Bull Crap Article

[sk732]

What??? A student got an x-ray wrong??? 

 

Allow me to elucidate the collective logic of this thread (and many others) in the form of logical propositions:

 

(1) No one understands, especially the media, how awesome PA training is, because they know nothing about it.

(2) I, a PA, know nothing about NP training, but ignorance be damned, I'll resolutely declare it inadequate

(3) Most NP's that I have worked with are great, competent, and smart.

(4) Therefore NP training is inadequate.

 

Anything I missed?

 

(1)  This student was wandering around with her nose in the air thinking her shyte didn't stink - she was an ER nurse but had never really worked on the other side as it were.

 

(2)  I do know how many of the training programs in that province were - a lot of NP students from certain universities were not doing well on national licensing exams because they weren't getting proper medical education.  There were loads of fluff courses they had to take to be able to qualify for their MSN;s - a friend of mine was actually asked to go and teach actual physical examinations to a class under the table because many of the exams weren't deemed "necessary".  Same university didn't have any physician or even physio involvement in teaching physical examination skills - one NP I worked with in the Service (trained at a different university) spent most of her clinical rotations and physical examination classes with docs.  There is an RN that works with us in my ER that just finished her online Master's and passed her licensing exam that almost killed one of our other nurses that was anaphylactic by saying the were good to go and nothing wrong without even examining them.  I still get calls from the NP clinic around the corner because someone's blood pressure is high and wanting them to be referred to the ER, or they've got a sore throat, etc - the lack of good, hard clinical rotations with many of these programs seems to result in decreased confidence and a distinct lack of clinical decision making skills. 

 

(3)  Yeah, a student missed a huge pneumothorax on an XRay - the fact they didn't obviously know the difference between what normal/abnormal looked like tells me that they didn't do much in the way of XRay basics in school.  If you're expected to work independently, you should be able to work at least semi-independently and read a basic CXR.

 

(4)  I THINK the issues many of us have with some of these NP programs out there is that there are many fly by night ones that pay lip service to the clinical side of things - it's felt that because they're already RN's going into the program, that the hands on stuff is "irrelevant", since they've allegedly done it.  However, the difference is that the clinical decisions they're expected to make as an RN are not the same as an NP and have to be based on a completely different set of reasoning skills and experiences.  I'm amazed at how many RN's will order labs at triage for instance, but either leave out things they ought to have ticked off or just shotgun the lab req, again without regard to chief complaint and differential lists.  You'd be surprised how many experienced ER RN's that give me the 4 headed alien look when I give the list of differentials for some presentations...diagnoses they've never even heard of. 

 

$0.02 Cdn

 

SK