How do you feel?

mrcleanscrubs, BSN, RN · Jan 16, 2018

@ mrcleanscrubs:
Recommend reaching out to the program directors for an informational interview, and ask them what they (and the specialty faculties) are working on and what experiences they have. I did that for all 3 programs I applied to and it made a significant difference when I had to choose which one to attend. I got a much better sense of quality of the program after doing that.

That is a great idea, thank you for that awesome recommendation. I will definitely be reaching out to program directors and clinical faculty to assess the faculty individually as well as assess the quality of the education provided in the program. Thank you!

FullGlass, BSN, MSN, NP · Jan 16, 2018

I'm surprised at the negativity regarding NP schools on this thread. It is up to applicants to research the school. You can look at rankings, but also talk to current students and to NPs that you know. There is a forum on allnurses for discussing specific schools.

A key difference between NP school and PA school is that PAs study everything. NPs must select a specialty and only study that. PAs can't set up an independent practice, but in 23 states and in the VA, NPs have full practice authority.

There are increasing numbers of NP residency programs, so that is an option. My classmates that applied to these got accepted and are happy.

I don't know ANY new grad clinician that feels adequately prepared - be it an MD, NP, or PA. Pretty much everyone is nervous and anxious when first starting out.

1. Do you feel as though your NP Program properly prepared you to safely and competently care for patients?

Well, as much as could be expected. My rotations for Adult and Geri Primary Care NP:

Intro rotation in SNF - I'm not counting this as it was only like 32 hours
Humongous LTC facility (Geri) - awesome preceptor with 30 years NP experience, including international. Focus was on caring for elderly patients with chronic conditions, including Alzheimer's and polypharmacy (how to reduce # of drugs safely and gradually). Rotation also included new issues such as colds, flu, pneumonia, etc. Preceptor really knew her stuff and was excellent teacher. Also got to spend time at the Occupational Health Clinic at this facility was another NP and it was great to get exposure to this interesting field.
Inner city Urgent Care - awesome preceptor with 40 years NP experience, 30 in this clinic. Super busy urgent care with lots of variety and emergent patients. She is a great teacher and mentor. My favorite rotation. In addition, spent a few days of this rotation with an NP who is a nationally known diabetes educator at the hospital's outpatient diabetes center.
Pain mgt clinic - preceptor was DO with over 30 years experience who had also been a medical researcher. He was the considered the best pain mgt doc in the city; other pain doctors referred difficult cases to him. Excellent teacher. Also had a Sports Med MD in practice and he was a great teacher, too.

In all my rotations, I was expected to ramp up to independently take Hx, do exam, develop different dx, defend my top dx, and recommend appropriate tests and prescriptions. Of course, all this was reviewed and corrected as necessary by preceptor. Also learned to chart as I went, for maximum efficiency.

2. Do you feel that you truly have an in depth understanding of Anatomy & Physiology, Pathophysiology, and Pathology?

Again, as much as can be expected. This is a life long learning process. My prereqs included anatomy and physiology. I had patho in the BSN program. Then I had Advanced Patho in the MSN program.

The DO also precepted MD residents and I observed them, too. They weren't masters of anatomy by any means. The DO told me most med school grads don't have an in depth grasp of clinical anatomy and both additional study and experience relevant to the specialty are required.

My pain mgt preceptor told me to always keep learning and make a habit of spending at least 30 minutes every day reading up on new treatments, etc., in medicine.

3. Do you feel as if your medical questions in lecture were answered to an extent that clearly illustrated that your professors were truly knowledgeable in advanced practice/medicine?; In that, they actually answered your question and not just answering stating, "That is something you will learn, 'on the job.'"

Yes, many of my faculty are nationally recognized subject matter experts. We also had many lectures from MDs from the adjoining medical school and hospital. Examples: radiologist gave lecture on medical imaging, cardiologist on EKG interpretation, psychiatrist on drug abuse, etc. Our pharmacology professor was the pharmacologist responsible for quality control at the adjoining hospital - he was just awesome.

