Comments

You must log in or register to comment.

SK10504 t1_j0hg3x6 wrote

who bears liability if nurse prescribes incorrectly? the nurse or the doctor employing the nurse or the practice employing the nurse?

38

guiltypooh t1_j0hosii wrote

Probably the same way it works with doctors

16

just4u11 t1_j0hdc2n wrote

I can see doctors are opposed, from what I read, a nurse only needs to complete an online masters for education to be an advanced practice nurse. They would definitely need more rigorous education to have the same prescription ability as a doctor

31

bananafishandchips t1_j0iomg1 wrote

You know that NPs deliver babies and provide anesthesia and do a host of other high risk procedures. Prescribing medication is certainly no more dangerous that doing those things. And they need a DEA license depending on the drug schedule, so that's another safeguard. And show me one doctor who actually reviews the scrips NPs under them write. I don't know any, and know plenty of MDs and NPs

−7

cC2Panda t1_j0iz6vy wrote

Considering the opioid epidemic, I think it's fair to say that bad use of prescriptions can have devastating effects not just on the individual but while communities.

9

[deleted] t1_j0j6bn2 wrote

Issue is they are recruiting students into NP programs before they even graduate when nurses should ideally go in NP program around 5-10 year experience.

So while there are many great NPs out there, there's also a lot of inexperienced incompetent NPs out there.

6

[deleted] t1_j0iqosc wrote

[deleted]

−5

theShhnozz t1_j0irewk wrote

Women? Not all women are nurses. How old are you???

0

cC2Panda t1_j0izyhw wrote

You are inferring a lot of erroneous stuff from that guys comment. He's basically saying women through most of history have delivered babies unassisted by modern doctors, but that doesn't mean some prehistoric woman is qualified to dole out opioids.

5

theShhnozz t1_j0j5ne8 wrote

APNs already have authority to do this elsewhere.

0

Rupert--Pupkin t1_j0ia2md wrote

This would be a total fucking disaster. As a plaintiff’s attorney it would bring me a lot of new business though

22

scarface123 t1_j0i8idm wrote

Doctors spend almost a decade (not including undergrad) learning to care for you. Lack of physician oversight will only harm patients with poor quality care. People love to say they’re for this but when it comes to themselves or their loved ones they immediately clamor for the MD/DO lmao

18

[deleted] t1_j0j7h5a wrote

PAs already prescribe meds. Also doctors neglect patients and pass off patients and the buck as well. The difference is the hospital will actually try to protect the doctor, not the nurse.

I'm against the OP post but this is crazy. Doctors don't normally spend much hands on time in patient care.

If anything, this news is more implying how much worse understaffing is and how much more delegation of responsibilities is needed if they're going ahead with this anyways.

If shit like this scares you, then demand change. Call your legislators and demand a state mandate for safer staffing. Put more resources in bridging people willing to work this field.

Complaining about nurses not being doctors isn't going to do anything. As much as you claim people will clamor about doctors, doctors will poke their head in your room for 5 minutes in the morning and that's it. Nurses will be with you all day. Even when you need meds ordered right now, your doc will tell you and nurses the meds are ordered but he or she didn't order them for example and then you wait hours for the order. This shit happens daily. Ofc it largely depends on the individual but no doc is spending upwards of 20-30 minutes with you if it isn't an emergency.

6

JerseyWiseguy t1_j0h874l wrote

Of course doctors are "opposed."

If you have a leaking toilet, any plumber is going to tell you to call a plumber.

If your check-engine light is on, your car dealer is going to say that you should bring the vehicle only to their certified mechanics.

Any time some citizen steps in to prevent a crime and protect some other citizen, the government always issues a statement that such things should be left to trained police officers.

Anyone who has a monopoly on something wants to keep that monopoly. To quote the legendary philosopher Gordon Gekko: "Greed is right. Greed works."

7

TroyMcClure10 t1_j0i0f8e wrote

The AMA is incredibly strong.

0

SK10504 t1_j0icvqw wrote

They are nothing compared to Pharmaceutical Research and Manufacturers of America (PhRMA) forcing US citizens to bear disproportionate share of drug costs compared to the rest of the world.

2

solesme t1_j0hpgn3 wrote

Not sure why your post and similar posts are being downvoted. I guess people think that doctors actually care about their well being. I know some do, but others want that $$$ green.

−6

[deleted] t1_j0j8pl9 wrote

Speaking as someone in nursing, there are just as many greed heads in nursing as there are doctors.

You see all these young NPs? Ask them how much clinical experience they have. Go back a decade ago and ask traditional NPs how much clinical experience had. Today that experience could be 0 years. Back then it was around 10 years of nursing.

As for the docs, I can't tell you how many times doc claims meds were ordered and even tells rhe patient so the buck is now on the nurse. Check epic and the order is not fucking there. Try to phone them for hours? No luck. Several hours later? Still no order. This isn't necessary and we don't need a desk jockey coming to talk about decade of med school to make that order.

4

New_Version_2394 t1_j0ivjhs wrote

Good. MDs are no longer providing primary care to the public because many of them opting to enter lucrative sub-specialties. Meanwhile the APNs, PAs, RNs and technologists are doing all the diagnostic grunt work and not getting paid. Lobbying by MD groups have prevented the expansion of healthcare options.

