How much did NP school prepare you?

  1. I have heard that Nurse Practitioner school is not as rigorous as other grad schools (such as CRNA school). I would like to become either a ACNP or a CRNA in the future. I am very interested in science-based learning, and am wondering which option would be best for me. I have such a strong passion for cardiac disorders, and could really see myself becoming a Surgical Cardiac ACNP. However, CRNA interests me for the hard-core science that is taught. CRNA students get such in-depth pharmocology and pathophysiology classes.

    For any ACNPs out there, did you feel confident in your pathophysiology and pharmocology knowledge after graduation? Or did you attend a fellowship after?
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  2. 37 Comments

  3. by   SoundofMusic
    I will honestly say, I strongly feel not all that much. I did 700 clinic hours, whereas my doc went to med school for 3 years, then did 3 years of solid residency ....that's what you NEED. I wish that's what I could have done. Now I'm out and expected to know and do what he does ...(well, not really), but sort of ...it puts you in a perpetual state of intellectual disarray and discomfort/risk ... even the PA's I work with were far better prepared. Now that I'm here, I wish I'd gone to PA school. A nurse turned PA is a nice combo -- you've got the nursing background, but get the medical training to prepare you more thoroughly. Just my .02.
  4. by   ICUman
    Quote from SoundofMusic
    even the PA's I work with were far better prepared. Now that I'm here, I wish I'd gone to PA school. A nurse turned PA is a nice combo -- you've got the nursing background, but get the medical training to prepare you more thoroughly.
    Definitely agree! I feel like the only advantage to being an NP over PA is the potential for independent practice, which the vast majority of NP's don't utilize anyway. PA's can switch specialties so much easier without additional schooling. And admission criteria is stricter. However I think both are/will be subjected to over-saturation soon. Most PA's I've worked with just seem more sound/confident in their clinical judgement; although, there are some outstanding NP's out there too.
  5. by   SoundofMusic
    Right -- I think that over time, as an NP you will catch up simply due to experience in practice, but it's very tough at first.
  6. by   BCgradnurse
    Keep in mind that regardless of which path you take, you graduate as a novice. If pure science is your passion, then definitely go the MD route.
  7. by   Dodongo
    You can do more clinical hours than what is required in the program. I don't understand why this fact escapes so many NP students. It's not at all hard to get over 2000 hours in the clinical year. That at least lets you hit the ground running when you graduate. 700 hours is nothing. That's just an introduction.

    If you go the NP route you need to do work on your own to make up for the low standards. Read more and do clinical full time.
  8. by   lwsoccjs
    Well the clinical portion has much to do with where you are placed and the simulations the school offers the didactic you have a lot of control over. Many NP programs if part-time are 7 credits or full time around 9 and I've never seen more than 12. PA, MD, pharmacist etc all take 15-18 credits a semester. So, take it upon yourself to say this semester I will learn biochemistry. Pick up a text book, and find a website there are plenty out there. Then learn the material and reach out when you hit a road block. Make the most of your time while in school. Nothing prevents you from learning. The sciences are not a special thing reserved for certain programs. The knowledge is completely available. If you need resources let me know. So yes the science portion is weak. CRNA's are trained more rigorously regarding the science. But, with ACNP you can walk away doing what you want to do, while also knowing what you want to know. No one forces someone to just be the minimum compentecy. Again all other programs are full time besides NP and many people assume they should work through them. You wonder why other programs can be taught more science. Of course they can because they are taking 18 credits lol. So pick a subject matter and study it. For example you want to know pharmacology. Well first pick up a Pharm book used via Pharm-D or med school and start reading then evolve from there.
  9. by   A&OxNone
    Quote from Dodongo
    You can do more clinical hours than what is required in the program. I don't understand why this fact escapes so many NP students. It's not at all hard to get over 2000 hours in the clinical year. That at least lets you hit the ground running when you graduate. 700 hours is nothing. That's just an introduction.

