RURALMED Posted June 25, 2015 Share Posted June 25, 2015 This gave me a good laugh! "As a nurse practitioner in hospital medicine I have multiple opportunities to interact with all sorts of physician hospitalist colleagues, hospital medicine group leaders, quality officers etc. Often their interactions with me take on a certain wary curiosity, like I am some exotic monkey or another creature that is unfamiliar to them. If I am speaking with someone who has had the benefit of successful collaboration with an NP or PA in hospital medicine that same interaction may take on a particular respectful reverence. Or if the physician hospitalist has had a less than stellar experience with a NP or PA in hospital medicine there may be regret, or reluctance to connect. I often wonder, after these interactions, when I and my other NP/PA colleagues will be seen as we wish to be seen: as highly valued and productive members of the hospital medicine team. I have been taking care of inpatients literally for a quarter of a century. I am a member of SHM and have been for seven years. I am chair of the NP/PA committee at SHM. I feel more supported and included at SHM than at any other professional organizations with which I have been involved. SHM has the wherewithal and future vision to espouse the values of the “big tent” philosophy. They know that the future includes us. It must. Yet my interactions often leave me somewhat frustrated and bemused. When I attempt to analyze this frustration I believe the foundation of migration is simply this: language. Language is powerful. I am not a nurse. I am a nurse practitioner. I am not a “physician extender” anymore than a cornerback on the football team is a “quarterback extender.” I am not a non-physician anymore than a catcher is a “non-pitcher.” I am not a “mid level.” What the heck does that mean anyway? I am a professional, seasoned, experienced, hard-working, intelligent, energetic member of the hospitalist team engaged in the sacred and sometimes profane mission of caring for the poor and down trod, the sick and infirm, the sad and scared, just as my physician colleagues are. Over time I have utilized many methods to heal my tiny wounds from the perceived slights. Chief of all these methods is the simple understanding that these minor cuts and bruises are rarely, if ever, intentional. I am sure my physician colleagues would be horrified at the idea they would ever intentionally cause me consternation. When these “cringe worthy” moments occur, and if I have felt a bit of sting from them, I just press the pause button, as Stephen Covey so eloquently describes, and then I think about the interaction. If time goes by and it’s still bothering me, I may find a non-stressful time to bring it up, giving the other party “the sandwich.” The dialogue might go something like this: “Hey great call on that patient the other day! Truly! Listen, I’ve been meaning to talk with you about something that was bothering me. When you were talking to that patient the other day, you referred to me as “your nurse.” I would really, really prefer that you refer to me as the nurse practitioner. I know you didn’t mean any offense by this and of course I value your support and love working with you.” I do find it difficult to express my frustration with these flaws in language. I don’t want to be militant and strident, calling people out amongst their peers in a demeaning way. I also don’t want to let these breaches blow past as I believe these changes are the cornerstone to a larger and more definitive change in the way my NP/PA colleagues are treated and perceived. I think this issue too, is complicated by my own NP/PA colleagues who often refer to themselves as “mid-levels” without acrimony or dismay. But I feel strongly that we must identify ourselves with accurate reflection. I guess the best option is for all of us, gently, professionally and one on one to demand and expect, from ourselves as well as others, to be named for what we are: Nurse Practitioners and Physician Assistants in hospital medicine." By: Tracy Cardin http://blogs.hospitalmedicine.org/Blog/a-rose-by-any-name-not/ Link to comment Share on other sites More sharing options...
delco714 Posted June 25, 2015 Share Posted June 25, 2015 Don't really know why this made you laugh? It's actually pretty fair and succinct. Link to comment Share on other sites More sharing options...
Joelseff Posted June 25, 2015 Share Posted June 25, 2015 ^ Agreed. The NP is spot on I thought... Sent from my S5 Active...Like you care... Link to comment Share on other sites More sharing options...
SocialMedicine Posted June 25, 2015 Share Posted June 25, 2015 People who use mid level are often ignorant as to why someone would be offended. A lot of time the language is ingrained into a hospital or administration and we are stuck with the term. I try not to be bothered much by it. Recently was invited to speak about midlevels in XXX area of medicine and refused because midlevels do not approach medicine differently than MD when it comes to that issue. The title was changed. It was just an issue of ignorance. Fixed easy enough many times. Link to comment Share on other sites More sharing options...
