NP education - a rant - page 4

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   Purlple
    [QUOTE=suzanne4]It is not experience just as an RN, but experience of working in healthcare and seeing all of the options that are available. Look at the numbers of nursing students that want to become NNPs. You do not do any type of rotation in school in an NICU, it takes a year or two of training to just feel comfortable in that area, let alone making life and death decisions on these kids.

    Suzanne, did you say "The drop-out rates from nursing school now is probably about 50%, meaning only about 50% of the students that started with you will finish with you."? Where did you get these numbers? It doesn't sound right.
  2. by   kash
    Finally, someone who speaks the truth. I have been a nurse since 1996 and I am also about to turn 30yrs. I have thought about NP soo many times but felt that I did not have enough experience to be held with such a duty. When I came out the nurses were serious about nursing. I learned from the old heads and I did not look down at the LPN's because some of them were the ones who taught me alot of the tricks of the tread. I really appreciate that now that I have matured in nursing. Also, when I first came out, you could not get into ICU, CCU or ER without 1 or 2 years of MedSurg experience. Boy how things have changed. Thanks so much for reminding us of the value and the standards we much uphold as nurses. We have had to fight hard to be were we are today( esp as a historically women profession).

    Quote from CatskillNP
    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 through an advanced MSN program" or "I'm sales person at Target with a Bachelors in sociology, and with just one year of school I can become an RN then get my NP degree!!!"

    Sorry about this but....Being a nurse practitioner is more than just getting the degree. The job requires experience. Not a year of med surg, not a two year Master's, but some real NURSING experience. We are NURSE PRACTITIONERS, that's nurses with additional skill to allow the diagnosis and treatment of patient problems. It requires the inate skill that makes a nurse magnified to the 'nth degree. What makes good providers as NP's is the same characteristic that made them good nurses. It's experience.

    I'm not on a high horse, just an NP that has seen too many "rammed through the system, get their money" NP's. This job is serious. It's serious on several levels. First and formost, you are being entrusted with the care of people that put their complete fath in you to make good decisions and provide quality care.

    This IS different that being a nurse. How many times have you sat back as a nurse and berrated a provider about their choice of treatment plan or pushed for the provider to make a decision and get on with it. That all changes when you're the one with the RESPONSIBILITY for the decision. Yeah, it's an ear infection, yeah amox should do the job. Are you ready to commit fully to giving someones most honored item, their child, a drug that could kill them??? It's not cook book. It requires a base of knowledge, experience, reponsibility, and a committment to furthering your skills. It's a lifestyle!

    The second group you matter to is the professional community. As NP's, we let the schools go freaking haywire in putting out as much crud as they wanted. They saw dollar signs and began pumping out graduates without regard to job markets or the economy of NP's. Boom, a flood of NP's. Fully half of them are transfer's in from "associated science's". Read sociology, psychology, earth sciences...all able to take their bachelors in science, convert to an RN in one year, and complete their master's in two more. These people may ultimately make good NP's, but not in three years!!!! What makes anyone think that this is the way to put NP's on the map??? What kind of fodder is given to the medical community, especially, to denounce the practice of NP's as being amateurish, poorly skilled, etc. It really opens us up to all kinds of flaming by other medical groups.

    If you're an RN, thinking about becoming an NP, don't do it for the salary, chances are you're going to make more as an RN in the right setting. If NP is for you, go out and work, get a job, get several and work in areas like the ER(still, in my opinion, the best experience), community health care, critical care, etc. Then after a couple of years, think about going the MSN/NP route. You will be a better provider, it gives more credence to the profession, and ultimately the little kid with the OM will thank you for your skills.

