r/Noctor

Throw away account due to obvious reasons. I got into nursing school. I’ve never wanted to be a nurse. Only reason that I applied was because my bf and my family convinced me to do so. I have my bachelors with all my pre med prereqs my science gpa is a 2.6. I was doing a diy post back at the local community college and a formal one at a very expensive private institution. I have experience working in different healthcare setting with MDs/DOs, PAs and NPs. Unfortunately I have seen the knowledge gaps that the NPs have. I had once had an NP tell me she was worried if she was reading the PFTs correctly, or if she was over or under ordering (the population was critical care patients), I’ve seen others defer their patient to the MD due to feeling uncomfortable with the complexity of the patient (which is what they should do instead of playing doctor). Also every time I’ve gone to an NP I’ve been wildly misdiagnosed, and gaslighted. I guess I am just uncomfortable with the idea of being an NP and being a nurse in general specially since in my state an NP can work independently. I love the PA route due to the fact that their education is more standardized, they’re are more prepared for surgical settings which is something that I love. I guess my dilemma is should I begin nursing school and use the classes to boost my science gpa for caspa or continue my diy post bacc and delay starting my life. Also the only reason I do not go MD/DO is because I love the ability to switch specialties and having a supervising physician that I can collaborate with.

I am a BSN student, and during my nursing program I discovered a deep desire to go into medicine (psychiatry). I get so sick of people telling me to just go NP because it's easier, or "practically the same thing." I posted a rant on the post-bacc subreddit about having to delay my dreams because I recently had to take emergency custody of my 8 year old sister, and will need to work as an RN for a few years first. This was the only comment I got on the post 🙄

https://preview.redd.it/pdn6wprw51bh1.png?width=925&format=png&auto=webp&s=198c4a7480573876c7479704b50670195f9d5b07

My rural hospital was recently bought out and got rid of our one anesthesiologist. We now only have CRNAs. Apparently this is legal in my state that CRNAs can work independently but what if something happens?! So before the corporation took over our anesthesiologist, managed the CRNAs and he would come to help for difficult cases or if patients requested him. (This is a small town so a lot of people knew him) but now he is gone. We have great CRNAs but now there is no safety net. Has anyone else experienced this at their hospital? Did it have any effect (negative or positive?)

I’m a resident at the hospital where all of the MD/DOs have a black badge that says doctor on it behind their name tag badge so that the bottom peaks through. I saw this girl in the hallway who had one and and I looked up to see that her degrees were NP. So this lady literally had to steal or request a doctor badge and put it behind her NP nametag…..

I need to vent about a Noctor my husband saw as his PCP for 6 years. MD/DO PCPs are hard to come by in my community, so that’s who he ended up with. His NP moved to a different practice location 1 1/2 years ago, so I convinced him to transfer to my PCP, a PA. He had seen the NP at least yearly for regular well-patient physical exams with no issues except renewing his existing cholesterol and thyroid medications. However his first visit with the PA indicated a heart murmur. We just finished the complete work up at Mayo Clinic Rochester (we are in a small town and it is close to us), and it is a severe aortic stenosis caused by calcification. The cardiologists all said the murmur must have been present for a long time to be so advanced. We are lucky, the TAVR is scheduled in two weeks, and we have a good plan going forward, but I am livid! What if he hadn’t transferred his care to the PA? What if his murmur had gone undetected for 2, 3, 5 more years at which point he could have really had heart damage? Luckily he has no effects beyond limited exertion, but it could have been so much worse. I am still trying to decide whether I should write to the practice with the NP currently and complain. Will it do any good?

AANA has withdrawn its trademark applications to register marks incorporating the term "Nurse Anesthesiologist" thanks to ASA's legal efforts to oppose this.

In June 2024, ASA filed opposition proceedings against two AANA trademark applications, for AMERICAN ASSOCIATION OF NURSE ANESTHESIOLOGISTS (Opposition No. 91292357) and AMERICAN ASSOCIATION OF NURSE ANESTHETISTS AND NURSE ANESTHESIOLOGISTS (Opposition No. 91292329).

After nearly two years, AANA filed motions to withdraw its applications on June 29, 2026. This withdrawal means AANA's applications will be denied.

The withdrawals represent a decisive victory for ASA and an important milestone in ASA's ongoing efforts to prevent improper and inaccurate use of medical titles and to protect patient access to accurate information about their care teams.

I am doing a pharmacy summer internship at a highly respected Market pharmacy, Not CVS or Walgreens. But we have to pick a topic, and I choose that pharmacist should not accept prescriptions from NP because their education stinks they do not have the training,

But does anybody know about their pharmacology classes, or any thing specific about any of the NP programs that can help me out here.

