Now I get why experience means everything yet nothing - page 5

Now I finally get why nursing experience can prove invaluable in NP school, yet actually means nothing. It appears that nursing experience gives a valuable base from which to relate but does... Read More

  1. Visit  Guttercat profile page
    1
    Quote from mindlor
    It will come down to personal preference for you. Do you prefer the nursing model or the medical model.

    To further complicate things, I am hearing rumblings that NANDA and nursing diagnoses may be going away relatively soon as studies have shown that this terminology confuses patients and causes issues with the delivery of care. The suggestion was that everyone get on the same page in regard to terminology.....we shall see.

    I haven't seen "nursing diagnoses" used in years at my workplace. Worthless and idiotic they are..."Potential for Infection..." Duh.

    However, they have not been done away with. No, they've merely been disassembled and then clumsily integrated throughout the unending and exponentially growing burden of hoop-jumping and check-boxes in any given E-chart .
    Rizz likes this.
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  3. Visit  Guttercat profile page
    0
    Quote from mindlor
    As for PA's

    They are assistants in every sense of the word.

    In fact, a PA cannot practice independent of a Physician.

    In many instances NP's practice independently.......

    Actually...no.

    Depends on state law. Something I'm trying to mete out in terms of the future.

    Again, nursing has sheer numbers and lobbyists on its side.
  4. Visit  nursel56 profile page
    2
    Quote from Guttercat
    Yes.

    NP's are as busy overcoming the word "nurse" as PA's are busy overcoming the word "assistant."

    There's been a longtime, heated movement within the PA realm to change their title to "Physician Associate." MD's do not like it, as the term "Physician Associate" is too close to home, and thus it has been shot down.

    Nurse Practitioners have a similar battle in public consciousness...that of getting rid of the stigma of the word "nurse." In other words, "can I start your IV and fetch you some pillows while I perform a full-on, differential diagnosis? Oh and btw, you have a pheochromocytoma."
    As a voracious reader of medical blogs - it would seem that patients very often see a nurse practitioner who works in a specialty team also have the positive attributes associated with nursing. Working in areas like oncology or nicu they are seen as more accessible, willing to spend more time explaining things, and able to help navigate the bewildering labrynth to those who are newly diagnosed and just lost, but not have to say "let me check with the doctor and get back to you" either.

    There are a lot of factors to consider. As I said earlier, I saw a transition period where many nurses felt ready to grow and expand beyond the bedside or unit manager roles, basically create these jobs for themselves and figure out what to call it later. Their roots in traditional nursing were deep, though. Maybe I subconsciously related it to that. Again, sorry for any misunderstandings!
    myelin and Guttercat like this.
  5. Visit  myelin profile page
    1
    Hey Nursel56,

    I appreciate your comments. Usually, when people make disparaging remarks about NPs w/o RN experience I get all frustrated, but you've provided some interesting context for your comments. Still, as a DE NP-to-be, I've gotta say, these programs aren't going anywhere. And as others have already stated, some truly excellent nursing schools (Yale, Columbia, UCSF, Boston College, Penn, etc.) all have DE programs. It's true that the market can be tight, but that really depends on your specialty. I'm going into psych and everyone has told me I'll be able to write my own ticket. Haha, I guess I"ll see in 3 years...
    nursel56 likes this.
  6. Visit  Guttercat profile page
    1
    Quote from nursel56
    As a voracious reader of medical blogs - it would seem that patients very often see a nurse practitioner who works in a specialty team also have the positive attributes associated with nursing. Working in areas like oncology or nicu they are seen as more accessible, willing to spend more time explaining things, and able to help navigate the bewildering labrynth to those who are newly diagnosed and just lost, but not have to say "let me check with the doctor and get back to you" either.

    There are a lot of factors to consider. As I said earlier, I saw a transition period where many nurses felt ready to grow and expand beyond the bedside or unit manager roles, basically create these jobs for themselves and figure out what to call it later. Their roots in traditional nursing were deep, though. Maybe I subconsciously related it to that. Again, sorry for any misunderstandings!
    No misunderstandings on my part, and thank you for your insight and thoughtful posts.
    nursel56 likes this.
  7. Visit  nursel56 profile page
    1
    Thanks myelin - and I don't think DE programs should be abolished, lol. Best wishes to you.
    myelin likes this.
  8. Visit  nomadcrna profile page
    4
    We are NOT mid-level providers, Please expunge that word from your vocabulary.


    http://www.aanp.org/NR/rdonlyres/5AC.../0/AANPMLP.pdf
    Rizz, Tinabeanrn, myelin, and 1 other like this.
  9. Visit  nomadcrna profile page
    1
    Actually yes. There is NO state that allows PAs to practice independently. Many states allow NPs to practice independently.

