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TakenusernameA 27 points ago +27 / -0

I have a friend whos a nurse, and she told me this nice tidbit.

Med errors are disturbingly common, and the nurses are the ones who take the blame, but in many cases the doctors are even worse.

Its no surprise that medical malpractice is the third leading cause of death in the U.S.

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GeneralBoobs [S] 20 points ago +20 / -0

But you must love and worship them! Clap for the tik tok nurses, clap for them!

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send_it 20 points ago +20 / -0

Medical errors are one of the leading causes of death even when the treatment is led by an actual doctor.

Now go read up on the profession called "nurse practitioner".

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Vicenzo 9 points ago +10 / -1

I have had better experience with NPs than most people say. Older docs are generally better too. But nearly any doc under 40 is likely a diversity hire brainwashed with modern medicine (social justice) and 100% pro pharma indoctrination.

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send_it 5 points ago +5 / -0

unfortunately statistics demonstrate the opposite. As for the nearly any doc under 40 part, do you genuinely believe this is any different in a nurse school? Lmao.

Resident teams are economically more efficient than MLP teams and have higher patient satisfaction. https://www.ncbi.nlm.nih.gov/m/pubmed/26217425/

Compared with dermatologists, PAs performed more skin biopsies per case of skin cancer diagnosed and diagnosed fewer melanomas in situ, suggesting that the diagnostic accuracy of PAs may be lower than that of dermatologists. https://www.ncbi.nlm.nih.gov/pubmed/29710082

Advanced practice clinicians are associated with more imaging services than PCPs for similar patients during E&M office visits. https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/1939374

Nonphysician clinicians were more likely to prescribe antibiotics than practicing physicians in outpatient settings, and resident physicians were less likely to prescribe antibiotics. https://www.ncbi.nlm.nih.gov/pubmed/15922696

The quality of referrals to an academic medical center was higher for physicians than for NPs and PAs regarding the clarity of the referral question, understanding of pathophysiology, and adequate prereferral evaluation and documentation. https://www.mayoclinicproceedings.org/article/S0025-6196(13)00732-5/abstract00732-5/abstract)

Further research is needed to understand the impact of differences in NP and PCP patient populations on provider prescribing, such as the higher number of prescriptions issued by NPs for beneficiaries in moderate and high comorbidity groups and the implications of the duration of prescriptions for clinical outcomes, patient-provider rapport, costs, and potential gaps in medication coverage. https://www.journalofnursingregulation.com/article/S2155-8256(17)30071-6/fulltext30071-6/fulltext)

Antibiotics were more frequently prescribed during visits involving NP/PA visits compared with physician-only visits, including overall visits (17% vs 12%, P < .0001) and acute respiratory infection visits (61% vs 54%, P < .001). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5047413/

NPs, relative to physicians, have taken an increasing role in prescribing psychotropic medications for Medicaid-insured youths. The quality of NP prescribing practices deserves further attention. https://www.ncbi.nlm.nih.gov/m/pubmed/29641238/

(CRNA) We found an increased risk of adverse disposition in cases where the anesthesia provider was a nonanesthesiology professional. https://www.ncbi.nlm.nih.gov/pubmed/22305625

NPs/PAs practicing in states with independent prescription authority were > 20 times more likely to overprescribe opioids than NPs/PAs in prescription-restricted states. https://pubmed.ncbi.nlm.nih.gov/32333312/

Both 30-day mortality rate and mortality rate after complications (failure-to-rescue) were lower when anesthesiologists directed anesthesia care. https://pubmed.ncbi.nlm.nih.gov/10861159/

Only 25% of all NPs in Oregon, an independent practice state, practiced in primary care settings. https://oregoncenterfornursing.org/wp-content/uploads/2020/03/2020_PrimaryCareWorkforceCrisis_Report_Web.pdf

96% of NPs had regular contact with pharmaceutical representatives. 48% stated that they were more likely to prescribe a drug that was highlighted during a lunch or dinner event. https://pubmed.ncbi.nlm.nih.gov/21291293/

85.02% of malpractice cases against NPs were due to diagnosis (41.46%), treatment (30.79%) and medication errors (12.77%). The malpractice cases due to diagnosing errors was further stratified into failure to diagnose (64.13%), delay to diagnose (27.29%), and misdiagnosis (7.59%). https://pubmed.ncbi.nlm.nih.gov/28734486/

