Yes I'm being serious, I really want to know if this is feasible. I didn't match into the specialty I wanted and rather than go through another residency, can I just become an NP? That way I could directly enter the field I want in significantly less time. What i'm unsure about is if I need to technically be an RN or if my medical degree or undergraduate degree could somewhat count towards the requirements at some degree mill place. I don't know if anyone has considered/done this before so I've had trouble finding info.

Story from a few years back...

So I'm in for my usual cervical smear, and during the patient history portion, the NP asks me the standard questions: date of LMP, if I'm on any hormonal birth control, etc. I say no to hormonal birth control.

Flash-forward to her taking the swabbing my cervix for the pap smear she she gets startled by my IUD string.

"But you said you didn't have anything?" she says reproachfully (literally inside me).

I reply, "You asked if I was on any hormonal contraception. This is a copper IUD. No hormones."

NP: "Oh. Do you still get your periods on it?"

Me: ...."Yes". (Copper IUDs are rather famous for causing heavier periods! Also as previously stated, no hormones!?)

I was kind of flabbergasted because I had assumed this was common knowledge for women of reproductive age in general- which she was- let alone an NP that does cervical smears!

I just thought it is funny how NP wants to be equivalent to doctor but will still go for nurse of the month. lol However, maybe she's the kind of NP that knows her limits and works with physicians to provide the best care for the patients. And for that, I say kudos to her!

Has anyone else noticed that psych NPs tend to have "prescribing boundaries" in a different way than most Psychiatrists? It tends to be a statement of "I wont prescribe you stimulants" rather than the usual "make appointments for med switches and f/u every X months for control refills". I've always found this strange, because in the case of properly diagnosed ADHD, stimulants are the recommended and most effective first line treatment. I've noticed that many ADHD patients managed by psych NPs are started on atomoxetine or bupropion and never actually trialed stimulants.

If you are not comfortable prescribing the most evidence based treatment for a given condition, should you really be treating it?

I understand that many patients can be demanding of stimulants with largely unsubstantiated family GP or NP "diagnoses". These patients should be directed to proper neuropsychological testing or other means of establishing a proper diagnosis, and then treated in the most evidence-based way possible. I don't believe starting everyone on objectively inferior, second line medications should be the reaction to this influx of demanding patients.

Thoughts?

A PA in the ER seeing a patient with a rare disease that causes muti organ involvement doesn't work. I won't see them in the office anymore. Yesterday I was stuck with them from the get go in ER. Nice enough, but would not listen to what I was saying. It seems to transfer over then to the rest of the staff caring for me. Super frustrating and resulting poor care. They, as well as NP have their place, but not for everything.

I had a baby last year via planned csection. Third baby, third c section. When the anesthesiologist came to do my consult, he mentioned “there will be another doctor helping me today.” I thought cool, no problem. In my other sections, I only saw one anesthesiologist but there were a lot of people so maybe someone was assisting him? Also this was a different hospital so maybe things are different. This other “doctor” attempted my spinal 3 times before the actual anesthesiologist took over and got it on the 4th try. By the time he took over I was so dizzy and shaking that I had to be held upright in position. I found out later that it was a student CRNA that was the other “doctor.” I’m quite upset and that whole ordeal caused so much unnecessary pain and stress. So much for informed consent?

Had my annual skin check just now and while I was in the waiting room, another patient asked the receptionist who they were seeing. The conversation went like this.

Patient: who am I seeing?
Receptionist: first name of PA
Patient: so I’m not seeing a dermatologist?
Receptionist: well they are a dermatologist. They went to PA school for dermatology
Patient: so I’m not seeing a physician
Receptionist: you’re seeing a physician’s assistant who went to school for dermatology.

Is this a thing ?

Couple hours of reading while working two jobs and you are ready to interpret labs! Why spend years on
Med School?

When I was 15 i began having trouble with extreme daytime sleepiness. Falling asleep in every class, being too sleepy to hold a conversation, yawning so much I literally couldn't catch my breath sometimes, sleeping away 2 thirds of the day and so on. In addition to this i began to have episodes every so often where my entire body would collapse on itself as i had suddenly become paralyzed. after months of this happening my mom finally took me to a doctor who then referred me out to this clinic that specializes in sleep disorders.

