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What's Wrong with Nursing Educators?


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My wife is acting director of nursing at a hospital, which she agreed to do while they hire the permanent director.  They have been interviewing candidates.  One of them, a PhD in nursing (not a DNP), nursing educator and presently a director of nursing at a large hospital out east met with my wife, the CEO, CFO and hospital board.  She made the following comments to them (my paraphrase):  "In the future we will see a much wider use of NPs in all departments, which will revolutionize medicine, making it better, patient oriented and more cost effective."

 

She didn't know my wife was married to a PA so my wife asked her in front of the group, "And PAs too."

 

To which she replied something like,

 

"Oh no.  PAs have been a diaster. They are so poorly trained that they have created a lot of bad medical practices and will probably be phased out."

 

My point is, this is the type of crap that CEOs of large organizations are hearing from nurses and have heard it for the past 30 years.  If I heard a PA making up such nonsense about NPs I too would be outraged.  So you wonder why many jobs are only offered to NPs?

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Guest Paula

Holy Toledo!!!  I sure hope that candidate was quickly ushered to the door and told why.  It is disturbing that a PhD in nursing is saying that type of nonsense but I fear it is more common than we like to think.  

 

About 2 years ago I had an NP student for a few days and she tried to tell me my education wasn't as good as her online program and that I "needed" supervision.  I put her in her place.  She said I was the best preceptor she had at the clinic and the NP and MD who she was supposed to be getting her experience from were rather ineffective and gladly let me take over for a few days.  Hmmmmmm. 

 

Is this the next project to take on:  PAEA comes out with push back to the NP educators with a defamation suit?  LOL!

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My wife is acting director of nursing at a hospital, which she agreed to do while they hire the permanent director.  They have been interviewing candidates.  One of them, a PhD in nursing (not a DNP), nursing educator and presently a director of nursing at a large hospital out east met with my wife, the CEO, CFO and hospital board.  She made the following comments to them (my paraphrase):  "In the future we will see a much wider use of NPs in all departments, which will revolutionize medicine, making it better, patient oriented and more cost effective."

 

She didn't know my wife was married to a PA so my wife asked her in front of the group, "And PAs too."

 

To which she replied something like,

 

"Oh no.  PAs have been a diaster. They are so poorly trained that they have created a lot of bad medical practices and will probably be phased out."

 

My point is, this is the type of crap that CEOs of large organizations are hearing from nurses and have heard it for the past 30 years.  If I heard a PA making up such nonsense about NPs I too would be outraged.  So you wonder why many jobs are only offered to NPs?

While I agree with you that this candidate is bullsh7t, I would assume that there are multiple instances of denigration throughout the clinician spectrum on a daily basis. PAs beat on NPs, PAs beat on physicians, NPs beat on PAs, physicians beat on them both. It can be overt such as above or covert, such as medical staff not allowing PAs and NPs to become full members vs affiliate/courtesy/allied health members. 

 

For savvy interviewers, the candidate above is outlining what kind of leader she is with this conversation, likely transactional and management by exception ie put out the fires. A knowledgeable administrator would know that she has to be encouraging and open to all three, PA, NP, physician. If not, she will be closing doors she will likely find she shouldnt have at a later date.

 

Divisive is an understatement, I hope she is not on the short list of preferred candidates. She strikes me as not very sophisticated based upon having a conversation like this at an interview.

 

I also think that this type of problem illustrates a need for action from PAs themselves. While I doubt that the PAEA nor other PA organization will mount much of anything in response to hearsay, these anecdotal situations shed light on the need for PAs to advance from the clinical and education arena to become leaders in healthcare. While I am aware that there are PA programs that will offer a dual degree such as MPH, I think there is also a need for a dual MBA or MHA degree. There are MD programs that offer this and for a certain % of PAs, this would be a more than reasonable endeavor to pursue. For those whom are already degree'd, there is the possibility that a large employer may offer tuition assistance for something of this nature. 

 

Thanks for bringing this to light.

G Brothers PA-C

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Speaking to this as a PA and Paramedic in CA, Im not surprised.  Nursing is much more politically oriented and has more political clout.

 

I have no doubt some see PA's as encroaching on "their" territory, much the same as with Paramedics.

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their is a reason they say nurses eat their young

 

It is this exact same attitude that has served them so well in the political arena

 

If you say you are better then everyone else you can agree you are just as good and get laws passed

 

Sorry, I don't buy it, I used to say our training was just different, now I say our training is better, but it does not make a difference two years out of school as that point forward is about the OJT.....

 

Have only meet one NP I didn't like and that was a personality issue, not a professional issue so I have nothing but good to say about the people with their feet on the ground in the trenches......

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However, I think we should be agressive anytime they make such foolish statements in a public forum such as in writing or as speakers at a conference.

 

Based on my limited experience, one could just about make a full-time job out aggressively responding to foolish statements.. 

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their is a reason they say nurses eat their young

 

It is this exact same attitude that has served them so well in the political arena

 

If you say you are better then everyone else you can agree you are just as good and get laws passed

 

Sorry, I don't buy it, I used to say our training was just different, now I say our training is better, but it does not make a difference two years out of school as that point forward is about the OJT.....

 

Have only meet one NP I didn't like and that was a personality issue, not a professional issue so I have nothing but good to say about the people with their feet on the ground in the trenches......

