There seems to be a lot of opinions about what role NP's should fill in health care. I offer my personal view for the future of advanced practice nursing. Please critique my proposal, as I am not a Nurse Practitioner I suspect some of my views might miss an obvious limitation or reality of nursing practice.
Near term: eliminate the proposed requirement for all NP programs to transition to DNP by 2015. emphasize NP collaboration with physicians as a mid-level practitioner. Revise and expand the curriculum for DNP and / or begin to model the curriculum after medical and osteopathic schools. Push for an expanded scope of practice for DNP's as primary care providers
Far term: Give DNP's full practice rights (they will probably have to take a route like DO's, begin with family practices and gradually expand into all specialties) Maintain masters degree prepared NP's as mid level providers with supervision or collaboration with DNP's and MD's/DO's
Are there any glaring errors or problems with this proposal?
Specializes in ICU, CV-Thoracic Sx, Internal Medicine.
Oddly enough, I'm from the same area and those are the experience-not-required programs I was talking about. How familiar are you with UTMBs program?
Since I've never been there, I assume so many students have experience because the universities prefer it, even though they don't require it, but I'm not sure. But it's entirely possible that's due to their med school model. Students apply more broadly and try to make themselves attractive to as many schools as possible, including racking up experience hours?
Please don't misunderstand my intentions in posting my comments regarding clinical experience comparisons between PA and NP applicants. Let me be very clear, my post is not intended to say one is less or more prepared than the other on admission. It is simply an observation in response to disparity between credit hours of each program.
I am somewhat familiar with UTMB. I completed my MSN/NP program there and shared a couple of courses with PA students. One of which was my fried from HS. Odd to run into her after so many years. My familiarity with the program comes solely through discussions I had with her. So I would say I'm casually familiar.
My best friend has her eye on UTMB's PA school, and all her research says she needs years of experience, but the school's website mentions nothing about it. She has her Master's in Psychology and she's back in school to become an MA to get experience, but she's hoping she can get in without actually ever having to work. Patience isn't one of her strong points :)
My friend, I mentioned above, had ZERO clinical experience. She was working in an auto insurance agency. This was 5 or 6 years ago when I last spoke with her, so I don't know. Maybe things have changed since.
Specializes in ICU, CV-Thoracic Sx, Internal Medicine.
Your post here is somewhat laughable. Sorry but there is just so much fail here that I'll have to go line by line and point things out.
Any citations to back up that statement that the majority of NP applicants have a minimum of 5+ years of clinical experience?.
I couldn't have made myself more clear when I posted that I was simply making a guess. Didn't know a guess would be scrutinized to infer that this was a fact. Citing sources on data that is presented as fact is a resonable request. Are you really requesting cited source on a guess?
LOL
The rate at which direct-entry programs have been expanding, in addition to the fact that I haven't met a single nursing student during my 3 years (so far) on the wards who wanted to stay a "regular" nurse (ie. every one of them wanted to pursue an NP or CRNA degree), suggests otherwise....
WANTING to do something and actually DOING something are two completely different things.
Many people WANT to be millionaires. Few are actually DOING the necessary to make it happen.
See the difference?
Of course, the number of nursing students I've encountered has definitely been less than 100, so there's some skewing there.
You should get out more. Also, talk to some Nurse Practitioners, not just a "regular" nurse as you put it.
But I get the sense, from talking with my nursing friends as well as reading around on these forums, that a lot of students who go into nursing want to become APNs as soon as possible rather than stay as floor nurses, etc.
Again with the want.
See above comment for further recommended reading and exposure.
That's why I'm hesitant when I read a post like yours that states that the majority of NP applicants have 5+ years of clinical experience. That certainly may have been true a decade or more ago; these days, I'm not so sure anymore.
How would you know this may or may not have been true a decade ago? Any citations to back up that statement?
See how I did that? Clever huh?
So, if you have any actual data on hand regarding this issue, it'd be great if you could cite it. Thanks.
Sorry, I don't have that information. It was just a guess. What can I say?
But I am a NP and I'm willing to bet I've met more NP's than you have.
Specializes in ICU, CV-Thoracic Sx, Internal Medicine.
Agreed. This has been my experience as well.
TX RN, even if some PA schools don't specifically require these hours of clinical experience, it's pretty much an unwritten requirement at most PA schools, from what I understand.
Unwritten requirement? That sounds really official. We wouldn't want to go not meeting all the requirements, written or not, now would we?
LOL
Just messing with you.
Sounds more like what you're saying is that applicants with some prior clinical exposure are looked upon more favorably.
Because to say something is REQUIRED but is NOT makes absolutely no sense and is contradictory.
I know we're in a nursing forum but you got to give us more credit than that. We're smart enough to know the difference.
It was similar for med school, where no school actually requires you to have clinical volunteering, shadowing, etc, but you'd have a ridiculously difficult time getting in anywhere if you didn't.
See what I mean? "No school actually requires..."
Semantics, I know. But it's important to clearly define what is and what is not. A "requirement" is exactly that, required. Again, I think what you mean to say is that programs look at an applicant more favorably if they have prior clinical experience/exposure.
And why shouldn't they? It shouldn't come as a surprise, this is true in any field of study. Yes, even nursing. :)
I don't claim to be an expert on PA training, but based on my interactions with PAs, what Stephalump states appears to be true. I've yet to meet a PA who hasn't been an EMT, RN, etc, prior to becoming a PA. Interestingly, at least in my region, most of them seem to have been EMTs for a few years prior to starting PA school.
