Are online ANP degrees destroying our credibility?

Nursing Students NP Students

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I was talking to a private practice doctor about an opening in his practice. Currently, I am employed by the hospital. He told me that they will only consider PA's due to having more of a hard science based training and longer residency. I have heard this before and brushed it off. Especially, considering that would only be of factor for new grads possibly. I brought this up and he gave me a second rejection with a whole new excuse. His practice as a whole were considering hiring NPs until a PA brought up you can get your degree online. He stated they can not take our education seriously with such low standards. UUUURRRGGGHH. I didn't really know what to say. Mostly due to not expecting that response. Either way he is not someone I would want to work for with that attitude. I want to know what other people's thoughts are regarding the online programs? Will it hurt our profession and the quality of our reputation?

Every patient you see is a "psych" patient, btw.

Yes, anyone with a brain is a psych pt., just like anyone with a heart is a cardiac pt., etc.

Still completely different. Completely!

Specializes in Anesthesia, Pain, Emergency Medicine.

Then why is our care judged by MD/DO standards instead of a lower standard?

AND, actually, NPs are able to take the comprehensive board exam which is basically the USMLE. As of now, it has about a 50% pass rate. I'm sure that will improve.

I do think it is a shame that one of our own is not supportive.

Then take the USMLE I & II. Pass the medical boards. Then you will prove that your education is substantial enough not to be labeled a mid-level provider. You are a health care provider. A medical practitioner. We are not MD/DO, to raise yourself to this level is a hoax. Don't confuse reality with political antics. Our profession has a very strong union lobby that affords us many very cushy rights. It sounds like buyers remorse. I like being a mid-level and understand our importance in the healthcare profession. In addition, I understand our limitations. Medical school is still available to anyone who qualifies and is willing to commit to the social and financial sacrifices.
Then why is our care judged by MD/DO standards instead of a lower standard?

AND, actually, NPs are able to take the comprehensive board exam which is basically the USMLE. As of now, it has about a 50% pass rate. I'm sure that will improve.

I do think it is a shame that one of our own is not supportive.

No, no it's not. The exam you take is a watered-down version of the USMLE Step III, which is widely considered to be the easiest of all the Step exams that physicians take. Your comprehensive exam is not the same Step III and it's not even remotely close to being at the same difficulty as Step I (which is the most important, and most difficult, Step exam that physicians take). To give you an idea, physicians take Step III during their intern year and generally, no one studies for it since it's considered such an easy exam. The fact that DNPs have a 50% pass rate on a watered-down version of this exam does not equate you to a physician.

Your standard of care is judged by MD/DO standard because the MD/DO is the standard of care. And, as an APN, you are expected to match that standard within whatever scope you practice. However, you do not receive the breadth or the depth of education that a physician who goes through 4 years of medical school + a minimum of 3 years of residency. A 2 year (possibly online) degree with 500 hours of clinical training is not equal to medical training. To try to equate yourself as equal to physician is plain misleading. Because you have a strong political lobby doesn't mean that you are equal in knowledge and experience to board-certified physicians in practice.

I work with great NPs and respect the profession and the work they do immensely, and we learn from each other quite often. But they (nor I) would ever equate themselves with the attending physician. They understand the important role they play in the delivery of healthcare, but they also understand what their limitations are. This is what makes them great providers to work with; they know when they reach their limits and consult with the residents/attendings. This is my last post regarding this issue.

Now, this has detracted away from the topic of thread enough so it's probably best to return back to the original topic of whether online education for the ANP degree is bad or not. I personally don't care as long as the end-product is competent.

Specializes in Anesthesia, Pain, Emergency Medicine.

Well, after 22 years of doing anesthesia, ER medicine and primary care. I can tell you that I've seen many physicians that I'm as good as, some that I'm better than and some that are better than me.

More importantly, there are 3 current peer review studies showing solo CRNAs anesthesia outcomes as good or better than either team or solo MDA.

There are 2 primary care studies showing that NP outcomes are as good or better than our physician counterpart.

Now, do you have any evidence to the contrary? I know you don't.

Evidence base medicine is where it is at. So you can TALK about the education differences and have your OPINION about them but I have evidence to back me up. Maybe the USMLE II, just does not make that much difference?

