Last month on Twitter, I came across a heated exchange among various physicians who were upset over a photo posted from a now deleted account. The photo showed a picture of a parking sign that read, “Consultant NP/PA/CRNA Parking.” The caption that accompanied the photo stated, “Physicians parking no more. More admin tactics to appease midlevels. First lounges, then parking. Physicians, if you don’t take a stand and stop training your cheaper decoys, expect worse. We did this.”
The unnecessary disdain for nursing professionals at all levels is becoming increasingly prevalent. Several anti-nurse practitioner (NP) accounts on social media are dedicated to highlighting the perceived “audacity” of NPs practicing health care without the approval or oversight of medical doctors. The overarching message is clear: health care should always start and end with physicians.
During my tenure at the bedside, there were many physicians who supported all things nursing – and the ones who didn’t were vocal about it. However, it’s still shocking to see a subset of doctors who feel that NPs are trying to replace them or take their positions. NPs are nurses and they’re aware of it.
If you walk into any academic medical center, you’ll find NPs working alongside physicians and providing excellent patient care. For those who don’t know, NPs are registered nurses who’ve studied advanced nursing concepts and theories, completed a multitude of clinical hours and passed licensing exams to treat patients. They’re not doctors nor do they try to be. Several states have passed laws that grant NPs full practice authority, allowing them to function independently without physician oversight. This allows NPs to run private practices and clinics in the same manner as physicians.
Think about the last time YOU needed patient care. How easy or difficult was it to obtain an appointment with your doctor? How was their bedside manner? How were you treated post care? Did you feel the physician cared about you as a person? Next, think about how many times you’ve been present in a room with a physician who’s assessing a patient and speaking with the patient or their family. When the physician leaves, what’s the tone of the room? Does the patient or their family ask you additional follow-up questions or to interpret medical jargon? Do you console the patient or family at times? In my experience, capitalism dictates that after spending a few minutes with a patient, the physician is off to chart or to see the next patient while nurses fill in the gaps and, at times, pick up the broken pieces. Unfortunately, this broken health care system leads to situations like the one I described. It forces patients to switch providers when they feel their needs aren’t met. Thus, we now have NPs!
The first NP program was created in 1965 to close the gap in primary/pediatric care so more patients could have access to services. Today, the role of NPs has expanded and health care is better for it. Why? Patients now have access to more providers that can meet their needs without waiting for a physician appointment. Patients have more choices! In a society that’s built on capitalism and free market enterprises, the freedom to choose NPs shouldn’t bother some physicians.
Every licensed clinician in health care is overworked, underpaid and stressed out! There are foundational issues within the health care system that affect both patients and professionals.
We shouldn’t have any “nurses versus physicians” issues because it doesn’t advance health care in any way. It’s not “us versus them” and it never has been until a select few decided to correlate nurses fighting for their collective rights as somehow eroding physicians’ rights. There are ways to address the issues plaguing both professions, while collectively working together so hospitals can enact changes that make better working conditions for all. Physicians can and should air their grievances without mentioning nursing professionals or degrading them. Punching down and attacking an entire profession does nothing to address systemic issues that physicians face. It doesn’t help patients obtain access or improve patient outcomes.
I believe that a lot of the vitriol spewed at nurses is rooted in misogyny – carried out by male physicians and internalized and reinforced by women physicians. In nursing school, we’re taught the history of nursing and how nurses were handmaidens to physicians. How many of you remember the stories of nurses getting doctors coffee, giving up their chairs so doctors could sit and essentially being at the beck and call of physicians who were primarily men. Much of society still views nursing as a profession for women.
If you’re in the business of health care, providing excellent patient care should remain your primary focus. With the influx of viral diseases, patient lives are on the line. Nurses and physicians need to co-exist and work together. The hierarchy wars and chest thumping only creates distrust in health care at a time when people need it most. What NPs and physicians have in common is the inherent desire to care for the sick. If the goal is what’s best for the patient, them having access to NPs shouldn’t upset you. It’s impossible to work in every facility and see every patient. Instead of attacking what’s deemed as an inferior profession, I challenge physicians to organize and invest their lobbying dollars to find real solutions. The notion that NPs and nurses want to replace physicians is false. While outliers exist, it’s not the collective. Focus on advancing health care without disrespecting the nursing profession in the process. This isn’t a competition.
Nobody wins when health care is in disarray.