Time to remove the "nurse" in APN? - page 6

More and more, I am seeing posts from people who want to leap straight from taking the NCLEX into an advanced practice role. (Often you see plans of "pre-nursing" students already plotting their CRNA... Read More

  1. by   Boomer MS, RN
    Quote from operations
    So if you were to put a minimum requirement on clinical experience for Nps, what would you suggest it be? And would it have to matter that that person practiced as an RN specifically (instead of emt, or other provider) ? Would they have to be a hospital RN or could they have worked in a different role? How could it be measured that this is the appropriate level of experience?
    I honestly do not know the amount of minimum requirement for clinical experience, and I would leave that recommendation to the experienced educators. And yes, I advocate RN experience for an EMT, paramedic or RT, meaning becoming an RN. There are medics who have extensive experience in Iraq or Afghanistan who might find some of the NP course work easier because of his/her experience. For the ACNP applicant, the specialty I am most familiar with, I think hospital experience in an acute care setting is necessary, preferably the ICU or ED. I have no opinion for a primary care provider in an office practice setting because it is not a role I know much about clinically.

    This debate seems to go and on presently. It was not an issue a few years ago when the application standards were quite different than today when more schools have opened and have promised a sometimes quicker way to become an NP. Disheartening, IMO.
  2. by   Boomer MS, RN
    Quote from shibaowner
    I'm not sure what your response to me is saying.

    1. I stated RN experience is not beneficial to a primary care NP and the studies bear this out. Do you have evidence to the contrary specific to PRIMARY care?

    2. I indicated RN experience is probably helpful to an ACUTE care NP. Most reputable NP schools require RN experience for ACUTE care NPs.

    3. Anecdotes are not evidence. I have a lot of anecdotes about RNs that appear incompetent and so forth.

    4. There is absolutely no need for a live in person class unless the instructor is going to interact with the students. If the instructor is just going to lecture, then I can watch a recorded video of that. I can then email or call the professor with specific questions. In addition, with modern technology, a live class can be conducted via Adobe Connect so that the students see and hear the professor in real time, and they can ask questions real time via the online education platform.

    I respectfully disagree with #4 above. There was a time when some of us were in academic lectures (undergrad) (200+) on the hard sciences, and all the students, including me, benefitted greatly by being able to ask questions during the lecture. Maybe you find in person lectures unnecessary, but saying "there is absolutely no need" is not gospel. The trend is for online, and I admit I am no fan. I'm so grateful I was able to get my BSN and MS before this became more main stream. I appreciated being able to talk face to face with all my professors and having conferences with my classmates in the flesh. Times have changed with the Internet for sure with some benefits. I find it all a trade off.
  3. by   operations
    Quote from Boomer MS, RN
    I respectfully disagree with #4 above. There was a time when some of us were in academic lectures (undergrad) (200+) on the hard sciences, and all the students, including me, benefitted greatly by being able to ask questions during the lecture. Maybe you find in person lectures unnecessary, but saying "there is absolutely no need" is not gospel. The trend is for online, and I admit I am no fan. I'm so grateful I was able to get my BSN and MS before this became more main stream. I appreciated being able to talk face to face with all my professors and having conferences with my classmates in the flesh. Times have changed with the Internet for sure with some benefits. I find it all a trade off.
    I think you misunderstood what she was inferring. What she meant is that an online education is just as effective as an in person education. There will be a difference learning styles appropriate for online, but the content and the outcomes are on par. Therefore, people who've taken these classes should be held in the same regard as if they were to take it in person. It wasn't inferring that there is no use for in person classes,or that it was a replacement, etc
  4. by   Boomer MS, RN
    Quote from operations
    I think you misunderstood what she was inferring. What she meant is that an online education is just as effective as an in person education. There will be a difference learning styles appropriate for online, but the content and the outcomes are on par. Therefore, people who've taken these classes should be held in the same regard as if they were to take it in person. It wasn't inferring that there is no use for in person classes,or that it was a replacement, etc
    I did not misunderstand the comment. Please reread #4. Perhaps the OP can speak for him/herself.
  5. by   operations
    I understand that advanced practice was initiated by just that, expanding knowledge based on expertise, but at some point we have to level with pragmatics a bit. I would say 5 years is a bit of a delay. Not that it isn't good to have more experience but it doesn't always mean better, as in, you willhave a peak and taper. If I was someone who is planning out their future, and you tell me I have to have a bachelors and then work five years just so I can go to school and then work as a clinician with very restricted priveledges and pay, I most certainly will laugh at you. And many other people will reject this. Some of them because they want to slid by, but some who really have talent and are just looking for the best option. I think a couple years at the most is enough, if not you are just delaying education. Yes you need to see the patients, recognize the disease processes that you will commonly encounter vs special cases, understand the way the hospital works, but you do not need to have a expertise in doing tasks you won't be doing in you goal career.