    If you go the NP route you need to do work on your own to make up for the low standards. Read more and do clinical full time.
    This would be awesome, except I barely was able to complete the amount of hours required because of lack of preceptors. I wish I could have all the time and resources at my disposal, but as somebody that graduates in two week, I'm literally going to the last day and the last hour to finish my required hours because it was so difficult to nail down time with preceptors. It is what it is, just saying the "do more!" opinion is a little unrealistic unless something changes.
  10. by   lwsoccjs
    Yeah I can understand what you mean. Another good point of a bullet list of things to improve in our education. Why is it some programs make getting the hours easy and others make it impossible. This inconsistency needs to be fixed, among other things.
  11. by   Dodongo
    Quote from A&OxNone
    This would be awesome, except I barely was able to complete the amount of hours required because of lack of preceptors. I wish I could have all the time and resources at my disposal, but as somebody that graduates in two week, I'm literally going to the last day and the last hour to finish my required hours because it was so difficult to nail down time with preceptors. It is what it is, just saying the "do more!" opinion is a little unrealistic unless something changes.
    Did you only find preceptors who worked casually? Or did they just flat out refuse to have you follow them for more than the bare minimum required? Or was it that you worked full-time and found it hard to coordinate your schedule with your preceptors? Should NP programs find you preceptors? Yes, of course. That's another issue. But your radius for searching should be as wide as you need to find an acceptable preceptor. If you made the choice to go to a program that doesn't find you preceptors, do what you have to do.

    Bottom line: Work less and do more clinical hours. Again, MD and PA students do not work during their programs so I have little sympathy when nurses work during their programs and then decry the low amount of clinical hours they got in their programs.

    And like what was said before, dedicate more of your time to reading and studying. If you are only taking 1-2 classes you can be reading SO much more each semester. Again, MD and PA programs require an incredible amount of self teaching which entails multiple hours of reading and studying on their own outside of class time.
  12. by   Dodongo
    Programs should be structured as follows:

    -Pre-requisite courses in bio 1/2, chem 1/2, organic chem 1/2, physics 1/2, microbiology, nutrition, etc - like many PA programs. If we aren't given that in NP programs it needs to be required prior to matriculation. And there should be a 10 year expiration.
    -GPA should be a 3.25 minimum.
    -The GRE should be required for all programs.
    -A minimum of 1 year of RN work experience should be required for all programs like CRNA schools.
    -NP programs should have a gross anatomy, pathophysiology, physiology, pharmacology, physical assessment and multiple integrative medicine courses.
    -No part-time option should be available during the clinical portion and a minimum of 2000 hours should be required.
    -Vetted clinical rotation sites and preceptors should be provided - this would obviously limit the online option. Students could be given the opportunity to find their own and if they are deemed subpar then they will be placed with one per the discretion of the program.

    I am just thankful for my first degree prior to my BSN because I took all the "hard-core" science classes. It does make a difference. I am in an ACNP program and I am going out of my way to read constantly. I took a gross anatomy course through the local medical school. I have read and am currently reading many medical texts required by the local medical school. Are NP schools lacking considerably? Yes. But I am also tired of people acting like they have no choice but to suffer through the terrible education as if there's nothing they can do to supplement it. Either go to PA or Med school, or put in the extra time. Even most medical students will tell you the majority of their learning was done outside of the classroom. They read and study like crazy for their board exams. On their own time.

    NP education has to change but it needs to come from the bottom up. Students need to put in the extra time/effort and then advocate for that as a requirement once they've graduated.
  13. by   aprnKate
    when you go to graduate school it is EXPECTED that you will be a motivated and independent self learner, no grad school will ever prepare you for the real world. Doesn't matter whether you go to a small town NP school or Johns Hopkins (I had a NP colleague who went to Johns Hopkins and he still stated that he felt like the program did not prepare him).


    If you want to be good at pathophysiology and pharmacology and read about it, in fact, read more about that subject more than what your instructors have assigned you to read for your discussion board or assignment because guess what? When you graduate NP school and start working as a NP, that's exactly what you will be doing... reading journal articles to try and educate yourself on the best practices out there. Your learning doesn't ever stop there, it continues. if you stop.. then you may find that your practices might be outdated.

    Fellowships help but are not necessary. Finding a good mentor and a supportive working environment and continuing to educate yourself is a MUST when your a new grad.
  14. by   Dodongo
    Read/study these texts and you will be golden:

    Netter's Atlas of Human Anatomy
    Guyton and Hall Textbook of Medical Physiology
    Robbin and Cotran Pathologic Basis of Disease
    Andreoli and Carpenter's Cecil Essentials of Medicine

    And the pharmacology text of your choosing. I read Lippincott's Pharmacology. I guarantee if you read these you will be light years ahead of any NP or PA student and more on track with a medical student. Were these assigned to me during NP school? Nope. Did I read them anyways? Every word - well, half way through Cecils.

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