Respectfully Declined

Last week I received another email from a local RN pursuing her NP degree, asking me to mentor her for her required 10-week clinical outpatient rotation. Instead of hiding behind my mountain of work and either ignoring her request, or offering a minimal reply, I decided to take the opportunity to tell her exactly why I will not agree to train her. As insignificant as this letter may actually be, a part of me would love to imagine the gist of it sticks with her just enough to make her more cognizant of the role that she will actually fill within medicine, rather than the role her professional organization is trying to foist on the medical community and on the public. By the same token, as insignificant as this blog post may actually be, a part of me would love to imagine that other physicians who feel uncomfortable and torn when asked to train a non-physician provider have their conflicts validated by what I wrote. Hell, feel free to plagiarize me. 

Dear “Melissa”*,

Thanks for your note; I appreciate and empathize with the struggle of finding quality rotation spots as a training medical professional. Unfortunately, and through absolutely no fault of your own, I have made the decision not to partake in the training of non-physician providers. This is a political decision on my part, as I have serious misgivings about the AANP’s lobbying efforts to secure unsupervised practice status for advanced practice nurses. I have many physician colleagues across the country who have lost jobs due to organizations preferentially hiring advanced practice nurses for financial reasons, and I hesitate to participate in training those who may put me out of a job and my physician specialty out of existence in the future. I work and have worked with many NPs (as well as PAs) with whom I collaborate closely and who are my personal friends. I respect their work and their dedication to their profession immensely, and feel they are an integral part of our care teams. However I disagree strongly with the poorly designed “studies” publicizing that the care of advanced practice nurses is equivalent to or better than the care of a physician, and I also feel it is misleading to the public. 

On another note, I am so glad you are pursuing your advanced nursing degree. I have noticed that the strongest NPs are those who have gained clinical experience as RNs first. If you would ever like to discuss medicine further, or shadow informally to see the type of work I do, I would welcome it. I’m sorry I cannot help you with your rotation and I wish you the very best of luck.

Sincerely, 

XXX XXXX, DO

(xxx) xxx-xxxx

*name changed

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