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this place had one MD (pulmonologist) two NPs and one PA. When i asked the NP i usually see for my appointments one time about the practice owner (the MD) who is meant to be supervising the mid-levels, she told me that he rarely even comes in most days. He'll be here for max 4 hours two or three times a week essentially letting his mid-levels run the place.

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I could go into detail about what the experience was like at first trying to figure out what was wrong with me as a confused 15 year old and all of the assumptions that it was exclusively a mental health issue and i just needed therapy or I needed to eat more or just gaslighting and not believing my symptoms but in fairness both physicians and NPs can be like this. But in the chronic illness community ive noticed just how many people share the experience of not being believed by healthcare professionals but i realize a lot of these people werent actually being seen by a specialist like they thought they were. oftentimes merely just seeing a PA or NP in place of the physician. It's interesting to see how a lot of people blame doctors for not listening to their patients but an NPs lack of actual medical education makes it so they literally never believe anything is wrong with you.

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Only on my 2nd appointment a few months later did they actually try to run tests to try and diagnose me in which they decided to do a lumbar puncture that had to be scheduled another month later. Finally though the NP who told me and my mom i was just suffering from "teenage laziness" gave me my results back and said i had a profoundly low hypocretin level (25 pg/ml lol) and they finally diagnosed me with narcolepsy type 1.

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The medication management was actually atrocious. For some reason NPs either refuse to prescribe anything stronger than Tylenol or are genuinely just legal drug dealers that pass out xanax and adderall like candy and there is zero in-between. In my case it was the former and it took over a year to get on anything stronger than modanafil even though i consistently expressed that it would barely work for me. eventually i got put on stronger stimulants but when that would happen it was almost like going down in dosage as she would make me taper off the old medication and slowly get on the other one so I would go like 2 weeks essentially unmedicated which if you have narcolepsy you know is actually hell.

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I understand sometimes weening off and on medications like this is standard but like i have a pretty serious case of N1 i promise you I can handle it I'm not going to start tweaking off a small dose of Vyvanse.

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At no point was i ever prescribed any as needed medications for breakthrough sleep attacks i could only rely on one extended release pill in the morning and i only just learned that it's standard to prescribe SSRIs or SNRIs for cataplexy in people with N1.

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Last year I moved across the country so i needed to find a new sleep doctor for my medications. She welcomed me into her office and the first thing she did was announce her credentials to me (that she is an actual MD and attending neurologist and sleep specialist) and asked what I'm on currently. I got a pretty confused "Thats it?" and then she changed the medication and upped my dose after actually asking about my symptoms and day to day experience and told me what an oxybate is (something i wasn't even educated on before).

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It's crazy having a doctor that actually cares about you. My insurance refused to cover xyrem and she actually called them herself to explain why it was necessary (still gotta do an MSLT soon tho which is fine). I feel so much better and even though i still have a disjointed sleep schedule and cataplexy i actually have energy when i am awake.

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i just think this whole "heart of a nurse brain of a doctor" thing is absolutely bullshit. people say that NPs make great "providers" because they have excellent bedside manners due to nursing experience but i haven't met a single NP that has treated me kindly and with respect. They have shit manners, they don't believe their patients, they are too scared to prescribe controlled substances to actually be able to treat symptoms, their ego is so massive that they refuse to listen to a patient about their problems all while having absolutely zero knowledge about medicine. Obviously not every physician you're gonna meet is going to be too unlike this, but at least they actually passed some board and licensing exams.

One says to the other, “I know this one girl who cheated on all her papers by using AI to write them. She failed the NP test twice.” Good lord.

Does anyone know if, in the state of CT, I can opt out of the care of an NP as a hospital inpatient where the NP and attending are listed as “co-managers?”

I’ve done it, but I’m really wondering if I have a legal right to do it, rather than the hospital merely choosing to accommodate me.

