Nurse Practitioner

[Gloria741]

Hello everyone,

I posted the same question from last night, but it seems like the thread was deleted (i donno why, if anyone knows, kindly let me know), so I am reposting this question.

I have just recently accquired a profession called nurse practitioner. They are Registered Nurses with an extra a year to two of training. With the additional training, they are allowed to perform similar duties as doctors: consulting patients, diagnosing, prescribing medication etc w/o the supervision of a physician. From what I gather from the Ontario website, nurse practitioners are basically family doctors. And from what I heard from a friend, nurse practitioners can earn more than doctors. However, I do not know anyone who is a nurse practioner or has been dealing with them. Hence, I am asking people who know more about NP to explain the cons n pros of the profession a little more. What exactly is the difference between nurse practitioners and doctors? How is the job prospect of nurse practitioner? Is it difficult to be one?

http://www.healthforceontario.ca/WhatIsHFO/FAQs/NursePractitioners.aspx

Thanks a lot in advance

[mangoarecool]

Hello everyone,

I posted the same question from last night, but it seems like the thread was deleted (i donno why, if anyone knows, kindly let me know), so I am reposting this question.

I have just recently accquired a profession called nurse practitioner. They are Registered Nurses with an extra a year to two of training. With the additional training, they are allowed to perform similar duties as doctors: consulting patients, diagnosing, prescribing medication etc w/o the supervision of a physician. From what I gather from the Ontario website, nurse practitioners are basically family doctors. And from what I heard from a friend, nurse practitioners can earn more than doctors. However, I do not know anyone who is a nurse practioner or has been dealing with them. Hence, I am asking people who know more about NP to explain the cons n pros of the profession a little more. What exactly is the difference between nurse practitioners and doctors? How is the job prospect of nurse practitioner? Is it difficult to be one?

http://www.healthforceontario.ca/WhatIsHFO/FAQs/NursePractitioners.aspx

Thanks a lot in advance

First of all nurse practitioners are NOT like physicians. They are advanced nurses who can perform more procedures and have the ability to diagnose some illnesses.

Lets clarify a a few things, in a major city or urban center you will not find a nurse practitioner working at a capacity of a family physician, you will only find them in northern towns where no FP wants to go. In cities nurse practitioner usually works as specialists in wound care or respiratory care, they very rarely will prescribe any medications or come up with a diagnosis without consulting a physician.

Its a pretty decent job though you are making 100K and have more autonomy then a RN. To become one you need to finish a 4 year nursing degree, then work for 2 years in a ICU/Emerg setting. Then you apply to a masters Nurse practitioner program which takes an additional 2 years.

Make sure your charge nurse actually likes you or she won't write you a reference letter to apply to the program.

[kpm]

Lets clarify a a few things, in a major city or urban center you will not find a nurse practitioner working at a capacity of a family physician, you will only find them in northern towns where no FP wants to go.

Actually, this is not true. I volunteer at Toronto Western Hospital in the Family Medicine clinic, and there is an NP who is essentially a family doctor.

[MarieJJib]

many people are unware of the current roles NPs play in Ontario.

NPs function as a primary health care provider. You can now choose to see either an MD or NP in most cases, they essentially have the same authority and ability in terms of diagnosis and prescribing in their specialized areas.

There are many NP lead family clinics and they also work in hospitals...they do not work under the supervision of a physician (this is the case for a physician-assistant). There are four NP specialty certificates....NP-Primary Health Care, NP-Pediatrics, NP-Adult and NP-Anesthesia.

after 4 years you receive you BscN, you work for 2 years and apply to your Masters of Nursing (2 years), then take a 1 year program for your NP certificate.

[Msclphrnc]

An NP or family physician might be in a better position to comment on this topic. I don't fully understand this because there are many regulations involved. For example, in Ontario most medical procedures fall under 14 categories of "controlled acts":

1) physicians are authorized to perform 13 of these
2) NPs are authorized to perform 7 of these
(For comparison: RNs can perform 3 of these, and only with permission from a supervisor higher up)

But it's more complicated because these controlled acts don't include everything.
In terms of freedom, NPs (in Ontario) are not legally required to consult with physicians, but some employers still require this.
In terms of NP pay though, I'm pretty sure it's less than a family physician's on average (~100k vs 200k).

Certainly, an NP's scope of practice is less than a family physician's, but how much less? I'm not sure. You really have to ask an NP + MD who has worked with each other. And remember, this is just in Ontario. Every place has a different regulation.

