In our last episode we discussed the rapid growth of nurse practitioner training programs and some of the challenges this has caused in ensuring that nurse practitioner graduates receive adequate clinical training to care for patients. Today we continue to explore concerns about nurse practitioner quality of education, as well as a new trend for nurse practitioners to seek work in cash-pay type practices, including opening medi-spas, infusion centers, medical marijuana clinics, and so on.
To help us explore these issues, we are joined again by Rayne Thoman, a registered nurse and former NP student who works to expose unethical nurse practitioner training and practice.
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This is precisely why I went back to the bedside as an ICU nurse. And I went to a good program I went to Ohio State University school of nursing with my masters degree as a adult geriatric nurse practitioner. There’s no way that we can treat patients in these programs because we are not adequately trained we have no residency and they were just quickly moving through to make their numbers look good.
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@Glam decor Adventures THIS is uncanny I had to explain to an NP why TSH was high in this pathology.
@Daffy155 The problem is it’s not all nurse practitioners it’s some nurse practitioners I think it’s the lazy ones I worked with a ICU nurse who is an NP school and I was shocked that he was because he was the most lazy and I’m sorry to say it in competent nurse that I’ve ever worked with yet when I went to see my PCP he was in the office with a white coat on training to be an NP I thought Jesus Christ God help his patients !
@Glam decor Adventures I agree but their training is not equivalent, I worry about patients with lack of access to care. In many pathologies like yours it would have been better to wait to see a physician than an NP. What if like most patients you were not educated about your disease.
@Patients at Risk you jumped on this so quickly. Let’s not look at an outlier and call it a norm. My grandfather’s doctor missed his cancer and an NP found it by looking closely at his abnormal labs and then referring appropriately. Do you want his number to run that story? 🤔🤔
My ex-husband was a child and adolescent psychiatrist. We went through premed medical school residency and then fellowship there is a lot of years of training and yes there’s no way I can imagine that a nurse practitioner could manage the complex patients that come through a psychiatrist office unbelievable!
@Daffy155 But I could also say the same about medical students/residents and what they have prescribed or deemed an appropriate plan of care for my CVICU patient’s when practicing as an RN. Comical at times.
@Kelci Hunter your comment shows like of insight. Medical students are NEVER allowed to prescribe or complete plans for patients, they are in clinical settings in a learning role although the interview patients and write notes it is always SUPERVISED by a licensed physician. As for residents they are SUPERVISED and must meet goals in order to advance in training. This type of incorrect rhetoric(that NP training is similar to that of medical doctors) is why POC and individuals with disadvantaged access to care are preyed upon by NPs. Im sure you think that you can come up with a better plan for a pt since you have been an RN for probably a respectable amount of time. I however would take my chances with a recent medical school graduate.
@aplinkal aplinkal Im not saying NPs are not needed. The degree is a joke that encompasses online training that mostly consists of fluff papers and presentations. A seasoned BSN can do what an NP can. there is no real difference between a seasoned Medical assistant and BSN either. The key concept is they need to be supervised by a medical doctor.
@Kelci Hunter FYI I got my ABSN and worked before continuing my education.
@Daffy155 Thank you. My thoughts exactly. No doubt NPs are an important part of the team, but they keep using this argument that they know more than residents, and that they save our butts, and SAVE our careers and patients… I’m yet to see this SAVING at my hospital. Yes, sometimes we have simple questions and we ask them, and sometimes we need a little help with some procedure… but they make it look like they are SAVING us. When I have a more complex question I don’t go to the NP, I go to my attending. As you said, we med students and residents are supervised by physicians, not by nurses and NPs.
