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Old 10-19-2012, 10:37 AM
 
5,760 posts, read 11,515,629 times
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I am just glad to hear that multi-million dollar salaries (+ whatever else?) to CEOs of Health Insurance Companies, Medical Service Corporations, Hospital Groups, and Pharmco Corps do not run up heath-care costs -- let alone the expense of Large Campaign Donations they make.

I knew it was those damn Nurses, all along.
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Old 10-19-2012, 11:01 AM
 
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I know some Lpn's and Cna's can't afford to go to school for the Rn,but when your job is on the line,you have to do it,or else don't complain when you are out of a job.
You have to adapt.
We Rn's don't just stop learning either. We have to take Continuing Education Courses,and in Nj we can't renew our licenses without them.
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Old 10-19-2012, 11:18 AM
 
28,109 posts, read 63,501,261 times
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Quote:
Originally Posted by jerseygal4u View Post
But why are they considered better than American nurses?
As an American citizen and American educated nurse I do resent that people feel that way.
You know what's happened around here? It seems instead of hiring American educated nurses,hospitals would rather hire them,even going as far to import them.
Only two of our Filipino nurses are foreign educated... all the rests are from California schools with the most from Cal State East Bay.

Certainly, the largest background for students in local programs is Asian... could just be the SF Bay area has a higher percentage of Asian ancestry.
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Old 10-19-2012, 11:23 AM
 
28,109 posts, read 63,501,261 times
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Quote:
Originally Posted by CheyDee View Post
It's really not odd, when you think about it. Most nurses, particularly hospital-based nurses, cannot just leave at the end of their tour of duty. They must be relieved by another nurse, so there is no break in patient care or services rendered.

For example, let's say a nurse is working a 7AM to 7PM shift. She can not leave until her relief shows up and she signs out to her relief. (I am using "her" as a generic, since most nurses are female. Of course, it could also be a "his".) If her relief is on-time but the day nurse is so involved with a patient at that time, she could be in the room an extra hour or more. This means she can't begin to sign out until 8 PM. I shudder to think what might happen if a patient was assigned a nurse with sub-par integrity, who might stall getting involved with a patient in need because it was too close to going-home time.

Another and more common example would be that the 7PM nurse did not show up. That could result from a last minute sick call-in, to the relief nurse forgetting she was assigned to work that particular night. The day shift nurse would wait a while, hoping her relief was simply a bit late. As time progressed, she would notify TPTB and let them know her relief didn't show. The hospital then has to scramble and try to get someone else to come in at the last minute and cover. If the hospital is successful, that substitute night nurse might not be able to get there until 11PM. The day nurse, who already worked 12 hours, would then be forced to work 16 hours - or else she would be abandoning her patients. Once the substitute nurse gets there, the day nurse still needs to "give report", or sign-out to the oncoming nurse, meaning the day nurse put in even more time.

Since most nurses are paid hourly, shouldn't she be entitled to be compensated for all of that extra time?
The change in overtime that was in effect for a short time was strictly in how and when overtime rates applied... the hourly wage for time worked was never never a factor.

I'm not in HR... as I remember, the change also looked at number of hours worked per week... so if a nurse worked 40 hours in a week and one day was 7 and the next day was 9... that nurse would not have recieved overtime differential for the 9th hour if her total for the week was 40.

It came about to address the precise issue you mentioned... the variables in patient care.
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Old 10-20-2012, 10:58 AM
 
Location: Native Floridian, USA
5,297 posts, read 7,600,167 times
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Quote:
Originally Posted by CheyDee View Post
[Emphasis mine.]

...snipped...Please keep in mind when making these comparisons, many teachers are off for the entire summer and in places like NY, some choose to get summer jobs to supplement their incomes. (One popular choice among NY teachers is to work as a summer lifeguard, on the beach. In fact, the NYS teacher's union now represents lifeguards too.) [Source] Teachers are also off on all holidays, both major and minor, for prep days, etc., while hospitals run 24/7 around-the-clock. Consider too a teacher's time off for fall break, Thanksgiving week, the entire period from before Christmas until after New Year, and spring break, while nurses average a total of 4 weeks vacation/year. (Two weeks in some other states, i.e. TX and AZ.) By including all the additional time off teacher's receive, you can make a closer apples-to-apples comparison. Please note too, these salary comparisons do not include any benefits you reference in your first paragraph.

