Nurse practitioner delusion / "Noctors" / "Midlevel staff" - Nurses get a 1 year degree and start thinking they are better than doctors

Cake Farts

Settling down 🍵
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It has always seemed to me that a lot of people in medicine have this kind of childish competitiveness to them. Like they enjoyed science in school because it made them feel smarter than everyone, got into medicine because they saw it as the ultimate one-up move in flexing your intellectual superiority, and just never stopped trying be smarter and more important than everyone they meet, even each other and especially if their professions overlap. Coming from an American.
Well yeah, that makes sense. From day one in college your colleagues are your competition, and you have to bolster yourself into a “be better than the rest” headspace if you want to succeed. I don’t know if it’s a similar story when you actually get to Medical School, but I don’t think this competitive attitude ever goes away.
 

Autopsy

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Not a lot of "haha" happening in this thread yet and I hate to contribute to that, but here's some more perspective:
  1. Doctors are already under assault by the legitimate threat of other specialists with superior non-diagnostic training taking over the treatment of patients, relegating the field to more of a narrow diagnostic role that isn't worth hundreds of thousands of dollars a pop, so the illegitimate threat of hapless nurses who think they're hot shit but still fall under the MD's oversight for malpractice cases really riles up most docs extra hard.
  2. Medical technicians are heaven-sent. Most of them do less education and learn more due to the nature of their institutions and work, and they don't have such an ego about it. Technicians are usually trained and hired on a per-specialty basis and as a result actually know some shit about what they do, and not just how to execute. Most of the really hardcore ones from when these positions just started opening are retired by now. The field's been muddied down considerably since then, but many early technicians also had to pass the NCLEX before more specialized credentials were devised, even though they weren't trained or licensed as "nurses."
  3. Nurses really don't like it when anyone points out that techs do more and are paid less, because much like doctors, they're horrified by the idea of getting muscled out-- even though that's why most hospitals were hiring them, to lower the number of regular doctors they needed to have on staff.
  4. One big difference between NPs and the actual healthcare professionals challenging the MD hegemony is that the rest are especially pushing to get permission to take patients off unnecessary medications a GP gives the patients before they even reach their door, rather than simply the ability to put them on new ones. Guess which group has had more success in lobbying?
 

Kujo Jotaro

Every Man Dies
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Hospital administration has ballooned in size over the past decades, particularly in the United States. To combat this increase in cost, hospitals have begun replacing practising MDs with Nurse Practitioners (NPs).

What are NPs?
They are trained nurses that have a level of autonomy and decision making far beyond what you traditionally may think of when you hear the word "nurse", and in some states are able to practice entirely on their own without direct supervision.

How does one become an NP? What is their training?
After completing a Bachelors degree, one can register for any number of online only Nurse Practitioner diploma mills programmes across the US. They take crucial classes such as lobbying, finance, and leadership and management, for one year. They finish off their degree with a research project that rivals a middle school science fair.
View attachment 1887590View attachment 1887591

PD's then shadow a MD for 600 hours. They are now fully able to practice on their own in whatever field they choose. For comparison, apart from the much longer and difficult education, an MD will have a residency of around 20,000 hours.

Why is this an issue? Who cares?
Malpractice is increasing,the USA is producing thousands of entitled idiots that have a high school level of biological understanding, and allowing them to treat patients who have no idea that the person they are talking to isn't a Doctor. NPs are notoriously pissy about being seen as lower than Doctors, and will try to hide the fact that they aren't constantly. They are going as far as to buy their own badges that say "Doctor" on Amazon.
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A case study in NP incompetence is Antoinette Thompson, an NP working independently in an ER that killed a 19 year old girl in 2015 due to clear malpractice. The girl had an elevated heart rate because she had a bloodclot in her lung and her body was compensating for the lack of oxygen by increasing the heartbeats per minute. With Thompson's bullshit education and training, she treated each symptom individually like it was a textbook MCQ, and gave the girl medication to slow down her heart rate. She never considered why it was that her heart rate was increased, only that she should reduce it. A deposition was held

View attachment 1887593

where Thompson cried and said that she didn't mean to hurt her. This woman is still a practicing NP. Cases like this happen constantly, and yes, they can do more than just prescribe you drugs. Here is a 6 minute video where an actual doctor talks about having to fix multiple fucked up procedures carried out by Nps.

Why can they do all this? NPs have ridiculous lobbying, the AANP constantly demands states to increase the level of power NPs can wield.

Why are they lolcows?

NPs are incredibly defensive about their abilities. They believe they are discriminated against by Doctors, and have the same skill level and ability as them.

View attachment 1887594
In the same breath they then ask eachother the most retarded questions that really show just how little they know.