    I know a rant, but it makes me nuts to think that being an NP is anything less than the greatest honor innursing you can become.
  3. by   oicu8bacilli
    [font='Times New Roman']I agree about experience issues to become an ARNP, but what about a PA who has no experience and 4 years of college? What makes him so ready to be a provider versus an ARNP with just a year or two of nursing experience? The PA doesn't have any nursing, medical, or anything experience, but walks into the same role.
  4. by   erezebet
    I am a nurse practitioner student and there are "gemini" students I go to school with who have a Bachelors in something or another who are getting their masters in nursing in just 2 years.....HOW CAN THAT BE????? I can't understand how this happens. An RN degree yeah, okay I can see that, but I can't see how they can get a masters and be good nurses......actually, they will never be made to deal with the bedside issues because they will be MSN's, and in 2 years they could never function competently as a nurse practitioner...could they?
  5. by   acutecarenp
    Quote from dtwaa
    I completely agree with the problem of churning out NP's without any experience but I don't think the solution is previous nursing experience. Being a nurse and being a NP are so different, I don't see the correlation. It is like saying that to be an accountant for a trucking firm, you should have trucking experience. The NP programs should, in my opinion, have some form of residency. Popping them out without experience doing what they have a license for is trouble. RN experience is certainly a benefit, but not the solution. Just my opinion.
    Well...
    you may not need to be a truck driver before you can work as an accountant, but you had better ride in the truck long enough to see how much fuel it uses!
  6. by   CatskillNP
    Quote from oicu8bacilli
    I agree about experience issues to become an ARNP, but what about a PA who has no experience and 4 years of college? What makes him so ready to be a provider versus an ARNP with just a year or two of nursing experience? The PA doesn't have any nursing, medical, or anything experience, but walks into the same role.
    They work "under he direct supervision of the MD" we work on collabotion, huge difference of responsibility and role. Also they go througha miniature medical model f a full time 40 hour plus week of education with much more clinical than NP's. that's why experience is important, there isn;t enough clinical in the NP programs. S
  7. by   ProfRN4
    [font=book antiqua]go catskill!! so glad you had the b@lls to say it. i was the queen of knowing what i wanted while i was in nursing school. ten years later, i finally figured it out. now i'm sure people will put me down and say "well i'm not as indecisive as you", but things change. i did not get the job of my dreams out of school. and due to other personal circumstances, my path to bsn took much longer than i anticipated. now i am back on track to my msn. i decided not to be so focused with dates and specific goals. i take it one day at a time (or one semester at a time). i don't regret the time it took me to get where i am, (i'm 31, so i'm not old). in my 10+ yrs of nursing, i've seen a lot. and i'm not finished exploring yet (i'm looking to change specialties as we speak).

    yes everyone is different. i never expected to be working where i am now. i beleive everything happens for a reason. everyone would tell me, 'you're young, what's your hurry?'. sure it's easier to go to school before you have kids (if that's your goal). but i value every experience i've had as a nurse, because it has helped me in my graduate study. and i don't think anyone is faulting anyone for wanting to go back to school. you just might not want to put all your eggs in one basket.

  8. by   Gennaver
    Hello there,

    I hope your rant helps you gain some perspective. I feel it was a good rant and cannot imagine anyone trying to become a nurse practitioner without some serious desire to work as an NP, (versus just for salary or because they are on a whim.)

    Hopefully also you will find out that it is not so easy to go from BA in anything towards the MSN, it takes years. It is another route...not an easy or quick route but, another route towards the MSN.

    I am most likely the enthused person you are talking about, (the one completing her BA in Sociology.)

    Lest you think I am on a whim let me share some more about myself, your potential cohort.)

    I am 38 and have been working in health care for over 15 years. I started out as an ambulance technician, then also became a nurses assistant and later a phlebotomist and medical assistant.

    I have worked in over four hospitals through the years, (hard worker and usually always had a part time job on the side, although, never worked at target.)

    As an adult I returned to school to pursue my RN degree but, found so much more that I also wanted to pursue. My associates is in Biology, my BA will be Sociology and my minor is Psychology, (have a minor in Spanish too.) All the while I have been completing the nursing pre-reqs at a gpa of 3.8. Meanwhile I continued to watch the waiting lists for local programs grow and yes, I am very happy to find this masters entry program.

    Meanwhile I was wracking up years of hands on hospital care experience. I am very secure in my choice to work as an Adult NP and to continue to certify as a nurse colposcopist. I worked in oncology and hospice for a year, in ortho and ortho day surgery for about a year, in med/surg and physical rehab for about three years and in a women's health care office setting for just under a year.