RURALMED Posted June 25, 2015 Author Share Posted June 25, 2015 I never said it wasn't accurate. It made me laugh because of how she put some humor into it. Link to comment Share on other sites More sharing options...
rpackelly Posted June 25, 2015 Share Posted June 25, 2015 As NPs or PAs we do get quite a few "microaggressions" every day which are probably not intended (although some are). Other examples include being called by first name during rounds when everyone else has a title, being called a nurse when your role is as a PA/NP, being called anything that is a possessive form ("my nurse, my nurse practitioner, my PA, etc.). Or from patients ("are you studying to be a doctor?", "when will the doctor come in to see me?", etc.) Similarly, from administrators, being grouped with "allied health professionals" (according to several federal departments, we are not), being excluded from areas where we need to interact with our other provider colleagues to care from our patients (cafeteria, lounge, etc) or being excluded from privileges that others on call get because they need to be available quickly (mobile phones, call rooms, parking). Link to comment Share on other sites More sharing options...
RURALMED Posted June 25, 2015 Author Share Posted June 25, 2015 It bugs me even more when faculty members from my PA program continue to use the term midlevel. How do we expect our profession to move ahead if we can't even organize ourselves? I really do admire how forward thinking and united the NP's are. And this is why I signed up for PAFT! Link to comment Share on other sites More sharing options...
Boatswain2PA Posted June 26, 2015 Share Posted June 26, 2015 "microaggressions"? I just threw up in my mouth a little bit. Removed the rest of the post so that I would not be reported to the PC police who would demand that I lose my job and retirement for not being politically correct. Link to comment Share on other sites More sharing options...
Guest Paula Posted June 30, 2015 Share Posted June 30, 2015 "microaggressions"? I just threw up in my mouth a little bit. Removed the rest of the post so that I would not be reported to the PC police who would demand that I lose my job and retirement for not being politically correct. Darn, I would have loved to hear what you posted. Link to comment Share on other sites More sharing options...
Boatswain2PA Posted June 30, 2015 Share Posted June 30, 2015 It would've had everyone with a skittles flag on their facebook profile screaming to moderators, and the state medical board, to have me permanently censured, drawn and quartered. Link to comment Share on other sites More sharing options...
SHU-CH Posted June 30, 2015 Share Posted June 30, 2015 Our big problem is that our profession is often defined by noting what we are not (namely, physicians). This is like asking a baseball player what he does and he responds "I'm a non-football player." The NPs have a fall-back identity as a nurse which is distinct from the medical profession. Midlevel is just plain dumb, because the implication is that there must be a low-level person. Words have power and we need to start controlling them. Link to comment Share on other sites More sharing options...
CAAdmission Posted June 30, 2015 Share Posted June 30, 2015 "microaggressions"? I just threw up in my mouth a little bit. Removed the rest of the post so that I would not be reported to the PC police who would demand that I lose my job and retirement for not being politically correct. Sorry to have missed it. It is sad that we have to self-censor due to overly sensitive people always trying to see who is offending them. Link to comment Share on other sites More sharing options...
Guest Paula Posted June 30, 2015 Share Posted June 30, 2015 At my work some of the staff think I'm an NP. I guess it's because I'm female and the other PA is a male. The NPs outnumber us 3:1. I'm now starting to get requests for consults for pre-ops from the specialties and they address me as P. Havisto, NP. Home health has addressed their notes to me as P. Havisto, NP. I searched our intranet and found a database that has me listed as an NP. I emailed the person who oriented me to the job and asked her to get that corrected. She did. But I think the damage is done. Even my SP accidentally dictated in an office e-com note that I (P. Havisto, NP) would be seeing his patient's in his absence. gee willikers. It's now the office joke. Link to comment Share on other sites More sharing options...
RURALMED Posted July 4, 2015 Author Share Posted July 4, 2015 Our big problem is that our profession is often defined by noting what we are not (namely, physicians). This is like asking a baseball player what he does and he responds "I'm a non-football player." The NPs have a fall-back identity as a nurse which is distinct from the medical profession. Midlevel is just plain dumb, because the implication is that there must be a low-level person. Words have power and we need to start controlling them. We need more educators like you! Link to comment Share on other sites More sharing options...
Recommended Posts
Archived
This topic is now archived and is closed to further replies.