Are online ANP degrees destroying our credibility?

RobBSNRN · May 7, 2014

So do we have the licensing exam more difficult to "prove our credibility"? I don't see how that would fly.. Not that I am against it in principle i'm not.

I actually go to a B & M NP school with online portions and as you say I think the issue is with for profit and questionable admission rates not online. Though on the other hand, every year we will see more and more formal education moving to online-only and showing up in person will become a secondary option if it is one at all. We may need to get used to it...

chillnurse, BSN, RN, NP · May 7, 2014

I agree. Online can be great. As long as the content is heavy science and has excellent in lab learning sessions. Not all this "nursing theory and leadership 101 bunk". My b n m school had some of those also.

bsnanat2 · Jun 21, 2014

I must say that I attended a hybrid program, which was a combination of online and brick and mortar face-to-face time every few weeks. I have been working inpatient alongside many MD's, DO's, NP's and PA's as well as regularly with students from each discipline. After a year of this from the NP side and not the RN side, I must unfortunately say that the online NP students who rotate have been woefully inadequate as a whole, to the point that the health system here is evaluating whether or not to continue to offer clinical placement for online only students. As an example, a staff nurse has enrolled in an online program that also has a brick and mortar program as well as a PA program. This is a private for profit school (will gladly name it if allowed). This person was accepted into their RN to MSN program but was rejected from the RN to BSN program at the school from which she received her RN just a couple of years ago. Her fellow staff nurses are dismayed by her attempting to move forward as she is adequate at best on the floor. I have proof-read a few of her papers and they were juvenile at best. Yet, she is rapidly moving through this program to the point of starting clinicals. Based on her questions, her knowledge base has not increased nor has it grown in sophistication. At this point in her program, she was actually shocked when told she would have to take a certification exam even though she'd passed the nclex already! I wish I were joking. There are a few NPs here who've attended rigorous online programs associated with medical centers who are great. These programs also require face to face time in blocks, especially for check offs in assessment and other critical areas. Bottom line in my opinion? Beware of schools that replace strict acceptance standards with higher tuition. Your willingness to pay the tuition should not be the determining factor in your acceptance. NP school should not be easy. It should not be impossible, but it should not be easy. We can no longer count on the fact that NP programs are rigorous to "weed out" the weak links, as many are no longer rigorous. Beware of programs that require no on campus or in person interactions. Pursuing dreams and increasing your ability to care for people medically should require some sacrifice and challenge you. If not, please reevaluate your program choice.

futureeastcoastNP · Jun 22, 2014

I must say that I attended a hybrid program, which was a combination of online and brick and mortar face-to-face time every few weeks. I have been working inpatient alongside many MD's, DO's, NP's and PA's as well as regularly with students from each discipline. After a year of this from the NP side and not the RN side, I must unfortunately say that the online NP students who rotate have been woefully inadequate as a whole, to the point that the health system here is evaluating whether or not to continue to offer clinical placement for online only students. As an example, a staff nurse has enrolled in an online program that also has a brick and mortar program as well as a PA program. This is a private for profit school (will gladly name it if allowed). This person was accepted into their RN to MSN program but was rejected from the RN to BSN program at the school from which she received her RN just a couple of years ago. Her fellow staff nurses are dismayed by her attempting to move forward as she is adequate at best on the floor. I have proof-read a few of her papers and they were juvenile at best. Yet, she is rapidly moving through this program to the point of starting clinicals. Based on her questions, her knowledge base has not increased nor has it grown in sophistication. At this point in her program, she was actually shocked when told she would have to take a certification exam even though she'd passed the nclex already! I wish I were joking. There are a few NPs here who've attended rigorous online programs associated with medical centers who are great. These programs also require face to face time in blocks, especially for check offs in assessment and other critical areas. Bottom line in my opinion? Beware of schools that replace strict acceptance standards with higher tuition. Your willingness to pay the tuition should not be the determining factor in your acceptance. NP school should not be easy. It should not be impossible, but it should not be easy. We can no longer count on the fact that NP programs are rigorous to "weed out" the weak links, as many are no longer rigorous. Beware of programs that require no on campus or in person interactions. Pursuing dreams and increasing your ability to care for people medically should require some sacrifice and challenge you. If not, please reevaluate your program choice.

Glad to see some people on this forum see things accurately. These for profit programs are ruining the profession every way possible. Credibility, over saturation, knowledge base. Every nurse in America is going to NP school because it requires absolutely 0 sacrifice when you can go to a for profit program. They have no GRE requirements, no interview, and accept 99% of applicants even when they write at an 8th grade level. Those people then go through pre canned modules and pop out as an NP 2 Yeats later. Its deplorable.

