Answers from Nurse Megan

Megan responded promptly last week and we took our sweet time getting this posted.  Here are the responses to the questions we received via comments and email.

Questions via comments:

1.  Peter B, on May 19, 2010 at 3:29 pm Said:

Megan,

I know you are not a Nurse Practitioner but I was wondering if you have any comments for the following question:

Other than filling the void left by the lack of general practitioners/ family medicine physicians (MD/DO), do you feel nurse practitioners will start to branch out into other fields of medicine? Do you feel they might be looking to gain surgical rights anytime in the near future?

I actually am currently enrolled in a nurse practitioner program. A good friend of mine from California is a nurse midwife and family nurse practitioner. She has rights to surgical assist. Surgeons sometimes can be glorified mechanics when the case is uncomplicated. Not much different from opening a car hood and looking at and manipulating the parts.  Many OBs can (and almost do) perform a C-section in their sleep. That said, when something goes wrong, you want the best surgeon you can find when you have a complicated case! (As is everything in medicine.) And for the first part of your question- there are Neonatal Nurse Practitioners, Pediatric Nurse Practitioners, etc., so yes, I think that they will continue to branch out to specialties.

2.Dan Cruz, on May 19, 2010 at 8:51 pm Said:

It seems nurses would be the best eyes and ears for things others take for granted. What is one common sense yet unlikely change that could be dome in your opinion to improve the state of things? This could have to do with healthcare reform but maybe you are even thinking somehing simpler like mandatory_____ or an incentives to _____?

If you’ve ever been overly intoxicated at a bar (I wouldn’t know from personal experience of course), a bartender can not serve you a drink if you are obviously intoxicated. I think that restaurant servers and convenient store clerks need to be prohibited to serve fatty and unhealthy foods to people who are obviously overweight. Obesity is killing our country and we’re not doing enough about it. Perhaps rewards for overweight people who lose weight or people who quit smoking. Everyone knows money talks! Think of the money we would save nationally by not having to treat the aforementioned person’s diabetes or cancer.

3.Katie Becker, on May 19, 2010 at 9:38 pm Said:

When did you know you wanted to be a nurse? Was there a point where you almost changed your mind and why didn’t you? Don’t take this the wrong way…I mean it in an empowering sense, if you knew you wanted to be in medicine, why nursing and I don’t just mean instead of a being a doctor (ie. anesthesiologist, psychiatrist, etc, etc)? What is the meanest thing you’ve ever said to a doctor and what is the meanest thing a doctor has ever said to you??

Nursing is a vocation. You are called to it. I truly have wanted to be a nurse my entire life and couldn’t imagine my life without it. I teach nursing at the university level in both the clinical setting as well as a didactic lecture. I’ve never doubted my decision and even after I become a nurse practitioner, I will still work on the floor as a staff nurse. And nursing is not medicine. This is a misconception that drives nurses nuts. Rarely will you hear a nurse say he/she is in the medical field. We are in the healthcare arena. Doctors are in the medical field. Doctors treat diseases, nurses treat patients. It’s a much more holistic approach. A doctor treats the disease, a social worker treats the social aspect of the case, a nurse treats the whole patient. We are the profession of caring.

Questions via email:

Dan Cruz asks- If you weren’t a nurse what would you be? Also, what did you think of the Dr. Mike’s interpretation of TV medicine?  Any shows to add or comment on?

If I weren’t a nurse I would be a high school English teacher. I love reading, writing, literature, etc. I think Dr. Mike was right on with his interpretation of TV medicine. “Scrubs” is very accurate, as is “Nurse Jackie”. Jackie is always putting her patients first, always advocating for her patients, knowing more than the young doctor, doing the doctor’s job, etc. A job well done by Edie Falco and Showtime. That said, I saw an episode of “Scrubs” where there was a shortage of nurses and the doctor took over as head nurse. That doesn’t happen. A doctor can’t just “step down” from his/her role and become a nurse because there’s a nursing shortage on the floor at that time. A doctor is a doctor a nurse is a nurse. It gave the impression that a doctor was just a promotion from a nurse. No doctor can do the job of a nurse and vice versa!

Adam Smith asks – How would you say the pay/incentives are for people to get into nursing are?  Could they be better?  Are there any bad incentives that contribute to bad care from doctors and or nurses that could be improved?

In general, I don’t like working with nurses who use pay as an incentive to work. There’s so much more to the quality of  job satisfaction i.e. what role nurses play in the shared governance that is the hospital. And as for bad incentives, talk to someone who has worked in a unionized hospital! (not to say there aren’t good things about a nursing union, but sometimes they get out of control!)