    The graduate entry program I am applying for is intense and competitive. We should be prepared to take the NCLEX-Rn after a rigorous 15 months courseload. Then we can begin the core courses while we work as nurses. After we have a year of clinical experience we can start our NP portion, approximately three to four years to become NPs.

    Do you still feel that all of us are flippant about our desires to become NPs? I hope not, and hope that you will find that those of us who gain acceptance and complete our degrees like this are indeed going to be able, caring, dedicated NPs.

    If your attitude stays so restricted, that is your perogative,
    Gennaver
    Last edit by Gennaver on Feb 1, '05 : Reason: to clarify better
  9. by   Gennaver
    Quote from CatskillNP
    Sorry about this but....

    I'm not on a high horse, just an NP that has seen too many "rammed through the system, get their money" NP's...

    Hi,
    I do want to note this, I hope you report these rammed through the system dangerous NPs. If someone is not capable, or is a risk wouldn't they loose their malpractice insurance? This is tragic.

    Then again, you were only ranting. Aren't NPs are answerable to governing bodies as are the universities that grant them their certificates.

    Personally I have always been leary of any online education but, that is where my 'chicken-littleness' comes out. Can't say that online ed would work for me, but, I will not say that anyone who has an online degree is not legitimate, as you seem to think Graduate Entry NP are not.


    You did qualify your post as a rant, and we all should be allowed to rant so, I hope you take my posts as what they are, a response to your unquantified, (not citations or stats) rant.
    Gennaver
    Last edit by Gennaver on Feb 1, '05 : Reason: typo
  10. by   Gennaver
    Quote from Annabelle57
    Okay, okay, I'll admit it: I was one of those stars-in-my-eyes tykes wanting to do a direct-entry NNP degree.

    I've changed my mind for a lot of the reasons already listed: though there may be prodigious NPs out there who did the direct-entry MSN route and did just fine, I didn't want to take the chance and possibly compromise a patient's right to quality healthcare because I wanted to take shortcuts,
    Hello Annabelle,

    I can see there are a lot of myths about graduate entry nurse programs.

    The course and program that I am choosing is not a shortcut by far. It will take me as long to work on my nursing graduate studies to become a nurse practitioner as it would for a medical student to become a doctor.

    I mentioned in a previous post that it is another route towards a graduate nursing degree, not a quick or easy one and definately not a short-cut.

    I am grateful for this thread and for everyone who had the courage to respond. I have heard and experienced 'status' style discussions before from LPNs to RNs to Diploma Nurses to BSN's and so on. This seems like a similar version of the same 'ol, same 'ol.

    Clearly, not everyone who applies to these graduate entry programs is going to be qualified or accepted or graduate, just as not everyone who applies to diploma, LPN, RN, or BSN programs is going to be qualified or accepted or will graduate.

    If nursing is truly about patient care and quality of nursing then this divisiveness against truly qualified nurses seems like nothing more than ego based self-inflation. If this is about patient care and advocacy then definately push to promote qualified standards and procedures for maintaining them, right?

    Thanks,
    Gennaver
  11. by   DidiRN
    Your "years of hands on hospital care experience" working as a nursing assitant and phlebotomist is not going to give you a big edge on being an RN,let alone an NP, sorry to say. I've worked with so many NA's who later became RN's who tell me time and time again how even though they worked side by side with RN's, they really had no idea of what they truly did until they became an RN themselves. There is a lot of critical thinking skills (which don't develop overnight; in fact for me it took a few years on the floor) and experience that comes into play here, and basic nursing assistant care of patients and phlebotomy skills do not even begin to give you the scope of what a bedside RN does.
    For the record I don't want to appear like I think these skills are nothing (ie nursing assistants/phlebotomists) and I can't begin to tell you how I appreciate so much a good NA. They are worth their weight in gold, pardon the cliche.You are reading some great insight from other experienced RN's here, I wouldn't completely discount these things that they are saying. I agree with the ones who say they cannot even imagine someone fresh out of school starting an NP program (or even with a year's experience)...IMHO it's dangerous.

