Dear practitoners, quick question on your school

newFNP2015 · Aug 7, 2014

Texas Tech and UTMB (Galveston) also have online NP programs. Any online school will require on-campus visits at some point during the program which may vary depending on school (some every semester, some just once or twice for a week at a time). For this reason, you should be aware and include travel costs in your budget for school.

Alternately, University of South Alabama and University of Southern Indiana also have fully online programs which do not charge out of state tuition, but will require campus visits. These may be additional options.

DNP for NPs by 2015 is an unrealistic goal which has been discussed ad nauseam on other posts on this and other forums. It is more likely that it will fall in the early to mid- 2020s, similar to the CRNA timeline. If you poke around the site, you will find many great debates on the matter. For the short version, many schools are still not set up to train BSN to DNP and until this happens, the goal will not be realistic because no one wants a master's degree that they can't use.

zmansc, ASN, RN · Aug 7, 2014

OP, I don't want to attack you personally, but your past posts make me question your thoughts about wanting to become an NP at this point in time. From the past posts I've seen, you mentioned that you don't like caring for patients. I also saw a past post where you wanted to know if you could preemptively strike a patient, and after getting very strong feedback that you could not only not preemptively strike a patient, you could not strike one afterward either, you continued to argue with the advice of those who have many years more experience than you do. Then I saw a recent post where you exhibited very strong opinionated negative feelings about anyone who seeks pain control and gave me the feeling you have no compassion for at least many of your patients, if not most of them.

As a NP, you will still be performing patient care, albeit the tasks will be different. You will still need at least as much compassion towards your patients as you will need in your current role. Striking patients will still be prohibited. So, it seems to me that a change in the role from that of a bedside RN to an NP will not help you in any of the areas you seem to be struggling with, in fact I think it would make them worse. Can you help me to understand why you believe that you are ready to transition from the role of an RN to that of an NP?

Again, I'm not trying to attack you, I just think that from what I've seen of your posts, you might be better off giving yourself some time to determine if you can be happy being a caregiver before you invest a lot of money and time into an education that appears to be one you will not benefit from. I think you could also benefit from a bit more maturity that will come with that time as well. There is nothing wrong with giving yourself some time, growing into your current role and learning more about the profession and what makes you happy in the mean time. My advice would be to not get into quite so much of a rush. I believe you mentioned somewhere that you wanted to learn the ER thing (hope your orientation has improved) and then try ICU nursing too. Do a year in both, get to know a bit about how each is different, it certainly won't do anything but help you to understand what you will be learning once you do go to NP school (if that is the choice you make).

Good Luck.

ahad153 · Aug 12, 2014

Interesting that you are going to further your education, a great endeavor. I am currently in my last year through Walden University, which does not have an on site attendence requirement. Before all the nay-sayers groan over the Walden tag, any NP program produces what you as the student put into it. This program has become very popular in my area due to the flexability and the no-residence requirement. Almost all that I know are nurses with over 5 years experience and the three that I know that graduated in the last 6 months they are 3 of 3 for passing their FNP certification boards.

I feel that if a nurse is going to attend a distance education program it is best to be beyond the beginner and novice nurse levels. Experience in practice leads to maturity in knowledge and will assist you through the program. I have been a nurse 18 years, have three specialty certs and spend 3 hours every day of the week studying or writing papers as well as my clinicals which I am doing now on top of working >40 hours a week and family. It can be done, but self education by distance is difficuly unless very diciplined.

Good luck in what ever you choose to do.

tarotale · Aug 13, 2014

Texas Tech and UTMB (Galveston) also have online NP programs. Any online school will require on-campus visits at some point during the program which may vary depending on school (some every semester, some just once or twice for a week at a time). For this reason, you should be aware and include travel costs in your budget for school.
Alternately, University of South Alabama and University of Southern Indiana also have fully online programs which do not charge out of state tuition, but will require campus visits. These may be additional options.
DNP for NPs by 2015 is an unrealistic goal which has been discussed ad nauseam on other posts on this and other forums. It is more likely that it will fall in the early to mid- 2020s, similar to the CRNA timeline. If you poke around the site, you will find many great debates on the matter. For the short version, many schools are still not set up to train BSN to DNP and until this happens, the goal will not be realistic because no one wants a master's degree that they can't use.

