Bernie2

My question " Why are we so FOCUSSED on heaps of training "...

Focus implies that other issues/objects/considerations are filtered out.

Anyway I believe the introduction of the UMAT in some medical schools entry criterion was to actually dilute such focus a little.

As for mistakes, I rarely go to doctor yet have encountered many mistakes or obvious malpractice. The rest of us with less market dominance cannot even forget to smile at the boss.

Yes, I also get the feeling that some posters are slightly out of touch with exactly what nurses do these day: the Lady of The Lamp image still persisting.

One great difference since the Crimean war is, of course, that nursing is no longer simply "women's work": the ratio of men is increasing. One poster asked why not send them to med. school to study and become doctors? Well, where on earth do you think they do study now?

Fledgling doctors and nurses attend the same classes in the beginning of their training as it is. Nurses graduate after 3 years - or 4 if they go for Honours. The criteria of attaining a Masters would increase their med. school training by another 2 years: bringing their total time to 5-6 years. A doctor of medicine must undergo another two years of practical work before qualifying but an NP, as I understand it, would be freed up to start practicing earlier than that.

As the term "Doctor" is only an honourary one in the case of medical practitioners who do not, like others with the title Doctor, actually write a Doctoral Thesis, theoretically I guess it would be possible for qualified nurse to continue studying beyond Masters and thus become a Nurse whose actual title was Doctor!

So, yeah, I agree with the poster who stated that we shouldn't get hung up on nomenclature. Rather think about ways to get qualified people into jobs quickly. As you said, Sociologist: "We have limited financial/ human resources. Like the global-warming race, we have no time".

However we part company when you continued: "Stick to something that has worked. " I would see the whole point of this discussion being that the system is no longer working.

Romany:
As a medical doctor practicing for the last 15 years and having taught both medical students and nursing students both in Australia and several countries overseas, I assure you that the knowledge base of the 2 groups are very very different.

I also hold 2 Masters degrees and a doctorate dgree, I would say that if I were sick, I rather be treated by a medical doctor who knows what he is doing and have no bedside manners that be treated by a Nursing doctorate with great bedside manner and without appropriate clinical knowledge. A doctorate historically stems from philosophy (hence PhD). The nature of the degree requires great emphasis and narrow focus (using the correct application of the word). By virtue of this fact it means there is loss of lateral perspective which is vital in clinical medicine. Word limitations here do not permit greater elaboration. In addition, many clinical specialty fellowship exams have knowledge requirements far greater than a doctorate degree. Having done both I can surely attest to that!

On systems that work, quantitative and qualitative studies have not been able to provide answers to what will work because of thenature of the rapidly evolving flied. Safe to say, most analysis points towards proven formulas.

Sir Lancelot Spratt (in the "Doctor" film series) would doubtless agree with Sociologist in maintaining the status quo, but knowledge, people and techniques have changed since Sir Lancelot taught at St. Swithin's.
Sometimes it is hard to accept that change is necessary. Marshall and Warren's Nobel Prize winning discoveries were scoffed at, yet this Australian pair went against ‘proven formulas’ for the betterment of us all. We would all likewise benefit if their kind of innovative approach was adopted to get rid of the dogma and elitism that pervades our health system. Doctors (honorary or otherwise) would be revered should they assist in the passage from an antiquated system more akin to monarchy to a system that addresses the reality of healthcare needs today (and tomorrow). There is a big risk that history will look back in shocked disbelief at a system that had the potential to change, yet did not in order to maintain the status quo.

I agree with Kiama kid that the only consistency in life is change. I also agree that no single group should have a monopoly or elite status for the sake of tradition.
However Foucault have shown that interactions in health is about an interaction of power. Unless humans turn into robots this will remain for quite some time to come. Incidentally, Barry J. Marshall and Robin Warren's contributions is in microbiology and pathophysiology. Not human social/healthcare systems.

The point of this current discussion is about having NP as an answer to the healthcare woes. As I see it, based on the proposals submitted thus far, it offers nothing extra to the end-user (ie the patient) for society's time and financial investment. It creates an increase in status for the special group of nurses for the sake of status itself. The same amount of time and money invested by society could be better off training to produce more nurses and doctors in absolute numbers, rather than increasing skill set of existing nurses to match that of a doctor but not really hitting the mark. Remember the end-goal is patient quality care in totality (ie whole of society). At the planning level we should see the big picture and recognise the interst groups and their unspoken agendas versus the means that will assist in producing desired outcome.

Status? Power? Elitism? Perhaps I am naive, but I had not for a moment considered that anyone would be arguing within these paradigms.

So is this what is boils down to for some, then? I had thought that the "nomenclature" that was proving problematic was simply that: a dichotomy concerning the title of NPs vs. RNs etc. Surely the days of people "revering" doctors ended - if they existed at all - with the demise of Spratt and his ilk?

If there is indeed concern that one particular group's star might wax as another's wanes then there is indeed little hope for reform. Adherence to the status quo would only imperil an already dangerously marginalised system.

Sociologist: I was simply being mischievous with regard to the Nurse-with-a-doctorate scenario. As a University Lecturer I am quite au fait with the scholastic hierarchy.

I am, however, bitterly disappointed that such considerations as status could be allowed to impact on such a serious issue as the nation's health.