Advanced practice clinicians and PCPs ordered imaging in 2.8% and 1.9% episodes of care, respectively. Advanced practice clinicians are associated with more imaging services than PCPs for similar patients during E&M office visits .While increased use of imaging appears modest for individual patients, this increase may have ramifications on care and overall costs at the population level. https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/1939374

APP visits had lower RVUs/visit (2.8 vs. 3.7) and lower patients/hour (1.1 vs. 2.2) compared to physician visits. Higher APP coverage (by 10%) at the ED‐day level was associated with lower patients/clinician hour by 0.12 (95% confidence interval [CI] = −0.15 to −0.10) and lower RVUs/clinician hour by 0.4 (95% CI = −0.5 to −0.3). Increasing APP staffing may not lower staffing costs. https://onlinelibrary.wiley.com/doi/full/10.1111/acem.14077

When caring for patients with DM, NPs were more likely to have consulted cardiologists (OR = 1.29, 95% CI = 1.21–1.37), endocrinologists (OR = 1.64, 95% CI = 1.48–1.82), and nephrologists (OR = 1.90, 95% CI = 1.67–2.17) and more likely to have prescribed PIMs (OR = 1.07, 95% CI = 1.01–1.12) https://onlinelibrary.wiley.com/doi/10.1111/jgs.13662

Ambulatory visits between 2006 and 2011 involving NPs and PAs more frequently resulted in an antibiotic prescription compared with physician-only visits (17% for visits involving NPs and PAs vs 12% for physician-only visits; P < .0001) https://academic.oup.com/ofid/article/3/3/ofw168/2593319

More claims naming PAs and APRNs were paid on behalf of the hospital/practice (38% and 32%, respectively) compared with physicians (8%, P < 0.001) and payment was more likely when APRNs were defendants (1.82, 1.09-3.03) https://pubmed.ncbi.nlm.nih.gov/32362078/

There was a 50.9% increase in the proportion of psychotropic medications prescribed by psychiatric NPs (from 5.9% to 8.8%) and a 28.6% proportional increase by non-psychiatric NPs (from 4.9% to 6.3%). By contrast, the proportion of psychotropic medications prescribed by psychiatrists and by non-psychiatric physicians declined (56.9%-53.0% and 32.3%-31.8%, respectively) https://pubmed.ncbi.nlm.nih.gov/29641238/

Most articles about the role of APRNs do not explicitly define the autonomy of the nurses, compare non-autonomous nurses with physicians, or evaluate nurse-direct protocol-driven care for patients with specific conditions. However, studies like these are often cited in support of the claim that APRNs practicing autonomously provide the same quality of primary care as medical doctors. https://pubmed.ncbi.nlm.nih.gov/27606392/


Although evidence-based healthcare results in improved patient outcomes and reduced costs, nurses do not consistently implement evidence based best practices. https://pubmed.ncbi.nlm.nih.gov/22922750/

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Vicenzo 1 point ago +3 / -2

Like I said older white docs and Asians are good. Older non-whites and younger doctors of every race are getting worse. Worsening cirrucla and focus on big pharma and CRT is destroying the average MD. Most doctors don't even look at their patients in person or do any examinations in person. Instead they spend 90% of their time in an office on a PC. This is similar to other providers including NP and PAs as well.

This is my personal opinion born from observation in 3 different hospitals I've been in so far. As for the quality of nurses refer to my previous comment.

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OldBullLee 3 points ago +3 / -0

the profession called "nurse practitioner"

I can see how more of these quasi-trained nurses might lead to more such incidents. What's the angle? Does it boil down to $, as usual? Pay one of these glorified midwives diddly shit and reduce the number of MDs on the hospital payroll?

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send_it 5 points ago +5 / -0

Basically it's very hard and takes forever and costs about half a million in student loans to become a medical doctor, so a bunch of people came up with the idea to offer specialist training to experienced nurses and then give them similar practicing authority as a resident physician (i.e. limited scope of work under the direct superfision of an attending physician).

Born was the nurse practitioner.

Then some dumbfucks decided that instead of people going to nursing school, working up experience as a nurse and then going to NP school, they could set up ~3 year directly-to-NP schools.