Thanks for the input! I have applied to one of the programs for next spring, and am going to apply for next fall program for UTA soon. I am really not leaning towards going to schools that are too far, especially if they require some attendances, so anywhere within 2hr distance and occasional attendance works for me. I will remember USA and USI fur sure, that tuition option sounds really generous.

tarotale · Aug 13, 2014

OP, I don't want to attack you personally, but your past posts make me question your thoughts about wanting to become an NP at this point in time. From the past posts I've seen, you mentioned that you don't like caring for patients. I also saw a past post where you wanted to know if you could preemptively strike a patient, and after getting very strong feedback that you could not only not preemptively strike a patient, you could not strike one afterward either, you continued to argue with the advice of those who have many years more experience than you do. Then I saw a recent post where you exhibited very strong opinionated negative feelings about anyone who seeks pain control and gave me the feeling you have no compassion for at least many of your patients, if not most of them.
As a NP, you will still be performing patient care, albeit the tasks will be different. You will still need at least as much compassion towards your patients as you will need in your current role. Striking patients will still be prohibited. So, it seems to me that a change in the role from that of a bedside RN to an NP will not help you in any of the areas you seem to be struggling with, in fact I think it would make them worse. Can you help me to understand why you believe that you are ready to transition from the role of an RN to that of an NP?
Again, I'm not trying to attack you, I just think that from what I've seen of your posts, you might be better off giving yourself some time to determine if you can be happy being a caregiver before you invest a lot of money and time into an education that appears to be one you will not benefit from. I think you could also benefit from a bit more maturity that will come with that time as well. There is nothing wrong with giving yourself some time, growing into your current role and learning more about the profession and what makes you happy in the mean time. My advice would be to not get into quite so much of a rush. I believe you mentioned somewhere that you wanted to learn the ER thing (hope your orientation has improved) and then try ICU nursing too. Do a year in both, get to know a bit about how each is different, it certainly won't do anything but help you to understand what you will be learning once you do go to NP school (if that is the choice you make).
Good Luck.

I don't feel attacked, on the other hand, I am very pleased and thankful that you took your valuable time for the advice. I know I got some explaining to do;

1. When pts ask me if I like what I do, I honestly tell them, no. But I am courteous to people who are not belligerently rude, and I can say from my heart I do the best I can to get orders done as fast as I can when they come. I can say I enjoy slightly more now since I am at ER, but in the end, I am tired of presganey and survey scores, management bull crap, putting up with abuse, etc. Pt can do and say whatever the hell they please and we just have to pull our pants down and get kicked in the butt; they act foolishly to the police they get beat down, or misbehave even at mcdonalds, they will get kicked out; my coworkers were saying at work, how long are nurses just going to keep getting abused like this? so yes, I regret choosing this career endlessly; what if I just became engineer and just sat back on my chair and make money, that would be nice. But then am I negligent? No, I keep policies, make sure my pts are okay, and pay attention to little things like needing a warm blanket. I do my job well, I just don't like doing it. We are nothing but a commodity for employers and the system.

2. About the pre-emptive strike, I corrected myself back to hitting back or fighting back imminent doom. And of course, nurses can't because no one gives rat's rectum about nurses. If nurse gets away, cool. If she gets hit and gets seriously injured or killed, too bad. They will say wait, Oh, you protected yourself by fighting back? No, No, the correct thing is to get your bone broken for satisfaction score or hospital image... ya back to #1 above. I used to work at very sketch neighborhood where ER docs will get hit by drug seekers, and yes, that population and exp drained all my love of humanity out of me. If I was offered some kind of desk job like research nursing or insurance nursing and get paid well, I will do it in heart beat.

3. I understand that mid-level providers work more like docs. I have a lot of respect for docs, PA, and NPs, and you know the saying, "it's to the eye of the beholder", I guess because I respect providers so much, I want to become one of them. I am still constantly trying to learn ER stuff on the job and on my own reading books, and this due to wanting to be good at what I do, not because I really have compassion, so I believe it's possible to be a good nurse without compassion. I love the fact that NPs can decide and order, and know as much as docs can (worked with many). You think ABC, then you order, and see how it goes. RNs can't do that. NPs get to use the brain in big picture. I just use my brain to prioritize, critically think to get jobs done but I don't do anything medically. I am not educated enough to tell a doc, "hey this pt has this lab elevated, we should do this", and I don't want to be just a work ant all my life.

I am young, and yes I did say lot of stupid things to vent :) but I want better. Something better. Thank you for caring!!!

