Why Nurses Need @GoogleDoodles: Day 25, Doctors Are Not Nurses & Rainy Rants

Holy Crap! Breaking news in today’s paper: NURSES ARE NOT DOCTORS.

Thank the good, chubby baby buddha that’s true.

Wrote the doodlers my thoughts on this article, and why I think it missed a big point in the NP vs. MD debate; the vs.


To: proposals@google.com

From: 12hourRN@gmail.com

Subject: Why Nurses Need @GoogleDoodles: Day 24, Doctors Are Not Nurses & Rainy Rants.

April 30, 2014. 9:24PM.

Hey, Doodlers,

          A friend texted me this article long before I could return home to read it in print. I left my paper on my doorstep this morning on account of the cold rain falling over Manhattan; newsprint and water typically make for bad reading.
          But I glanced quickly at the headline between tasks at work – Nurses Are Not Doctors – and scanned the first few paragraphs. Of course, I thought, a reaction to the recent law I wrote about on Day 18 – no more physician supervision for NPs in New York State. 
          My first thought-reaction was, “Well, thank goodness!” What would the world be like if nurses and doctors were the same? My second thought-reaction was, “I wonder if any nurse will write a retort to this, titling it, ‘Doctors Are Not Nurses.'”
          While the author brought up some valid points, such as the vast difference between required experience during training, and the cost difference between NPs and doctors, he also made some pretty weak ones. “Primary care, though often routine, is also about finding the extraordinary in what may appear to be routine…to do so consistently, I believe, requires a doctor’s expertise.” Huh. Why?
          It saddens me to see an article like this, pinning a slanderous attempt on NPs as practitioners trying to replace MDs. But I can see why this physician wrote it; the fact that NPs are filling in the gaps that weren’t good enough for America’s MDs, essentially the non-glamorous, low-paying battle grounds of primary care, and can now do so without MD supervision, is frankly, kind of a slap in the face. Suddenly, the ACA has made primary care kind of glam, and doctors everywhere are in a terrible-two-ish-tizzy; primary care is ours, and now we want it back! It’s kind of like a little rich kid putting his old toys on the curb, only to take them back when the kid from down the block thinks they’re still worth playing with.
          The thing is, no NP ever set out to be a doctor! IOM never wrote a sentence saying, “Allow NPs to practice to the full scope of MD practice.” Sure, some NPs have the MD chip on their shoulder, but those are never the good ones. The best ones have a passion for their patients that stems from years at the bedside as a humble nurse, where minutes and hours and days were spent finding the extraordinary, and often life-changing details in their ordinary patients, and then reporting those findings to the physician. 
          The very good NPs recognize that their experience is a nurse’s experience, and acknowledge the shifts and months and years spent seeing patient’s care dictated by physicians – sometimes well, and sometimes poorly – as their foundation. Yes! I agree, NPs should be required to have a minimum amount of experience to be licensed – nursing experience, prior to their graduate studies. The NPs who do, run their practices with the same skilled humility they ran their bedside practice; assess, make conclusions, collaborate, treat patient. 
          Too bad the author of this article failed to mention that the law that was nixed a few weeks ago was largely seen as a lifted financial hurdle. It did little to really broaden NPs scope, except to give them a chance to come out form under the financial burden of physician supervision. Oh you didn’t hear that? Yeah, no more extra “supervision” money for MDs from those poor NPs getting paid only 85% to do the same job. 
          But I don’t want to get petty. I just want us to stop with the comparing of doctors and nurses and nurse practitioners. They’re not the same, and every good doctor will admit he or she’d never have what it took to be a nurse, and every good nurse would say likewise. Why fight what seems to have become a natural trend in healthcare – a niche for NPs in primary care?
          What are we really warring about, anyway? The discarded toys at the curb, or the maximum benefit to the person we’re all in this for in the end – the patient? Bickering over titles seems a lot like throwing apples and oranges and bananas at each other in hopes of proving one is superior. We are all working for the patient in different, unique, innovative, and even perhaps, extraordinary ways. I just wish we could all remember that.
          Amanda Anderson, RN

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