 

This is pretty much where I am at this point.  I have yet to meet an NP in the clinical setting that I didn't like and were easy to work with.  

 

NP's as a political lobbying group, however, are borderline insufferable

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This is pretty much where I am at this point.  I have yet to meet an NP in the clinical setting that I didn't like and were easy to work with.  

 

NP's as a political lobbying group, however, are borderline insufferable

 

Agreed, but does this sort of thing require a response if its systemic?  I dont know much about the higher level politics of the issue, but that can't be a good thing.

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Agreed, but does this sort of thing require a response if its systemic?  I dont know much about the higher level politics of the issue, but that can't be a good thing.

There's always that possibility, but I've yet to see it happen, no matter these well-meaning groups that have come before like the American College of Clinicians and places like Clinician1- somehow, when it gets down to the political arena, those friendships/collegiality go out the window. Maybe that's just my experience. I know that rcdavis noted something similar to this before his untimely passing.

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I wonder what the age of this candidate was? I am hoping that she was part of the old curmudgeon nursing generation that will hopefully die out. Like everyone else that knocks our profession, the response should be, "That's interesting. What data are you basing that judgment on?" If the data shows we provide substandard care we should go extinct. If there is no data, this is just an opinion. To paraphrase my high school football coach, "Opinions are like [anuses]. Everyone has one and they all stink."

 

Hopefully the AAPA can start having some high level discussions with nursing organizations

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Speaking to this as a PA and Paramedic in CA, Im not surprised.  Nursing is much more politically oriented and has more political clout.

 

I have no doubt some see PA's as encroaching on "their" territory, much the same as with Paramedics.

Nice avatar Davo. That's a Tele right? Tough guitar to play.

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There's always that possibility, but I've yet to see it happen, no matter these well-meaning groups that have come before like the American College of Clinicians and places like Clinician1- somehow, when it gets down to the political arena, those friendships/collegiality go out the window. Maybe that's just my experience. I know that rcdavis noted something similar to this before his untimely passing.

Disclaimer: Maybe I am bias with extreme prejudice, being from California and part of the "old curmudgeon PA generation". I also applaud what Mittman et al are trying to do, but it is not just your experience. You nailed it TA.  I'm still waiting for our Rodney King "Can't we all get along moment?" but not holding my breath. 

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Well, I hate to say this, but of the five candidates, guess who is getting the nod? She is being offered the position because of her credentials. She is a PhD nursing educator/administrator from CA not "out east" as I had first thought.  I will have to give the PAs who work for the hospital a heads up if she accepts the position.

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Yikes! I wish PAFT had the magic wand to cleanse the brain of that PhD nurse.  It will be the responsibility of WA state PAs and the ones from that hospital to step up to the plate and organize NOW and anticipate any changes that this nurse might implement.  Get a plan in place, guys.  Get the collaborating physicians on board. too. 

 

She just may sound the call for battle.   (maybe she won't take the job????)

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My very first, real job was in 1982.  After interviewing with the owner/director (out and in patient headache center) he wanted me to interview with the head nurse.  She too taught at the U. of Michigan nursing program.  In the interview she simply said, "I don't want you here because having a PA on staff will lower our standards of excellence and if you are hired, I will resign."  I was hired and she did resign and I took over her office.

 

Flash ahead 17 years. I was the first PA hired by the department of neurology at Mayo Clinic. During my 2-day interview process I was required to meet with the head nurse of neurology.  She said, "I don't want you hear because having a PA on staff will lower our standards of excellence and if you are hired, I will resign."  I was hired and she resigned and I was given her office ( I didn't want her office as it was a head nurses office and not a real provider's office where I could see patients.)

 

So the moral of the story is that I have never, ever heard a PA say that if a NP is hired he or she will resign.  I just don't understand nursing politics and my wife is a nursing director and previous nursing educator.

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I wonder what the age of this candidate was? I am hoping that she was part of the old curmudgeon nursing generation that will hopefully die out.

 

I would hope so too, but I feel that the real scenario is more murky. At my university associated hospital, we put a TON of floor nurses through masters degrees, all fully paid (they work through the program). The majority will be NPs, some become educators or admistration. They usually go into their programs humble, but towards the end, you can tell that with a little bit of knowledge and a lot of confidence, many feel fully on the same level as docs. PAs are an afterthought since there are so few here, but believe me its eye opening to see the attitude towards fellowship trained, published, acclaimed ivory tower docs. All specialties too - it really is crazy. You get them arguing with surgery over why or why not the surgeon cuts or not. Ditto for other specialties. I feel like it comes from the deeply rooted "advocate" part of the nursing creed, gone slightly awry. A bit of experience with patients, some pathophys and pharm, and prescriptive authority makes you a doctor with a different name!

 

This is the next generation we are talking about here, these NPs are often younger than I am.

 

I'm not knocking nurses, its just that they have such a robust and thorough indoctrination through school, and hospital based or political based leadership, they seem to get so pumped up on the profession itself, the whole science part of medicine is neglected.

 

Its actaully a major sticking point with me and the two professions. I have days where I go hell, they get what they want, I might as well be one. I could always teach myself the rest of the medicine I miss out on from PA school over time. I don't bother thinking what goes on in all the various different board meetings and committees at my shop. It would probably blow my mind.

 

One last thought, the majority of NPs that I work with in plain old practice are excellent. I think they see the truth, which is basically that there is enough room for both professions.

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