    Internship may be the answer to that. Have the students be able to complete their education and get experience doing the role they want to master. Make it mandatory for 6-12 months after they finish school, and make it paid. Waive it if they have X amount of experience being a rn in acute care. And allow people into the program that are exceptional. If someone is truly exceptional, I really believe they will be safe to release to the public in 6-12 month's

    All in all, with the need for clinicians, and so many people understandably turning away from the excessive requirements that medical training would demand on their lives, surely there are pragmatic ways we can design medical education, without affecting standard of care. We are losing so much talent unnecessarily. I think incompetent graduates derive from the admissions office. I don't think experience has as much to do with it as allowing the wrong person to be in that position. Let's face it, think of the people that you've known were incompetent. There was something missing in that person that experience can't fix. A talented person is cautious and has high adaptability. Doesn't overestimate themselves and hits the books if necessary. I always favor talent over experience for this reason.
    Last edit by operations on Sep 5
  6. by   operations
    Quote from Boomer MS, RN
    I did not misunderstand the comment. Please reread #4. Perhaps the OP can speak for him/herself.
    I'm not sure what you understood from the comment then. Ok. The whole conversation was about people who think online education isn't as good as in person education. Ok, I guess talk to her then if you want, idk.
  7. by   EJN, RN, BSN
    Operations: I just have a random thought... Don't waste your breath. There are people who feel entitled to vilify and smear others because they feel that they, and only they, can ascertain who makes a competent provider and supply endless anecdotes about “someone they know” who was almost killed by a NP who they disapprove of. They have decided that young people are bad, online classes are bad, progress is bad -- No amount of evidence is going to persuade them against their supreme excellence for being old and being unable to evolve... After all, everything was excellent 20 years ago and we should all just stay there permanently. No matter how strong the evidence is proving competence in those they disapprove, their bias will always rule supreme. This type of threads pop up every so often in order for them to reassure themselves of their superiority and to squash anyone who may disagree or may have evidence that contradicts their 'truth'.
  8. by   shibaowner
    Quote from Boomer MS, RN
    I did not misunderstand the comment. Please reread #4. Perhaps the OP can speak for him/herself.
    In the interest of clarity, I feel online didactic education is just as effective as B&M. I do believe in an in-person class for a seminar with lots of interaction. However, people are certainly free to seek a pure B&M education if that is their personal preference. There is no reason to denigrate good online education and it wouldn't matter, anyway. Schools are moving to online and this trend will only continue.
  9. by   shibaowner
    Quote from EJN, RN, BSN
    Operations: I just have a random thought... Don't waste your breath. There are people who feel entitled to vilify and smear others because they feel that they, and only they, can ascertain who makes a competent provider and supply endless anecdotes about “someone they know” who was almost killed by a NP who they disapprove of. They have decided that young people are bad, online classes are bad, progress is bad -- No amount of evidence is going to persuade them against their supreme excellence for being old and being unable to evolve... After all, everything was excellent 20 years ago and we should all just stay there permanently. No matter how strong the evidence is proving competence in those they disapprove, their bias will always rule supreme. This type of threads pop up every so often in order for them to reassure themselves of their superiority and to squash anyone who may disagree or may have evidence that contradicts their 'truth'.
    Well said! Anyway, the ship has sailed. They can fuss and fume all they want, but it won't change anything.
  10. by   SCSTxRN
    I am a PMHNP- I wish there had been more Psych CNS style skills in my education, and I still work to bone up my therapy competency, as well as trying to improve my psychopharmacology knowledge. I'd do a DNP in either one, but only one of those.

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