Thank you

This video is mostly about the hell that is prior authorization. But in the middle she talks about the ER Noctor looking up “What is Hemophilia” right in front of her.

I had DVTs in both legs in 2020, then another one in my left leg in 2023. After the one in 2023, the NP at my hematologist’s office took me off anticoagulants after only 1 month, even though I had initially been told that I would need them for life. I’m 25 and the NP said it would be “super rare” for someone my age to get an unprovoked clot (even though it already happened twice??). I also have complex regional pain syndrome (CRPS) and PTS, so I was really fearful of getting another DVT.

So I started having pain in my calf roughly 1 month ago. Went to the ER and the NP said I’m too young to have a DVT. She did not order an ultrasound or even so much as a d-dimer, just did an EKG told me that my leg hurts because of anxiety. I have PTSD as a result of some previous hospital experiences and the EKG triggered a flashback, so I was panicking and quite anxious in that moment. I fail to see how that would make my leg hurt though! My anxiety is well controlled and panic attacks are rare - it was really just the hospital environment that set me off.

Went to the ER again 2 weeks ago. It was the same NP who saw me. Still no ultrasound. She saw that my feet were red and swollen (they always look like that due to the CRPS and PTS), so she diagnosed me with cellulitis and prescribed… a medrol pack? Spoke to my PCP and she prescribed 7 days of keflex + ordered an ultrasound (which my insurance denied).

I felt better for a short time after the antibiotics, but a few days ago my left foot suddenly swelled up and I developed several blisters on the top of my foot. Called my PCP and she recommended urgent care or ER because she’s out of the office this week and can’t see me. Back to the ER (different hospital this time), and they did labs, a leg ultrasound, chest x-ray, and an MRI of my foot. Not only do I have a DVT going from my ankle to just above my knee, but I have the beginning signs of osteomyelitis.

I’m still in the hospital on IV antibiotics and will be getting a thrombectomy this afternoon. While I’m glad that I’m getting appropriate care now, I’m incredibly frustrated by how I was treated by that NP. I also can’t help but think that this whole thing could’ve been avoided had the hematology NP just kept me on anticoagulants.

I understand that this sub mostly focuses on physicians and practicing medicine, but as a social worker getting ready to return to practice, I'm surprised by how often PNPs are providing and billing for mental health therapy.

If you work in the mental health profession, are you seeing a lot of of this going on? What impact is it having on your profession and your clients? Do psychiatric P.A.s also provide therapy? How does their education, clinical training and supervision requirements, and continuing education compare to ours?

I open to hearing any facts that come my way. But at this time, the prospect of anyone other than a psychiatrist providing both therapy and medications makes me uneasy.

Sorry for the long read but a tldr is at the bottom

At my son's 2.5-year well-check, we saw a Nurse Practitioner (CRNP DNP) instead of his doctor. She did a 5-second oral check, wrote his mouth was 'clear,' and then blamed his speech delay on autism. She also apparently told the other nurses in the office that my son had autism. As I was leaving one of the nurses who helped give him a shot said oh my son is autistic too. And when I asked her why would you think he's autistic she could not give me an answer.

She then referred me to a specialist and ignored everything that I said about the fact that he had swallowing and latching issues and I suggested that he might have a tongue tie.

I didn't mind getting my son a evaluation for autism. However before I could even get on the list to do that I took him to a pediatric dentist to immediately identified a severe lip and tongue tie.

Now every time I have to interact with his new pediatrician's office... Which also has a nurse practitioner she keeps talking about autism. Our last visit I informed her that he is in occupational therapy and sees a speech language pathologist weekly who has assessed his abilities as exceeding expectations given the circumstances.

However she keeps pushing this idea that he's autistic simply because he does not like the doctor's office and refuses to speak to her. Even though he will speak directly to me in the office.

Outside of that she never gives me any information on why she believes this other than he doesn't seem to have enough words in his vocabulary currently. When I pointed out he has to learn how to articulate and he has had full conversations with me and others and has limited access to other children because I am currently unemployed and he is not in daycare she completely ignores that and mentions the fact that she has a 3-year-old at home.

Additionally I mentioned to her that he is on the list to be assessed for autism but based on the criteria for autism he doesn't seem to meet any of the requirements other than speech issues which stem from his tongue tie and lip tie which have recently been corrected a few months ago.

Currently I am looking for a new pediatrician's office that does not make patients see a nurse practitioner. This has been an exceptionally frustrating experience. Aside from constantly being dismissed for objective issues that would affect someone's speech.

