Nurse practitioner delusion / "Noctors" / "Midlevel staff" - Nurses get a 1 year degree and start thinking they are better than doctors

When you see articles about staff quitting due to "moral injury," it's not vaccine objectors. That odious buzzword is how they summarize "wanted to Help People, could no longer handle being a tiny moving part in a huge Kafkaesque blind and unconscious machine."
Practically everyone I went to med school with has quit. Things aren't looking good. Doctors were infamous for never retiring.

This really has nothing to do with midlevels. Everyone's tired of being a fucking cog in the grinding machine.
 
It's amazing how much and yet how little regulation there is in the US medical system.

Monumental effort required to get insurance to cover reasonable treatment, but the provider responsible for writing the magic words can be a Dunning-Kruger NP who passed a "lol whatever" program.

If people were aware and honest about their scope, NPs would be the perfect adjunct to a packed ED. Triage peels off the UTIs and the "free pregnancy tests," all the should-have-been-a-PCP complaints to a fast-track with a midlevel, who knows when to kick something up the chain. But that would be adding staff, which costs money, so instead they just replace an MD/DO with an NP/PA, pocket the cash, and things are as slow as before but now less safe.

When you see articles about staff quitting due to "moral injury," it's not vaccine objectors. That odious buzzword is how they summarize "wanted to Help People, could no longer handle being a tiny moving part in a huge Kafkaesque blind and unconscious machine."
NPs are perfect for 90% of what an ED sees.

“I think I have an STD” like you said
“My mom with Alzheimer’s took two metoprolols instead of one”
“I smoked weed and drank vodka and now I’m vomiting”
“I missed dialysis because <insert excuse here>”
“I started coughing today do I have Covid???”

The problem is yes these greedy fucking hospitals replacing doctors with people who have nowhere near the same number of hours of training and nurses having this mindset that they are just as capable as doctors (wrong). I think the medical field is in for some very big problems in the next decade because people are quitting and people aren’t going to become nurses or doctors because it’s a shitty corrupt profession. Hospitals are going to be panicking and scratching their heads when they find themselves in this situation, as if they haven’t been short staffing and otherwise fucking over their employees for YEARS (and it’s only gotten worse since Covid).
 
The problem is yes these greedy fucking hospitals replacing doctors with people who have nowhere near the same number of hours of training and nurses having this mindset that they are just as capable as doctors (wrong).
Yeah, that's the big problem.

Add an NP to help the night hospitalists field pages about ms-tele inpatients: good for patients, good for staff.
Replace one of the night hospitalists with an NP: monetary savings for the shareholders.

Difficult decision for Management, I guess.
I think the medical field is in for some very big problems in the next decade because people are quitting and people aren’t going to become nurses or doctors because it’s a shitty corrupt profession. Hospitals are going to be panicking and scratching their heads when they find themselves in this situation, as if they haven’t been short staffing and otherwise fucking over their employees for YEARS (and it’s only gotten worse since Covid).
How could hospitals have ever possibly foreseen the obvious consequences of their actions? Sure love living in interesting times.

COVID just (greatly) accelerated what was already in progress, except now you can't even talk about the situation without people chiming in about hurr durr vaccine mandates. Hospitals (here, anyway) are rubber-stamping vaccine exemptions; the staff who quit are tired of getting shit from all sides. Meanwhile the ANA has decided that the best use of dues is to solve racism, all on their own.
 
Yeah, that's the big problem.

Add an NP to help the night hospitalists field pages about ms-tele inpatients: good for patients, good for staff.
Replace one of the night hospitalists with an NP: monetary savings for the shareholders.

Difficult decision for Management, I guess.

How could hospitals have ever possibly foreseen the obvious consequences of their actions? Sure love living in interesting times.

COVID just (greatly) accelerated what was already in progress, except now you can't even talk about the situation without people chiming in about hurr durr vaccine mandates. Hospitals (here, anyway) are rubber-stamping vaccine exemptions; the staff who quit are tired of getting shit from all sides. Meanwhile the ANA has decided that the best use of dues is to solve racism, all on their own.
Not all hospitals are- there is one where I live that definitely is rubber-stamping, one that is being relatively stingy, and one that would not even approve medical exemptions involving previous exposure with anaphylaxis. (Yes I saw the documentation). Still have no idea what they and their legal team are thinking there- they certainly were not OVERstaffed to start with, so what are they trying to accomplish? Maybe getting new hires in at a lower pay rate.
 
