NP education - a rant - page 6

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   DidiRN
    You really seem to be taking this as a personal attack on your ability to do this. If you really read carefully, you will find that most feel the education you would receive would be inadequate, not you or future nurse jess as students or nurses in the future. They are not insinuating that you or anyone else can never do this. Only the way your education would be given to you in the form of a rapid entry MSN-NP. I admire anyone with high ambitions, but please do not ignore folks who have been in this business for a long time who question this way of training. That is a very unwise thing to do. The OP may have come rather caustic to you and insulted you, but others completely agree with the bottom line message of it. That to me gives it tremendous validity.
    If you read more of the BB, you will find multiple examples of RN's/LPN's who used to be NA's who tell time and time again how they really never knew what being a nurse was like until they were graduated, received their license and actually practiced on their own. I guess I don't understand people who do not listen to others who have much more experience in the field.
    I'd like to know what kind of hands on work you did with the doctors and nurses that had something to do with their malpractice insurance. Can you explain exactly what you were doing? I'm curious.
    Still waiting on the explanation of "integration" in your previous post.



    Quote from Gennaver
    Hi Jess,
    You were right on target with some of the things I was trying to clarify. It did seem like the original ranter thought that all we needed to do to become a graduate entry np was to hang up our McDonalds or Targe aprons and go to school for a year.

    Although, since reading through more comments on this thread I do realize that some posters here not only think that NPs who become one without years of exclusive bedside RN work are incapable I also see how some of the posters in this thread also think that all new RN grads are poorly equiped and incapable too! Surprising, really, all new RNs? Could they merely have meant green,just like they were too one day?

    That pretty much clarifies this thread as not having any validity.

    It was indeed started as a rant and it continues to be one. In other words, it seems very dubious as to any validity. I am very grateful to the countless nurses and doctors that I have worked with over the years who did let me hands on work with them, (knowing that it was their malpractice insurance and that they must have really known me and my ability well, although, like I said, even if I was a Target employee with a Sociology degree....so?)

    Gennaver
  2. by   DidiRN
    Physicians have a tremendous amount of hands on training as well as classroom training that take many years that is much more intensive than for an RN. Four year of undergrad, four years of med school, and then the years in their chosen field (ie anesthesia).RN and NP training and education doesn't come even close to that. Don't look at just the number of years but on what exactly they are doing in those years. Compare hours spent in the hospital training to classroom work.
    I think gender has zero to do with this. Look at the huge amount of female pre-med, interns and residents, as well as physicians. It doesn't scare us in that we think we are "threatened", we are scared for the patients who unknowingly would be taken care of by someone without enough education and experience and would be harmed. That is what is scary.


    Quote from future nurse jess
    Again, do anesthesiology residents scare you? They have about as much schooling and clinical practice in med school that a Bachelors prepared nurse with a year of RN expereince plus a CRNA master's program would have, no?

    I don't want to get all gender bias here- but why is it so scary to some nurses that a bright, focused nurse can achieve her (presumably, her) goals without spending years and years in an RN role which in this case particularly does little to prepare her for the job she ultimately wants to be doing, as a nurse anesthetist? But it somehow is less scary that docs can do it in slightly longer timeframes and with a larger scope of practice. Is it because med students are mostly men?

    Sorry to be so provocative here.

    Jess
  3. by   ProfRN4
    Quote from medsurgnurse
    do np schools really accept students who are not already an rn. my school required, rn, bsn and one year experience. most of us are older experienced folks.
    sadly they do. it's about the $$$ i suppose.

    you know, i think another thing that offends some nurses here, is that some students have no intention of becoming a nurse, and are just going through the motions just to become an np. as a future educator, i think that would bother me, if i was teaching a student who didn't feel she (or he) needed to learn x,y,z because nps don't do that.

    and it also seems that these same people don't believe what the seasoned nurses (or nps) have to say. no one is taling anyone out of becoming an np. it's just advice. granted, no one asked for advice in this thread (it started as a rant). but there are other ones where advice is asked for, yet people challenge it. that's the thing about advice, you do what you want with it.

    we've all had different personal experiences, some of which we feel are worth sharing (as a learning exerience). you guys don't have to listen. i look at everything i read here (or hear from other nurses) as food for thought.

    Last edit by ProfRN4 on Feb 2, '05
  4. by   fergus51
    Quote from future nurse jess
    I should have been more specific- the 700 hours are only for the advanced practice componant. There are also clinicals above this that are part of your RN training. Still, I don't think it's enough.