The only consultation for those of us attending real schools is knowing that once they do oversaturate the market, its they who will be unable to find jobs. I'm attending Columbia and no one is going to choose a for profit graduate over a Columbia graduate. If you can't put in the sacrifice to go to a reputable school be prepared for a hard road ahead as the market tightens.

futureeastcoastNP · Jun 22, 2014

Glad to see some people on this forum see things accurately. These for profit programs are ruining the profession every way possible. Credibility, over saturation, knowledge base. Every nurse in America is going to NP school because it requires absolutely 0 sacrifice when you can go to a for profit program. They have no GRE requirements, no interview, and accept 99% of applicants even when they write at an 8th grade level. Those people then go through pre canned modules and pop out as an NP 2 Yeats later. Its deplorable.
The only consultation for those of us attending real schools is knowing that once they do oversaturate the market, its they who will be unable to find jobs. I'm attending Columbia and no one is going to choose a for profit graduate over a Columbia graduate. If you can't put in the sacrifice to go to a reputable school be prepared for a hard road ahead as the market tightens.

Also I want to add something to this: EXPERIENCED nurse practitioners from for profits don't apply to this. They become nurse practitioners before the market became saturated, and were able to get jobs and gain valuable experience. After 2-3 years in practice, no one cares what school you went to, whether its for profit or online or whatever. You've proven at that point that you are a capable provider.

The word of caution I spoke about in my previous post applies to people currently in for profit programs or applying to them. The landscape has changed. The number of NP graduates has literally doubled in the past few years. The competition will soon ramp up considerably for jobs, and it will be an employers market. Just as the nursing surplus has allowed employers to choose BSN only nurses, the NP surplus will allow employers to pick and choose only those from the top schools.

As someone else said above, becoming a provider is not supposed to be easy. Doctors make sacrifices, physician assistants make sacrifices, and so should nurse practitioners. If you're applying to a program where the only barrier to entry is ensuring you have a tuition check, PLEASE do yourself and the profession a favor and choose somewhere else. If your grades and experience aren't good enough, go back and work hard to fix it and go to a good school.

KansasFNP · Jun 22, 2014

I graduated from an online program, had rotations with some of the best physicians in the area in internal medicine, pediatrics, OB/GYN, and geriatrics. I received high marks on all evaluations from my preceptors. I have passed the national certification from the AANP and am now licensed as a nurse practitioner in my state. I had no problem finding a job whatsoever. My online programming taught me the skills necessary to become a great nurse practitioner. So I have to kindly disagree with some things are being said in this forum. I think what is destroying the credibility of nurse practitioners is a lack of consistency when it comes to educational curriculum, an over-emphasis on theory-based courses, and a lack of knowledge regarding advanced pathophysiology and pharmacology.

bsnanat2 · Jun 22, 2014

I graduated from an online program, had rotations with some of the best physicians in the area in internal medicine, pediatrics, OB/GYN, and geriatrics. I received high marks on all evaluations from my preceptors. I have passed the national certification from the AANP and am now licensed as a nurse practitioner in my state. I had no problem finding a job whatsoever. My online programming taught me the skills necessary to become a great nurse practitioner. So I have to kindly disagree with some things are being said in this forum. I think what is destroying the credibility of nurse practitioners is a lack of consistency when it comes to educational curriculum, an over-emphasis on theory-based courses, and a lack of knowledge regarding advanced pathophysiology and pharmacology.

Don't disagree with you. Problem still remains that many of the online programs are responsible for the issues you just listed. Many, not all. I work with someone who did UAB's online program...she is not only top notch but her program seems to have been. Yet again, they have a standard for admission, an expectation of performance and require "face time" for specific courses. If the only barrier to acceptance into a NP program is your ability or willingness to pay, then that is a problem. The NP education market model seems to be either high standards for entry or high tuition in lieu of high standards. The low quality of some new grads is directly related to the problems you listed that is now compounded by the issue of poor online education. It will inevitably lead to the loss of the ground gained by NP's in many states. We've already seen a decline in the "readiness to practice" for new RN's, now those same folks are enrolling in NP programs that are a step down academically from their undergrad programs? Would we ever accept RN preparation that was totally online with no requirement for academic face time? Would you allow yourself to be defended by an attorney whose degree was obtained strictly online? Would you allow a surgeon to 'cut on you' with a strictly online education to back him up? You get my point. As time goes on, don't be surprised when other providers (physicians, PA's, pharmacists, etc.) question you about how your education was obtained and you have to work a little harder to gain their trust. My facility has already declined to accept students from a nearby PA program that lowered its acceptance standards. And as I've said, they are specifically questioning the validity of strictly online NP programs. Doesn't matter if you agree with the facts are not. They are still facts.

bsnanat2 · Jun 22, 2014

If you can drink beer while you're doing it, then it's not a sport...

