NP education - a rant - page 13

I came to the site today and saw lot's of posts of wonderfully excited people interested in becoming NP's. The vast majority of the tones of education were: "I have the opportunity to become and NP... Read More

  1. by   Gennaver
    Quote from Cyndee, MSN, NP
    I agree 100%. I'm just blown away by the fact that someone can become a NP with absolutely NO nursing experience. The school I went to has a "direct entry" program. More than half of the students in the NP specialties had never worked as a nurse! You won't believe this, but they actually started the NP program BEFORE TAKING THE NCLEX! I remember they were in such a rush to take the NCLEX, so they could begin their clinical rotations in the NP program! HOW INCREDIBLY INCREDIBLE IS THAT?

    snipped to shorten
    Hello,
    I would like to know just which schools are offering clinical NP courses to non-NCLEX-RNs. I doubt its likely.

    Oh sure, a pre NCLEX-RN can take a graduate level nursing class but, doubtful that they can take a clinical course. I am taking the generalist courses towards my masters but NOT any NP courses.

    Do you know which schools are doing that? How are they able to? Is it just a misperception? Also, which school are allowing students to take NP without having any Clinical NURSING?

    None I suspect.
    Gen
  2. by   Gompers
    Quote from Gennaver
    Hello,
    I would like to know just which schools are offering clinical NP courses to non-NCLEX-RNs. I doubt its likely.

    Oh sure, a pre NCLEX-RN can take a graduate level nursing class but, doubtful that they can take a clinical course. I am taking the generalist courses towards my masters but NOT any NP courses.

    Do you know which schools are doing that? How are they able to? Is it just a misperception? Also, which school are allowing students to take NP without having any Clinical NURSING?

    None I suspect.
    Gen
    I do believe she mentioned that the students had to take their N-CLEX before they would be allowed to start clinical courses.

    From other posts I've read, it seems that there are quite a few programs allowing nurses to take the NP programs without any actual nursing experience.
  3. by   Cyndee, MSN, NP
    Quote from Gennaver
    Hello,
    I would like to know just which schools are offering clinical NP courses to non-NCLEX-RNs. I doubt its likely.

    Oh sure, a pre NCLEX-RN can take a graduate level nursing class but, doubtful that they can take a clinical course. I am taking the generalist courses towards my masters but NOT any NP courses.

    Do you know which schools are doing that? How are they able to? Is it just a misperception? Also, which school are allowing students to take NP without having any Clinical NURSING?

    None I suspect.
    Gen
    Vanderbilt School of Nursing. The pre-RN/NP's were not allowed to begin NP clinicals until after they passed their NCLEX. It was hilarious to hear them discussing the NCLEX during class, when we were in a NP program! I know there are other nursing programs out there that accept non-nurses into their NP programs...Columbia Univ may be another one. I know it's hard to believe, but you can check out Vanderbilt's School of Nursing website for proof!
  4. by   BAtoCNM
    That last post seems contradictory. Are pre-NCLEX students allowed to take graduate clinicals or aren't they?
  5. by   BAtoCNM
    Also, I think that there are misconceptions here. You can't be an NP w/o being an RN first; I know this because I'm in the process of applying right now. Straight from Vanderbilt's website:


    Pre-Specialty Entry for Non-Nurses

    Students who have completed at least 78 semester hours of transferable college credit or have earned a bachelor’s degree "bridge" into the Masters of Science in Nursing (MSN) program via a three semester sequence of accelerated generalist nursing courses. The three semester pre-specialty year prepares students for the NCLEX exam to become a Registered Nurse (RN) and provides the foundation equivalent to the bachelor's degree in nursing for course work in the selected nursing specialty. Upon completion of three semesters of pre-specialty courses, students enter an additional three semester sequence of courses in their declared specialty in order to earn the MSN degree.

    So in addition to your undergrad and pre-requisite work, you have at least 3 years of nursing education (clinical and classroom) before you are "let loose" as an NP.

    As a non-nurse, I have to say I'm very confused. Why aren't we allowed to change our minds and go into nursing after all? I've met people with BAs in sociology or Chinese who then complete the pre-med coursework (about 1 year) and get through medical school just fine. Should they be required to be nurses first? Do CNAs out there think that that RNs must have several years of CNA experience first before being accepted into RN programs? I welcome anyone to help me understand these distinctions.