I wish there was a website that tracked these horrendous practices by state. It would really put politicians on the radar if they are noted as responsible for states being the worst for unsupervised dangerous practices
I am thankful that I came across your channel. I am an FNP MSN student and I have been so confused as to why I am seeing so much discussion among the NP community about lucrative business opportunities, such as those you discuss in this episode. Frankly, I am embarrassed with the lack of professionalism by the NPs that were mentioned in this episode. We have all of the EBP we need to make decisions…they are called guidelines…why are people asking these questions on FB? I have been very fortunate to have had positive experiences with dedicated nurse practicioners during my practice as an RN and as a patient. I know that you would never discourage anyone from seeking to further their education, but are you discouraging the path of the NP, or just making the point that more education should be required to practice as an NP or that masters prepared NPs should not be allowed to practice independently? (I would not disagree, by any means.) I suppose my understanding of pursuing this degree was to be able to provide a valuable service that would allow me to be perform duties that extend beyond the RN for the purpose of assisting a supervising physician with health promotion, education and maintenance while allowing that physician to focus/dedicate more time to complex patient care. Most of my preceptors have been medical doctors, and I feel that they have been very supportive of the NP role while allowing me to experience medicine from a perspective outside of the education I am receiving. Thank you for your insight! I look forward to following your channel.
This is an amazing series
I am against NPs having independent practice. However, the Yale-trained NP, in this case, was considering the most appropriate medication for someone with Bipolar Depression who is an extremely high suicide risk. The Pediatrician doesn’t know what she is talking about. Lithium is the only medication that will lower suicide risk which is 100 times higher in this patient than the risk of suicide in the general population. The patient needs medication. Please shut your mouth pediatrician. Lithium (or ECT) for severe bipolar depression is the only treatment that will work
Yes, thank you to Rayne for speaking out as a nurse. I found that when I started to speak out about it, people didn’t believe, and I learned to keep my mouth shut.
Here’s another comment from one of the facebook groups that I had to quote because it emphasizes the hypocrisy, and pure comedy here:
“So let me get this straight… a pediatrician bashes NPs but oh, BTW, when
you look at her website, she makes money off of an NP in her practice.
Pediatrician also complains about NPs working outside of specialty but
she gives her diagnosis on an adult and multiple treatment ideas on
psych meds, pediatric psych, all outside of her certification. Then we
have Dr. Bernard complaining about NPs working in a cash practice when
she owns a cash, concierge, practice. And about working outside of
training she’s either a psych offering physicals or she’s a PCP offering
psychotherapy.” I 1000% agree Biased. Comedy.
Shame on Rayne! Why shame other nurses with isolated FB cases? They are asking colleagues for suggestions for some very difficult child psych cases. Certainly CBT or other therapies in combination with medications is paramount. Meds alone are never the answer.
Making generalizations of an entire profession based on the ambiguous actions of a tiny subsection of that profession is called prejudice.
The vast majority of NP’s that work in a collaborative agreement with an MD RARELY “bother” the MD and yet the MD raked in barrels of cash because of the collaboration. If their education wasn’t up to standards they wouldn’t pass boards and also many patients would be hurt or dying as a result I.e. lawsuits. That’s not happening because they aren’t hurting anyone at any rate greater than MD’s, DO’s or PA’s.
This series reminds me of Plandemic. It’s conspiratorial and ignorant. Sinister and prejudiced. Seems like a push to control competition and control the market and political power than actually helping patients.
I find it interesting that two MDs are sitting there bashing NPs (trying to lump us all into a category of not being well trained), when there are decades of medical malpractice cases against MDs including surgical removal of the wrong body part, opioid overdoses causing death and dependence etc. I am an NP, well trained, however we are ALL constantly learning about the ever changing body. There are many cases that require the eyes and ears of another professional. Most MDs I know refuse to collaborate due to pride and then they end up misdiagnosing a patient because they felt like they knew what they were doing. Regarding the psych issue, as an NP you must go back to school if you wish to work as a Psych provider. In family practice all I heard was “psych takes 3-6 months for new patients so you have to treat them”. If you refuse then you risk sending a depressed patient into a suicide situation rathe than start them on an SSRI or SNRI. The lack of Psychiatrists and Psychologists is why so many NPs are going back to school. We are sick of seeing patients suffer due to lack of providers.
Also here are some famous malpractice lawsuits which even include Duke physicians: https://leightonlaw.com/12-famous-medical-malpractice-cases/
@aplinkal aplinkal Can you please send me the links for the data where you got this information from? I’m talking about the data to back up you statements that the patient outcomes and satisfaction for NPs are superior to physicians, and the almost 0 malpractice assertion you made. I looked all over and can’t find it. I would love to see this data. Thank you.
