubstantiated and biased medical community comment: "Also, since these nurses with a doctorate can use “Dr.” some physicians worry that patients could become confused. “Nurses with an advanced degree are not the same as doctors who have been to medical school,” says Roger Moore, incoming president of the American Society of Anesthesiologists." Some within the medical community seem to think that this is nurses attempt to "fool" patients into thinking we are actually physicians. If the vast majority of us wanted to go to medical school, we would have. We are proud of the fact that we are nurses first and bring a "who...