    -Jess
    Ok, makes a little more sense, but I agree it stll wouldn't be enough for me. I'm glad you are obviously willing to put in more time so that you'll be confident enough to practice.
  5. by   fergus51
    Quote from future nurse jess
    Again, do anesthesiology residents scare you? They have about as much schooling and clinical practice in med school that a Bachelors prepared nurse with a year of RN expereince plus a CRNA master's program would have, no?
    I know this wasn't directed at me, but yes, residents scare me. Not anesthesia in particular, but I have worked with too many residents to not be scared of their ability to practice without close supervision. Have you worked with many? I prefer working in teaching hospitals and I love most of our residents, but I know they need a whole lotta support and supervision. It isn't because they aren't intelligent, it's just that experience does matter and by definition they don't have enough to practice independently yet. Every practitionner was at that stage at one point.
  6. by   jeepgirl
    I can see what some nurses are saying... that they want NP's to have years of experience as RN's before they start their NP. And that's fine.

    I think that there are some people who basically want to go straight through because they have other reasons. For me, for instance, I have a three year old. I want to have more babies, and honestly, I want to be done with school before my kids are out of school!

    So here was my plan. I got my ADN. Now, I am working full time while I get my BSN. When thats done, I haven't decided if I will go straight into MSN or if I will wait a year, take a break, and then go in. Either way, it makes little difference. Either way, when I graduate I will only have 3-4 years of nursing experience. I plan on going part time to school while working FT. I say that that is an acceptable amount of experience in most instances.

    I do wonder, however, how a PA can go in and not have previous experience and be a mid-level also without question. And NP... we just have a fit if someone has little experience beforehand. Not all PA programs offer more clinical hours than NP.

    I can see why some people want to do direct entry or progress through the programs fairly quickly. Because they want finish that chapter of their lives and get one with more important things. I can't blame them for that. I would just try to encourage them. Like I said, I can see all sides of the issue. But I don't think that these people need to be discouraged, you know? Those that progress right through are usually very smart, enthusiastic, and motivated people.

    Someone mentioned something that made me think of something. I worked as an NA while I worked while going to school. I graduated when I was 20 years old. I'm sorry, but doing NA work was completely and totally different than being the RN. And you know, it makes me furious when I get an NA (not going to school, either) that says "Oh, I've been doing this for 5 years, so I am basically an RN." I've put more than one of THOSE in their place for saying that crap. I usually bring up the fact that I was a teen volunteer for three years (I did NA work on the floor, not candy striping!) then I worked for 2 years as an paid NA and now I'm a nurse.

    And you know what... I didn't know squat. And even if you know some of the interventions... what is more important is knowing the rational behind those interventions and pulling it all in together to manage the care and specialize it for that specific patient. Any NA that thinks she is basically a nurse is dangerous.

    Now, the previous poster did NOT say that at all (so I'm not bashing you!), but it just made me think of it.

    And, when I go for that NP, I'm not going to tell myself that I've had all that experience as an NA so I will be ok. I expect that I will probably be the youngest and least experienced nurse in the pack. So, that means I'm going to have give a 110% to everything I do. I just hope that those I am with in school and while training encourage me rather than shoot me down!
  7. by   fergus51
    I've never worked with PAs, but I was under the impression that they were supervised by a doc (as opposed to NPs). Aren't they?
  8. by   jeepgirl
    yes, they do have to practice under a doc. i guess NP's can be independant, but they mostly work with a doc also.
  9. by   ProfRN4
    Quote from fergus51
    I know this wasn't directed at me, but yes, residents scare me... I love most of our residents, but I know they need a whole lotta support and supervision. It isn't because they aren't intelligent, it's just that experience does matter and by definition they don't have enough to practice independently yet. Every practitionner was at that stage at one point.
    I feel the same way
  10. by   bruinlaura
    After reading many of these posts I have noticed that many people think that the direct-entry programs provide different NP education than traditional programs. The classroom and clinicals are the exact same. The difference is merely not having the extra years of RN experience (since most people in NP programs work at least part time as an RN). All of the programs I have looked into (and they are too numerous to count) only accelerate the RN portion of the program (which also means the same curricula just faster). The NP portion is 2-3 years depending on the field they chose to focus on. I just thought I would clarify that since many people have stated that direct-entry NPs have inadequate education when in fact they have the same classroom and clinical as the traditional NPs. IMO the debate should stick to the RN experience factor.
    Last edit by bruinlaura on Feb 5, '05 : Reason: emphasize points
  11. by   Gennaver
    Quote from sherrimrn
    You really seem to be taking this as a personal attack on your ability to do this. If you really read carefully, you will find that most feel the education you would receive would be inadequate, not you or future nurse jess as students or nurses in the future. They are not insinuating that you or anyone else can never do this. Only the way your education would be given to you in the form of a rapid entry MSN-NP. ...
    Still waiting on the explanation of "integration" in your previous post.
    Hello Sherrimrn,
    You are very right, I did take the initial comments from the OP direct as they were aimed at a poster who was all enthused about completing her Sociology degree and entering a Direct entry program, (that would be me the OP was referring to).