Oh and a considerable bunch of states now allow those medical retards to perform their witch doctory without the supervision of an attending, making them essentially attendings themselves as far as their authority goes.

Basically they're absolutely dogshit nurses (because they've never done any practical nursing) who pose as medical doctors, have very little idea of anything because they never went to med school let alone put in the clinical hours after, but get to prescribe you benzodiazepines and opiates anyways. They're objectively shitty healthcare providers and their education doesn't even measure up to the US Step 2 level (which is a mid-study exam a med school student must pass... Then there's a Step 3, and multiple years of residency before they are allowed to work unsupervised).

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OldBullLee 3 points ago +3 / -0

instead of people going to nursing school, working up experience as a nurse and then going to NP school, they could set up ~3 year directly-to-NP schools.

Holy shit. Leave it to the universities to seriously fuck up what seems to have been a good idea.

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Vicenzo -1 points ago +1 / -2

Ya basically a MD costs so damn much few are going that route anymore.

Most stuff is easily seen by a nurse (remember school nurses?) with a year or two of specialization. However the general quality of medical education (and nursing too) is getting so piss poor its dangerous.

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send_it 3 points ago +3 / -0

Most stuff is easily seen by a nurse with a year or two of specialization

until it isn't, then they'll be the first to shout from the rooftops that they're not actually practicing "medicine" but "healthcare".

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Vicenzo 0 points ago +1 / -1

Probably. I'm more saying most medicine can be delivered with like 2 years of real education a la practical nurses. However the actual cirruculum, and those for doctors as well, is bloated and filled with straight bullshit like vax maxing.

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Vicenzo 10 points ago +11 / -1

Nurse here. Yes med errors are very common because your average staff nurse is about as intelligent as a grade school teacher. Some good. Most average. Some functionally illiterate. Same with math skills.

My advice is be proactive in your treatment plan and collaborate and verify what is being done. If its to you as a patient, or be there for your family or friend if they can't advocate for themselves.

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MargarineMongoose 4 points ago +4 / -0

Just more reason to take your health seriously.

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BrainJuice 2 points ago +2 / -0

To be fair, giving someone Tylenol when they asked for Aspirin is technically a med error, even if nothing bad happened. Two patients have the exact same prescription but one is generic and the other is name brand and you accidentally switch the pills? Med error.

I'm not trying to excuse the more serious med errors here, just trying to explain that "med error" is a pretty nebulous term at times.

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Vicenzo 1 point ago +2 / -1

That's not really true as hospitals don't stock trade variations of each med unless medically important (thyroid meds can change based on manufacturer for example).

Most med errors are inappropriate timing as nearly every other part of med dispensing has been automated except for the window when the patient gets it.

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BrainJuice 1 point ago +1 / -0

I think that would fall into the category of "more serious med errors" though.

EDIT - Also, hospitals aren't the only place where nurses work. Retirement homes, assisted living centers, clinics (doctors office), etc.

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ghostfox1_ 17 points ago +17 / -0

RaDonda

Dindu confirmed

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BrainJuice 10 points ago +10 / -0

My wife, a nurse, absolutely HATES "Tik Tok nurses" with a burning passion. Mocks them every chance she gets.

I think a nurse being part of the "Tik Tok" variety depends on two things:

  1. The field they're a part of. I've noticed that clinic nurses are the ones who overwhelmingly tend to fall into the Tik Tok, "gonna get me a doctor" group. They get used to sitting at a desk for 80% of the day with very little patient interaction and lower pay than nurses in other settings (nursing homes, ER, etc). This leads to a general disdain for their work and the people they're supposed to care for. Nurses in very active settings, such as the aforementioned nursing homes or ERs, tend to be the actual caring individuals who want to help. It's funny that there really doesn't seem to be a middle ground. Either a nurse is a caring, more traditional female who is family oriented...or she's a bitchy snot who depends on hook-up culture to feel wanted. I've known several nurses and those are just about the only types of nurse.

  2. Why they got into nursing. Those who became a nurse because they sincerely wanted to help tend to be more well adjusted individuals compared to those who thought they'd get rich just by being part of the medical field.

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subbookkeeper 9 points ago +9 / -0

Iatrogenic deaths is the medical term for this type of death.

Do a search for it and prepare to be shocked.

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TheImpossible1 3 points ago +8 / -5

Wow, a pussy pass for killing one of their own. That's new.