B&M vs Online

[Owlgal]

I see a whole lot of hate for the online Nurse Practitioner programs. I'm wondering if anyone has any statistics regarding poor performance based on whether a NP went the traditional route versus online?

Or are we assuming that they are lesser simply because they "must be" inferior?

Personally, I don't think that anyone should be going through an NP program without at least 3-4 years of solid nursing experience. I'm far more concerned about a young NP straight out of school who has no real-world healthcare experience than I am about an experienced RN going the online route for their NP.

Thoughts?

And to disclose, I am one of those online, for-profit school NP students that seem to draw all the negative attention. Of course, I've also been a nurse for about 14 years and have been in hospital administration for the last several years.

[prelift]

Shia owner. I don't even comment on what you said except to point out you stated two opposing statements in your post.

What exactly do you want me to find evidence for related to that?

The only studies done physician vs np are for the basic 5 diagnoses. Others don't exsist. What do you want people to do studies on exactly? Just be cause studies have not been done doesn't mean one can't derive that physician education is superior than np education.

I guess you know it all as a new as a new grad though right and aren't working under a physician since you think you can solo medicine.

Pass step 1 and then we can talk about equal education

i guess since there have not been studies done in regards to physician vs software engineer ability to code google should hire me next. I mean there is no data to refute this right??? So obviously I am just as able of a programmer since no studies say otherwise

[prelift]

It's ok tho. Only been in neuro residency one month and have had three nps on the hospital service consult me for confusion/AMS on patients with cirrhosis without even ordering NH3 lab.

Not sure where their attending is but lol. And yes we get consults day 3 on service considering first two are computer orientation.

How bout them livers

[shibaowner, MSN, RN, NP]

Prelift. Are you waiting for a facelift? Why are you on this discussion board if you are an MD? So you can sneer at NPs? Please take your snarky attitude, go away, and be a troll on the numerous MD discussion boards out there.

If you really are an MD, I don't know how you got through med school since you lack basic reading comprehension. The topic here is not NPs vs MDs, but rather NP online schools vs B&M NP schools.

There have been over 100 studies of NP vs MD outcomes and every single one has found NP outcomes to be as good, or better than, MD outcomes. Most NPs work in primary care. So if you have an issue with that, then produce some evidence or can it.

As for my post, I was talking about NPs who have RN experience vs NPs w/o RN experience. This has nothing to do with MDs. Also, if you were able to read and understand, my post stated that RN experience had no effect on MSN academic performance or on clinical skills as evaluated by MDs and NPs. What my post also said is that if an NP went to an online for-profit school without a big name, but had RN experience, that would be helpful for the persons' job search, as a working RN may have no other option.

I helped my last clinical preceptor, an MD specialist, hire an NP. He did not want another MD or a PA. He wanted an NP. While going through resumes, if a new grad NP went to a big name school, that definitely got his interest. For new grad NPs who had prior RN experience, it was okay if they went to an online for-profit NP school while having to work full-time as an RN. We both admired people who had to pull themselves up by their bootstraps.

If you really are a resident, then I pity your patients. And you must be really insecure if you want to troll the nursing discussion boards. No one here is impressed. You are just embarassing yourself.

[shibaowner, MSN, RN, NP]

Prelift - what studies show only 5 diagnoses evaluated? Citations, please, if they really exist. You do know how to provide citations, right?

[prelift]

Prelift - what studies show only 5 diagnoses evaluated? Citations, please, if they really exist. You do know how to provide citations, right?

I've read most of them. "Equal outcomes for high blood pressure, diabetes, high lipids, blah blah blah"

Then it follows mortality rates, luckily most people don't die during 6 month long studies so yeah of course it is equal.

Then in fine print at the bottom for many it says physician with np vs physicians alone so it's not even really independent practice. Go read them on pubmed yourself with an unbiased looking glass.

Plus they are all published by nurses almost so you know if they did have a study that didn't fit their "criteria" they just would not publish it.

Almost all nurse practitioners work alongside physicians also, so how do they even know that the np isn't bouncing ideas off of the physician for treatments evaluated in the studies? What about nps that were trained by physicians? Without the mass of medical knowledge procured and passed down to mid levels via MD counterparts where would NPs be?

Can you answer those questions or do you still think that you can manage everything that walks thru the clinic door without physician oversite?

[shibaowner, MSN, RN, NP]

Owlgal, you have stirred up quite a discussion! I am very impressed by your grasp of argumentation and evidence-based medicine. I don't think you will have any trouble getting a good NP job.