    As you point out now though that all those other posters were not indeed talking about personal incapabilities but rather failings of our universities to train us credibly...that seems like a stretch to me. After reading the post which said "crammed through the system,get their money, NPs" I wonder how true a concept people's understanding of MSN-NP direct entry programs are? They are not a quick and easy degree, they are not overnight, they take time and training.

    To address your question about how nurses and doctors put their malpractice insurance on the line....well, don't you do that everytime you let the tech or assistant do anything that is supposed to be your job? Although the things I was talking about were not exactly always in the scope of an assistant many of the things that affects a nurse's malpractice insurance are indeed things that are delegated to the assistants hands. Make sense? Hope so, otherwise I can't communicate worth a poops.

    As for the term integration, that wasn't clear, trying to say how we are all going to be care-givers. How can we be effective if we are busy acting divisive and not working together. Yet, if you are afraid or trusting the 'education' of a graduate entry NP then so be it, live and learn.

    Gennaver
    p.s. I read the OP correctly and the many of the others who chimed in "hear hear!" were clearly against these NPs not necessarily the program
    Last edit by Gennaver on Feb 3, '05 : Reason: because of typos
  12. by   Gennaver
    Quote from jeepgirl
    Someone mentioned something that made me think of something. I worked as an NA while I worked while going to school. I graduated when I was 20 years old. I'm sorry, but doing NA work was completely and totally different than being the RN. And you know, it makes me furious when I get an NA (not going to school, either) that says "Oh, I've been doing this for 5 years, so I am basically an RN." I've put more than one of THOSE in their place for saying that crap. I usually bring up the fact that I was a teen volunteer for three years (I did NA work on the floor, not candy striping!) then I worked for 2 years as an paid NA and now I'm a nurse.
    Hello Jeepgirl,
    No harm taken, just clarifying since I am the person who revealed that I worked as an NA. I was responding to the OP who claimed direct entry program applicants were basically target salespeople who decided to try to go to school for a year or so and suddenly become an NP.

    For what it is worth though, I listed my history of healthcare work and that was for 15 years, in four hospitals, also as an Ambulance tech, also as a lab/tech-phlebotomist and also as a medical assistant.

    I was not saying that I had anything at all over RNs.....not at all.....I was merely trying to explain that applicants to direct entry programs had more going on than just hanging up their clerk apron. We have to be qualified enough to become accepted to our programs, we have to have a BA degree, we have to have high enough GRE scores, we have to have enough experience and a realistic idea of what we are trying to do, we have to have clear goals and expectations, we have to be able to withstand the rigorous training because, all in all,that training is going to be a minimum of four years.

    Gennaver
    p.s. good luck with your route too! My intent was to debunk the original posters innacurate assumptions about direct entry applicants
  13. by   mattsmom81
    Quote from medsurgnurse
    I am also deeply disturbed by the numbers of first semester nursing students who state that they will be a CRNA in 5 years. They say 'I graduate, get my one year of experience and start CRNA school." It absolutely scares me.
    Me too, Medsurgenurse. I get these types all the time as students AND new grads in my ICU and they pizz me off as well as scare me. Seemingly little appreciation either for the profession or specialties of nursing, IMHO, its just one huge 'brain suck' expedition to get where they want to be: I sense they hope to fast track to 'looking down' on all the lowly bedside nurses they leapfrogged over, without ever acquiring their skills and knowledge base. I don't understand why this is being allowed to happen. But then I also don't understand the fast track RN degree programs, taking anyone with any degree and making them a BSN to MSN in 18 months (example) either....

    Part of this problem as I see it is the academic elitism that disdains practical experience and experiential learning, choosing baccalaureate/classroom settings. JMHO.

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