My faculty was comprised of lecturers, clinical instructors, preceptors, and a wonderful academic advisor. All the NP faculty both practiced and taught. All of them were excellent, IMHO.

4. Do you feel that your thirst for medical knowledge was satisfied?

This can never be satisfied, nor is it possible to learn everything in school. It is a lifelong process. My school did offer many incredible resources: multiple Grand Round lectures everyday, access to incredible nursing and medical research libraries, and many interesting electives and elective certificates that could be completed along with the regular MSN curriculum.

I only had one "fluff" course in the MSN program - it was one class that combined Ethics and Nursing Theory. Ethics is important, and med students study this, too. Nursing Theory - bleah. With the exception of one statistics and one research class, every other class was clinically focused. And I think an NP must be able to evaluate research publications and be able to write an article suitable for submission to a peer-reviewed journal, which was the focus of our research class. The research class was also an opportunity to perform a "deep dive" on an area of personal interest.

Again, in healthcare, learning is lifelong. That's also why we have CE requirements.

5. Do you feel satisfied in your role as a Nurse Practitioner?

I'm a new grad, so we'll see, but I am very excited to begin my new job, and of course, anxious to provide safe and effective patient care.

Oldmahubbard · Jan 17, 2018

You had some very unusually good preceptors and great clinical experiences. Which have always been difficult to find, and based on what I read, don't seem to be getting any easier.

Dodongo, APRN, NP · Jan 17, 2018

I only had one "fluff" course in the MSN program - it was one class that combined Ethics and Nursing Theory. Ethics is important, and med students study this, too. Nursing Theory - bleah.

I've honestly never, in my entire nursing education, taken a "nursing theory" class. What, exactly, does one learn in such a class?

FullGlass, BSN, MSN, NP · Jan 17, 2018

I've honestly never, in my entire nursing education, taken a "nursing theory" class. What, exactly, does one learn in such a class?

I'm still not sure! LOL

Oldmahubbard · Jan 17, 2018

Jack squat?

Not even.

mrcleanscrubs, BSN, RN · Jan 21, 2018

@FullGlass ,

Hello,

Wow! Your post blew me away! You definitely attended an incredible program. I could not agree with you more on everything you touched back on. I also do agree with the fact that many providers, be they NP, PA, MD, or DO - really don't know / remember the anatomy they learned. I actually spoke to multiple physicians from different facilities in NYC and they said they really don't use their anatomy as often as we'd think. You had great experiences, and it was refreshing to hear some good things! Thank you for your extensive reply!

Shurlburt · Jan 23, 2018

I agree with all your answers

JBMmom, MSN, NP · Jan 26, 2018

OP, I appreciate that you started this thread, I have found much of it very interesting. I'm just starting out on my NP journey and am interested to hear the experiences of others. I am at an on-line school and I will have to find my own preceptors, however, I'm very happy with how that seems to be working out for me. I chose to go back to school because of the NPs I have had the opportunity to interact with in my RN role, so I've got preceptors lined up in a few different roles in the hospital including ED, hospitalist, surgical and palliative. I had some concerns about an on-line program initially, and hoped for a brick and mortar program but that didn't work out. Then I realized that in any of my previous jobs, my education didn't prepare me to step out and work independently on day one. It prepared me with the broad tools I would need to be successful and it was up to me to do the rest. Whether a school has proctored exams or not doesn't impact my experience. I had classmates in nursing school and in my first graduate program that cheated right in the middle of the proctored exams. Did their cheating impact my education? Not really. I've had great professors at community colleges and crappy ones at expensive private colleges. Other than being frustrating at times, did they really impact my ability to be successful after school? Not really. Once again, I'm going to get out what I put in. There will be awesome NPs that had to attend a school that others will turn up their noses at, and there will be NPs from the fanciest of schools that patients don't want within 10 feet of them. So much of it is up to us as the learners and new practitioners that I think we can find success in many ways. All the best to you on your journey.