5

JDBennett257 t1_j0hkffw wrote

Like with any situation, it's not so black and white. Currently I'm in school to be a nurse practitioner and will have a doctorate when I graduate. Experience counts and I understand the concern that doctor's have. Ultimately we have to be good little scientists and let evidence and studies show if this measure is a benefit or detriment.

3

ballade__ t1_j0iy6l7 wrote

A DNP does not prepare you to be an independent practitioner. There’s a reason docs go through four years of medical school then three (at the very least) of residency. I think once you get out into practice you’ll see the amount that you simply do not know.

11

[deleted] t1_j0j9ld8 wrote

The issue is NP programs are recruiting nurses with literally 0 work experience or like 1-2 years. Not that NP doesn't teach you this or that. Np are supposed to be practitioners with close to a decade of nursing experience under their belt. Now, you see students who haven't worked a single shift even under orientation get into NP programs.

People here wasting energy arguing NP vs MD when they should be asking if this helps with our thinning resources of healthcare workers. The only reason delegation of responsibilities is a good thing even when said delegation can reduce the quality of the task or procedure performed is in the situation where half assed care is better than full on neglect.

5

Jeff-Van-Gundy t1_j0jewsf wrote

Who said they are "supposed to have a decade of experience" before getting an NP?

−3

[deleted] t1_j0jkrv6 wrote

Thats ideal. You think its a good idea pulling nurses into NP with 1-3 years experience, you're wrong. Those people are the exception not the norm.

This is a common point talked about in r/nursing.

Average new grad NP is less experienced and doesn't know as much as a floor nurse with 5 years experience under their belt.

Medicine and patient care is all experience. It's why even doctors get outperformed by nurses at bedside procedures. Because nurses been doing them.

3

solidblu t1_j0j3tma wrote

I see a lot of people apposed to this, but I wonder if there is a middle ground where there is a subset of things that are ok, like refills for non-controlled substances, meds to treat common things like flu, cold, and allergies.

That might gain some safer efficiencies with out all the danger everyone is rightfully bringing up.

3

basa_maaw t1_j0jaejo wrote

People in this thread have very little understanding of how much APN's do to even get their education let alone what they do on the job.

3

SnooGiraffes7471 t1_j0kcx0m wrote

APNs in NJ are already prescribing without direct oversight. They just need a collaborating physician and X number of cases reviewed by that physician yearly. And that number is just an arbitrary number in their collaborative contract (5? 10? 20).

2

WPackN2 t1_j0h7vav wrote

Of course doctors will strong oppose it. How are they supposed to charge $100 for prescribing OTC medicine as cure?

0

SK10504 t1_j0ibhq9 wrote

that's what the doctor might charge, but that's not what they get paid by insurance. get rid of having to go through insurance, and watch the fees charged go down to reasonable levels like the rest of the world.

it would be helpful if there are any physicians following this post to give us some idea of what they submit to insurance and what they actually get reimbursed. i believe a typical explanation of benefits the patient receives is not truly representative of what the doctor who treated the patient gets paid by insurance.

6

[deleted] t1_j0jaa93 wrote

Most docs don't run private practice and most don't do their own numbers.

2

Sohailian t1_j0hki1r wrote

Whether a doctor or a nurse practitioner, they're going to have the same prognosis: it's something viral.

0

misterplentyoftime t1_j0khtkd wrote

This is great and long overdue. For the vast majority of health problems a mid level can deliver better care for less money. Keep the physicians doing complex disease research and therapy and let the apns and pas handle the day to day. Doctors opposed to this are corrupt pos's who want to maintain a monopoly.

Apns already have full scope practice for everything but prescription in NJ. They have full scope in many other states. The sky isn't falling.

0

Hickawa t1_j0hl42z wrote

Seems simply limiting the types of drugs they have the power to prescribe would solve every issue the doctors have (-Ego). Why the fuck do I need a doctor to prescribe extra strong ibuprofen? I can see why letting them prescribe controlled drugs would be a problem. But that's it tbh. Doctors are over worked and many are undereducated when it comes to what actually matters to a patent.

Also, pay the nurses more. They do more work than doctors and harder work.

−2

scarface123 t1_j0i929l wrote

Undereducated lmao, they spend a minimum of a decade learning about the human body and the myriad of issues that can arise. Any training a nurse gets is quite literally minuscule in comparison and of a completely different nature.

4

Hickawa t1_j0igpyp wrote

I have worked with enough nurses and doctors that I completely disagree. It's just my opinion but I stand by it. Most doctors I have interacted with in hospitals were either overworked people who are only barely hanging on to their sanity or an old fuck who's not really interested in the patient's beyond here is what you need, pay on the way out. Not to mention still believe outdated information on things they should have continued to educate themselves.

3

bananafishandchips t1_j0inzzw wrote

underscore the old fuck who's not really interested and emphasize that's exactly why NPs are appropriate solutions for almost every routine medical issue. we already let them deliver babies and administer anesthesia--there's nothing more life and death that that.

−3

Electronic-Nature114 t1_j0i257v wrote

I’m pretty sure the APN’s primarily handle low level cases. They’re not making med decisions in the Icu for someone who was run over by a bus.

−2