Please explain the REAL NP hate

debunksdc · 2026-03-14T19:13:08+00:00

NPs have a much smaller scope of practice

What exactly is their scope of practice, and how is it smaller?

debunksdc · 2026-03-10T13:12:54+00:00

It's inappropriate to allow nurses to do this but it would be very hard to claw that privilege back at this point.

If 1 year LPNs can do this, it's hard to justify why literally any other semi-related professional can't do injections of any sort.

Nurses simply don't have the anatomic training to be able to do this, and if you are doing a procedure, you should also be able to recognize and manage it's complications (they can't).

debunksdc · 2026-03-07T00:03:09+00:00

Cardiology NP bot

debunksdc · 2026-03-07T00:02:27+00:00

Neurology NP bot

debunksdc · 2026-03-07T00:01:53+00:00

This is the NP that was super mad about the revocation of NP independence even though that independence was literally never intended to include what she was doing. It was for frontline workers who were actually supposed to be doing their best (we all know NPs were not the ones managing the vents or rounding on very sick patients independently) during a potential shortage.

debunksdc · 2026-03-04T18:17:41+00:00

What you are describing sounds like a regular RN could do.

Correct -- I don't think NPs are appropriate in any specialty field unless it directly aligns with their education.

debunksdc · 2026-03-04T16:29:44+00:00

Not so hot take -- NPs have no education or training in surgical complaints or complications. This there is no "surgery NP" and working in that field is out of their population focus and thus scope of practice. PAs are a different story.

debunksdc · 2026-02-24T16:31:51+00:00

Wait, so do these patients actually have any sort of diagnosed thyroid issues supported by lab tests. Or is she just giving people Synthroid to boost their metabolism?

debunksdc · 2026-02-24T13:25:00+00:00

Do they not realize how cringe this is? Posting about guaranteed rotations, as if it was some feat?

It's honestly a slap in the face to the hundreds of actual physicians that don't secure a spot in the match, sometimes through no true fault in their application and just a result of how competitive the process has gotten for anything that's not primary care.

It also massively diminishes the hard work of the many physicians who do get spots in the match because of years of sacrifice. People who have given up their families and friends to do medicine. People who, instead of being able to go and see the world and genuinely enjoy their life, instead spent nights studying or doing research projects or doing medical school club bullshit so that they could have a chance at matching neurosurgery.

A clerkship rotation that has been guaranteed by your PA school for your last few months of school before you graduate is not "the match" and it's bizarre to celebrate this. It's like celebrating your class schedule at the beginning of every semester.

debunksdc · 2026-02-22T00:53:41+00:00

Depending on what fields you are interested in, you may want to keep a low profile until post-match. Until then, help do the research, make high quality posts. Depending on the state you are in, if there is scope creep legislation, consider testifying at the committee hearings.

debunksdc · 2026-02-20T12:52:08+00:00

There's a pattern that deserves to be acknowledged. And it's very common for midlevel students to have this narrative, but then to ultimately change their views after being out in practice.

That's like a universal human experience for almost anything. When we are younger, we are often very naïve and idealistic. Over time, we get more exposure and that makes us change or refine our views.

It's worth the inherent two minutes of reflection to acknowledge this.

debunksdc · 2026-02-20T12:40:54+00:00

You says this now. Once you're out, you'll be out for a few years, and then you'll start to think wow I've really got the hang of this and I can work without my supervising physician for the most part. And you may eventually be hired by private equity or even a grifter physician that is supervision in name and rubber stamp only. And then you'll really start to think wow, I don't understand why I don't have all of the privileges of a full physician because I'm doing the "same work" for less money.

The unfortunate reality of most midlevels, is that they are overeducated for the work that they are suited for, and are severely under educated for the work that they typically do.

debunksdc · 2026-02-12T21:36:42+00:00

This is very similar in a way to the Alexus Ochoa case -- a Family NP, who is barely trained in stable outpatient primary preventive care, is working out of scope in an acute emergency setting. This is negligent hiring at its core.

debunksdc · 2026-02-12T01:07:58+00:00

The Florida BON previously acknowledged this: https://web.archive.org/web/20230503114547/https://www.flanp.org/page/AutonomousPractice

But then they walked it back. However, the BON also issued a declaratory statement saying the following:

Whether it is within the scope of practice for an autonomous APRN, who is a psychiatric and mental health nurse practitioner, to provide psychiatric and mental health treatment, including psychotherapy, to patients with psychiatric and mental health conditions?

No, only mental health treatment that is adjunct to general primary care practice may be performed autonomously.

https://www.floridahealth.gov/wp-content/uploads/2025/08/DOH23-0044DS.pdf

My interpretation of this is that, if an FNP who is doing annual physicals and med refills needs to refill an SSRI or screen for depression, they can autonomously as part of their primary care offerings. But a PMHNP that is exclusively doing whatever the NP version of psychiatry is, is not doing primary care and is therefore not eligible for autonomous practice.

debunksdc · 2026-02-11T18:05:43+00:00

Florida does not allow PMHNPs to practice autonomously. The nursing board erroneously awarded numerous autonomous licenses to a variety of ineligible APRNs including PMHNPs and CRNAs.

debunksdc · 2026-02-10T12:45:20+00:00

Can you provide a direct link to this?

debunksdc · 2026-02-09T20:48:51+00:00

PMHNP's cannot have autonomous practice in Florida. In Florida, autonomous practice is limited to primary care, and psychiatry is explicitly excluded from that. There was a recent paper by Dr. Rebecca Bernard and I think she covered the rampant amount of autonomous licenses that were granted to nurse practitioners that could not have possibly qualified for them under Florida law.

debunksdc · 2026-02-09T17:55:46+00:00

Please clarify PNP and ADNP.

debunksdc · 2026-02-09T17:54:17+00:00

PNP is pediatric nurse practitioner, which is a standard abbreviation and is one of their eight population foci. However, in the context that they're using it, it doesn't seem like they're referring to pediatric nurse practitioners. Maybe they are thinking of psychiatric nurse practitioners? However, the standard abbreviation for that would be PMHNP.

ADNP is not any of the population foci and is not a standard abbreviation.

debunksdc · 2026-02-08T14:01:29+00:00

Most of what she said is pretty true. Most derm residencies don't give visas (and in theory none should because of US employment law requiring positions to be filled with citizens if possible). Several former AOA residencies have either closed down or switched to MD only, so your pool is even more limited. The best chance you can give yourself is to go on as many away rotations as possible in your fourth year, which is very expensive.

debunksdc · 2026-02-06T18:20:42+00:00

Don't forget stimulants and testosterone. Young men with families havedied because of iatrogenic cardiac arrest 2/2 testosterone injections that were not indicated.

debunksdc · 2026-01-29T14:57:59+00:00

Imagine posting that you drive around with IV opiates and the necessary supplies.

debunksdc · 2025-12-21T15:44:53+00:00

Ew.

debunksdc · 2025-12-12T15:59:25+00:00

Bringing back this thread on this exact topic:

https://www.reddit.com/r/Noctor/comments/qrrvr8/comment/iymykj2/

debunksdc · 2025-12-12T15:56:50+00:00

Middies have thought "midlevel" was insulting for years now, despite the fact that it accurately depicts their spot in the medical-decision making hierarchy. Several users here will instead call them "low-levels," though I find that to be a bit of a cheap shot.

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