Patricia: AANP has this data. Well known
@aplinkal aplinkal can you source the research article that proves this?
This argument is invalid…Comparing the training of a physician to an NP is like comparing an ocean to a lake. Institutions cannot control the actions of the individuals they train. However governing bodies DO hold them accountable. For example multiple CNRAs have avoided serious repercussions due to their “lack of training” a more specific example of an NP dodging proper malpractice is Gerald Baltz a so called “psychiatrist” really an NP(so many people complained he had to change his title on google” ad a sexual relationship with Stevie Ryan while treating her..she later committed suicide. Had it been a doctor he would have lost his license and most likely ended up in jail. Lots of people want to be doctors but no one wants to put in the work, the delayed gratification, and the time. Tell yourself what you want….
@aplinkal aplinkal lol. I wouldn’t expect anything more with the brain of an NP.
Scroll on, Perfect example of an uneducated MD 😬
Yes!
Calling someone who went to school for roughly 8 years and tens of thousands of hours of supervised practice uneducated? I dont even know where to begin….
If these folks are so concerned about patient care, why aren’t they providing additional education to support other members of the healthcare team? As much time as you spent making this video you could’ve provided an educational piece on preventing renal complications for the patient with diabetes or how to manage prenatal care for the African American female. Use your time wisely.
There are NPs who are following in their collaborative physician’s shoes in setting up these practices.
Also did Rayne leave NP school or was she dismissed? What type of program. There are many excellent NP programs and some mediocre just like there are Medical Schools. Students and prospective NP’s must do their due diligence and investigate board passing rates and reputations of the programs. Students looking for an easy way out and an easy program can likely find one. I personally have worked with many mediocre physicians in my long career but do not blog nor do podcasts about them. No I spend my time educating and providing primary care and trying to help people to be healthier. Such a waste of time!!
I wonder what it’s like to be such a miserable person that you have to focus on others instead of improving your own practice…. maybe it’s your own incompetence that you are deflecting from.
Exactly. She could be actually practicing medicine and helping people!
LOL someone got butthurt for exposing the NPs.
get over it you’re not smart enough to be a doctor or get accepted to medical school, btw stop misleading the patients to think you’re actually doctor.
You’re delusional. Are you actually OK with the current state of nurse practitioner education? Smh. Hope you or your loved with a very complicated illness is handled by a wannabe doctor who got their doctorate degree from a 2-year 100% online program.
Shame on you all!
I’m an NP with fellowship training. During my fellowship I worked closely with med students, residents, NPs, PAs and attendings. The truth is, the learning curve for any new grad is steep, including NPs to Interns. Picking on NPs is unprofessional and sad to see. I agree that the education that we receive needs to be improved and some sort of new grad training is needed nation wide but this is not the way to go about it. Unless some sort of mandatory change is made, we can talk all about it, but programs will continue to churn out new grads, RNs will continue to become NPs.
Say that again. A girl here did NP Residency at a Federally Qualified Health Center (FQHC). That was after 20 years as an RN in ICU, Telemetry, Oncology, Med Surg, Ambulatory Care, and everything in between. Our NP Residency comprised 30 NPs from all over the country. Some graduated from Columbia and Yale. The Residency was rigorous as we had our own patient panels and walk-ins and performed procedures including suturing, Nexplanon insertions and removals, joint injections I&Ds, shave biopsies, etc. The Residency involved one on one training with specialists: Endocrinology, Nephrology, Dermatology, Orthopedic Surgeon, General Surgeon, ER, Peds, Women’s Health, Podiatrist, and community involvement taking care of the homeless population. Not bragging but may whoever thinks NPs lack whatever with such generalizations STOP ALREADY. I had several patients boot their MD/DO PCP’s to establish care with an NP. Besides, an NP with a BSc in Nutrition, BSc in Nursing, post-MSN in infectious disease has tons to offer. Before anyone shuns some of us think twice. May God bless the patients in our care who see competent, highly qualified healthcare professionals. We have a highly competent bunch saving lives. Have a great day ya’ll.
I’m really glad you’re speaking out.
I do agree there is a problem with the training and education NP programs provide and standardized training and entry is so needed but there is a need for NPs and there are a lot of competent and knowledge NPs.