zmansc, ASN, RN · Aug 13, 2014

I don't feel attacked, on the other hand, I am very pleased and thankful that you took your valuable time for the advice. I know I got some explaining to do;
1. When pts ask me if I like what I do, I honestly tell them, no. But I am courteous to people who are not belligerently rude, and I can say from my heart I do the best I can to get orders done as fast as I can when they come. I can say I enjoy slightly more now since I am at ER, but in the end, I am tired of presganey and survey scores, management bull crap, putting up with abuse, etc. Pt can do and say whatever the hell they please and we just have to pull our pants down and get kicked in the butt; they act foolishly to the police they get beat down, or misbehave even at mcdonalds, they will get kicked out; my coworkers were saying at work, how long are nurses just going to keep getting abused like this? so yes, I regret choosing this career endlessly; what if I just became engineer and just sat back on my chair and make money, that would be nice. But then am I negligent? No, I keep policies, make sure my pts are okay, and pay attention to little things like needing a warm blanket. I do my job well, I just don't like doing it. We are nothing but a commodity for employers and the system.
2. About the pre-emptive strike, I corrected myself back to hitting back or fighting back imminent doom. And of course, nurses can't because no one gives rat's rectum about nurses. If nurse gets away, cool. If she gets hit and gets seriously injured or killed, too bad. They will say wait, Oh, you protected yourself by fighting back? No, No, the correct thing is to get your bone broken for satisfaction score or hospital image... ya back to #1 above. I used to work at very sketch neighborhood where ER docs will get hit by drug seekers, and yes, that population and exp drained all my love of humanity out of me. If I was offered some kind of desk job like research nursing or insurance nursing and get paid well, I will do it in heart beat.
3. I understand that mid-level providers work more like docs. I have a lot of respect for docs, PA, and NPs, and you know the saying, "it's to the eye of the beholder", I guess because I respect providers so much, I want to become one of them. I am still constantly trying to learn ER stuff on the job and on my own reading books, and this due to wanting to be good at what I do, not because I really have compassion, so I believe it's possible to be a good nurse without compassion. I love the fact that NPs can decide and order, and know as much as docs can (worked with many). You think ABC, then you order, and see how it goes. RNs can't do that. NPs get to use the brain in big picture. I just use my brain to prioritize, critically think to get jobs done but I don't do anything medically. I am not educated enough to tell a doc, "hey this pt has this lab elevated, we should do this", and I don't want to be just a work ant all my life.
I am young, and yes I did say lot of stupid things to vent :) but I want better. Something better. Thank you for caring!!!

OP -

Thanks for responding. The first step in any personal growth is to assess yourself and figure out where you need to grow, you have shown that you are doing that, which is far more than most are willing to do.

I'm glad you know what you like and what you don't like about the job. It sounds like a big issue to you is how your patients and their family treat you and the rest of the staff. I will agree that there are days when I get frustrated with how patients treat me or others on my team. However, one thing to remember that is very different between how a police officer deals with the public and how healthcare professionals deal with patients is that when someone is a patient (we will discuss frequent flyers a bit later, although some of this applies to them as well) they are out of their element and in the middle of yours. Regardless of if your an NP, MD, RN, or CNA, you are not in pain, uncomfortable, feeling imminent doom, etc. If you put yourself in the position of that young father, who's precious little 7yo daughter broke her arm and is crying in your gurney, it all makes sense to get upset if no one is telling him what is going to happen, when, who is going to fix this, and why it's not happening now. His main role in life is to protect this little girl, and he can't do it without you, but yet you (not you personally, but the healthcare workers he is interfacing with) are not communicating with him because your too busy with other patients. I often find, that for many patients, a moment of time to explain what is going on and how we are going to help them or their loved one goes a long, long way, because now your on the same team.

Whatever role you choose to play on the healthcare team, this dynamic is going to be vital for you to learn and master. I have found that mastering this is one of the most important skills I have needed and has given me far more than almost any other skill as far as making my work environment much, much more pleasant for me and my patients.

Now, having said that, there are still situations where there are patients that want to step out of line. Mostly behavioral, drunk, or the like. It's important to realize that these patients are also sick, and need someone to help them, but to balance that with a need for you and I to be safe as well. No one is suggesting that you or any healthcare worker place themselves in harms way, there are many ways to keep from doing that, but what we are all saying is that the suggestion of striking out at them is the wrong way to go about dealing with them. As you gain experience in the ER, I hope you will learn how to recognize the various signs of dangerous situations, and keep yourself aware of those. Do not let the rush of the ER push you into going into rooms with potentially dangerous situations without considering how to get yourself out if you need to. My EMT training taught me to always think of scene safety first and foremost, if you have former EMTs on your team, you might consider picking their brains about how to recognize signs of danger from them.

I find it very encouraging that you are working to learn more about ER nursing on your own time, that is the kind of dedication that will make you a great nurse, regardless of your role. Yes, there are easier ways to make money, but believe me, almost all professions have their pluses and negatives. I will disagree with you that you are not educated enough, as a RN, you should be educated enough to interpret lab values. I have always gone to my docs, and told them what I think is going on with the patient. Only one has ever given me **** about it, and he's no longer at the hospital, so I don't worry about his opinion anymore. The other docs will either agree, disagree, or tell me to wait. Often if they disagree, they will tell me why, and what they think they should do. On occasion, they will do their plan, find out it was wrong and even admit that I was right to begin with! As you gain experience and learn more from these sessions and from reading in your books, they will even start asking you what you think is going on and what you think we should do.