mrcleanscrubs, BSN, RN · Jan 27, 2018

OP, I appreciate that you started this thread, I have found much of it very interesting. I'm just starting out on my NP journey and am interested to hear the experiences of others. I am at an on-line school and I will have to find my own preceptors, however, I'm very happy with how that seems to be working out for me. I chose to go back to school because of the NPs I have had the opportunity to interact with in my RN role, so I've got preceptors lined up in a few different roles in the hospital including ED, hospitalist, surgical and palliative. I had some concerns about an on-line program initially, and hoped for a brick and mortar program but that didn't work out. Then I realized that in any of my previous jobs, my education didn't prepare me to step out and work independently on day one. It prepared me with the broad tools I would need to be successful and it was up to me to do the rest. Whether a school has proctored exams or not doesn't impact my experience. I had classmates in nursing school and in my first graduate program that cheated right in the middle of the proctored exams. Did their cheating impact my education? Not really. I've had great professors at community colleges and crappy ones at expensive private colleges. Other than being frustrating at times, did they really impact my ability to be successful after school? Not really. Once again, I'm going to get out what I put in. There will be awesome NPs that had to attend a school that others will turn up their noses at, and there will be NPs from the fanciest of schools that patients don't want within 10 feet of them. So much of it is up to us as the learners and new practitioners that I think we can find success in many ways. All the best to you on your journey.

Greetings JBMmom !

Thank you! I am so glad you shared your story. I think what the points you touched on are very important. A lot of people will look down their noses on NPs based upon where they received their education. I think it is absolutely unprofessional and unacceptable. I completely agree with you, no matter what program one may attend - it truly is up to the individual to make sure that he or she is putting in the time and effort to not only understand the material, but to really know it - and to have integrity and in regards to exams whether they be proctored or not. You made some valid points, and I am glad your shared your experiences thus far.

Thank you, and good luck to you in all of your future endeavors!

Kindly,

MrCleanScrubs

staphylococci, NP · Jan 27, 2018

1. Do you feel as though your NP Program properly prepared you to safely and competently care for patients?

Somewhat. I'm grateful that I had preceptors who pushed me to be as independent and autonomous as possible during clinicals. If not, I think I would be drowning right now in my first NP position seeing 25 - 30 patients/day. The didactic portion of the FNP program left much to be desired. There definitely weren't enough clinical hours.

2. Do you feel that you truly have an in depth understanding of Anatomy & Physiology, Pathophysiology, and Pathology?

Not really. I'm fortunate a biochemist taught my Advanced Physiology/Pathophysiology class, so we had very in-depth lectures. I supplemented my studies by reading Guyton & Hall, Netter, and Robbin's, but I don't think that I know as much as I should.

3. Do you feel as if your medical questions in lecture were answered to an extent that clearly illustrated that your professors were truly knowledgeable in advanced practice/medicine?; In that, they actually answered your question and not just answering stating, "That is something you will learn, 'on the job.'"

A lot of lectures (but not all) were just professors reading off PP slides. Other times we didn't have lectures on a topic but were given journal articles to review instead. There were a few professors who seemed to be very knowledgeable about medicine and the basic sciences.

4. Do you feel that your thirst for medical knowledge was satisfied?

No, but it never will be. :)

5. Do you feel satisfied in your role as a Nurse Practitioner?

I feel pretty satisfied, especially in comparison to being an RN, but I'm also a new grad FNP in primary care. I know that I need more time to learn and grow as a provider. Sometimes I do wish that I had went to medical school and completed a residency instead. Mais c'est la vie!

Dodongo, APRN, NP · Jan 27, 2018

I supplemented my studies by reading Guyton & Hall, Netter, and Robbin's, but I don't think that I know as much as I should.
...
Sometimes I do wish that I had went to medical school and completed a residency instead. Mais c'est la vie!

I did the same thing. I read so much more than what was required of me. It shows on rotations when you're next to medical students and PA students and you are answering the majority of the attending's questions - correctly. There's still so much more I need to learn but I can't imagine where I'd be if I hadn't done that.

And I feel that way sometimes as well. Whenever I catch myself thinking that I remind myself that the attendings take call every 3rd week and weekend - getting phone calls and coming in at every hour of the day and night. It's all a trade off.