Thanks for giving me a good reason to continue throwing out the offer letters I get from them every two months.
Union shop, so I get the newsletters from the ANA and the AFT-whatever and a good percentage of the articles are the "how is this going to help us sell burgers?" comic, moreso with the AFT.

On the plus side, the ANA magazine does keep coming with free sample packets of Calmoseptine attached to it, some of which even make it through the mail sorter intact.
they certainly were not OVERstaffed to start with, so what are they trying to accomplish? Maybe getting new hires in at a lower pay rate.
New hires also don't know what it was like with better staffing/lower ratios/less general insanity, so in theory they'll put up with more abuse.
 
New hires also don't know what it was like with better staffing/lower ratios/less general insanity, so in theory they'll put up with more abuse.
This right here is something to keep in mind, especially with younger people who probably don't have a wide breadth of professional experience. The idea of "the grind" amongst the younger generation also has become detrimental to some of them where they see the pay but not the bigger picture. It happens in every industry and career field and it's crazy trying to break some of these young guys of the idea that by putting up with shit they'll get noticed by management.
 
New hires also don't know what it was like with better staffing/lower ratios/less general insanity, so in theory they'll put up with more abuse.
This crap is why I'll never work in a hospital again. Not from the shit I've been seeing in /r/nursing.

"I graduated three months ago and now I'm precepting and also I'm charge with a full patient load" like what the fuck is going ON. They just running these nurses until their wheels fall off? Working in the ED was always a shitshow at the best of times but if you told me this was going to be the current state of health care I would have never believed it.
 
This crap is why I'll never work in a hospital again. Not from the shit I've been seeing in /r/nursing.

"I graduated three months ago and now I'm precepting and also I'm charge with a full patient load" like what the fuck is going ON. They just running these nurses until their wheels fall off? Working in the ED was always a shitshow at the best of times but if you told me this was going to be the current state of health care I would have never believed it.
I don't even work in healthcare, but we still see this shit in my field too. "I just started two weeks ago but they've already got me running the gate solo on twelve hour shifts." "Hey, I know I've only been here five months but they told me they're considering me heavily for a shift lead position!"
 
Dropping in to say this is a great idea for a thread and I'm glad it's been done. NPs are often the worse people you knew in high school now lecturing you on social media on "public health" when half of them crush pills and change pisspans for old people.
 
The idea of "the grind" amongst the younger generation also has become detrimental to some of them where they see the pay but not the bigger picture. It happens in every industry and career field and it's crazy trying to break some of these young guys of the idea that by putting up with shit they'll get noticed by management.
It's worse than that: imagine a workforce almost entirely made up of codependents. All the officially-printed signs about how you're responsible for your own "self-care," and then they guilt staff into more shifts and more workload because if you don't, who will care for the patients? (And if that doesn't work, letting your coworkers down.)
This crap is why I'll never work in a hospital again. Not from the shit I've been seeing in /r/nursing.

"I graduated three months ago and now I'm precepting and also I'm charge with a full patient load" like what the fuck is going ON. They just running these nurses until their wheels fall off? Working in the ED was always a shitshow at the best of times but if you told me this was going to be the current state of health care I would have never believed it.
1. Yes
2. It's so hard to find anything but anecdotes, because everything gets bogged down in COVID partisanship and the official info sources are corporations.

One huge problem here is that the SNFs have no staff, moreso than usual for SNFs. SNFs (LTC etc.) can barely take any discharges, and pick and choose so they don't end up with patients with tough behavioral issues. So med/surg is backed up with patients who were ready to discharge literally six months ago, and ED is holding med/surg patients for their entire 2-3 day admissions, and more people keep walking in the door. If ED staff wanted to work inpatient, they'd have signed up for that, and now they're turning, pottying and Ensuring Satisfaction at the same time they're trying to stabilize ED patients.

Obviously the thing to do is to send out sanctimonious form emails about how you touched the chart of a patient who later developed a pressure injury, so since you're a lazy idiot would you like to go to a class about how to treat and prevent pressure injuries? What do you mean morale problem; heroes work here.

Dropping in to say this is a great idea for a thread and I'm glad it's been done. NPs are often the worse people you knew in high school now lecturing you on social media on "public health" when half of them crush pills and change pisspans for old people.
This thread has developed wicked subject drift; sounds like you're talking about regular nurses (and lowest-paid nurses) being full of themselves. This is nominally a thread for the hubris of midlevels; NPs have gotten their credentials to get away from bedpans.

