Can anyone offer insight to a distressed RN?

Nursing Students NP Students

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Hey all!

I'm new to the forum and come with a heavy questions for those who can offer advice about shifting gears with my career. Here's a little bit about me:

I'm 29 years old, male with a BSN and I presently work in a busy metropolitan ED. I have about 3 years of experience as an RN with 1 total in SICU and 2 in emergency department nursing. I worked for nearly a decade as a paramedic in a very busy ED. I became a medic early out of high school and had intentions of attempting to get into medical school, but I did not have the financial means to go to school without working full time and my grades suffered. Not to mention I struggled with crippling ADD which is fortunately well controlled now.

I'm writing a post because I have become very disenchanted with my current way of life. I am the type of person that wants to enjoy my work and look forward to my job with pride and a desire to constantly hone and improve my skill. I'm tired of the whole job of bedside nursing because of the nearly complete lack of analytical challenge. My job, no matter the discipline, seems to be centered around redundant and simple tasks as well as time management. I don't feel challenged or stimulated to give a damn about my profession let alone be proud of the things I have accomplished. I live for the 5% of people who actually are having an MI, who actually are the victim of traumatic circumstance, who actually have a reason to be in the ED besides abusing the system for a hot and a cot. Now that I'm done ********, I'll get to the point.

I want to know what kind of satisfaction DNPs or NPs get from their work. I want something to actually challenge my mind for a change. Some line of work where I can THINK about a patient's presentation and try to help prevent, treat and manage disease. I want to know if DNPs or NPs think the work is worth it (School)? Do you feel satisfied every day? Do you truly wake up every morning and loath what you're walking in to, or does the thought of work spur some excitement within you?

My primary concerns regarding the DNP/NP route is the training. Where and when do you learn about medicine, advanced assessment, long term disease management, health promotion, more advanced human anatomy and pathophysiology? All the NP students I have discussed this with describe the same exact, "fluffery" I had to put up with in nursing school, but on some "higher level" involving research. I want to do something in advanced practice nursing, but I'm very concerned about the curriculum.

What about independence in practice? Do you feel that your training prepared you to manage the more complicated patients? I don't want this to seem like I doubt an NPs capabilities, because I know plenty of NPs who were so smart they seemed intimidating to be around. I just question the curriculum that is used to train people who are being trained to function like physicians. Was the cost of your education worth it? Becoming a PA in my area seems like the wisest thing to do, but at the costs here in Minnesota I would be driven so far into debt I would spend the better part of my life paying just the interest off.

As always to forum posts, thanks for your time and consideration. I know the answers will be biased as those perusing a nursing forum to answer a stranger's questions have a passion for nursing to begin with. Nevertheless, I'm desperate for unadulterated input and concrete answers to my questions. Not the typical,"Do what your heart tells you to do. Money doesn't matter if you love what you do." type garbage most spew out at the first opportunity.

There is no defensiveness there; it is a statement pointing out the ignorance of some posters giving advice to another member about something hey know absolutely nothing about.

I bet it really ruffles your feathers when you take orders from NPs, as they aren't oh so much different from you huh?

We are still nurses. Nurses trained to function at a higher level than you are. Something perhaps you should respect.

What ruffles my feathers? The fact I make more than most NPs in my area? Is it knowing 95% of NP programs would accept me as long as I have that check? Or is it because those orders I see written constantly changed by pharm or the MDs? Perhaps it's moonlighting NPs working as floor nurses asking me the most obvious questions? (Hey at least they ask)? No good sir my feathers aren't ruffled in the least. I am merely a simple bystander watching these daily threads about getting the quickest, cheapest and easiest NP programs and waiting for the situation of saturation and poor quality to come to a head.

Respect is earned not given. I did BSN fluff an nauseum so I am pretty sure I have the intellectual capacity to ID NP fluff.

Specializes in nursing education.

I don't understand why these threads always turn into arguments. OP comes looking for advice/help; other people turn it all about themselves. It's just kind of sad.

I don't understand why these threads always turn into arguments. OP comes looking for advice/help; other people turn it all about themselves. It's just kind of sad.

Told the OP PA might be a good fit nothing more nothing less. I guess the notion of someone being a PA over an NP is absurd here.

What ruffles my feathers? The fact I make more than most NPs in my area? Is it knowing 95% of NP programs would accept me as long as I have that check? Or is it because those orders I see written constantly changed by pharm or the MDs? Perhaps it's moonlighting NPs working as floor nurses asking me the most obvious questions? (Hey at least they ask)? No good sir my feathers aren't ruffled in the least. I am merely a simple bystander watching these daily threads about getting the quickest, cheapest and easiest NP programs and waiting for the situation of saturation and poor quality to come to a head.

Respect is earned not given. I did BSN fluff an nauseum so I am pretty sure I have the intellectual capacity to ID NP fluff.