    I'm wondering if our medical education system, though flawed, is based around the idea that experience is the best teacher. Thus, they fill students - whether nursing or medical - with lots of knowledge and then throw them into the mix, to be mentored by more experienced clinicians and learn from their new jobs. I heard somewhere that in med school and residency, "medical education is a series of calculated mistakes." Or something along those lines. That scares me as a patient and a future practitioner, but if that's the way it's done, why penalize _only_ the direct-entry NPs for this fact?
    Last edit by BAtoCNM on Aug 25, '06
  6. by   Gennaver
    Quote from Gompers
    I do believe she mentioned that the students had to take their N-CLEX before they would be allowed to start clinical courses.

    From other posts I've read, it seems that there are quite a few programs allowing nurses to take the NP programs without any actual nursing experience.
    Hello,

    Ah, I guess if they are taking the non-clinical courses pre-licensure that makes sense but, not clinical ones. That just sounds like a malpractice nightmare too, at the very least.

    Thank you for pointing it out, I missed that. It sometimes seems that many people, (including myself as an applicant before I started my program) really simlify how these programs work. I myself said that "I am going to be an NP in three years" based on a superficial look at another school's misleading looking application.

    Reality is, no one can go from zero to NP is three years at all. At best, maybe acedemic year wise it would like like it but, not in reality time.

    Gen
  7. by   LilPeanut
    I'm coming back to this thread, nearly a year later. I have now gone through four quarters of nursing classes and clinicals and wanted to share my experiences.

    I've listened to the BSN students as we've all studied in the common rooms before tests. The biggest difference I see is that we as GE students are expected to retain and understand the same information, with less time in the classroom. By the time I sit for my RN, I will have had MORE clinical experience than the BSN students. They just design the GE program that way. When undergrads get weeks and weeks of lecture on nursing dx's, and how to write care plans, we got one 6 hour seminar, and from there on out, were expected to be able to do them and do them well. If we don't understand or struggle, we have to take our own time to learn it and grasp it.

    I just finished my high-acuity quarter, in which I was in the NICU. This fall we have psych and community both, then our leadership courses and we'll be ready to sit.

    I've done exceptionally well in both theory and clinical and so have the vast majority of my cohort. We are all hardworking and obsessive about getting it right. We've all come to nursing from different backgrounds and for different reasons, but we are all driven to be nurses and NPs.

    And ftr, it is a national requirement that you work for a minimum of 2 years in a lvl III NICU before clinical work, which works out to being about 4000 clinical hours as a nurse, then you switch to part time, work and do your NP clinicals.

    Evidence based practice has shown that these programs are successfully producing competant nurses and NPs, it's just an unwillingness to change and gross and/or willful misconceptions that cause so much fo the problem.
  8. by   Josh L.Ac.
    Quote from BAtoCNM
    As a non-nurse, I have to say I'm very confused. Why aren't we allowed to change our minds and go into nursing after all? I've met people with BAs in sociology or Chinese who then complete the pre-med coursework (about 1 year) and get through medical school just fine. Should they be required to be nurses first? Do CNAs out there think that that RNs must have several years of CNA experience first before being accepted into RN programs? I welcome anyone to help me understand these distinctions.

    We actually covered a topic in the developmental psych class (that I was forced to take as a pre-req [actually was a great class] for my accelerated BSN) that can partially explain the discord on this subject:

    Some people are "smarter" than others.



    I know we have been trained to avoid this topic because "smarter" is a subjective term that does not take into account learning style, socio-economic background, or if our momma's loved us enough. But, despite our PC programming, it does explain quite a bit.

    Some people struggle through their associate's degree while others, like one of my ex's little sister, finish their AD as they graduate high school. Some people struggle through their bachelor's while others complete it in three years. Some people can barely finish their nursing degree while others walk through medical school without missing a beat.

