from emcare. discuss

[andersenpa]

Anderson - I would agree with you except for the issue which you already alluded to...the nursing mafia has no dedication or allegiance to us. Nor will they ever, there just isn't any need for them to. The physicians, on the other hand, do have a reason to (we work FOR them, and thus make their job easier and make them money!)

 

Only in that we share similar background compared to docs- we are both mold-breakers as nonphysicians performing physician level services.

We add to their ranks and have more likelihood of being equals in a joint partnership, where we will NEVER be equals with physicians.

 

And unless you are in a pvt/small group practice (less common nowadays) your pay as a physician is not directly related to PA collections. PAs may free their time to increase THEIR billable work but they are not directly skimming the top of what we make...that's going to the group that employs the physician as well (most common scenario in 2013).

[Boatswain2PA]

I don't think a merging of the professions (or better put an acquisition of PAs by nursing) is out of the realm of possibility.

The PA-NP bridge is only palatable if there is a distance learning pathway. The working PA who wants the NP for full practice ownership and scope freedoms is probably NOT going to go back and muddle through an RN program.

 

But again, WHY would the nursing mafia have any desire to do this? They simply don't, and never will.

 

And no, we won't EVER be equals with physicians. Neither will NPs, because we have a fraction of the Physician education.

 

Agreed with the reduction in number of physicians directly taking PA collections, but MOST PAs I know are hired because they make their Doc more efficient, and thereby making him/her more money.

 

Or, in my case, they get to sleep at night! :-)

[EMEDPA]

 

Or, in my case, they get to sleep at night! :-)

me too. the shift I cover used to be single coverage md. now single coverage pa.

[andersenpa]

But again, WHY would the nursing mafia have any desire to do this? They simply don't, and never will.

 

And no, we won't EVER be equals with physicians. Neither will NPs, because we have a fraction of the Physician education.

 

Agreed with the reduction in number of physicians directly taking PA collections, but MOST PAs I know are hired because they make their Doc more efficient, and thereby making him/her more money.

 

Or, in my case, they get to sleep at night! :-)

 

this is all personal opinion on both our parts. I just think of either group, NPs are more likely to take us in their ranks with equal footing. That is what we as PAs are always fighting for (a move towards parity) so from that perspective it makes sense.

 

There are several features of the national PA presence- consistent quality providers, standardized education, and most importantly a MUCH greater footprint in specialty care that NPs would be eager to claim as part of their collective. PAs are a great resource and they'd rather buy us when our stock is low, rather than hand a cheap deal over to docs, who they are at war with.

[RetNavyPAC]

I was dumbfounded by the one reply by Leila McKinney, DNP, the one where she claims that "my DNP included a full two year residency in internal and emergency medicine". Unless she is talking about a new program I've never heard of, I'm throwing the BS flag. Can someone PLEASE send me the information and/or website of the DNP program, ANY DNP program, that includes a two-year residency in IM and EM? I've worked with and precepted local DNP students and am struck by a couple of things: how much they don't know, and how incredible they think they are for completing what are mostly online programs with a minimum of clinical hours.

[rcdavis]

I was dumbfounded by the one reply by Leila McKinney, DNP, the one where she claims that "my DNP included a full two year residency in internal and emergency medicine". Unless she is talking about a new program I've never heard of, I'm throwing the BS flag. Can someone PLEASE send me the information and/or website of the DNP program, ANY DNP program, that includes a two-year residency in IM and EM? I've worked with and precepted local DNP students and am struck by a couple of things: how much they don't know, and how incredible they think they are for completing what are mostly online programs with a minimum of clinical hours.

 

Agree completely...

I suspect her "residency" was in fact her basic training rotations.. If she did indeed rotate at all..

[EMEDPA]

most of these programs include a "residency" of 1000-1500 clinical hrs or so....you know, almost 2/3 as much as a pa with a certificate or a.s. degree gets...

[Guest Paula]

This might answer your questions! I'm not really sure what he is saying, though.

 

Reply by Michael Terry, DNP, APRN-PMH/FNP on July 20, 2011 at 3:27pmHi Nicholas- the most clinically (vs. "practice") program of which I am aware is the Columbia University DNP program. I mention clinical vs. practice orientation in keeping with the promulgated DNP competency-focused essentials. It has taken me a while to really understand the value of that difference, but I realize now that this makes sense to me personally as I look back on my own career.

I'm an FNP who went back for a PMHNP after 10 years of family practice recognizing that most of what I was striving for with my patients required behavioral change (plus, I also recognized that my psychiatric training had been scant ;-) It also happened that I kept getting pulled into administrative, consultative and system roles simply because I was so frustrated with the limitations put on me, my colleagues and our patients by the clinic and/or health care organization itself and was determined to change these conditions in order to improve my clinical practice. After decades of working within this tug-of-war between clinical roles and system roles to improve the care I could provide, I began to realize that both were, in fact, essential and represented two sides of the same coin. Thus, I came to understand that the coin of the health care realm was "practice," and consisted of a clinical domain and a systems domain.

Once I was explaining my DNP training to a colleague. After thinking this over for a while she remarked, "So the DNP is maybe a recognition of the reality of what you've learned over the length of your career; that if you were to design a program that provided the kind of education and training that would be needed to do these various roles and functions, it would look like a DNP program?"

"Exactly that" I replied. So I offer this to you Nicholas as a context of where to put clinical and systems skills within an overall practice concept. I'm also of the opinion, from watching national DNP program trends, that as more nurses enter DNP programs at the post-BSN level rather than the post-MSN/NP, we will see a focus on building the clinical skills first then adding the system skills next. I also think that even at that point, new DNPs will still not have enough training in either clinical or system skills - we'll still have to deal with the "nurse practitioner impostor phenomenon" we all experienced upon graduating from our NP programs; we'll all still need residencies and on-going CME. But if you think about MD programs, they've got the opposite problem - they get all the ortho, derm, radiology, and surgery courses then forget most of what they learned as they focus more narrowly on their area of specialty during residency and career. Maybe someday we'll all finally be able to drop the term "practice" because we'll have figured out how to do this right from the beginning

[rcdavis]

You are right to wonder what he is saying....

 

Even if he were to learn essential skills such as how to paragraph, I doubt I could really understand what he was saying.

 

There is a hint of a cogent answer in that verbage... But it is well hidden.