Care to back up that statement by citing your source?
Please don't misunderstand my intentions in posting my comments regarding clinical experience comparisons between PA and NP applicants. Let me be very clear, my post is not intended to say one is less or more prepared than the other on admission. It is simply an observation in response to disparity between credit hours of each program.
I am somewhat familiar with UTMB. I completed my MSN/NP program there and shared a couple of courses with PA students. One of which was my fried from HS. Odd to run into her after so many years. My familiarity with the program comes solely through discussions I had with her. So I would say I'm casually familiar.
My friend, I mentioned above, had ZERO clinical experience. She was working in an auto insurance agency. This was 5 or 6 years ago when I last spoke with her, so I don't know. Maybe things have changed since.
No malicious intentions taken from your comments at all. Just making conversation based on what I've seen in the years I've spent obsessing over choosing between MD, PA, and NP. But I do find it interesting tha your friend had zero experience. My buddy will love to hear that!
And I really don't blame her. While I do understand the value of experiencing the healthcare world before investing time and money into pursuing it, her scope of practice is so different, the benefit is definitely limited, in my opinion. 5 years on a nursing floor before becoming an NP in your speciality seems far more beneficial.
The debate about PA vs NP clinical hours annoys me to no end. A PA needs to have all those clinical hours because they are generalists and can work in any medical specialty once they graduate, so they have to dilute their hours over multiple branches of medicine. A NP has more limited clinical hours because all of their hours are focused on one specialty. If they want to practice in another specialty they have to go back to school (and get more clinical hours!) in order to do so. It just really annoys me when people basically argue that NPs training is so much worse compared to PA training because of the hours discrepancy. I would take a brand new psych NP over a new PA any day of the week, because I know that psych NP has taken extra coursework focused on that specialty, had all their clinical hours in psych, been trained and licensed to provide therapy, etc, etc.
Also, I think it is a really good point that all NPs have *at least* had RN training and clinical experience prior to practicing as a NP. Many PA programs are direct entry (they're not rare in the least, at least not around here). And contrary to what others believe, they do accept many students who have not worked in the medical field. I remember reading a stat that 30% of PA programs now have no paid healthcare experience requirement… I'll have to track down where I read that, though. The students accepted to these direct entry PA programs usually are academically competitive, have volunteer experience, research experience, etc… but so do most people who enter direct entry NP programs, which are also highly competitive. At least a person in a direct entry NP program becomes an RN first. I just find the whole conversation disingenuous.
eta: This is not to say anything bad about PAs or PA programs. I went to a PA recently when I hurt my foot and he was fantastic. I just think PA and NP are both viable career paths and which one you choose really depends on your career goals and specialty interests, etc. I don't think one is automatically superior to the other, at all. I actually was very interested in PA school (I was trying to decide between going into emergency med or psych). In the end, I chose psych, which is why I chose NP school, since I think NP training in psych is superior compared to PA training.
Specializes in ICU, CV-Thoracic Sx, Internal Medicine.
No malicious intentions taken from your comments at all. Just making conversation based on what I've seen in the years I've spent obsessing over choosing between MD, PA, and NP.
Great! Tone is so important in getting a point across that sometimes I feel my posts lack clarity and leave the door open for misinterpretation. I too get tired of the PA vs NP comparisons.
Both disciplines have proven time after time to be of high quality and complimentary to the medical model.
If you don't mind me asking, which program are you in and how far along are you in your studies?
But I do find it interesting tha your friend had zero experience. My buddy will love to hear that! And I really don't blame her. While I do understand the value of experiencing the healthcare world before investing time and money into pursuing it, her scope of practice is so different, the benefit is definitely limited, in my opinion. 5 years on a nursing floor before becoming an NP in your speciality seems far more beneficial.
Yep, I don't think she'll lose anything by applying now. Honestly, being a provider is like nothing else, yes even if you are a RN. Clinical exposure in any number of roles helps to lower the learning curve. Some roles more are more beneficial than others, but even still I think you're friend would be better served by just applying now. No sense in paying for an education (MA) that she won't be using. Not to mention the time invested.
Seems rather counterintuitive to invest in something you have no intention of using.
well, you've only looked at med school, NP curriculum but MD education continues to residency and fellowship which requires research before you graduate (ACGME rule).
I'm sorry but this is required at my school for the BSN degree as well. It's highly integrated into the curriculum. Also the statements I keep reading about "Studying 7 hours a day every day and on the weekends" yes, that's my school, too. I understand not all BSN programs are created equally but I can say that we get an education at my school. We have MDs from other countries attend our program and have difficulty with it. We have had doctors of chiropractic have extreme difficulty in our program. Yes, med school is hard, but so are many BSN programs. Don't underestimate the work being done right now by nursing students all over the country.
TX RN
255 Posts
Please don't misunderstand my intentions in posting my comments regarding clinical experience comparisons between PA and NP applicants. Let me be very clear, my post is not intended to say one is less or more prepared than the other on admission. It is simply an observation in response to disparity between credit hours of each program.
I am somewhat familiar with UTMB. I completed my MSN/NP program there and shared a couple of courses with PA students. One of which was my fried from HS. Odd to run into her after so many years. My familiarity with the program comes solely through discussions I had with her. So I would say I'm casually familiar.
My friend, I mentioned above, had ZERO clinical experience. She was working in an auto insurance agency. This was 5 or 6 years ago when I last spoke with her, so I don't know. Maybe things have changed since.