You are correct that you (and all of us) have made mistakes. There is nothing wrong with that if we learn from our mistakes, which you are showing a willingness to do. Keep that up, and you will do great in whatever role you choose. I hope you find a role that brings you joy and makes you want to go to work in the morning, because that really is worth alot more than making the most money (not saying money isn't important because it is).

Good Luck!

ICURN7 · Aug 15, 2014

Hmmm….interesting..:)

tarotale · Aug 15, 2014

OP -
Thanks for responding. The first step in any personal growth is to assess yourself and figure out where you need to grow, you have shown that you are doing that, which is far more than most are willing to do.
Good Luck!

I can say that from the gist of it, the ER nurses get treated far better with respect from patient and family members compared to what the floor nurses get (from my perception and experiences), but then again, the surrounding areas where I used to work medsurg was... not very nice... one of the most frustrating part of the whole healthcare thing is, however, the fact that our "clients" have too much power; I know this sounds weird so let me explain. It is getting (or already is) harder for physicians to say "no, you don't meet the criteria for admission, no we are not giving you dilaudid, go home." Why? Because they will get a nice letter note that whines about how horrible doctor they are for not giving into patient demands, add to that the lawsuits and crap... I think like this. If there were no doctors, no nurses, no modern medicine, then a lot of stuff pts come to hospital for, they would be helpless and probably die. But then out of grace and mercy, here we are, healthcare workers working hard to save them. So how is it computed in their head that they think of hospitals like hotels? how in the world is it that they "deserve" healthcare? Everyone deserves choice of healthy lifestyle, there's no such thing as right to healthcare. Healthcare is a privilege. how managers want to control everything with stupid scores? This is one field where we see more punishments and punitive threats (esp towards nurses) rather than a simple appreciation. The sense of entitlement embedded in the head of people in this country... is phenomenal, and let's just leave out the fact that we are paying for the vast amount of people that come to us and whine about everything under the sun.

well, that was one of the few cores reasons I hate working for the healthcare field... I know my ideas probably doesn't go along with the "holy are thou" mindset of nursing either. I'm very cut and dry, and that is just blunt way of how ways are right now; the important thing is I don't convey this to my patients... I don't know, I have plans to go to missions later as NP and if I like it, I might just do that for good.... so who will know the future? :)

Riburn3, BSN, MSN, APRN, NP · Aug 19, 2014

I hate to break it to you OP, but unless you're your own boss, no matter what field you're in, your going to deal with a lot of BS. Being your own boss in medicine brings it's own awful headaches. Surveys, client satisfaction, and benchmarking are standard practices in all fields. Your reservations and dislikes about being an RN seem to stem from your own personal experiences because you work in bad situations.

I've also never been in a situation in my 7 years where a patient/family member can act or say whatever they please and get away with it. If that's the culture of your facility, run, and run fast. As nurses we are expected to smile when being faced with resistance and difficult people, but there is a limit. If you feel like you're being abused, say something, and if they don't do anything about it, don't work there.

Additionally, your comments of a sense of entitlement coming from patients represent the vast minority, and most people are incredibly apreciative of the services we as nurses provide. For every pain in the butt patient I've had that is just awful, there's been 20 patients that treat me like I'm their savior. I also think you forget that they are our "clients". Healthcare workers are paid handsomely for their services, and healthcare is one of the most expensive things a human will have to pay for in their lifetime, with medical debt being one of the biggest causes of bankruptcy. You seem to forget that at some point, each and every one of us will need healthcare regardless of how well and healthy we have lived, and we should all be entitled to exceptional care regardless of social class or financial situation.

Lastly, as for being a provider, if you dislike nursing, prepare to hate being an NP. You're still going to be measured by the same standards you hate, whether you're working in a clinic or an ER, with some of your reimbursement tied directly to how much your patient likes you. Also, if you aren't using your brain to get the big picture in the ER, you are doing something wrong. I am yet to come across a provider that hasn't appeciated my input on the appropriate course of action as an RN, and absolutely love it as an NP student when the MA or RN where I am working gives me a heads up and makes suggestions for me.

futureeastcoastNP · Aug 19, 2014

Nothing wrong with OP's point of view. It's very possible (and common) to hate being a bedside RN and love being an NP. You think all physician assistants (who do the exact same role) could handle being nurses? There's an entirely different "set" of challenges, and for some people the intellectual/paperwork challenges of a white collar career are easier to tackle than the stress/manual labor/disrespect that occur in bedside nursing.

OP, good luck in NP school, from reading your prior posts you are one of the few nurses who realizes that your own happiness and safety is more important than your employer's. I'm in NP school too and can already tell that the level of respect from both colleagues and management is complete 180 degrees from bedside.