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

[Road Work Ahead]

Whoopsies part 2:

Rate me late, but I have to know. How the fuck does someone screw up this badly? I'm just a retard on the internet that knows jack shit about medicine, but on what planet does abdominal pain = ear infection?

 

[Aunt Carol]

Rate me late, but I have to know. How the fuck does someone screw up this badly? I'm just a retard on the internet that knows jack shit about medicine, but on what planet does abdominal pain = ear infection?

They didn't post a lot of details, but I assume this is a kid too young to speak/point to where on their body it hurts.

God knows what they thought they saw in the kid's ear, though.

 

[Beresford's Whip]

Rate me late, but I have to know. How the fuck does someone screw up this badly? I'm just a retard on the internet that knows jack shit about medicine, but on what planet does abdominal pain = ear infection?

Referred pain can be weird, where the pain in one area of the body is caused by injury in another part, but I don't think I've ever run across anything involving ears. @Aunt Carol probably has it right, the kid was most likely too young to really communicate.

 

[Dan Abrams]

Your post has the reply bug @Aunt Carol but I hope my patients know I'm listening to them while I stare at a screen all day filling out their suicide risk assessments (on every single patient) and explaining to my superiors why my patients need a foley or CVC.

 

[Aunt Carol]

Your post has the reply bug @Aunt Carol but I hope my patients know I'm listening to them while I stare at a screen all day filling out their suicide risk assessments (on every single patient) and explaining to my superiors why my patients need a foley or CVC.

Sleeping on it, I'm better able to articulate my irritation at that article, and this is part of it. They make us do this stupid, unhelpful charting, and it turns out the very customers whose asses we're trying to kiss just see it as "those kids and their Nintendos."

I bet the answer to it all is to assign more mandatory charting.

Reply bug is Null's doing. He doesn't want people quoting a huge post for a one-line reply, so it triggers for long posts or posts with too many links

 

[Larry David's Opera Cape]

They started requiring the suicide screen at well child visits beginning at age 9 out in these parts. The common wisdom is "it can't hurt to ask, and it might save a life!" I wonder if that's scientifically validated (TM) in the case where you have to explain to the patient for the very first time in his innocent young life what it means to an hero.

 

[eternal dog mongler]

They started requiring the suicide screen at well child visits beginning at age 9 out in these parts. The common wisdom is "it can't hurt to ask, and it might save a life!" I wonder if that's scientifically validated (TM) in the case where you have to explain to the patient for the very first time in his innocent young life what it means to an hero.

Sounds like defensive medicine gone wild to me. Wrongful death suits for kids have gigantic judgements.

But what the hell would the intervention be? Oh, little Billy there said he felt like hurting himself sometimes so let's section him and send him to ped psych, the happy place with the 300-lb middle school kids built like NFL linebackers that love to choke people. That'll definitely improve his mood.

 

[Aunt Carol]

But what the hell would the intervention be?

Suicide screening in non-behavioral settings is broken all over. So many of the questions are "have you ever " and dude, if someone's 80, of course they have. It'd make more sense to ask "so are you gonna kill yourself in the next uhhhh week?" because otherwise it's just "hey do you want your visit for CHF exacerbation to become really awkward and longer and do you like finger food? yeah your adult kids are totally going to figure out why you have a sitter and/or q15 checks."

All we can do here is remove ligatures and pull an aide to stare at the patient expensively therapeutically. Assessing suicide risk is a good idea, poorly executed, and with abysmal follow-up; something else implemented defensively from above and then immediately lost interest in.

 

[Larry David's Opera Cape]

Sounds like defensive medicine gone wild to me. Wrongful death suits for kids have gigantic judgements.

But what the hell would the intervention be? Oh, little Billy there said he felt like hurting himself sometimes so let's section him and send him to ped psych, the happy place with the 300-lb middle school kids built like NFL linebackers that love to choke people. That'll definitely improve his mood.

Why fluoxetine and risperdal, of course.

 

[anliteralidiot]

I have nothing to add in terms of quality of education, but I've been enlightened about how some NPs are educated in my area. It's petty bitches all the way down!

One common thing was the instructors would post YouTube videos of them reading the PowerPoint, and then test the students on, potentially, something entirely different. This style of testing has resulted in, potentially, the entire cohort failing!*

They are overloaded with study material, with almost 1,000 modules per test. But without knowing what the test will be on...who knows!

It's also just very petty, catty, and exceptionally unprofessional. One professor had the gall to complain about getting emails over the weekend, in front of a group of students, one of whom had sent an email over the weekend.

*They still might not, but who knows.

 

[John Andrews Stan]

Who the fuck wants to wake up at 6 AM to drive to the clinic to get your dose then get subjected to random piss tests.

If you’re not willing to wake up at (or stay up till) 6AM to get your fix, are you really an addict? Maybe you just identify as one.

@Aunt Carol I’m not a nurse or in medicine exactly but that article pissed me off big-time. All of these patient complaints framed as if they’re all valid, with scant recognition that extra time is a luxury most can ill afford — especially in a hospital environment! Some of the comments were phrased in such a way that I wanted to punch the author — who I am positive made up all that “feedback” to suit the lecture she wanted to give from the start. My “lived experience” is that she’s a fraud and a scold.

 

[NoReturn]

 

[double second]

Suicide screening in non-behavioral settings is broken all over. So many of the questions are "have you ever " and dude, if someone's 80, of course they have. It'd make more sense to ask "so are you gonna kill yourself in the next uhhhh week?" because otherwise it's just "hey do you want your visit for CHF exacerbation to become really awkward and longer and do you like finger food? yeah your adult kids are totally going to figure out why you have a sitter and/or q15 checks."