Yep, thanks to the proliferation of cheap, for profit online programs with 99% acceptance rates, this is the image many people are beginning to form of NPs. As a future NP I will do my part by attending a top ranked program at a reputable research university, and I am sure I will end up every bit as prepared as the average PA graduate, but I am constantly worried what the future holds as long as places like Walden, Kaplan, and Phoenix continue to not only exist, but enjoy almost endless support from nurses on this forum.

I believe in this profession and I believe in the mission of Nurse practitioners. I know sometimes I come across like I am attacking NPs and the education system, but it's only because I care about the future. I want people to understand that every time another student goes to one of these diploma mill schools, or posts on here about the cheapest fastest program we take a step backwards. There are people out there dedicating their lives to furthering the profession and proving the skills of NPs to both lawmakers and the public, and supporting fluff courses over science and for profit schools undermines their efforts.

Specializes in Adult Internal Medicine.
I think it's ridiculous that some posters on this board seem to think they are the only ones capable of classifying what is fluff and what isn't. I'm sorry but when the course description says it's a course about learning how to do a literature search and the only required textbook is the APA guide, I'm pretty sure I can guess I'm not going to be learning anything clinical. Just as BSN programs have ridiculous fluff courses (which I have firsthand knowledge of), so do NP programs.[/quote']

Some perspective may make you look at that "fluff" differently, as will attending the actual class. Knowing how to read, interpret, and conduct research isn't "clinical" knowledge it most definitely impacts your clinical practice as an NP and it furthers the profession. PA programs and medical schools include research methods as part of their curriculums as well

Specializes in Adult Internal Medicine.
watching these daily threads about getting the quickest cheapest and easiest NP programs and waiting for the situation of saturation and poor quality to come to a head [/quote']

As much as we disagree about most things you are actually right about this. It's a major problem and I have posted about the "trifecta" many times before.

Specializes in Adult Internal Medicine.
Told the OP PA might be a good fit nothing more nothing less. I guess the notion of someone being a PA over an NP is absurd here.

There is absolutely no problem with PAs from my point of view, they are competent providers. I personally believe that there is a bonus to NP vs PA but that doesn't mean PAs are not capable providers.

As much as we disagree about most things you are actually right about this. It's a major problem and I have posted about the "trifecta" many times before.

I think all three of us can agree on this one.

Specializes in Emergency.
Dude PA school stat. If you want hard hitting science and a large breadth of medical immersion in a 2 year period without the commitment of med school, go for it. Paramedic background is a huge plus and that is where many PAs come from. I think you will be disenchanted with much of the NP curriculum.

Just came back from a PA info session I went to for fun and I was amazed and what they have to learn in 29 months. Almost 0 fluff and the faculty member was a former RN which made it all the better when answering my questions.

I've heard this alot, so just for fun I did a comparison of two programs offered at UNM. I picked UNM because it is the state university of my state, it offers both a PA program and a FNP program (they also have other NP programs, but I just compared the FNP program). This was not an extensive review, as each has their own model, however what I found:

PA program: 2 courses in the non-scientific/clinical category.

NP program: 4 courses in the non-scientific/clinical category.

All the rest of the courses in each program were comparable, scientific or clinical based courses. The courses names were slightly different, and there was likely some slight differences in the breakout of the courses, but they covered the same basic material. I.e. Adult health vs Adult & Geriatric Medicine II

Now, again, I'm not suggesting that the two programs are almost identical, in fact there are significant differences between them. I just don't think that the suggestion that NP school is all "fluff" classes and PA school is all "hard sciences" holds up.

References:

Physician Assistant Program :: Family and Community Medicine | The University of New Mexico

http://nursing.unm.edu/common/docs/prospective-students/fnp_cur%202014.pdf

I see neuroscience emergency medicine dermatology etc all in the PA curriculum and nothing like that in the NP curriculum. I also see the PA curriculum has about 3 times as many classes. I'm much more impressed by the PA curriculum you posted..

Specializes in Psychiatry, Mental Health.

An important difference between PA and NP in my eyes is that PAs cannot practice independently, while in several states NPs can and do.

Also, of course, there is the difference between the medical model (PA) and the nursing model (NP) of health care provision. As a PMHNP, I've never regretted not going the PA route.

Specializes in Adult Internal Medicine.
I see neuroscience emergency medicine dermatology etc all in the PA curriculum and nothing like that in the NP curriculum. I also see the PA curriculum has about 3 times as many classes. I'm much more impressed by the PA curriculum you posted..

The PA courses aren't full semester courses. This is just the block-style of the medical model compared to the integrated style of the nursing model.

A PA program has more total credits but it also geared to those with no formal medical or nursing education.

Neuroscience, emergency, and dermatology are all included in the NP education under the integrated approach.

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