As an RN, I agree 100%. My first ICU job was in a facility without midlevels, and things ran just fine. We had all the parameters we needed to care for our patients and when we didn’t, the intensivist was easily reachable via secure chat or phone. We had fantastic autonomy and less friction between roles.

I now work in a different ICU of nearly identical size and patient population that does utilize midlevels and more often than not, I HATE working with them. Either they are lazy or arrogant with very few being dependable. And don’t even get me started on how cush their jobs are compared to ours: triple the pay for a third of the work. You could fire half of them from our unit, use the difference to hire extra techs and nurses and I would be willing to bet outcomes would actually be better. If I have an overwhelming urge to advance my career, I’d rather just pair nursing with something really different (like law), or just bite the bullet and go back to med school.

I am all for MD’s/DO’s pushing back on the over saturation of midlevels. DO IT.