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NP student cannot find pediatrician to agree to have her for 6 week preceptorship

Home The Lounge NP student cannot find pediatrician to agree to have her for 6 week preceptorship

  • childay childay 
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    The midlevel model worked well when a physician would add a well trained NP or PA to her practice and actual supervise him.  That just isn’t the case anymore.

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    +10

    #235134 Reply
    Avatar jm129 
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    capitalistic forces on steroids.

    at the end we want more prescribers in the market who will order more tests and do more procedures; driving the profits through the roof for hospitals, pharmaceuticals, and bio device corporations.

    health care is the biggest industry now and everyone is jumping on the bandwagon.

    “providing” the health care service pays not actually bringing the patient to health, hence the quality of education does not matter

     

    of other note..this thread has gone way out on a tangent

    #235149 Reply
    Vagabond MD Vagabond MD 
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    I have wonderful news! NP2B has secured a rotation in the health center associated with a public school system that is operated by PNPs. I am confident that in her six weeks there she will get the equivalent training of a three year pediatrics residency and will enter the job market on a nearly equal footing to compete with the practicing pediatricians in the community. Hooray!

    Lordosis Lordosis 
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    Just the other day I found out that a nurse that I know from our hospital is getting an NP degree.  She has about 10 years experience already.  I asked her if it has been hard securing rotations and she told me that it was not for her because of her experience she could draw on the physicians that worked with her on the floors.  She did say without prompting that her classmates with no experience are having a much more difficult time.

    “Never let your sense of morals prevent you from doing what is right.”

    #238887 Reply
    Avatar G 
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    I have wonderful news! NP2B has secured a rotation in the health center associated with a public school system that is operated by PNPs. I am confident that in her six weeks there she will get the equivalent training of a three year pediatrics residency and will enter the job market on a nearly equal footing to compete with the practicing pediatricians in the community. Hooray!

    Click to expand…

    thanks for the “guffaw”…I believe that’s the right word for what I just did.

    I actually injured myself today rolling my eyes after listening to a neuro NP spout unsolicited advice in the ER.  pediatrics, stroke neurology…such a waste on all that useless education!

    #239028 Reply
    Avatar highdoseamox 
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    Here, this should save her a week or two: peds urgent care for mid levels who usually see adults:

    Cough: chest X-ray, azithro (bronchitis or “cover for pertussis”)
    Fever: full labs, chest X-ray, rocephin (pending blood culture results)
    Bronchiolitis: chest X-ray, steroids, tons of albuterol, and diagnose intercurrent otitis so you can throw some abx on as well
    Diarrhea: full labs, plain film or abdominal ultrasound
    Not sure what the pathology is: high dose amox

    #239048 Reply
    Avatar Dilaudidopenia 
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    Just the other day I found out that a nurse that I know from our hospital is getting an NP degree.  She has about 10 years experience already.  I asked her if it has been hard securing rotations and she told me that it was not for her because of her experience she could draw on the physicians that worked with her on the floors.  She did say without prompting that her classmates with no experience are having a much more difficult time.

    Click to expand…

    No self respecting physician should be allowing any of these people to rotate with them.

    #239075 Reply
    Lordosis Lordosis 
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    No self respecting physician should be allowing any of these people to rotate with them.

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    The point I am trying to make is that there are really 2 types.  I have worked with a few “good” NPs.  They know what they don’t know.  Always it is one with real nursing experience prior to getting the advanced degree.  They also seem to correlate with the ones who do not go rouge and start practicing in a specialty they do not really understand.

    I think there is a place for midlevels in healthcare.  Just not the online degree, no experience, no supervision kind.

    “Never let your sense of morals prevent you from doing what is right.”

    #239082 Reply
    Avatar SValleyMD 
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    I disagree.

    Imo the concept of nursing “experience” is vastly overrated.

    I’m not sure how the current state of nursing really prepares them to diagnose and treat. Sure it’s some exposure to a handful of things but I really don’t thing the carryover is that significant. Most are also in completely different settings (outpatient, specialty) as well.

    We’ve had better luck with fresh ones that are trained up . That’s probably anecdotal

    I think it just comes down to the individual and they type of direct supervision they get in their early NP years.

    #239090 Reply
    Liked by snowcanyon
    Zaphod Zaphod 
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    Its a yogi berra situation, the ones that are good are the same ones that realize they have no business practicing independently.

    That said, I think there is a front line very low acuity role that would be helpful, but thats not how america works. We didnt sit down and figure out how to best complement the system and address shortfalls, they just put up mills and put them out there in the world.

    #239091 Reply
    Liked by Lordosis
    Avatar StateOfMyHead 
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    They will take over primary care at least for majority of people on Medicare/medicaid. People with private insurance will be able to see docs.

    I would be very leery about going into primary care now.

    Above statements are predictions, not what I consider ideal. Docs are foolish, unable to organize and thusly allow this crap to proliferate. Being replaced by online degrees, it’s pretty pathetic tbh.

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    This is happening in my area in many specialties including neuro, gyn and derm. The wait list for a physician is 4-6 months or longer but there are plenty of PA/NP openings…thank you but I will wait. I’m hanging on to my sweet spot age physicians, 45-55yo range with a death grip. It has become an interesting lesson in adherence to recommended treatment as I am now more diligent about staying connected and attending the routine checks for fear of losing my “spot” with a physician.

    #239094 Reply
    Liked by Zaphod, Tim
    Lordosis Lordosis 
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    I disagree.

    Imo the concept of nursing “experience” is vastly overrated.

    I’m not sure how the current state of nursing really prepares them to diagnose and treat. Sure it’s some exposure to a handful of things but I really don’t thing the carryover is that significant. Most are also in completely different settings (outpatient, specialty) as well.

    We’ve had better luck with fresh ones that are trained up . That’s probably anecdotal

    I think it just comes down to the individual and they type of direct supervision they get in their early NP years.

    Click to expand…

    I see your point.  I think a lot has to do with the individual.

    Either way there has to be training.  Not online classes and thrown together shadowing.

     

    “Never let your sense of morals prevent you from doing what is right.”

    #239096 Reply
    The White Coat Investor The White Coat Investor 
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    This trend is not solely limited to APCs. There are lots of medical schools where the students basically have to line up their own rotations. Many of these are Caribbean schools or DO schools, but even USUHS has this to a certain degree.

    I really think it’s poor form for a school to charge tens of thousands in tuition and then not make sure there are top notch clinical rotations lined up as part of that education.

    Site/Forum Owner, Emergency Physician, Blogger, and author of The White Coat Investor: A Doctor's Guide to Personal Finance and Investing
    Helping Those Who Wear The White Coat Get A "Fair Shake" on Wall Street since 2011

    Avatar jm129 
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    so let’s make screening criteria for ourselves….

     

    here are “my two cents”…

    – must have at least 5-7 years of nursing experience in a specific specialty

    – have completed NP education from a reputed program, certainly not online

     

    #239104 Reply
    Avatar snowcanyon 
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    What administrators and CMS fail to account for is the general laziness and lack of work ethic endemic to mid-levels.That’s why they became…mid-levels. Not many of these folks want to do anything aside from punch a clock from 9-5, M-F, which just isn’t how medicine works. They can’t work fast, they can’t work efficiently, and they won’t work when they don’t want to. This alone will limit their penetration. And boy does it make precepting them hell.

    Patients love them, though, because they give them whatever they want, like a live action Dr. Google.

    #239143 Reply
    Liked by Flipped

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