All we can do here is remove ligatures and pull an aide to stare at the patient expensively therapeutically. Assessing suicide risk is a good idea, poorly executed, and with abysmal follow-up; something else implemented defensively from above and then immediately lost interest in.

(Sorry for the late reply, but I think this is a super interesting issue) I can’t remember exact numbers because I heard about this in a class awhile ago, but the thinking is based on a study that found that some high number of completed suicides were predated by a visit to the doctor. I want to say over half involved a person who saw their doctor within the few months before, usually with a poorly defined and presumably psychosomatic complaint. Suicidal people also generally saw their doctors more than average. So I think it makes sense for PCPs to ask, but god they do it badly. “Have you ever thought” is pointless and “have you thought about suicide” is confusing, and non-MH people do both all the time. It would be better to use a standardized tool like the ASQ screen for all patients 12+, for example, than to say “just ask, there’s no harm”. And that doesn’t even touch on the total lack of structure regarding next steps for PCPs when a patient does report MH issues.

 

[Big Bang]

Anyone in the medical industry (but especially nurses, who interact with patients more than most others in the medical industry) should need to take the MMPI to weed out as many bad people as possible, just like they do in firefighting and law enforcement.

 

[Dan Abrams]

download.mp4
download (1).mp4
download (2).mp4
download (3).mp4
download (4).mp4
download (5).mp4

Thanks for making me feel ashamed to be a nurse. I'm sure #1 in particular people love working with her.

Anyone in the medical industry (but especially nurses, who interact with patients more than most others in the medical industry) should need to take the MMPI to weed out as many bad people as possible, just like they do in firefighting and law enforcement.

I had to look this up but if you're going to make every nurse take a personality disorder test there will be like 2 nurses in the whole hospital.

 

[TheBigZee]

I thought the suicidality screener was two parts. Do you have thoughts, followed by do you have a plan. Thoughts get you a referral and a plan gets you an involuntary hold.

I've read (open access journals, no way for me to evaluate the quality of the articles) that successful child suicides (5-11) have increased dramatically since 2000. It's now in the top ten causes of death in that age group.

Inpatient pediatric psychiatric doesn't really seem set up to handle it. @eternal dog mongler is right, from what I've seen of inpatient children's wards they mostly treat disruptive or violent behavior issues, with a lot of the kids coming from group homes. On top of that there is such a shortage of appropriate beds I've heard stories of suicidal 10-11 year olds being kept in the ER for up to a week.

 

[Larry David's Opera Cape]

I thought the suicidality screener was two parts. Do you have thoughts, followed by do you have a plan. Thoughts get you a referral and a plan gets you an involuntary hold.

I've read (open access journals, no way for me to evaluate the quality of the articles) that successful child suicides (5-11) have increased dramatically since 2000. It's now in the top ten causes of death in that age group.

Inpatient pediatric psychiatric doesn't really seem set up to handle it. @eternal dog mongler is right, from what I've seen of inpatient children's wards they mostly treat disruptive or violent behavior issues, with a lot of the kids coming from group homes. On top of that there is such a shortage of appropriate beds I've heard stories of suicidal 10-11 year olds being kept in the ER for up to a week.

If these kids had functional parents there would be no need to park them anywhere at all. Even assuming one parent had to work without interruption constantly, the other one could clear the decks and sit with that kid at home, setting up constructive activities and hiding any hazardous objects. Even an imperfect implementation of this would be a thousand fold better than the best hospital "milieu." But the kids with psych problems are split between the children of complete dysfunctional lowlife degenerates on the one hand, and helplessly stupid affluenza sufferers on the other, and neither of those groups would parent if a life literally depended on it. It has to be farmed out to institutions and authorities.

 

[TheBigZee]

If these kids had functional parents there would be no need to park them anywhere at all. Even assuming one parent had to work without interruption constantly, the other one could clear the decks and sit with that kid at home, setting up constructive activities and hiding any hazardous objects. Even an imperfect implementation of this would be a thousand fold better than the best hospital "milieu." But the kids with psych problems are split between the children of complete dysfunctional lowlife degenerates on the one hand, and helplessly stupid affluenza sufferers on the other, and neither of those groups would parent if a life literally depended on it. It has to be farmed out to institutions and authorities.

I'd caution against taking such a black/white stance on it. Functional, responsible people are capable of creating an absolutely toxic home life for a particular child. Once you know a nine year old wants to hang themselves and you don't know anything about the child and their home beyond their medical chart, what do you do?

 

[NoReturn]

Given that this is an aesthetician it's kind of pushing things for this thread, but I'm including her for three reasons.
First, she makes being a nurse central to her social media self-presentation.

Second, her social-media tactics are similar to Sidhbh Gallagher in that her videos are presented as "informative" but they're just ads/normal dumb shit.
Third, look at her dumb videos.

---

This is Natalia Wilson, she went semi-viral for her TikTok about how she'd change Stranger Things star Natalia somethingorother's face:

She's a "MSN-FNP" whatever that means.

And she works for, I shit you not, Hebe Skin Health in Laguna Beach, CA.

Anyway, here are six of her videos because the media limit won't let me post more:

 

[Boris Blank's glass eye]

And she works for, I shit you not, Hebe Skin Health in Laguna Beach, CA.

This one probably has nothing to do with pedos: Hebe was the goddess of youth in Greek mythology. She's cringe af though.