    Sherri





    Quote from Gennaver
    Hello there,

    I hope your rant helps you gain some perspective. I feel it was a good rant and cannot imagine anyone trying to become a nurse practitioner without some serious desire to work as an NP, (versus just for salary or because they are on a whim.)

    Hopefully also you will find out that it is not so easy to go from BA in anything towards the MSN, it takes years. It is another route...not an easy or quick route but, another route towards the MSN.

    I am most likely the enthused person you are talking about, (the one completing her BA in Sociology.)

    Lest you think I am on a whim let me share some more about myself, your potential cohort.)

    I am 38 and have been working in health care for over 15 years. I started out as an ambulance technician, then also became a nurses assistant and later a phlebotomist and medical assistant.

    I have worked in over four hospitals through the years, (hard worker and usually always had a part time job on the side, although, never worked at target.)

    As an adult I returned to school to pursue my RN degree but, found so much more that I also wanted to pursue. My associates is in Biology, my BA will be Sociology and my minor is Psychology, (have a minor in Spanish too.) All the while I have been completing the nursing pre-reqs at a gpa of 3.8. Meanwhile I continued to watch the waiting lists for local programs grow and yes, I am very happy to find this masters entry program.

    Meanwhile I was wracking up years of hands on hospital care experience. I am very secure in my choice to work as an Adult NP and to continue to certify as a nurse colposcopist. I worked in oncology and hospice for a year, in ortho and ortho day surgery for about a year, in med/surg and physical rehab for about three years and in a women's health care office setting for just under a year.

    The graduate entry program I am applying for is intense and competitive. We should be prepared to take the NCLEX-Rn after a rigorous 15 months courseload. Then we can begin the core courses while we work as nurses. After we have a year of clinical experience we can start our NP portion, approximately three to four years to become NPs.

    Do you still feel that all of us are flippant about our desires to become NPs? I hope not, and hope that you will find that those of us who gain acceptance and complete our degrees like this are indeed going to be able, caring, dedicated NPs.

    If your attitude stays so restricted, that is your perogative,
    Gennaver
  12. by   Jess RN
    How is it ok for a med student to spend 4 years in school and at the end of the process become a doctor with a wide scope of practice- but graduates of 3 year direct entry NP programs (which, including prereqs are more like 4 years) are a shortchanging of the nursing profession? Someone said it before and I totally agree- what's missing is a residency after graduation.

    Am I missing something here?

    -Jess
  13. by   Gennaver
    Quote from sherrimrn
    Your "years of hands on hospital care experience" working as a nursing assitant and phlebotomist is not going to give you a big edge on being an RN,let alone an NP, sorry to say. I've worked with so many NA's who later became RN's who tell me time and time again how even though they worked side by side with RN's, they really had no idea of what they truly did until they became an RN themselves. There is a lot of critical thinking skills (which don't develop overnight; in fact for me it took a few years on the floor) and experience that comes into play here, and basic nursing assistant care of patients and phlebotomy skills do not even begin to give you the scope of what a bedside RN does.
    For the record I don't want to appear like I think these skills are nothing (ie nursing assistants/phlebotomists) and I can't begin to tell you how I appreciate so much a good NA. They are worth their weight in gold, pardon the cliche.You are reading some great insight from other experienced RN's here, I wouldn't completely discount these things that they are saying. I agree with the ones who say they cannot even imagine someone fresh out of school starting an NP program (or even with a year's experience)...IMHO it's dangerous.

    Sherri
    Hi,
    I think you may not have read the part where I noted how it would be a year before we are allowed to start the NP portion. Hopefully in our 2 to 3 years after that point we can glean these precious critical thinking skills. If only to prevent the danger you foresee.

    Now, how about integrating? Or is this just doomsday bawling?

    Gennaver

    p.s. even if I hadn't had my previous hands on experience, (working with great mentors, nurses and doctors alike,) you seem so willing to discount the ability of graduate entry program NPs? Why? is there some specific case you know of?

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