Orientation Week: Day Four

The morning started with a speech from our Distinguished Visiting Professor, Diana J Mason from Hunter College. We used her book during our Health Policy class in the MSN program at Bellarmine, so it was great to hear the author's voice. The bulk of the presentation concerned the role of the nurse in reforming health care. I feel I have been beaten over the head with health care reform enough. While it is true nurses play an important role in the restructuring of our healthcare system, this reform bill discourages nurse entrepreneurship through increasing regulation and taxation on small businesses (even those that are not healthcare-based!).

Here is a mix of things that ran through my head during the presentation (this is not inclusive, I wrote several pages of thoughts on this):

Primary Care Physicians assume they have the skills to be primary care providers – they specialize in diagnosis and treatment of disease, but not health promotion and disease prevention as part of care coordination. They also assume they have the qualifications to supervise DNPs! WE ARE NOT THE SAME PROFESSION!

Contrary to the contention that DNP's are not qualified to stand side by side with primary care MDs because we do not have a residency, we do have to proper education and clinical training that matches our scope of practice. Rather than front loading our programs with didactic work and coming out of medical school with little true patient time and responsbility, nurses have an integrated residency model that combines didatic and clinical work starteing the sophmore year at the BSN level. In fact, for many years one could graduate with their MD and do NO residency as long as they stuck to primary care and not a specialization. And guess what - those folks are grandfathered in to the states who finally decided to make residency a requirement for medical practice. It is worth reiterating ADVANCE PRATICE NURSES ARE NOT PRETENDING TO BE DOCTORS NOR ARE WE PHYSICIAN EXTENDERS! We are not "nurses with a little extra training" and we can do more than put a bandage on a wound and prescribe a Z-pack. We are our own profession with our own role in primary care that works with, not against physicians.

Why don't advanced practice practitioners train together in some type of integrated clinical experience? Good communication and collaboration can only benefit the patient and the various professions.

Another student gave a speech that I have said many times. MDs did not have a problem when Dentists, Podiatrists, Psychologists, Physical Therapists, Naturopaths, and Chiropractors encroached on the "Doctor" title that MDs commandeered as their own (despite the fact all of these are practice, not research doctorates). Why pick on the DNP?

“Communication is how we change things” I used to think just because you change the name of something doesn’t mean you change the perception. Changing nursing home to health home, patient to client (and probably coming soon, customer), noncompliant to noncoalescent does not change the facts that the home is under-funded and depressing, the person is seeking healthcare, and the person is not doing what you prescribed. On the other hand, I also believe “language is how we view the world” and that view can be altered if we change what we call it, though I do not believe the actual fact can. I hope.

After the conference, I realized I needed to get my butt in gear and join the APNA, especially since their conference is in Louisville this year and I have a clinical group on Friday that could benefit from viewing the poster sessions.

We had yet another training in the afternoon. I have been using Blackboard for nearly 10 years now, and while I am not perfect, I did not learn anything new. All of these sessions really seemed targeted at learning the basics of the software and I wish that had made these sessions voluntary. In the meantime, I did set up my NAMI walk page, so it was not a total waste of time! Check out the Stigma Stampers team by clicking HERE.

The day ended with a gathering of all of us in the psych track and going over the timeline of clinical and requirements for the next 2 years. am so excited that I will have an opportunity to work with some of my mentors and that I am not strictly limited to MD and ARNP preceptors. This program really fosters learning, not just jumping through many of the usual arbitrary nursing hoops and red tape "because that's the way it is done, dear."

***If anyone is interested in a copy of Dr. Mason's lecture notes, let me know and I can forward a copy***