How do I look at X-rays?
View attachment 1887596

How do I ask patients questions?
View attachment 1887597

What can we actually do?
View attachment 1887600

In the medical field they are often referred to as "mid-levels", and other communities criticising their actions refer to them as "Noctors"

Where can you find these communities?

There are hundreds of Facebook groups for Nurse Practitioners ranging from harmless study groups to terrifying advice pages where they try to pool together their collective knowledge to see if it can reach the level of an actual doctor ("My patient has had chlamydia 3 times in the past 6 months, and I'm still prescribing him the exact same treatment each time and it isn't working. Weird right?", "Can I give my alcoholic patients xanax prescriptions?")

Additionally there are large communities on Twitter and even TikTok, where they shill to children into thinking they are as qualified as Doctors.


- For critical posts about NPs

The majority of the facebook groups are private, although they will accept anyone if you apply usually

One of the biggest is


TLDR
Nurses are getting shitty degrees and are getting the power to treat YOU. They fuck up constantly and scramble to defend themselves while only making it worse by highlighting their lack of knowledge in key areas. Those ethnically ambiguous overweight women twerking in the hospital while patients die beside them are likely NPs. Those literal whos on twitter that post about their glow-up etc with pictures of them graduating, and claiming to be a doctor, are likely Nps They are the medical equivalent of a chihuahua, constantly barking as if they are tough shit and looking for attention. This would be comical, if the medical industry wasn't then assigning these chihuahuas to be guard dogs.

Note: I am not American and as such could have gotten some details wrong when it comes to the requirements for becoming a NP vs a MD. I also admittedly know next to nothing on the NP lobby, apart from the fact that it is a huge pain in the ass. Let me know if there are mistakes or information to add, and I'll make the changes.
Regarding your note at the end, its hard to say the exact requirements to graduate from NP school, but most reputable schools offering an NP program require at least 2-3 years if not 4. Online schools however while typically cheaper do fast track you and have sketch results from what I've heard. In my state for instance you need specific licenses to work in psych, family practice, geriatrics, etc.. each of which will cost you extra. In the programs I looked into taking you could bypass some of the requirements in any given specialty if you already had your dnp in something else. I've been told by NP's I've met that they believed NP school was easier than regular nursing school(granted the school they and I attended is notorious in our area for being retardedly hard to pass). While NP's definently know more than your average nurse, and are probably ok to work in family practice (low stress environments with some oversite) they should not be working in ER's or even acute care for that matter. They also should have oversite for some extended time by a physician, at the very least 5 years. Lastly given the group of people I know who've either gone to NP school or aspire to your characterization of them as narcists is apt.
 
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repentance

True & Honest Fan
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Ask, and you shall receive.

...Maybe that Malaysian schizo was onto something with that "meds are my maker!" crap.
That is truly disturbing, as is the fact that becoming a NP in the US is such a short path.

I was a bit surprised to find some criticism of the diploma mills on allnurses.

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A quick look at allnurses confirmed that it's possible to qualify as a NP in the US without having worked as an RN.
 
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Takayuki Yagami

Justice is Blind, and Autistic
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I keep hearing from the medical industry that there is a nursing shortage and I suppose that's behind the need to get as many bodies into these programs as possible. However the quality of nursing care will continue to drop in America as stupid students are never whipped into shape in public school regarding math and science. Science especially is needed to be a competent medical practitioner but Americans are usually too stupid to understand it, at least in the number of students needed to go on to get medical certifications.
As far as the science shit goes, I have a minor story/pl relating to this sentiment. I have a bio degree, and a lot of the other kids in my extended family got into nursing. Something that floored me early on was that their science requireds weren’t as stringent as mine. They didn’t need to make their own agar in micro, I’m actually not sure they even maintained their own cultures, which I assumed was SOP because it’s piss easy.


This thread has potential
*replaces your knee with pizza*
Hey Hey People, Sseth here.
 
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Bins

LGBTQ+, BIPOC, Autistic, Nonbinary, infinitfat
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As far as the science shit goes, I have a minor story/pl relating to this sentiment. I have a bio degree, and a lot of the other kids in my extended family got into nursing. Something that floored me early on was that their science requireds weren’t as stringent as mine. They didn’t need to make their own agar in micro, I’m actually not sure they even maintained their own cultures, which I assumed was SOP because it’s piss easy.


This thread has potential

Hey Hey People, Sseth here.

From what I've experienced, as well as confirmed by teachers I've chatted with, anytime the nursing students at a school I attended years back left the "nursing bubble", they ran into problems. It was so prevalent that a teacher who primarily taught the basic "Intro to Bio" level 100 courses was let go do too many complaints that it was "hard." This school was heavy into its nursing program, so they ran the shots, and retention, not education, was the primary focus of the school. The only positive was how easy the nursing students were to lay.
 