Prior to becoming an RN and then NP, I was a business executive with extensive recruiting and hiring experience. Because of this, on my last NP clinical rotation, my MD preceptor asked me to help him hire an NP. For a new grad NP without RN experience, the school did matter. This was in Baltimore, so the Univ of Maryland and Johns Hopkins new grads garnered a lot of interest. For NP new grads who had significant RN experience, the NP school was not as important to us. We looked at the RN experience and if it was relevant to this practice. RN experience was viewed as a plus. We understood that a lot of RNs have to work full time and an online for-profit school may have been their only option.

There are a lot of other factors in hiring someone, like personality, culture fit, and being a team player.

Most potential employers have biases. Some are snobs and only want elite schools. Some don't want new grad NPs at all. And so on.

Have faith that the right job with the right employer is out there! Good luck!

[traumaRUs, MSN, APRN]

Hey guys/gals - several posts have been deleted. While we encourage lively discussion, please stay on topic. Thanks.

[Owlgal]

I do appreciate a lively discussion. I'm fairly new to this site and spent a little time reading through various posts/threads. It seems that there are a variety of concerns that are posted here by NPs and one medical student(?). The medical student thinks that NPs should be done away with, apparently, as NPs are somehow stealing MD thunder. I'll disregard that. Even he admits that all the studies show that outcomes (on at least 5 major diagnoses -- providing a large sample size) are as good for those patients treated by NPs versus MDs. Outcomes should reign king (or queen. lol) as we should all be focusing on getting our patients as healthy as they can be. It has been demonstrated that NPs are reliable and skilled practitioners. They happen to be cost effective for practices to employ.

Yes. I have been in healthcare management for the last 12 years. I've run outpatient areas such as Cancer Centers, Pain Centers, Pulmonary Clinics, Home Health, and Hospices. I also place a mean PICC line. I understand the management, billing, and regulatory environment that we all work in. Things are changing in the way practitioners bill and get paid. ACO's aren't going away and are the new way of practicing healthcare. Everything but the most acute care is moving outpatient. Inpatient stays are getting shorter and shorter and hospitals are penalized for re-admissions. Ignore these healthcare realities at your own peril. And while we can debate with our lone medical student whether his ability to be precepted performing sutures trumps my real-life learning of that skill, some 13 years ago; that really isn't what I was getting at. This isn't a debate as to whether a FNP needs the same education as an MD to provide excellent outcomes -- studies already show that NP outcomes are congruent with physicians while NPs also perform higher in customer satisfaction surveys vs physicians.

The question was, do we objectively KNOW that B&M schools turn out better NPs than for-profit online schools?

Just as I have my preconceived notions about direct entry programs that I may have to set aside; I wonder if the hate for online schools is a factor of preconceived notions of how education is best done coupled with the unease current NPs feel with the flood of new graduates (and how this affects potential pay and job prospects).

[shibaowner, MSN, RN, NP]

Evidently, there is no evidence that for-profit online NP graduates provide worse care to their patients. I think you get out of any school what you put into it. Ignore all the negativity here.

[Skippingtowork]

Stepney, NP salaries vary by location. Baltimore is a very reasonable cost of living area and yes, a brand new PMHNP can make $150 K there. Most new grad NPs in Baltimore will start at around $90K. A decent 1 BR apt in a good area rents for $800 and up. I am working in rural California and it is even cheaper than Baltimore and I'm making $90K as a new grad NP and will be making $140K within 18 months if I meet performance objectives.

Didn't know Baltimore was that affordable.

[Skippingtowork]

Lol. Encountered it over and over. I'm not talking about the common presentations. I guess we will agree to disagree. I'd take knowing what to look for opposed to not recognizing it from lack of education base, but to each their own.

Can you give a little example of what you've noticed?

[Skippingtowork]

Wow, you just do not get it. What I am saying is the content that is taught at NP school is watered down. It lacks the depth that I would like out of a degree. The fact that you're understanding the material is great. I want much more than just to get the minimum from NP school. So moral of the story is yes the amount of time does matter. Especially if you want more than just the fluff information that NP school gives you. Good luck in your endeavors. NP knowledge, unfortunately, will never be enough for me.

An I applaud you for recognizing that and best of luck to you as you pursue medical school (not sure if you're in or contemplating). We need a variety of health care professionals out there, with each bringing something important to the table.