Nurse Practitioners are becoming more recognized by healthcare organizations because of our financial contributions to the bottom line, and salaries are finally starting to reflect that. However, if you think for one minute that you will be recognized for your excellent exam and diagnostic skills, you might consider getting your head out of the sand. Granted, there will be that one physician, and the handful of patients who notice when you are able to diagnose and treat something other than a sinus infection or UTI, but beyond that, most people we care for would prefer if you call an emergency consult with the pulmonologist for their community acquired pneumonia, or the gastroenterologist for their chronic abdominal pain cause by too many narcotics and blocked plumbing.
So you diagnose this CVA, after the patient was admitted with sinusitis and "cant swallow," you start Plavix, order a swallowing study and rehab, and for safety's sake, you order a Neuro consult because it's expected. Nothing will kill an ego quicker than for a family or patient to say " yeah, that Dr Saint saved my life, I know he did, he's really good ." the appropriate response to this is NOT " oh, actually I did that!" Although that's exactly what we want to say, it's not very good PR for when you really need the neurologist. Just agree and "manage up" your specialists, it will get you much more respect and the patient will at least realize that you, the nurse who "almost made a doctor," are part of the TEAM that has provided the best care possible. This is the part where you take a deep breath, roll your eyes (don't let them see you,) and smile.