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Once again, a meme posted in the spirit of fun triggers a storm of #butthurt on all sides. Clearly we must be doing something right.

Bullying, “punching down,” scope of practice controversies, hierarchy vs. holarchy and more. Watch the Facebook Live video and lend your voice in the comments!


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  • Paige Sturm

    This is a great discussion, however it would have been nice to invite a nurse and nurse practitioner to participate. Especially since the overall message is respectful collaboration. I agree that we need to acknowledge the differences in background and roles and we all have different strengths and weakness based on those backgrounds. The problem is when we try to establish whose better or worse based on those differencs rather than respecting and seeing the value in differences. In terms of “jealousy” from nurses this is a misconception. I didn’t become a nurse practitioner because I couldn’t hack it in med school, I chose this role because it fit better with how I saw patients and the underlying philosophy that I wanted to guide my practice. And I don’t want to be a doctor because, among other things, I love the background I obtained through nursing and it has helped me to approach patients in the way that fits with my personal strengths. I can be proud of my accomplishments and skill set while still having enormous respect for the intense training that doctors undergo. I think patients benefit most when they have a team with both MDs and NPs because in my view they then get the best of both worlds. I have worked with wonderful doctors who generously shared their knowledge with me and have undoubtedly made me a better practitioner, but the ones I learned the most from were the ones who clearly saw me as a peer (not peer as in we are both doctors, peer as in we are both smart capable members of the healthcare team) rather than an untrained incompetent poser. And I have met some amazing nurse practitioners that unquestionably have plenty of knowledge that can benefit young physicians. In other words let’s stop ragging on each other and learn more about each other’s backgrounds so we can see the value of each of our roles.

  • Emmas-mom Marquis

    I am a PA and I love your stuff. I have been in the ER for 13 years and I have seen amazing nurse Pratitioner but I have also seen the new grad that did 100% online… get hired… and then crash and burn at work. It’s hard on the medical team, the patients and the “practitioner.” I really feel that new grads (PA or NP) should all be required to do some type of post graduation residency for at least a year or more. When I went to school we had 3 years of clinicals and when I graduated my ER requires that I staffed 100% of my patients with an ER doctor for years!!! Now I see almost 100% of my patients on my own… and I am so thankful for my 3 years of clinicals and multiple years of staff with my doctors to get me where I am. New grads can be very dangerous… especially when they are “online” grads. Mandatory staffing with dr’s would really help this.

  • Angela Youmans

    Excellent discussion! I was a CNA for 10 yrs, became an RN and worked as one (in the ICU as well) for 5 years, and became an NP and currently work as a hospitalists NP. I do not pretend to be an MD or that have as much knowledge as an MD. I come with my own skill set that contributes to healthcare. I am proud to an NP. If I wanted to be an MD, I would have went to medical school. I know there are gaps in my knowledge, and my MD colleagues are AMAZING and help me with educating myself when needed. I find being an NP helps fill the gap between nursing and physicians. I love my job and love your show as well! I get butt hurt when people assume I’m trying to be an MD!

  • Rachel Booker

    I am a psychiatric mental health nurse practitioner. When I was getting ready to graduate high school and attend my BSN program, my favorite teacher asked me “Why do you want to be a nurse? You’re smart enough to be a doctor.” I told her I was smart enough to know I didn’t want to be a doctor. So many people seem to forget that Nurse and Doctor are two different professions. One is not an extension of another, though we do overlap. I am also concerned about the 100% online programs, because they reflect badly on my chosen profession and leave their students in the lurch. I feel the same about the offshore “med schools” that require nothing more than a name and a fistful of cash.

    • Kimberly Brown

      Please tell me more about these “offshore” medical schools of which you speak. I am an EM physician that graduated from one and my institution requires (and required) more than a name and a fistful of cash to get an MD. Please tell me your personal experience in attending one? I’d be careful what you say. The MD that you’re collaborating with or treating you that you love so much just may be a graduate of one of these schools.

    • Paige Sturm

      I was also told by a professor in undergrad that I was smart enough to be a doctor and therefore should change my major. He really couldn’t imagine that I would choose this path unless I just didn’t believe in myself enough. Had to explain this was my first choice, not me settling. He still didn’t get it. As for online schools, let’s talk about that. I actually am a duel certified NP and did my FNP program at a large university that was traditional in its approach. I got my ACPNP through an online program. While I agree that online programs “look bad” to many on the outside of those experiences I would argue this is more a cultural perception brought on by the unfortunate popularity of for profit unaccredited schools rather than a reflection of all online program’s reality. My online program quite honestly was far better than my traditional one. I learned so much more and felt more prepared to be an NP. My professors were also much better in my online program. In addition, I attended a grand rounds presentation that looked at medical education programs and they found that the evidence does not support traditional programs being better than online programs. In fact they found that they produced similar quality results. They did find however, that flipped classroom programs were superior to both traditional and 100% online programs. So there is definitely room for improvement with both traditional and online educational models, but evidence does not show that traditional models are superior to online.