    Now if one is going to argue that accelerated or direct-entry programs are flawed because they lack clinical time, then that is a subject that can be debated. But saying someone should have to take a slower route just because you struggled on the path is just plain silly.
  9. by   romie
    I am continuously disheartened by the inflammatory words of naysayers regarding direct entry MSN programs. I have commented in other threads about this very topic, which usually runs along the line of "dont those people realize they have to earn their dues or else they are going to fall on their faces? Who do they think they are? How dare they bypass us!" I think most of people with this attitude not only are severely mis-informed about direct entry program curriculum and the extensive educational and professional backgrounds of most direct entry MSN students, but they are also revealing their own jaded and limited perspective of their life choices and direction.

    Most of the students, current and prospective, of direct entry programs I have spoken too already have master's degrees and are extremely successful in their current fields of employment. They are not retail industry workers or baristas with degrees in basket weaving who woke up one day and decided they want to be nurse practitioners. Sure, there may be these people out there thinking about direct entry programs, but I can tell you from experience that they cannot compete with the current application pool trying to get into these programs. I personally have had over 10 years of healthcare experience across a spectrum of populations and settings and it is this rich perspective that direct entry programs appreciate. The rigorous application process of direct entry programs weeds people out pretty well. In short, most direct entry MSN students are academically gifted, already well developed critical thinkers, expert communicators and have broad and rich life, educational and professional experience.

    Another misconception is that the direct entry programs have limited clinical hours. My programs pre-NCLEX portion has 21-24 hours per week of pure clinical hours over four semesters, before as single NP course is ever taken. This translates to 3 eight hour days of clinical each week. I compared this to ADN programs in my area, where the clinical experience was only 1 six to eight hour day in clinical per week over four semesters. So my direct entry program has around 3 times as much clinical time as an ADN program and this all before a single graduate class is iniated. Before MSN course begins, the student has to pass the NCLEX, so they are licensed as nurses during their MSN clinicals. As far as fears of "not having experience as an RN" is concerned, my program fully anticipates that most direct entry students will work part or full time while completing the MSN course work on a part time basis.

    As far as this fairy tale idea that people are "becoming NPs in less than 3 years", I retort. First of all, direct entry students have already spent 4-7 years completing their bachelors and masters degrees in their other fields. Then they are spent anywhere to a semester to two years completing pre-reqs before even applying. When all is said and done, I personally would have spent 11-12 years of my life as a full time student of higher education. I guess for the naysayers, this isn't enough education for an NP.

    I agree with Josh LAc that just because you stuggled and had to take it slow doesn't mean everyone else has to.
  10. by   traumaRUs
    I think the point about direct-entry MSN's is the lack of nursing experience in some programs. Believe me, I'm all for more nurses and more NPs.

    That said - when you identify yourself as an NP or any APN - there is an expectation that you have experience in the area that you are working in. I am finding that out myself now. I recently accepted a position as a dialysis advanced practice nurse. Until 8 weeks ago - I had never even seen dialysis actually done. Let alone know the pathophys, lab values, dietary concerns, etc of these patients. However, what I fall back on is my assessment and prioritization skills that I have honed via 14 years of staff nursing in high acuity units. That is not something you can teach in school.

    I am not against entry level MSN RNs - not in the least. However, I do think it bodes well that any RN get experience prior to getting an NP. Now whether that is done while in the MSN program or not is up to the student. Good luck.
  11. by   Cyndee, MSN, NP
    Quote from BAtoCNM
    That last post seems contradictory. Are pre-NCLEX students allowed to take graduate clinicals or aren't they?
    Pre-NCLEX students can NOT take NP clinicals, but they can certainly take classes that don't have a clinical component. There are several classes that do NOT have a clinical component (advanced patho, advanced pharm, theory, research, etc) and they are front-loaded in these programs and this allows additional time for the non-nurses to study for the NCLEX. They had to have passed their NCLEX before the 2nd semester began, because that's when clinicals began.