If all it requires is some free time and money, then it's not an education.

KansasFNP · Jun 22, 2014

You provide some very great anecdotal "facts" based on your experiences in your area of the country. I live in a very rural area in Kansas. There is not a graduate school of nursing for 200 miles in any direction. Utilizing the online program from one of the state-approved universities allowed me to continue my education, complete top-notch training, and enter into the field as a well-prepared nurse practitioner. Believe me, in the rural and inner urban areas of United States, individuals are not as concerned about whether you had the privilege to attend a Ivy League brick-and-mortar school or received your education at a distance. Their concern that you are a well-qualified candidate that is certified in your specialty area. That is all. This debate will continue on and on without any immediate resolve I am sure. The nursing profession has never done a great job about identifying weaknesses within the profession and fixing them. They have however done a really great job at attempting to divide themselves as many ways as possible. At the end of the day, I am proud to say that I am an online graduate and a certified nurse practitioner working hard to assure that the rural communities in Kansas that I serve receive top-notch healthcare. Your dislike for online programming does not take away my experience, my certification, nor my ability to legally and professionally care for my patients.

KansasFNP · Jun 22, 2014

Goodness knows I wish I could've received my educational kicking back and drinking beer. If you know of a program that allows this please let me know ASAP!

futureeastcoastNP · Jun 22, 2014

Jreed you seem to be misunderstanding peoples post. Both bsnanat and I have stated we are not against online programs. We are against low standard and for profit programs. Many top programs are online.

MrLungvent · Jun 22, 2014

NP credibility is still constantly underfire, traditional or not, depending on who you talk to or which side your on, but most of it is political.

This is not an NP vs PA debate post, but it does generally relate back to the credibility issue in some sense....why do people choose one route over the other?

The answer: NP route is extremely attractive to many because (***Note, I referenced the following points from a PA forum):

-The schools are generally easier to get into,

-Cheaper

-More convienent, can be done part time

And most importantly....some of these programs can be done Online?

vs the PA route: Very expensive, Extremely Difficult, only the truely elite get in.

***of course the PA's on that forum ripped the online portion the most...

Now to me.....my opinion on this is: Academic Integrity and Credibility remain the two biggest concerns with online education in general. I just think it all depends on how its done.

Thats the public perception of many online schools.......

However, ..........it is the individual and his expereinces that makes the clinician, not the school, or method of instruction.

There are many NP's (PA's and MD's as well) whom sat through traditional learning styles and likely dont know "their you know what" between a hole in the ground.....but there are many NP's who went through online programs who are outstanding, knowedgeable and competent clinicans.

And again, going back to the NP vs PA debate....some ask whats the difference?

I usually say: NP's follow a Nursing model, study Nursing Theory, learn from a Nursing Prospective and treat the whole person "holistically".....MD's and PA's follow a medical model, they practice medicine and focus on the disease.

Look at the design of these programs? Many PA programs are designed for people with limited expereince in healthcare (although they do admit people with some substansial clinical backgrounds)....but they are technically designed to admit people with very limited experience....online programs especially would not work at all for PA's because of the tremendous amount of clinical exp....needed

NP programs are designed to admit people with years of clinical experience to build off of what they learned...thats why there's no direct entry NP programs that allow you to skip RN and go directly to NP school....the programs are designed for expierenced practicioners who wish to transition to an advanced practice role.

Unfortunately, many often rush into NP school immediately (Some dont even work as an RN if they can and jump right to NP) likely before they are ready, and thats what may hurt the credibility of an NP.

So overall, to sum this up: it is the individual and his expereinces that makes the clinician, not the school, or method of instruction.

However, what will end up hurting the credibility of the NP profession wont be online schools and the fact that they are online...it will be two things:

#1.) The Number of Schools out there and the number of students they admit

#2.) Admissions standards of these schools.....if the barrier of entry is too low, it could flood the field with NP's.

(and this wont be good for PA's either)..hell theres even been talk about an Advanced Practice Respiratory Therapist in the next 10 to 20 years.....if that ever comes to happen....add it to the flooding.

In my opinion,......because an important part of NP practice is the previous RN exp, I think there needs to be expeirence requirements prior to admissions, especially for the online NP programs.... many schools do not have such requirements, especially the for profits.