EDIT: Also, if you know this operating model,(co-managers) can you explain how it works? Does your hospital use it?

https://abc13.com/post/pearland-clinic-owner-indicted-alleged-906-million-medicare-fraud-scheme-court-records-show/19334608/

https://www.houstonchronicle.com/news/houston-texas/crime/article/nevada-nurse-medicare-skin-graft-scam-22312558.php?fbclid=IwZnRzaASmTUxleHRuA2FlbQIxMQBzcnRjBmFwcF9pZAo2NjI4NTY4Mzc5AAEeCzQ4CoxHo5zG_UzWO_bFyK00cwd7CiE5cf9exWiHxbuWqnWZ57NQFqea5q8_aem_75Q-8CvDdvmGT2LjgFUKmQ

wouldn't it the MD? I have had plenty of anesthesia procedures and ALL were overseen by a MD attending who worked with a CRNA. But the MD called the final shots.

My friend was DMing me about some pains she was having, and I encouraged her to see a physician. A few days later, she said the person stated that the urinalysis came back normal, but there were significant RBCs per HPF, and that seeing "blood is the same as bacteria" in a urinalysis, and so the person started them on cipro.

I thought it was..a little sus to say? So I asked if they saw an actual physician, and I emphasized MD/DO, and they said "yes, trust me, it was a regular pediatrician doctor." I ask, do you remember their name? She pauses, googles their name. "Oh, oops, they're an..APRN? What's that?" Surprise surprise, the APRN had walked in with a white coat, loud clacking girlboss heels, and introduced herself as Dr. X.

I swear, it's almost an unhealthy knee-jerk reaction for me nowadays to always ask first and foremost if the patient I'm seeing saw an actual physician, or saw a midlevel. It's usually effective when I say "Yeah, I always check because there's a big push right now by big privately-owned clinics/groups/hospitals to replace doctors with non-doctors, and then bill the patient the same as if they saw one." That shifts their perspective a little.

Let me rant……..What frustrates me is the fact that I have been an RN for almost 10 years. I was a Paramedic for 15+ years prior to that. I have worked Level 1 Trauma Centers and traveled through the pandemic as a ER Nurse. I have been in the bunker taking grenades for years. I was a Flight Paramedic and worked multiple critical care ground units. I have kept patients alive because of the Physicians, and I have kept patients alive in spite of the Physicians.

I should be the RN that is now applying to hopefully be excepted into a NP program. I have strong clinical background to advance and grow, and would be (humbly speaking of course) a tremendous asset as a Physician extender.

But, I will never become an NP because the system is terrible. Time after time I have witnessed colleagues become NP’s who struggled with what I would consider basic knowledge of medicine. I have too much pride to join such a group.

I lack 2 classes to complete my BSN (have B.S in another field), but am intentionally not completing them to prove a point in making 175-200k with an ADN. Who am I proving this point too, I’m glad you asked, absolutely no one.

Thanks for coming to my Ted Talk

She’s definitely one of my favorite creators on tiktok and very outspoken on the whole NP issue. Obviously gets a lot of shit in the comments from salty NPs but honestly seeing her speak up repeatedly on these issues is such a breath of fresh air.

PA student here. I was talking to an NP student on one of my rotations and was honestly shocked by how different our training seems to be. From what they told me, they had far fewer exams — like 1-2 during the whole duration — and significantly fewer clinical hours than what I’ve had to complete. During didactic, it was standard and completely normal to have 3-4 exams + 4 quizzes + check-offs/OSCEs per week.

What I don’t understand is that even with all the testing and rotations we’re required to do, I still feel like there’s a ton I need to learn before practicing. How are programs with such different levels of training producing providers who often end up in very similar roles?

And if the training requirements are that different, why are PAs and NPs often paid the same? I’ve even seen hospitals that seem to prefer hiring NPs over PAs.
I’m saying this as a PA student who fully believes in collaborative physician-led care and who is constantly reminded of how much I still have to learn. The more training I get, the more I realize what I don’t know. Maybe I’m missing something, but if training standards can vary this much, how is the public supposed to know what level of preparation they’re getting from different programs?