[jerkstore]

An NP or family physician might be in a better position to comment on this topic. I don't fully understand this because there are many regulations involved. For example, in Ontario most medical procedures fall under 14 categories of "controlled acts":

1) physicians are authorized to perform 13 of these
2) NPs are authorized to perform 7 of these
(For comparison: RNs can perform 3 of these, and only with permission from a supervisor higher up)

But it's more complicated because these controlled acts don't include everything.
In terms of freedom, NPs (in Ontario) are not legally required to consult with physicians, but some employers still require this.
In terms of NP pay though, I'm pretty sure it's less than a family physician's on average (~100k vs 200k).

Certainly, an NP's scope of practice is less than a family physician's, but how much less? I'm not sure. You really have to ask an NP + MD who has worked with each other. And remember, this is just in Ontario. Every place has a different regulation.

Do you mean a FAMILY physician is allowed to perform 13 of 14, or just any physician? If it's the latter what's the one they're not allowed to do?!

edit: never mind I looked it up, dental-stuff. Why isn't dentistry just a medical specialty?:)

[Msclphrnc]

Do you mean a FAMILY physician is allowed to perform 13 of 14, or just any physician?Both.
A family physician is allowed to perform those 13 acts, and the same applies for every other physician, regardless of specialty.

[leijona88]

after 4 years you receive you BscN, you work for 2 years and apply to your Masters of Nursing (2 years), then take a 1 year program for your NP certificate.

At Lakehead you can do a combined MPH (specialization in nursing) with NP which takes 2 years. Or NP cert without the MPH is one year as far as I've heard (graduated nursing at LU and pretty sure this is the case).

In reference to prior posts about wages, I know a couple NPs who work in community and what they tell me is you can make similar money to a family doc, because NPs usually work in a clinic or health centre where they don't have the overhead of the lease, secretary, hydro, etc that a family physician would have. But I have also heard newly graduated NPs say that being an NP your workload is similar to a physician but with less pay. An NP quoted to me that the difference between RN and NP pay is $4 per hour. She said not to do it for the money. These NPs told me to go to med school if I can get in lol. They work in a hospital though, so maybe NPs in community make more? in general I don't think you're gonna hit 6 digits. But wage-happiness are only positively correlated up to 60K a year, then flat-lines so as RN or NP we're good ;)

[futureGP]

Actually, this is not true. I volunteer at Toronto Western Hospital in the Family Medicine clinic, and there is an NP who is essentially a family doctor.

i'm sure NPs look like they're doing similar things (run a clinic, see some simple bread/butter cases)

but it is true that NPs are limited in what they can do from either education or legislature.

It is a form of nursing where you're given a great deal of autonomy, but that said if you really want a full-out autonomy with no one telling you what to do and having all the abilities to do what you want (or the potential) in terms of procedures, diagnosis, treatment -- just go to med school and don't deal with the part turf-war, politics, and patient perspectives that go along with being an NP.

[leijona88]

It is a form of nursing where you're given a great deal of autonomy, but that said if you really want a full-out autonomy with no one telling you what to do and having all the abilities to do what you want (or the potential) in terms of procedures, diagnosis, treatment -- just go to med school and don't deal with the part turf-war, politics, and patient perspectives that go along with being an NP.

What do you mean by pt perspectives?

[futureGP]

What do you mean by pt perspectives?

it goes both ways.

some patients think NPs are great because they look at you as a whole (not that MDs don't) and take longer time with you (idk if that's true.. i've heard they don't actually do that... when I saw an NP for by TST, she didn't even say anything to me lol.. but yeah anyways)

some patients think they might as well see a 'real doc' (not that NPs are not competent) than a nurse, you know?

the public doesn't know much about nurse practitioners so if you're in the field you might be in a position where you need to advocate for yourself, whereas if you're an MD, people know what you can do etc

[leijona88]

it goes both ways.

some patients think NPs are great because they look at you as a whole (not that MDs don't) and take longer time with you (idk if that's true.. i've heard they don't actually do that... when I saw an NP for by TST, she didn't even say anything to me lol.. but yeah anyways)

some patients think they might as well see a 'real doc' (not that NPs are not competent) than a nurse, you know?

the public doesn't know much about nurse practitioners so if you're in the field you might be in a position where you need to advocate for yourself, whereas if you're an MD, people know what you can do etc

Gotcha. I've never been to an NP myself. They are on salary though rather than fee-for-service so I would assume they would be less inclined to rush through a visit.. A guy I play hockey with mentioned that he started going to an NP-led clinic, I asked what he thought of having an NP for a primary care provider, his reply "she's very nice." lol, didn't have much else to say about it. But I guess for a lay person it's pretty tough to tell whether a HCP is competent or not in most cases. But yeah it is a very new profession so it'll be interesting to see where it goes.

[jerkstore]

Were MD's ever on salary instead of pay per service?