People have asked why I have “flipped” from a advocate of FPA to a advocate of Physician led team care. Although I have explained it several times, I am going to do it ONE last time for everyone to read. Please read carefully. /1

I have always been an advocate of safe care. Patients come first, always. Their needs outweigh my needs. Always. It’s been that way since day one. Since I first called myself a nursing student. That has not changed and will not change. /2

I used to be an advocate for Full Practice authority. I believed that nurse practitioners were every bit as capable as caring for patients on the same level as a physician, providing the same care, and that we were simply being held back by physicians and legislators, /3

I thought the only plausible reason that nurse practitioners were being held back was because physicians wanted to charge us collaboration fees, wanted to control us, felt we were incompetent, and of course they had huge egos /4

I was wrong. Yes, you read that correctly. I was 100% wrong. If anyone has big egos from my POV it is the NP who believe they can do everything a physician can do without even a third of the education. That is hubris. /5

So, what made me open my eyes? It was a combination of factors. First, I have had several conversations with physicians over the last year who have not only explained their side but given me food for thought. It still wasn’t quite enough, but they had my ear. /6

Next, I have acted as a preceptor for many students and I can say the level of devotion to the profession that I saw, from all types of schools, varied - but mostly the students were just doing their time, didn’t want to learn any extra, /7

And a lot of them were new to nursing in general with less than 5-years as a nurse (this is what schools were sending me). On top of this, my last 4 students proceeded to cheat on their tests, fabricate hours, and were allowed to use a video game type clinical setting for hours/8

Yes, you bet, I told the school. I was frankly told to just please get them through the session and they appreciated my time. Nothing happened to the students. Two of them graduated. So, Needles to say this changed my view of current educational standards. /9

So, now we have poor education of new graduates literally in my face, lying about the clinical hours, numerous conversations about safety of the independent NP — all of this is in my head. Then, I take a job working in a team environment with a supervising physician in-house /10

I can no longer ignore the difference it makes having a physician in-house or in the clinic with you. Those of you who say it doesn’t are either being naive or have not worked in the setting where you are truly learning every single day. /11

Or maybe I am just not as smart as I always thought I was and need a physician. I can tell you working in neurology has been an eye opener. I learn every day. At least one new thing. I wouldn’t be learning at all if I was still believing I already knew what physicians know. /12

I know people will ask, what about Primary care? I believe NPs need to be working with physicians there too...primary care is the gate keeper of all healthcare. You have to know about all disease processes. /13

How can a NP do that with very limited education and training? They get by, right now. Legislation has approved the limited care. Some patients have a choice of a doctor & others don’t - it’s not equal at all. /14

So, back to why I “flipped” I opened my eyes, I listened to my heart, and I grew as a person...I made a choice knowing that I was not doing the best I could for patients and I am doing better for them now on a physician led team /end

@epidural you asked...I answered. Please keep your snark to yourself.