PetrifiedTom

Bugged life mechanics!
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Even in my shithole country nurse after graduation in med school and additional 2 year course in depth of her chosen spec field (oncology, pulmonology u name it) CANT perscribe any drugs. She can prolong the existing intakes but not take iniciative what patient should or shouldnt take.
 

Crunchy Leaf

cronch
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From what I've experienced, as well as confirmed by teachers I've chatted with, anytime the nursing students at a school I attended years back left the "nursing bubble", they ran into problems. It was so prevalent that a teacher who primarily taught the basic "Intro to Bio" level 100 courses was let go do too many complaints that it was "hard." This school was heavy into its nursing program, so they ran the shots, and retention, not education, was the primary focus of the school. The only positive was how easy the nursing students were to lay.
Aren’t there licensing exams for nurses? Professional programs ride or die on their exam pass rates.

There are so many programs that admit unqualified people to make money off them, in every field. Lower tier law schools are notorious for this. I’m not some sort of ‘you should only go to college if you’re getting an engineering degree!’ person, but I do think the government should, at minimum, start cracking down on professional programs with terrible exam pass rates. It’s predatory. People who barely graduated from high school and then barely graduated from college thinking that because they got into nursing (or whatever) school they’ll somehow turn it around academically.
 

Cryin RN

True & Honest Fan
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As far as the science shit goes, I have a minor story/pl relating to this sentiment. I have a bio degree, and a lot of the other kids in my extended family got into nursing. Something that floored me early on was that their science requireds weren’t as stringent as mine. They didn’t need to make their own agar in micro, I’m actually not sure they even maintained their own cultures, which I assumed was SOP because it’s piss easy.
Because nurses never do this in Western healthcare systems. It's unlikely to ever be a job requirement because lab staff are significantly cheaper per hour than nurses in almost all jurisdictions.

In Noctor news, this lady (archive) passed medical school in the Caribbean, after dropping out of two other med schools, but couldn't get a residency placement. Luckily Missouri doesn't care and lets unmatched med school grads turn into what is effectively an instant NP, "assistant physician" (different from "physician assistant"). Skip a few years and she's selling amniotic fluid?? as a stem cell treatment???
Derges exclusively obtained amniotic fluid, which she marketed under the name Regenerative Biologics, from the University of Utah. Derges advertised Ozark Valley Medical Clinic as a “Leader in … Regenerative Medicine,” including stem cells, and marketed her “stem cell” practice through seminars, media interviews, and social media. The federal indictment cites an August 2019 seminar in which Derges told her audience that the amniotic fluid she used in her stem cell practice was a “stem cell shot” and that it contained “mesenchymal stem cells.” According to the indictment, Derges made similar claims in personal consultations.

In fact, however, the amniotic fluid Derges administered to her patients did not contain mesenchymal stem cells, or any other stem cells. The amniotic fluid she obtained from the University of Utah was a sterile filtered amniotic fluid allograft (a tissue graft comprised of human amniotic membrane and amniotic fluid components derived from placental tissue). The amniotic fluid allograft was “acellular,” meaning it did not contain any cells, including stem cells.
Oh, and of course
In an April 11, 2020, Facebook post Derges wrote of amniotic fluid allograft: “This amazing treatment stands to provide a potential cure for COVID-19 patients that is safe and natural.”
Oh AND she was making it rain Oxy scripts on patients she had never seen in person, because that's a free space in Bad Midlevel Bingo.
 

palmtreesalad

Add some Croutons
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Ok, I love this person and all, but one of my family members is like this.

She was a nurse once upon a time and, despite this, her medical knowledge isn't so great. They prescribed another family member medication and she convinced him to only take half a pill or maybe to even skip it all together because "that's what works for me and doctors don't know squat." He collapsed a few days later, had to call 911 to make sure he was ok.

This also reminds me of a similar subject, herbalists/witch doctors. People who think their spiritual beliefs are practices are superior to Western medicine. Unfortunately, sick people believe in this and end up dying. People will skip getting chemotherapy and drink wheatgrass or participate in rituals instead.
 

Kujo Jotaro

Every Man Dies
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Ok, I love this person and all, but one of my family members is like this.

She was a nurse once upon a time and, despite this, her medical knowledge isn't so great. They prescribed another family member medication and she convinced him to only take half a pill or maybe to even skip it all together because "that's what works for me and doctors don't know squat." He collapsed a few days later, had to call 911 to make sure he was ok.