Im finding that when I go to specialist they identify what I initially thought was the correct understanding of the issue e.g. pediatric dentist identifying severe lip and tongue tie, speech therapist noting that speech can be delayed due to said tongue/lip tie, and occupational therapist who has questioned why he is being referred for autism when he does not have any other symptoms.

I just find that the majority of my experiences with pediatric nurse practitioners has been abysmal. They are quick to refer children to different programs but when asked for further context or reasoning which I will have to provide to the programs they can't tell me anything and instead get defensive.

Has anyone had any experience like this?

TLDR:

Two different pediatric Nurse Practitioners (NPs) have completely ignored my son's severe, structurally verified tongue and lip ties (which were later confirmed and surgically released by a pediatric dental surgeon). Instead, they used a standard office questionnaire and his situational clinic anxiety to label him as a "medium autism risk" on his chart. His weekly Speech-Language Pathologist and Occupational Therapist both say his delay is strictly mechanical/rehabilitative and that he shows zero signs of autism.

Anyone else banned from the NP subreddit for a fairly innocuous comment?

I wrote “dead men tell no tales” on their study suggesting an association between NP care and lower remission rate. Apparently, that’s enough for a ban.

When I became an NP a few years ago, I followed the Noctor sub mainly out of curiosity but overtime my curiosity led to me siding with the overarching position that NP practice as it stands is not only dangerous but can prove substandard to medical practice.

For context, I’ve been a RN for over 15 years. I have worked in most clinical specialties with the exception of L&D and the OR. Those two specialties are just not my jam lol. For half of my career, I worked in behavioral health and decided to further my career to become a psychiatric-mental health NP. I felt my experience in inpatient psych and other combined experience prepared me for advanced practice.

What I did not realize is my education was subpar and the advanced practice expectations were the same for a physician, who has significantly more experience and education. In my opinion, the NP education, whether brick and mortar or online, is not advanced enough to permit independent practice. We are held to the same expectations as MDs, like psychiatrists, with less education/experience and lower reimbursements for similar professional expectations.

In my state, NPs require supervision for 3-5 years (legislation recently changed) and the NP may apply for full autonomy with MD sign off after supervision requirement has been met. I was on the path to full autonomy and I woke up one day like “what the hell am I doing?”.

NP practice has evolved into something incomprehensible. What started off as a role of physician extender, such as handling routine/follow up cases, has evolved into the role of medical leader with limited formal “medical” training. Several factors are driving this including shortage of MDs, expansion of Medicaid/increased access to care, payers/insurers trying to cut costs, etc.

I support increasing efforts to increase access to medical schools, changing NP educational requirements (including requiring at least 10 years of RN experience prior to program admittance, standardizing clinical requirements, changing the existing treatment model, etc.), and developing MD-NP initiatives to revert to the original NP model in which we served as extenders of MD-led settings handling prevention, health promotion, vaccines, minor procedures, routine and follow-ups, less complex cases, etc. because this is what I signed up for.

I haven’t received the best support for “stepping down” because people really don’t get it. But I know it was the best decision for me.

Reference, I'm a newer PA. I don't support independent practice. I ESPECIALLY don't support online medical education.

I consistently see NPs who would assert their "dominant medical education" over PAs (and somehow phsyicians too????) due to their "prior nursing experience and education".

Life goes on, but I seriously can't comprehend how these part-time, online degree NPs feel safe to practice medicine.

EDIT: Dentists, vets, podiatry, optometry, perfusionists, physical therapy... also don't allow part-time schooling.

Context: I am a PA student and am genuinely curious as to why mid levels seem to be so disliked? Is it an issue you have had with coworkers you have personally experienced? Is it that you disagree with the profession/role or its position in healthcare as a whole?

Honestly curious. There is so much anger in this forum that it is seriously really difficult to tell where it’s coming from towards the profession. Just looking for someone to have an honest option here.

“So you’re the associate physician. Oh wait you’re associate professor of cardiology oh wait you’re my cardiologist oh wait…you have a long white coat so you’re my doctor but who are you again?”

What happened to ethics in this country?
Does no politician or organization care about patient transparency?

Being a doctor in the hospital meant something. It reflected the long arduous path to get here , the blood sweat and tears that for most of us started as early as high school. It meant you always had to put in a shit ton of effort every step this marathon to get to where we are. The 10,000 hours of training, shelf exams , 9-10 hour long multi day board exams that you were prepping for 12 hours a day for weeks to months, grueling residency hours and still an anxiety and trauma induced first few years of being an attending. And even then keeping up with new literature to ensure your patients receive the best care possible.

Thats what it took to take care of patients well.