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NPs are killing us


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The NPs are killing us politically and legislatively. I wrote up a long argument for having APP leadership in our huge organization. I never heard a thing back but today I got a system wide email that 3 APPs have been appointed to leadership positions covering 3 different areas where we all work. All 3 are NPs.
The one covering primary care is one of the worst clinicians in the system. She is the queen of Zpack and steroids for colds among other thing mostly having to do with whatever makes the patient happy. She has never held a leadership position and , IMHO, couldn't lead a boy scout to an outhouse. Why? Because admin is full of nurses and they picked these people like you pick a prom queen...by popularity.
To say I'm not happy today would be an understatement.

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I am dogging this issue to the point of getting a bad rep with admin. I'm not letting this go. The positions weren't advertised within the system as required and qualified candidates were ignored. I also pointed out that it suggests the organization thinks we are all the same which simply isn't true.

I may get written up or fired but I am dogging this until I get some answers.

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19 minutes ago, Cideous said:

lol for the 1 thousandth time...it's our name, but no one listens.  Until it changes, we will go no where.  Just diminish and fade into the west....

Ironically the Spanish translation for PA is "asociado medico", literally physician associate, which does more justice to what PA's do than the English word.

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One on my goals is to start an PA/MHA combo program with the goal of getting PAs in admin positions early in their career. Is it perfect?  no ideally it should be guys and gals with years of clinical experience in these roles, but I do believe PAs are missing out on admin opportunities and something needs to be done. 

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Health care admin is a self licking ice cream cone that's dominated by RN's (who at least usually have health care experience) and of course plain old B/MHCA geeks, almost all of whom couldn't lead their way out of wet paper bag with Power Point directions and direct supervision...but when it comes to promoting, they'll promote more nurses - it's not just an NP thing, it's an RN thing.  I have an issue with people that are not only incapable of doing their primary job, but also the one they've been promoted into, and telling me how to do mine, especially when they aren't trained to do what I do.  Old school first principle of leadership is "Achieve professional competence"...of course, if you're dealing with the Civil Service or health care admin, it's usually more along the lines of "If it makes sense, do the exact opposite" and "Promote people to three levels beyond their highest levels of incompetence".  

Of course, those of us trained in the military know all this and usually have forgotten more about leading and managing folks than most of our bosses combined know or have learned.  Would be interesting to compare CV's with some of the front runners you had to deal with Scott.

SK

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That's that particular healthcare system for you, Scott.

Just be aware, rocking the boat gets you terminated there. 

I went to compliance and had some long discussions with the hospital lawyers over a dangerous MD, and next thing I knew, they had put completely fabricated stories about me in my employee file and said they no longer needed me as a PRN anymore.  I had a case for retaliation easily, but I couldn't justify the $$$ and time for a lawyer since I'd already found other employment.

I was happy to leave after 2 years of being treated like s$*t mainly because I am a PA.  That system is NP happy, just like the rest of East Texas.

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The NPs are killing us politically and legislatively. I wrote up a long argument for having APP leadership in our huge organization. I never heard a thing back but today I got a system wide email that 3 APPs have been appointed to leadership positions covering 3 different areas where we all work. All 3 are NPs.
The one covering primary care is one of the worst clinicians in the system. She is the queen of Zpack and steroids for colds among other thing mostly having to do with whatever makes the patient happy. She has never held a leadership position and , IMHO, couldn't lead a boy scout to an outhouse. Why? Because admin is full of nurses and they picked these people like you pick a prom queen...by popularity.
To say I'm not happy today would be an understatement.


Agreed. Picking by popularity was spot on. My practice also appointed an NP as a site director. In the process of joining an UC that designate director of APP as an NP. This NP interview every prospective NP or PA and makes job offers & negotiates salary ( sick 2 my stomach). Yes. We are way better trained but admin careless.
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On ‎1‎/‎26‎/‎2018 at 5:41 PM, CJAdmission said:

If it makes you feel better, we are not alone - in addition to killing PAs, NPs are killing a lot of patients, too.

lol that ain't cool man. Where's the research to support that comment? Some pretty stupid PAs out there; there are more stupid NPs though lol.

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I believe a lot of it is in our title, the other piece is the "D" many of them have in front of the NP. 

Political backing (whether direct or indirect), the perception of competency, and competition (us) with comparatively little advocacy combined with an antiquated title = victory for the NPs.

At Kaiser before I left they appointed a DNP as the new statewide head of APP practice. She had been there 1 year. To be fair she was competent---she had military leadership experience and seemed to be legit in most respects. Plus she appointed PAs as her "senior enlisted personnel", so to speak.

We have so much ground to cover it's hard to imagine a future where we arent just medical labor.

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On 1/26/2018 at 6:41 PM, CJAdmission said:

If it makes you feel better, we are not alone - in addition to killing PAs, NPs are killing a lot of patients, too.

I once worked as an itinerant PA on an island out in the Bering Sea with an NP as the Medical Director. She told me that she felt that her family was medically safer when I was on the island!!

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13 hours ago, BruceBanner said:

I believe a lot of it is in our title, the other piece is the "D" many of them have in front of the NP

Political backing (whether direct or indirect), the perception of competency, and competition (us) with comparatively little advocacy combined with an antiquated title = victory for the NPs.

At Kaiser before I left they appointed a DNP as the new statewide head of APP practice. She had been there 1 year. To be fair she was competent---she had military leadership experience and seemed to be legit in most respects. Plus she appointed PAs as her "senior enlisted personnel", so to speak.

We have so much ground to cover it's hard to imagine a future where we arent just medical labor.

I actually don't agree with the latter part of the first statement. The vast majority of NPs I am seeing in practice only have their master of science in nursing. The DNP is gaining traction, but they still represent the minority. I will be obtaining board certification in family practice, but I will not be pursuing the DNP at this time (not worth the money at all). 

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9 hours ago, 2234leej said:

I actually don't agree with the latter part of the first statement. The vast majority of NPs I am seeing in practice only have their master of science in nursing. The DNP is gaining traction, but they still represent the minority. I will be obtaining board certification in family practice, but I will not be pursuing the DNP at this time (not worth the money at all). 

This has been my experience as well.  I only know of one NP I worked with a couple years ago that went back for a DNP.  Otherwise, I don’t personally know any.  

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^^This. The main reason I sought to have a PhD is because, at the time, I was doing a lot of legislative and regulatory work. Legislators are no different than anyone else. They like titles and degrees.

In my current circumstance it was moot because the nursing leadership got together and picked 3 "leaders" like you pick a prom queen....by popularity. No interviews. No pre-defined requirements or qualifications to hold the position. There was no formal process just a committee of nurses. Why? Because nurses go into administration and then take care of other nurses.

In our organization medicine is generally run by physicians and everything else by nurses and PAs are not a presence.

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On 1/30/2018 at 9:50 AM, BruceBanner said:

Minority notwithstanding, the "D" gives the perception of competency and all of the NPs I have seen in admin positions have the DNP designation.

I agree. There's an old saying that "perception is reality", and that applies here. True or not, the "D" gives the appearance of competence and holds legitimacy in the eye of the public and policy makers. When making their arguments for greater autonomy/independence, NPs can legitimately say that they are "doctorally prepared" since their "standard" degree is the DNP. Lots of quotations there, and for good reason; it is still a relatively small percentage of NPs that actually have the DNP, but that doesn't matter when the public and politicians increasingly have their attention drawn to the "D". 

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