    I'm not saying one is better than the other but that is just the way the laws are.

    Quote from Guttercat
    Actually...no.

    Depends on state law. Something I'm trying to mete out in terms of the future.

    Again, nursing has sheer numbers and lobbyists on its side.
    Guttercat likes this.
  10. Visit  Guttercat profile page
    0
    Quote from nomadcrna
    Actually yes. There is NO state that allows PAs to practice independently. Many states allow NPs to practice independently.

    I'm not saying one is better than the other but that is just the way the laws are.

    "Many states?"
    How many exactly? Correct me if I'm wrong but the last account I read put it at less than ten states, as "independent pratice" and "scope of practice" have very different implications.

    Btw, PA's can and do, own their own practices under the "supervision" (cough cough), of an MD...fuzzy lines drawn in the ever- shifting sands of legal interpretation.

    And I agree, one is not "better" than the other.
    Last edit by Guttercat on Mar 18, '12
  11. Visit  zenman profile page
    1
    Quote from mindlor
    Lots of ignorance flying around.......lots of jealousy.....

    Someone please tell me whhat slinging zpack at walgreens has to do with bedside nursing?

    Let me tell you. Diddly squat.

    I had a lengthy conversation with the dean of the FNP program at Columbia University. Her opinion is that every day working at the bedside is time and money lost......

    Just sayin
    Handing out meds at Walgreens means a lot more of you've followed patients daily at the bedside and observed their daily response. The dean's opinion means little as she probably never worked on the floor prior to becoming a NP. Now, if she wants to go head to head with a nurse who had 37 years of experience prior to becoming an NP, I'll be waiting.
    SHGR likes this.
  12. Visit  mindlor profile page
    0
    Quote from zenman
    Handing out meds at Walgreens means a lot more of you've followed patients daily at the bedside and observed their daily response. The dean's opinion means little as she probably never worked on the floor prior to becoming a NP. Now, if she wants to go head to head with a nurse who had 37 years of experience prior to becoming an NP, I'll be waiting.
    I very clearly posted the contact information for the school. Feel free to give her a call. She can hold her own, I assure you.....
  13. Visit  JeanettePNP profile page
    2
    Quote from mindlor
    I very clearly posted the contact information for the school. Feel free to give her a call. She can hold her own, I assure you.....
    What the job market tells you matters a lot more than what a school recruiter will tell you. Of course they want to boost their enrollment and student population as much as they can. More prestige and $$$ flows to them. But are they really serving their student body well by telling them they don't need nursing experience to become an NP, when 90% of NP job listings specify that they're looking for minimum 3-5 years of nursing experience?
    CCRNDiva and SHGR like this.
  14. Visit  bsnanat2 profile page
    3
    I actually think that many of the views here are not that far apart. First of all, I personally think that SOME bedside experience is important and necessary, but due to the difference in the RN vs NP roles, bedside experience is not CRITICAL. This is a new viewpoint for me. Remember, only a fool never changes. Some people, depending upon how they learn, their level of confidence, and how their undergrad nursing program taught, need more or less bedside experience…… depending upon the person. Yes, I think direct entry NP grads are at a disadvantage, but we’d better get used to the idea. One thing we all seem to keep forgetting is that years ago, many years of bedside nursing were required to reach the level of knowledge necessary to step into the NP role. Now, many things that could only be learned by experience are taught in undergrad BSN programs….the knowledge base has grown, so the timeline to reach “expert” status has shortened. This does not mean that newer NP’s are smarter than previous ones or that newer NP’s lack “respect” for the hard work of the past, but that newer NP’s simply have the benefit of this larger knowledge base. The other thing forgotten here is that time and experience mean nothing if the person involved makes no use of it. How many RN’S do you know who only do the minimum required by law to keep a license, thus making them near incompetent or just downright dangerous? On the other hand, there are CNA’s and LPN’s who constantly read, listen, question and research and have grown tremendously in their knowledge base but will never be able to be NP’s. Which do you think is better: A fresh BSN RN who spends one to three years asking questions, researching and absorbing knowledge OR twenty years of someone who just punches a clock, follows the orders on the chart and occasionally picks up a few gems here and there? I have my own ideas as to why nurses (and thus NP’s) in-fight and backbite more than PA’s or MD’s, but I’ll save that for another thread.
    Again, I think much angst comes from people making the wrong choices to further their careers. The other issue is that those of us here who “have put in the work” can’t get upset at those who benefit from that larger knowledge base and those of us who gain that benefit can not forget to be respectful and thankful of those whose work in trenches made our path shorter.
    jyager, Guttercat, and SHGR like this.


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