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.
Quote from zmansc
3) Independence/Quality of Education as a Provider. Let's first discuss the quality of education as a provider. Instead of taking anecdotal evidence from individuals who would likely be biased towards their own education, let's look at facts... If the NP education did not produce providers who were capable, then NP providers would produce worse outcomes in their patients. However, study after study shows this to not be the case, so I think we have scientific proof that there is no quality of provider issue, and thus, no quality of education issue. This is not only true for NPs, but as far as I know also true of PAs practice results.
Now, for independence. The real issue here is control over marketplace. It has very little to do with quality of care, as in most states that require a "collaborating physician" or whatever that state calls it, the physician doesn't actually have to see the pt, review the case, or do anything actually medical with the patient. If the patient needs a specialist, the patient still gets referred to the proper specialist, so that's not an issue. Really, the only issue at play is competition. Physicians don't want independent NPs because then they wouldn't be able to keep some of the revenue that the NPs bring into their practices! Who does it benefit? Physicians? yes. Patients? no. NPs? no.
While I agree these studies are great and prove NPs provide excellent care, they were largely conducted before the greedy for-profit schools began to rise like crazy and pumping out poorly prepared NPs. The NPs practicing during most of those studies went to reputable, not for profit programs, where they practiced in labs, were taught by veteran NPs, and their preceptors were vetted and provided. Things have changed, new NPs from the inferior programs are not the same. They can sit in front of a computer and get their BSN at a for profit, then sit in front of it again and get their NP degree, only leaving long enough to do a few hundred hours of clinicals with whoever they can convince to do it. The negative changes to NP education will likely filter through in the next 5 to 10 yrs and these Walden and Kaplan grads will give the MD groups all the ammo they need to show scientific proof of inferior outcomes from NPs.
All pre-NPs and NP students should take a stand and refuse to give a single dollar to these horrible programs. It will come back to bite us all in the butt one day if we support them.
Last edit by futureeastcoastNP on Feb 22, '14
Quote from BostonFNP
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.
Last edit by Dranger on Feb 22, '14