Sources: [1] [2]
It won;t let me rep you again. Excellent post !
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Old 10-13-2014, 03:23 AM
 
519 posts, read 774,392 times
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Something I never fully understood is why some nurses (practioners) are able to essentially function in the same capacity as a doctor, someone who went to medical school. It bothers me when I make a doctor's appointment and I end up seeing the nurse practioner instead of the doctor. She does everything the doctor will do, and even prescribes me medicine, but she's never been to medical school. What's the difference between her and the doctor, besides the pay? I've never been able to figure out why a nurse basically being a doctor is considered acceptable practice. I get that some doctors use nurse practioners to lessen their personal patient load, but nurse practioners are not MDs.
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Old 10-13-2014, 07:06 AM
 
Location: NNJ
15,050 posts, read 10,031,581 times
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Don't be distracted by the "nurse" term in nurse practitioners; they are practically MDs. Most are doctorates and many will continue on to medical schools. Some of the best care I have received was through Nurse practitioners; they seem to possess more real clinical experience than some MDs (especially the ones still in residency). The line drawn between the responsibilities between NP and MD varies from state to state. They all seem (I may be wrong) required to be under some sort of supervision of an MD.

IMO, its a natural progression of the industry. No reason to consume a MDs time with less critical cases. Nursing now encompasses a wide range of educational levels starting from associates level all the way to doctorate which is a good thing for any industry. What I don't think is healthy is the increasing requirements for employment at the lower tiers.
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Old 10-13-2014, 07:59 AM
 
Location: Georgia, USA
37,010 posts, read 41,051,729 times
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Quote:
Originally Posted by usayit View Post
Don't be distracted by the "nurse" term in nurse practitioners; they are practically MDs. Most are doctorates and many will continue on to medical schools. Some of the best care I have received was through Nurse practitioners; they seem to possess more real clinical experience than some MDs (especially the ones still in residency). The line drawn between the responsibilities between NP and MD varies from state to state. They all seem (I may be wrong) required to be under some sort of supervision of an MD.

IMO, its a natural progression of the industry. No reason to consume a MDs time with less critical cases. Nursing now encompasses a wide range of educational levels starting from associates level all the way to doctorate which is a good thing for any industry. What I don't think is healthy is the increasing requirements for employment at the lower tiers.

No, they are not "practically MDs." The duration and depth of training is nothing like an MD's. The doctorate awarded to a NP does not represent the same education a physician receives. A Nurse Practitioner is Nurse, not a physician. In fact, it would be misleading foe a NP with a doctorate to call herself "Doctor" and not make it clear to patients that she is not a physician.

NPs can be helpful with managing patients with an established problem who are doing well or patients with no problems who need regular maintenance exams. I would not want to see one for a new problem and if my primary care doctor sent me to a specialist I would want to see the specialist, not a NP.
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Old 10-14-2014, 05:48 PM
 
Location: NNJ
15,050 posts, read 10,031,581 times
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Quote:
Originally Posted by suzy_q2010 View Post
No, they are not "practically MDs." The duration and depth of training is nothing like an MD's. The doctorate awarded to a NP does not represent the same education a physician receives. A Nurse Practitioner is Nurse, not a physician. In fact, it would be misleading foe a NP with a doctorate to call herself "Doctor" and not make it clear to patients that she is not a physician.

NPs can be helpful with managing patients with an established problem who are doing well or patients with no problems who need regular maintenance exams. I would not want to see one for a new problem and if my primary care doctor sent me to a specialist I would want to see the specialist, not a NP.
Never said they were the same. :-/

They have the ability to prescribe. Like MD but with restricted limits.

