[NPInfo] Re: Referrals (was Physician blogs maligning NP s)

[Jeffrey Hazzard]

   Christine,
       They will adapt.  It is hard for a RN to perceive the different kind of education/training and the extent of training that we NPs and PAs go through beyond RN education.  They don't see the integration of what they already know into the next step.  They are "doubting Thomasinas" who must be shown your knowledge with time.  Trust will be built with the repeated routine of nominal operations with your apparent skill, breadth of knowledge, and clinical acumen.  It will come.  You hold all the marbles and they will tire of the fight for "turf" when it becomes that they have no cause for alarm over you, or protection of their own status.  Kindness, teaching them things they don't know to keep them interested in a scut-work job, seeking out their opinion, and especially FOOD, help!
        I have occasional occ health WC patients, frequently coached by a coworker or spouse, who demand that they "see a doctor."  Recently a HR lady from one of the companies told a worker, "You have the right to ask to see a doctor, but I see Mr. Hazzard, and asking to see someone else is foolish.  He's the best in town."  I tried to hide being pleased by my prideful moment of vindication.  Keep doing your work and keep reminding everyone you come in contact with that you are a NP or PA.  We need to reiterate quality care with the profession.  Our detractors will be browbeat into shame by the throngs that love us.  
                  Jeff Hazzard

Christine Smith <chrisbsmith at mindspring.com> wrote:
  I think California NP is right. These attitudes are often from the medical
office staff or nursing (especially if in the hospital) and not always from
the MD like we assume. We always want to blame the big bad doctor and I am
not convinced they are always the culprit.


I have been in "fights" for several months, along with the rest of my ER
group at one site, with nursing surrounding how they treat/perceive NPs and
PAs. I thought me being a nurse first, that I could win these people over.
Nope - it is worse for me than for the PAs I think. They see me just a nurse
who wants to be a doctor. They go over my head constantly on my own patients
when they are not satisfied with an order or the course of care.
Fortunately, every single doc I work with backs the NPs and PAs up and keeps
pushing the nurse back to us. 

I encounter the same resistance when I call an office from the ER to speak
to an MD. The phone person, the minute she finds out I am not an MD, my call
is of lesser value or "ok, we will have him call". These people I straighten
our real quick once I get a hold of the doc - the docs have been excellent
about putting an end to it and setting their staff straight. Also, most docs
are very respectful to me and I have had multiple docs send me reports to
the ER about a pt update and thanking me for the referral.

Funny, in one hospital, where I have worked very hard to have a good
relationship with all the nurses in the ER, I am well respected and sought
out for care when it is their family member that is ill or kid that needs
care. In the other two places, they are fighting the NPs/Pas every inch of
the way and I assume it is going to just take time, perseverance, killing
them with kindness and bringing food to win them over.

Christine Smith, NP



-----Original Message-----
From: npinfo-bounces at nurse.net [mailto:npinfo-bounces at nurse.net] On Behalf
Of Calif NP
Sent: Thursday, March 13, 2008 12:28 PM
To: NP Info
Subject: Re: [NPInfo] Re: Referrals (was Physician blogs maligning NP s)

hmmm? So often it seems that bad-mouthing of NPs happens with a
Physician's office staff/manager who act out of some sort of
passive-aggressive need or a sick sense of 'loyalty' to their employing
Physician, or dare it be said, female office staff, yes even 'nurses' who
really do NOT like the NP practice concept, particularly in their assertion
that NPs really are 'just nurses' (can we say "misogynism" kids!?)
Wouldn't you like to have a hidden camera in the purse of the client your
are referring to a Physician to catch the statements of the doctor's staff-
do you think you'd see/hear comments such as "oh, this isn't from a doctor?"
or worse? Wonder what the doctor's staff members' body language or facial
expressions might be? Probably would be very upsetting.....

----- Original Message ----- 
From: "Thiem" 

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