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Specializes in Community health.

I am about to graduate from a PMHNP program. It has been rigorous— all on-campus at a well-established local university. Detailed oversight of our clinicals, with site visitors from the university every semester, interviewing our preceptors. But recently I have met some PMHNP students in what I would absolutely call diploma mills.

One of them attends an online university and he described his clinical to me: it is fully on Zoom, with a psychiatrist who does TeleHealth. The psychiatrist is "precepting" 50 students; they all log on and watch his appointments as a group.  

Another acquaintance of mine has a wonderful work history as a NICU nurse. She was in school to be a pediatric NP, but couldn't find any clinical sites. So she changed to psych— with zero change to her coursework. She took no psych-specific classes at all. Just general A and P, pharmacology, etc. Graduated and is now working as a PMHNP. 

The psychiatrist I work with told me that, in looking to hire a PMHNP, she interviewed 5 new graduates, none of whom had ever seen any patients during their entire training. She was asking standard interview questions like "tell me about a difficult experience with a patient" and all five responded "Well, I've never seen a patient, so I don't have any experiences like that.”  

This has to stop. It is a humiliation for our profession.  I am afraid that every state in this union is going to move to strip our prescriptive authority— I would, if I were hearing about this nonsense and had the power to. So the question is: Who do I write to?  Is it the bodies that accredit the colleges? Or the state licensing boards?  Both, neither?  I understand so little about how the process works— I just know that diploma-mill graduates with no clinical experience should not be allowed to enter our profession and do harm to the public. 

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Anytime someone speaks out against things like this they get accused of being pessimistic, too negative or even gatekeeping.

Not EVERYONE was meant to be a provider. With 90% acceptance rates even at big-name schools with little to no clinical oversight (and ridiculous hand-waving clinical experiences) as you describe, it makes us look pathetic.

People will defend their shoddy education till the end because how else could a single parent working full time and unable to move complete their clinical doctorate right? They all deserve to be a provider right? By any means necessary.

Name ONE medical or medical adjacent profession which acts as NP diploma mills do.

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Specializes in New Critical care NP, Critical care, Med-surg, LTC.
CommunityRNBSN said:

The psychiatrist I work with told me that, in looking to hire a PMHNP, she interviewed 5 new graduates, none of whom had ever seen any patients during their entire training.

I admit that I had no idea that this could happen. I know that many people were impacted by COVID for a few semesters, but if these are recent graduates, I would have thought that they would have at least had some clinical experience back to normal.

I think my school fell somewhere between diploma mill and top notch. It has a well respected brick and mortar program, but I thought the online program fell a little short. I was lucky I had fantastic clinical preceptors and experiences, and my working experience as a NP so far has been that I was as well prepared as my peers after graduating. 

I don't know what we can do to ensure that our profession doesn't get dragged down by schools turning out anyone with a pulse as a qualified NP. I understand the desire to do it, and to make it fit into life. I also wasn't in a position to relocate my family for my schooling, so I did what worked for me, so I'm sympathetic to an extent to those that feel like they can make it work despite their program. But graduating without seeing a single patient doesn't seem like it should be allowed to happen. 

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Specializes in Community health.
JBMmom said:

I admit that I had no idea that this could happen. I know that many people were impacted by COVID for a few semesters, but if these are recent graduates, I would have thought that they would have at least had some clinical experience back to normal.

I think my school fell somewhere between diploma mill and top notch. It has a well respected brick and mortar program, but I thought the online program fell a little short. I was lucky I had fantastic clinical preceptors and experiences, and my working experience as a NP so far has been that I was as well prepared as my peers after graduating. 

I don't know what we can do to ensure that our profession doesn't get dragged down by schools turning out anyone with a pulse as a qualified NP. I understand the desire to do it, and to make it fit into life. I also wasn't in a position to relocate my family for my schooling, so I did what worked for me, so I'm sympathetic to an extent to those that feel like they can make it work despite their program. But graduating without seeing a single patient doesn't seem like it should be allowed to happen. 

I was horrified by it too.  I think what happens is, in many online schools, students are responsible for setting up their own clinicals.  So they go through the phone book and call anyone with a license or-- even worse-- they get a friend or family member who is an NP to agree to "precept" them.  But the schools just require that the student and the preceptor sign some forms that say, "Sure, she did 180 hours with me" or whatever. NO actual requirements as to what those hours entailed.  So, if the preceptor is shady and the student is too, they just float semester after semester getting papers signed but getting no clinical experience.

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Specializes in New Critical care NP, Critical care, Med-surg, LTC.
CommunityRNBSN said:

So, if the preceptor is shady and the student is too, they just float semester after semester getting papers signed but getting no clinical experience.

I can't imagine picking a preceptor without giving thought to their work/integrity. I was lucky that I had crossed paths with my preceptors professionally before starting school. I don't think I would have enrolled if I didn't already have some options for clinical rotations set up.  I chose my first rotation preceptor because he wrote the best admission notes I had ever read while a floor nurse. I had one NP and four MDs as preceptors and each time I was their only student and they were very committed to pushing me to really learn what was going on. It was way out of my comfort zone but I'm so thankful for all of them because that's what made my education worthwhile. 

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JBMmom said:

I admit that I had no idea that this could happen. I know that many people were impacted by COVID for a few semesters, but if these are recent graduates, I would have thought that they would have at least had some clinical experience back to normal.

I think my school fell somewhere between diploma mill and top notch. It has a well respected brick and mortar program, but I thought the online program fell a little short. I was lucky I had fantastic clinical preceptors and experiences, and my working experience as a NP so far has been that I was as well prepared as my peers after graduating. 

I don't know what we can do to ensure that our profession doesn't get dragged down by schools turning out anyone with a pulse as a qualified NP. I understand the desire to do it, and to make it fit into life. I also wasn't in a position to relocate my family for my schooling, so I did what worked for me, so I'm sympathetic to an extent to those that feel like they can make it work despite their program. But graduating without seeing a single patient doesn't seem like it should be allowed to happen. 

See I am just not. This have-it-your-way sort of education style speaks volumes about the education quality. Yes, it's 2023 and a lot of classes can be done online, but when comparing NP education to my brother's CRNA program (he had to move from the West to East Coast and uproot his life) it's not even close.

I think we all would agree that an online and pick-your-own-preceptor CRNA school would be horrifying. However, NPs make life-altering decisions too and patients should not be subjected to providers who took the convenient path to a script pad. I don't want someone who just made it work with part-time online schooling and scrounged whatever trash hours they could from friends and acquaintances to graduate, treat me.

Not everyone was meant to be a provider but the nursing powers are going to do their best to make it happen.

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