They have the ability to be a primary physician. Like MD

They have significant clinical experience (again not saying more than MD). Like MD.

They can specialize in areas. Like MD.

They can be in a position of teaching and research... Like MD.

Typical Doctorate NP is 8 years of academic experience which is similar to that of an MD. IIRC, MD has a longer residency.

If you search, you will find some studies showing that the quality of care from an NP is often on par with MD and in some cases superior. Of course this is controversial.

One of the nice things about nursing as a career choice is that it has a reasonable entry into the field; 1-2 year LVN or LPN. Provides a nice career path starting from there; 4 year BSN/RN, Masters, and Doctorates. Not so for MD... perhaps that's what is driving the misunderstanding.

I think the big misconception is that people (including MDs) see NP as a potential replacement for the traditional MD role. This is not true. They have different core focus and should be complimentary to each other. Your tone in your response seems to fall into this category.

Furthermore, people don't realize just how different in both experience, education, and responsibility there is between LVN/LPN,BSN and NP. Often its because they all have the "Nurse" in their title they assume they are all the same.


My personal experience is that NPs have a more one on one personalized approach. Perhaps they can because of how the work load is distributed between NPs and MDs. They seem to be just as knowledgable as the MD even though I often still prefer to get the opinion of the MD. My primary physician is an MD.


So while you say "No". I say Yes. So there. lol
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Old 10-14-2014, 06:14 PM
 
Location: Georgia, USA
37,010 posts, read 41,051,729 times
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Quote:
Originally Posted by usayit View Post
Never said they were the same. :-/

They have the ability to prescribe. Like MD but with restricted limits.

They have the ability to be a primary physician. Like MD

They have significant clinical experience (again not saying more than MD). Like MD.

They can specialize in areas. Like MD.

They can be in a position of teaching and research... Like MD.

Typical Doctorate NP is 8 years of academic experience which is similar to that of an MD. IIRC, MD has a longer residency.

If you search, you will find some studies showing that the quality of care from an NP is often on par with MD and in some cases superior. Of course this is controversial.

One of the nice things about nursing as a career choice is that it has a reasonable entry into the field; 1-2 year LVN or LPN. Provides a nice career path starting from there; 4 year BSN/RN, Masters, and Doctorates. Not so for MD... perhaps that's what is driving the misunderstanding.

I think the big misconception is that people (including MDs) see NP as a potential replacement for the traditional MD role. This is not true. They have different core focus and should be complimentary to each other. Your tone in your response seems to fall into this category.

Furthermore, people don't realize just how different in both experience, education, and responsibility there is between LVN/LPN,BSN and NP. Often its because they all have the "Nurse" in their title they assume they are all the same.


My personal experience is that NPs have a more one on one personalized approach. Perhaps they can because of how the work load is distributed between NPs and MDs. They seem to be just as knowledgable as the MD even though I often still prefer to get the opinion of the MD. My primary physician is an MD.


So while you say "No". I say Yes. So there. lol
The content of nurse education is totally different, with nowhere near the depth or breadth of a physician. You will probably find that studies about the quality of NP care are done by NPs. Forgive me if I am a bit skeptical about their conflicts of interest.

Being able to do what they do does not make them just like physicians. They are not physicians, they may be allowed to be "primary care providers" but they must go to medical school to become a physician.

If they are "just as knowledgeable" as the MD, why do you need to get the MD's opinion? That sounds as if you are not completely convinced.

Here is a comparison of the training of a nurse practitioner compared to that of a Family Physician:

http://www.aafp.org/dam/AAFP/documen...NP-UPDATED.pdf

MD or DO 11 years; NP 5.5 to 7 years total training time
MD or DO 20,700 – 21,700 hours; NP with a doctorate of nursing practice: 2,800 – 5,350 hours.

If there is a NP who can pass all three steps of the exam that MDs and DOs take, I will consider her just as qualified as an MD or DO. Until then, no. The push to replace physicians with nurse practitioners does exist, unfortunately.
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