Decce – How do you feel about this? http://www.nytimes.com/2010/05/27/us/27hosp.html

I am not as educated on the role of hospitalists but I will say this; patients are to blame as well for the disparage of healthcare in this country. I had a pregnant woman come in with a headache (which- by the way- can be a symptom of a very serious condition called pre-eclampsia). She took a Tylenol, given by a nurse, at a hospital, and felt better 30 minutes later, then sent home. Had she just taken her Tylenol at home and eradicated the headache, she would have saved herself a trip to the hospital and saved the hospital, her insurance  company, and the nurse, time and money. Of course, consequently, had she taken Tylenol and NOT felt better, she should come in of course! People complain about healthcare in this country, but if they took better care of themselves and avoided hospitals altogether, they would have nothing to complain about. As long as McDonalds and Phillip Morris are in company, though, that will never happen!

Alannah K asks  – What is the current state of men in nursing.  I’d imagine that overall there are still more women than men and the men at least on the surface can take a ribbing from their friends?

Of course there are many more women than men in nursing. That said, a lot of women are being pulled away from nursing. Historically, if a woman were to be educated, she would be a teacher or a nurse. Now we have so many women lawyers, doctors, event coordinators, etc. This is what has contributed to the nursing shortage. Male nurses tend to be great nurses and are wonderful assets on floors like the ICU, where heavy lifting is a job description!

Also, do you hang out with a lot of nurses or doctors outside of work?  Do you ever find it hard to relate to friends not in the medical field?

I rarely hang out with other nurses or doctors outside of work. I can’t help but talk shop with them outside of the hospital. A bad day at work for my roommate is her boss was in a foul mood and the office coffee was cold. A bad day for me at work is a 25 year old woman dies suddenly in labor (I’m a Labor and Delivery nurse) and I spend the rest of my day in Risk Management, preparing my deposition for he inevitable impending lawsuit. Nursing is a very esoteric field and I’m very happy I don’t live with another nurse!

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9 Responses

  1. I’m glad we have nurses like you…you’re very well spoken, too. Cheers!

  2. PS if you still are reading this…do doctors ever treat male and female nurses differently?

    • hmmm not sure about that but it would be interesting to know! I don’t work with any male nurses, but I can consult some of my colleagues who have and get back to you!

  3. Interesting. So, in general nurses like the portrayal in Nurse Jackie you think?

    Also, it’s obvious how doctors abuse the system. Is that what you mean by nurses who are in it for the money?

    • The American Nurse’s Association does not like Nurse Jackie! The ANA also states that a professional nurse have at least a Bachelor’s degree. tell that to a nurse who has worked over 40 years from a diploma program! and “ER” is probably the worst portrayal of nurses ever! I have written to NBC regarding the character of Abby! (who later went on to medical school because she was “too smart” to be a nurse!)

  4. Regarding Nurse Practitioner: my personal experience is that when given a specific job i.e. running a chemo center, performing annual physicals or stiching up wounds these clinicians are effective and can be more exact than MDs since they are focused on only one task. However there are areas of medicine that require years of experieince and training. The programs provided for the nurse pratitioner is lacking psychiatry. The overall interaction between the physical and mental needs is not adequately explored. Nurse practitioners have limited exposure to variety of pharacology and the complicated impact. Often a psychatrist needs to be creative with medications and have the confidence that what they are perscribing is not going to negatively effect the patient. I do not believe the modified training of a nurse practitioner makes that possible. My feelings are based on personal experiences having worked with both psychatrists and APNs for the past 10 years as a behaviorist.

    • There are specialty psychiatrist Nurse Practitioners. Like medicine, there are specialities in advanced nurse practitioners. and notice how you said that psychiatrists need to get creative with meds? that’s because doctors are trained to treat the diagnosis, not the patient.

      • Psychatry is not an exact science. The cause and effect of general medicine is not exactly present in the mentally ill. The balancing of brain chemicals is similiar to balancing hormones. They often change without an anticident. The general rule of thumb is one drug per dx. A really experienced psychatrist will make every effort to adhere to that guideline, but will know when it is time for polypharmacology. The proverb of start low go slow is the idea, but you need to have the experience and confidence to know when to be aggressive. At that time, the nurse practitioner needs to pass the patient over to the MD. Unfortunately, too many (in my opnion) don’t.
        Good luck in your studies, I’m sure you have all the confidence and knowledge to be an effect APN.

  5. […] I used an image of Judy Reyes (as Carla) in my question and answer series: Ask a Nurse and the response post Answers From Nurse Megan. […]

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