Unless there are NP imposters out there. There probably are; I've met an LPN imposter. (It turned out she was a dental receptionist.) I didn't ask why she picked LPN to claim; probably like changing the D on your report card to a B instead of shooting for the suspicious A.
 
It's worse than that: imagine a workforce almost entirely made up of codependents. All the officially-printed signs about how you're responsible for your own "self-care," and then they guilt staff into more shifts and more workload because if you don't, who will care for the patients? (And if that doesn't work, letting your coworkers down.)
Excuse me? Work on your wellness modules, peasant. Have you tried mindfulness meditation? Actually why is everyone quitting in droves
 
Excuse me? Work on your wellness modules, peasant. Have you tried mindfulness meditation? Actually why is everyone quitting in droves
Instead of hiring more staff and having safe ratios we created this calming mindfulness meditation room you can visit anytime! Visit when you don't have 8 med-surg patients constantly shitting the bed and hitting their call bell to bitch about NPO status, their low salt diet for CKD, or 1500mL fluid restriction they hit at 10AM. If you're PCU you can visit when you don't have 4 borderline ICU patients. It's only two vented trachs that constantly need suction or they will plug, one on BiPAP working on get intubated who constantly rips off the mask, and one on 10 mics of fixed rate dopamine with a MAP of 60 and one functional 22g in the right AC. Visit anytime!

By the way we removed the ability for anyone to take vacation and removed sick time accrual to ensure adequate staffing! Bonuses for this year are not being distributed as the health system did not meet their financial goals. Better luck next year! If you are struggling with you're neglected self care we have this useless hotline you can whine to while you cry in your car after work. Don't forget to take time for yourself after all of your mandatory overtime shifts!
 
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Dropping in to say this is a great idea for a thread and I'm glad it's been done. NPs are often the worse people you knew in high school now lecturing you on social media on "public health" when half of them crush pills and change pisspans for old people.

I used to work in an ALF as a care aide. The nurses there would not help with jack. One got pissed because an elderly man projectile vomiting and coughing up a lung was "under her pay grade" I had to help the poor guy not aspirate.

She got pissed I told her to stop taking smoke breaks where she gave out meds to our diabetic patients because there was still smoke in the air when a resident came in with their O2 tank. She told me to know my job role.

An absolute ghoul. I reported her to management, the company that owned the place, nursing board, and social services for how she treated residents.

Eventually she got fired because I think one day the fire alarm got triggered by her smoking because we had to evacuate everyone
 
Half the problem is the other patients clogging up the system, half is the system.
Saw a case of this recently when two noctors in a row tried to prescribe pain meds because they wanted the patient out of their hair. Patient had to push back about not wanting the damn pain meds, she wanted to know why she was in pain the the first place and they seemed genuinely confused.
It was like "But these pills will make the pain go away." and the patient was all "I don't want the pain meds, I want to know what's wrong!"
 
It's worse than that: imagine a workforce almost entirely made up of codependents. All the officially-printed signs about how you're responsible for your own "self-care," and then they guilt staff into more shifts and more workload because if you don't, who will care for the patients? (And if that doesn't work, letting your coworkers down.)
It gets even worse since a lot of Zoomers see (or think they see) "promotion" and immediately jump on it like the thirsty motherfuckers they are without realizing that being in charge of a shitshow is a bad thing and that "leadership experience" means absolutely dick all on a resume since everyone sees right through that shit.
What do you mean morale problem; heroes work here.
I am so glad that despite being "frontline" and "essential" during the entire pandemic literally no one has ever tried to paint us as heroes.
Excuse me? Work on your wellness modules, peasant. Have you tried mindfulness meditation? Actually why is everyone quitting in droves
80+ hour work weeks tend to do that.
 
The recent media deification of low level nurses who have a God complex is a concern I think. The pushing of their egos and their normie tik tok dancing lack of optics is not a good combination.

I'll never look at nurses (especially the holier than thou fat ones) the same as I did precovid
Another reason to not deify nurses: because they are narcissistic attention whores:

 
StUPiD dOcToRs are jUsT JeLlY!

Whoopsies!
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Whoopsies part 2:
67B12BC3-DEFF-4DD7-8115-A75A72547F9D.jpeg

Year long Psych-whoopsies
6EDFABC5-C06D-4827-89A4-39328D983738.jpeg

B7BDFF87-4A65-4CFB-BFAE-0242E3D400A8.jpeg

“Don’t worry! I’m an NP!”
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NP can’t find patients anus:


Wanted to link to the TikTok, but she seems to (quite wisely) have deleted it.
 
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