You can also Monday morning quarterback NFL games all day long. It still does not properly prepare you to get on the field and play the actual role.

Actually it does put you way ahead of someone who can't Monday morning quarterback.

You stated, "I also have to agree with my husband that my prior nursing experience did not provide any advantage to actually Dx and Tx pts."

If that is true for you I find it very amazing you did not avail yourself of a great learning opportunity and actually just wasted a lot of time of your time. Let me try this again and if you do not get it, will someone else please try?

Let's say you work in an ED. A patient comes in with a broken femur. You say to yourself, "I'm diagnosing this as a broken femur due to an obvious displacement." (This is a diagnosis, whether you make it or a physician makes it.) Now, to learn something and verify your diagnoses, walk over to the ED doc and ask him if you are correct. If he agrees, you are learning something. Now watch what he does to treat the patient.

Now fast forward to NP school. A patient comes in with an obvious displacement of the femur. You search your database and remember that you have seen this before. You can now, by virtue of being an NP student (and almost legal to formally diagnosis) make a diagnosis of a broken femur. And now, because you saw all this back in your nursing experience, you can also say that you know how to treat this patient. Your preceptor will smile and be glad you're not a direct-entry student.

That's as simple as I can say it. I've also worked with docs who said their EMT or CNA experience helped them in medical school.

Anyone else having trouble with this?

Yes, anyone with a brain is a psych pt., just like anyone with a heart is a cardiac pt., etc.

Still completely different. Completely!

I'd like to hear you explain that one!

"Psych" is body-mind. Ask anyone with PTSD. Do you know the "psych" problems cardiac patients face? Do you know the "psych" problems every ill patient face? Even entering the hospital today will make you a "psych" patient!

Yes, anyone with a brain is a psych pt., just like anyone with a heart is a cardiac pt., etc.

Still completely different. Completely!

Can you explain the difference?

Specializes in Community Health.

Totally off topic....Nurse Practitioners and Physicians are two separate medical professionals. To say that NP's are "midlevels" would imply that the training is comparable to physicians. It's not. NP's are not "midlevel" physicians. They are advance practice NURSES. Two separate entities so please people...stop trying to lump the two professions together in order to make one inferior. As mentioned before, podiatrists, dentists, and optometrists are not "midlevels" because they are all different health care professionals with different training. So stop using the word midlevel because it's not the correct title.

Well, after 22 years of doing anesthesia, ER medicine and primary care. I can tell you that I've seen many physicians that I'm as good as, some that I'm better than and some that are better than me.

More importantly, there are 3 current peer review studies showing solo CRNAs anesthesia outcomes as good or better than either team or solo MDA.

There are 2 primary care studies showing that NP outcomes are as good or better than our physician counterpart.

Now, do you have any evidence to the contrary? I know you don't.

Evidence base medicine is where it is at. So you can TALK about the education differences and have your OPINION about them but I have evidence to back me up. Maybe the USMLE II, just does not make that much difference?

I agree that over time you can find doctors, NP or PA's that are better or worse compared to their counterparts. However, I am talking about the school and what prepares you the best. During the first 1-5 years are when most mistakes occur. MD/DO are far superior compared to NP/PA. Hands down. I would say my husband PA school did a much better job compared to my brick and mortar NP school. This is my experience.

Totally off topic....Nurse Practitioners and Physicians are two separate medical professionals. To say that NP's are "midlevels" would imply that the training is comparable to physicians. It's not. NP's are not "midlevel" physicians. They are advance practice NURSES. Two separate entities so please people...stop trying to lump the two professions together in order to make one inferior. As mentioned before, podiatrists, dentists, and optometrists are not "midlevels" because they are all different health care professionals with different training. So stop using the word midlevel because it's not the correct title.

Yes, two different professions, yet both practice medicine. So what is the difference? Schooling and training. We both Dx and Tx. We are not so different in our day-to-day jobs in family practice. Just in training and schooling.

Can you explain the difference?

I could explain the difference, but if you don't understand the difference. Then you need to take a serious look at your education and maybe brush up.

I'm going to Kyudo class today from 9-5. (I am after all, Zenman) This art helps me diagnose and treat, especially when I have two admissions and a discharge on the psych unit, and I'm hung up on another floor with consults and getting back-to-back phone calls.

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