Nurse Practitioners…Groveling Every Step of the Way

For those who don't know, I am a student nurse practitioner (NP). This is the main reason as to why I am not able to post as much to support my husband's website. The other reason is partially due to the fact that nursing school has sucked the creativity out of me so much so to the point that the only creative juices I am able to produce are through the means of a power point presentation. But, I digress. The point of this article was for me to point out how hard NPs have it in the healthcare field. It does not start in practice, but rather, in school. Since I am in the Family Nurse Practitioner (FNP) program, I am required to complete a total of 750 practicum hours before I graduate. Practicum is basically where I practice in a clinical setting (with real patients and real problems) as a student NP underneath the direction of another NP or MD. This amount of hours is fine with me since I am going to be working with other NPs and MDs who will consider me to be their colleague. Also, I will be making important life and health decisions with many families which requires much training. However, in the program that I am in, I have to find people who will be willing to precept/take me under their wing in this process. My practicum placements are totally made up by me in my free time between going to school full-time and working my 3 separate part-time jobs. This results in several rejections from people (because a student would decrease their productivity) and many calls and e-mails that are unanswered (they are too busy to call me back or they just don't have the time). I can understand why some NPs do not want to get back with me for one reason or the other, though. NPs are not paid extra to precept student NPs. So this means that their productivity decreases AND they are not paid extra. On the other hand, MDs are paid extra to precept physician assistants (PAs). PAs do essentially the same duties as an NP does. It's just a different discipline of thought when it comes down to it (medical vs. nursing). Okay. So now I'm a bright-eyed and bushy tailed NP in the world excited to conquer new things. I accept the first job that comes my way. A PA who has just graduated from a 2-year community college with an associate's degree (vs. me, who has graduated with BA and 2-years of masters training) has also just landed a job in my same place of work. This person, on average, is going to be making at least $20,000 more than I am based on the fact that 1) he/she was physician-trained and 2) this person is most likely male (I'm not even going to go there at this present time.). It's bad enough that NPs have been around for over 100 years and they're just starting to get recognized in 2006. Next year will officially only mark the 40th anniversary of PAs. Unfortunately, the reason that NPs are more recognized now, is not because MDs want to promote collegiality, but rather, because MDs want to specialize. They are willing to pass many of their regular patients on to NPs now in order to make more money for themselves in specialization. This is not the case for all MDs...but they all know who they are. It saddens me when a patient demands to see an MD. Then when he/she is told that the MD is unavailable, they'd rather settle for the PA than the NP. These patients freely admit that they would rather see a PA opposed to an NP just because of the name "physician" in "physician assistant." They claim that they have got to be the next best thing to doctors. Haven't us nurses paid our dues already? We're not in the old-school days of hospitals being places to go and die and the healthcare professionals they label as "nurses" are really the town prostitutes. Do your research. It's true. I just feel that for a profession that has been around for so many years, I don't feel I should fight for everything that I've already worked so damn hard for. It's just ridiculous.

  1. Found your blog! You are right on the money when it comes to finding preceptors. I’m often having to play catchup due to contract delays.

    NPs Save Lives
    November 10th, 2006 at 9:45 am
  2. I love to visit the NPs at my doctor’s office. My doctor takes like 2 weeks to get an appointment with, and is always an HOUR or two behind. Not very good when I have an earache. When I need to get medical care that’s, you know, TODAY….I visit the NP who takes me that day and at the scheduled time. I don’t think I’ve seen my regular doctor in years.

    Budweiser should do a “Real Men of Genius” about NPs….”Here’s to the nurse practitioner, who will see you today, identify the pus, and send you home with free drug samples.”

    November 10th, 2006 at 10:34 am
  3. Just a few side notes from a PA and PA educator. The majority of PAs are female. 70% of all PA Program’s give a master’s degree. Very few provide preceptors with any financial incentive. And PA students generally do more than 1900 clinical hours after completing 15 months of didactic training anf 60+ hours of undergraduate coursework. PAs and NPs frequently work side by side taking care of patients. We all face difficulties associated with our chosen profession. Let’s focus on our own profession rather than sharing misinformation about another.

    PA TD
    November 20th, 2006 at 1:41 pm
  4. All the information that I received was from the American Academy of Physician Assistants ( website. The point that I was trying to make was that a nurse practitioner with master’s training should not have to succumb to a pay level considerably less than an associate trained person, no matter the sex or the amount of hours spent in training. I’m not trying to turn this into “profession vs profession” thing. The point I was trying to make was that people are willing to give PAs a chance just because of the name “physician” in the profession name.
    Also, you made the point that 70% of all PA programs give a master’s degree. You missed my point, again, here. Just because there are 70% programs offering the master’s degree, doesn’t mean people are immediately starting out with that. I understand that you eventually need your master’s degree within a certain time of becoming a PA; however, that doesn’t change the fact that the PA with an associate’s degree hired on at the same facility that an NP who is bachelor’s and master’s trained will still be getting 15-20,000 more dollars for whatever reason, even though they are doing similar duties.

    Annie Mo
    November 24th, 2006 at 1:58 am
  5. Grow up honey, You sound like a cry baby. Why is that every wanna be doctor out there seems to blames physicians for their own problems. I work with physicians AND nurses every day, and I can tell you that NO ONE works harder than docs. If you want to be respected as a doc and sacrifice everything they sacrifice. (Which is a whole lot more than a pathetic 750 hour practicum. Docs can’t say it because its politically incorrect, but I can, If you want someone to blame blame your own profession. Why should docs mentor you and slow themselves down, (no amount of extra money can make up for that) and anyway, I thought nurses didn’t want to be like doctors. I thought they had their own independent “discipline.” You gys can’t even support each other you ate so busy crying over how togh it is. Grow up and get a life!

    February 12th, 2007 at 3:37 am
  6. Trina, calm your ass down. Seriously.

    February 24th, 2007 at 8:31 pm

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