    I know it's incredible that these programs are allowed to exist. It is an extremely controversial subject and I fully expect for these programs to get shut down. The ANCC is already requiring that pre-NNP's work as a neonatal nurse for AT LEAST TWO FULL YEARS before they can even apply to a NNP program. That new rule just went into effect in January 2005. I know neonatal nurses who are absolutely blown away by the fact that non-nurses were EVER allowed to become NNP's!
  12. by   Cyndee, MSN, NP
    Quote from BAtoCNM
    Also, I think that there are misconceptions here. You can't be an NP w/o being an RN first; I know this because I'm in the process of applying right now. Straight from Vanderbilt's website:


    Pre-Specialty Entry for Non-Nurses

    Students who have completed at least 78 semester hours of transferable college credit or have earned a bachelor's degree "bridge" into the Masters of Science in Nursing (MSN) program via a three semester sequence of accelerated generalist nursing courses. The three semester pre-specialty year prepares students for the NCLEX exam to become a Registered Nurse (RN) and provides the foundation equivalent to the bachelor's degree in nursing for course work in the selected nursing specialty. Upon completion of three semesters of pre-specialty courses, students enter an additional three semester sequence of courses in their declared specialty in order to earn the MSN degree.

    So in addition to your undergrad and pre-requisite work, you have at least 3 years of nursing education (clinical and classroom) before you are "let loose" as an NP.

    As a non-nurse, I have to say I'm very confused. Why aren't we allowed to change our minds and go into nursing after all? I've met people with BAs in sociology or Chinese who then complete the pre-med coursework (about 1 year) and get through medical school just fine. Should they be required to be nurses first? Do CNAs out there think that that RNs must have several years of CNA experience first before being accepted into RN programs? I welcome anyone to help me understand these distinctions.

    I'm wondering if our medical education system, though flawed, is based around the idea that experience is the best teacher. Thus, they fill students - whether nursing or medical - with lots of knowledge and then throw them into the mix, to be mentored by more experienced clinicians and learn from their new jobs. I heard somewhere that in med school and residency, "medical education is a series of calculated mistakes." Or something along those lines. That scares me as a patient and a future practitioner, but if that's the way it's done, why penalize _only_ the direct-entry NPs for this fact?
    So, you're at Vandy? Well, you are in for a big surprise when you start NP clinicals. Every single "DE" student I knew had a tough time during clinicals, specifically because they were lacking nursing experience. Obviously you already know this, but you will have to complete all your NP clinicals in Nashville or the surrounding area. Unfortunately for DE students, all the nurses at those clinical sites are very well aware that the vast majority of Vandy students never practiced as nurses. One of the students I knew hated going to clinicals every day because a LVN would constantly tell her that she had no business becoming a NP without any nursing experience. I can tell you this, going through clinicals and having to be "on top of the game" is tough enough without having to deal with those attitudes day in and day out. And if you think that's bad, then try doing clinicals with a NP who went the traditional route!
  13. by   Jess RN
    Quote from Cyndee, MSN, NP
    Unfortunately for DE students, all the nurses at those clinical sites are very well aware that the vast majority of Vandy students never practiced as nurses. One of the students I knew hated going to clinicals every day because a LVN would constantly tell her that she had no business becoming a NP without any nursing experience. I can tell you this, going through clinicals and having to be "on top of the game" is tough enough without having to deal with those attitudes day in and day out. And if you think that's bad, then try doing clinicals with a NP who went the traditional route!
    See, this is the attitude that just baffles me. Why not reserve judgement and give students what they are in clinicals for- a learning experience, not a whole lot of attitude on top of that. The bottom line is that graduates of DE programs will be "new nurses" just like new BSNs & ADNs. Everyone has a learning curve and isn't going to be running the show from day one. New DE MSNs will have managers supervising them just like other new grads, who will evaluate the competence and safety of their practice. And if the evidence shows that their patient outcomes are good- then really, what is all the fuss about? My word- we should want more nurses, not fewer!

    When I was applying to programs, I asked if there was any way I could join an in progress undergrad BSN cohort- and there was no such option at any of the schools near me. The only option that would get me into school without having to re-take a lot of useless (non-nursing, non-science) classes was the DE programs. The ADN programs had very long waiting lists and were a joke in terms of pre-reqs (college writing...um, I was an English major, but I guess that doesn't count. college math...does statistics or either of the two math classes I took in undergrad count, no? ok.) I'm far from apologizing for the speed of my program or clinical hours or my lack of nursing knowledge, at the end of my program I'll be a new nurse- just like every other new nurse.

    Just wondering, what do nurses who are anti-DE programs think of PA programs- same length of program (or shorter), usually more clinicals, same scope of practice once they graduate? Do new PAs need to be put in their place as well?:spin:


    -Jess
    Last edit by Jess RN on Aug 26, '06

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