Humble Beginnings: What Can a PA or NP Do for Your Practice?

I’m sure there will be some who think I am anti-nurse, anti-NP from some recent posts critically reviewing information/position statements put forth by the American Association of Nurse Practitioners (AANP). I can assure you I am not. As I graduate medical school this month, I reflect back on my 15 yrs as a registered nurse (RN) and 8 yrs as a Psychiatric NP prior to starting med school. I’m humbled. It is especially fitting as it is currently National Nurses Day/Week, and I find myself thanking RNs and NPs all day. They say to never forget where you come from. I have bore witness to the notion of distinguishing yourself in the nursing profession. It was ACLS, it was specialty certification such as CCRN (Critical care RN) or RN-BC PMH (American Nurses Credentialing Center Board Certification for Psych Mental Health RN). The latter even got me a hefty bonus in the US Army while I was on active duty. Then came the Advanced Practice RN (APRN) of which there were mainly NPs, Clinical Nurse Specialists, Nurse Midwifes, and CRNAs (certified RN anesthetists – NOT anesthesiologists, as some will have you call them today). APRN became the next tier to distinguish oneself. Then came the push for PhD and DNP (Doctor of Nursing Practice). Now the push is for full practice authority for NPs. This is where I step off and tell my former profession to “hold up,” slow down, you’re starting to step on toes of other professions. It was all fine for me when it was kept within the nursing profession, which with all the advances and hard work I’ve seen, I have the utmost respect. However, I’m not for stepping on toes and going outside my proverbial lane. I don’t support NP full practice authority and I believe in Physician lead multi-disciplinary healthcare teams. Heck, I’m still licensed as an APRN though I’ll be an MD in mere weeks, so I believe I can still say this with credibility. I’ve walked on both sides of the asile. It is times like this that I reflect back to my roots and try to stay humble. I still remember receiving my acceptance letter to my Bachelor of Nursing (BSN) program in 1992 – yes, I started med school in my 40s (after ‘retiring’ from the US Army). I would urge my former profession colleagues to also on this day reflect back on individual careers and try to remain humble. With so much angst and animosity going on amongst NPs and MDs, I think my former profession has lost some of it’s humility. I see so much defensiveness. I believe it is the majority of both RNs and NPs that are on the front lines doing good and wonderful work, but this is being overshadowed by a zealous few. As a member of my former profession, let me apologize on their behalf and urge other professions to acknowledge the good ones that are out there. Thank a CNA (certified nursing assistant), thank an RN, thank an NP that you believe is doing good and making a difference this week. Trust me MDs, a simple thank you goes a long long way. Also, see the referenced article: “What Can a PA or NP Do for Your Practice?.” Disregard the nurse zealots and know that utilized correctly, APRNs can add value to MD led multidisciplinary healthcare teams. I may be leaving my former profession, but I never forget where I come from. Thank you.

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