This also reminds me of a similar subject, herbalists/witch doctors. People who think their spiritual beliefs are practices are superior to Western medicine. Unfortunately, sick people believe in this and end up dying. People will skip getting chemotherapy and drink wheatgrass or participate in rituals instead.
Nurses don't know why dosages are given, they know what a normal dosage might look like say for instance "2tabs 325mg acetaminophen every 4hrs", but in the case of most medications don't know why that specific order was made. Nurses are not trained to understand dosages, just to correctly administer them, and in some cases understand when a dosage is dangerous. Never take a nurses words on changing your dosage as an absolute, they might be on the right track but always check with a pharmacist or physician.

Similarly nurses (specifically rn's) are trained to look for signs and symptoms of common diseases like heart disease, hyper/hypothyroidism, diabetes, etc.... Basic diagnostic indicators, which they can't and shouldn't make conclusions on. The purpose of this is to help provide physicians with relevant info, the most important function of a nurse outside of direct patient care is accurate information gathering for physicians. The problem occurs when they take basic diagnostic indicators and start making conclusions, telling patients they definitely have x, or decide it's ok for them to write orders or administer meds based on their limited knowledge. It doesn't help that you have nursing instructors inflating nursing students egos about their diagnostic abilities during nursing school.
 

MembersSchoolPizza

Sworn Brother of the Cult of Browning
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To slightly power level...

NP nearly killed my father. I moved a while back, and my father had recently widowed, and was having trouble on his own, so he moved with me. I helped him find a new doctor in the area. We found one that was purportedly a great doctor for elderly patients.

When we got him in, we were told he would see a NP. Well... Okay, fine. His previous doctor (elsewhere) had used a NP sometimes, and it was a fine arrangement. The NP was great, and would go get the doctor if something went past where she was comfortable. But if all you needed was to get a cold looked after or something, it was fine.

Five visits to this "doctor", and neither he nor I ever met the doctor. Ever. Never even saw him in passing. Five visits, and he only ever saw a NP.

Two days after his final visit to that clinic, my father had a stroke. Brought on by a (treatable) condition that the NP repeatedly failed to diagnose, but the first actual doctor spotted right away. Thankfully, as strokes go, it was "minor", although Dad has never been quite the same. You don't notice it most of the time, but he has trouble with his memory and sense of time now. Anything that wasn't very recently (a few days ago) or obviously years ago is "a couple months ago, right?" now. And he's... Just more hesitant and uncertain than he ever was, now. Like the stroke damaged his ability to make a decision. He needs people to prod him a lot over very obvious, easy things he should be able to tackle, but to him they feel like insurmountable problems.

Thanks-a-fucking-lot, NP. And yeah, I blame myself, too. After the second visit in a row dad didn't see a doctor, I should have been raising hell, but I didn't... Dad seemed to like the NP, and I didn't wanna cause him problems. But I should have done something.
 

MembersSchoolPizza

Sworn Brother of the Cult of Browning
kiwifarms.net
That's a hell of a story. Was your dad able to get some renumeration? If nothing else, for the money you paid to see a doctor without ever actually seeing a doctor?

Eh.

Something might have been possible, but it wasn't clear cut enough for anyone to take it pro-bono, particularly with dad being "fine", and the resources just aren't there to pursue it legally if we're paying out of pocket and no sure victory. And thankfully we're only out "out of pocket" a few hundred dollars, most of that dealing with the stroke itself, because dad has pretty good insurance...

I was going to at least do the impotent rage thing and leave a scathing review of the clinic, but it was pointed out to me - I'm potentially tainting my own name in the eyes of the medical system around here if I do that. Because basically there are no "independent" GPs down here, they're all part of this corporate conglomerate, or franchise system, or something. They're allowed a lot of individual leeway, so there are good clinics and bad clinics (Thankfully I found dad a much better clinic), but it's all basically a cyberpunk dystopian octopus... They are all in the same "system". I still did it, but with a little less vitriol than I felt the situation deserved.

So, no, basically, every aspect of it was shit, and not only did dad suffer, it really drove home to me just how much everything about the health care system here sucks.
 

Vlinny-kun

Being gay is now illegal.
True & Honest Fan
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In Noctor news, this lady (archive) passed medical school in the Caribbean, after dropping out of two other med schools, but couldn't get a residency placement. Luckily Missouri doesn't care and lets unmatched med school grads turn into what is effectively an instant NP, "assistant physician" (different from "physician assistant"). Skip a few years and she's selling amniotic fluid?? as a stem cell treatment???

Oh, and of course

Oh AND she was making it rain Oxy scripts on patients she had never seen in person, because that's a free space in Bad Midlevel Bingo.
Well what were they expecting with a name like Dregs?
 
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