Am I Crazy? Revaming the RN/NP school curriculum...

hoosier guy · Jun 6, 2012

i will preface by saying that i am not a nurse. but i do have a better than cursory knowledge of nursing curriculum. generally speaking there are probably a lot of thing that would be useful to know but that must be weighed against the time and cost adding those things to the current curriculum. despite the lack of organic chemistry, physics, and in-depth biology, do you feel that nurses are able to satisfactorily perform within their scope of practice?

myelin · Jun 6, 2012

It's hard to say. I do agree that NP programs should step up their game, especially the professional programs that farm out their clinicals/practicums (how programs like this are even allowed to exist boggles my mind). However, isn't the difference between a PA and a NP pretty minimal once they've been in practice a year or two? So then does it really matter to have the more in depth background in basic sciences? It's an interesting thought.

allnurses Guide · Jun 7, 2012

It's hard to say. I do agree that NP programs should step up their game, especially the professional programs that farm out their clinicals/practicums (how programs like this are even allowed to exist boggles my mind). However, isn't the difference between a PA and a NP pretty minimal once they've been in practice a year or two? So then does it really matter to have the more in depth background in basic sciences? It's an interesting thought.

I think there is a big difference between PAs and NPs, regardless of experience. They are educated under different models and have drastically different licensing and autonomy.

My two cents.

greygooseuria · Jun 7, 2012

@hoosier: I think we churn out RNs to function at a basic level, instead of striving for an OPTIMAL level. I think knowledge of the sciences would help RNs regardless of their scope of practice in understanding the fundamentals behind their actions since the basic sciences clarify the natural world in which we live.

@myelin: I think you're referring to outcomes data rather than a core set of knowledge. Having a background in the hard sciences would encourage independent thought and problem solving rather than churning out an algorithm generated by one's textbook.

RNGriffin · Jun 7, 2012

Physics is a requirement for many NP programs; along with Chemistry. When I was in school we were required to take Biology I, Anatomy and Physiology I & II, Microbiology( which compares greatly to Organic Chemistry). You are more interested in the molecular level of the human body, which would require you to take up these courses. To say that every nursing student should take Physics, Organic Chemistry, etc. as if he/she were a research scientist, absolutely not. The Microbiology & A&P courses give you a thorough foundation of what you need to know as far as hormonal messengers, enzyme responses, and susceptibility to bacterias & foreign invaders.

Nursing is a hands on critical thinking profession. If you are interested in chemical drug reactions, by all means take up the courses. But, not all nurses share the same passion.

tigerlogic · Jun 7, 2012

Out of curiosity, why would you want to go to med school after getting your NP? Is this a new development for you (as in would you have chosen med school straight out if you could go back) or would you feel that both are useful?

I'm curious as I'm soon to start in an AcBac program and my first degree is in Biochemistry (with over 3 years working in a lab) and feel that my academic background has given me an advantage over my pre-req taking classmates, but nonetheless, I'm consciously choosing nursing over med school and may or may not take an NP one day.

Also, based on my experience with a year of Organic Chemistry (12 credits lecture and 10 credits lab) and a wussy Microbiology class that I'm taking now as a pre-req, I don't think they are at all comparable. I don't think the Organic Chemistry particularly would make a big difference on whether someone is a good nurse or not, other than the memorization skills...

RNGriffin · Jun 7, 2012

@tigerlogic,

Talk to me when you complete nursing school, we can then discuss whether the basis of nursing is all memorization. I would expect a different opinion from someone who has a biochemistry background and is now interested in joining the ranks of nursing. Maybe you should just head off to Med school, since we're only flash cards to you! :-)

tigerlogic · Jun 7, 2012

@griffenchet: I'm sorry! That's not what I meant at all!! I meant that the only thing useful from O-chem that I really take into my future is being good at memorization. (though personally, I do love the pushing electrons around) Of course nursing school requires much more than memorization! I wouldn't be interested in it if it wasn't critical thinking and complex people! I'm merely saying that having some memorization skill is useful, I'm most certainly not claiming it's sufficient. And thank goodness!

I chose nursing over med school because of the holistic/patient centered care. I don't want to look at appointments as diseases and problems to solve, I look at people as patients who need help/caring/education/intervention/etc. -- but mostly patients are people and no amount of memorization helps you listen to, interact with and truly care for people. Many good doctors have these skills as well, but in my experience it's the nurses who have the healing touch/demeanor/skills that make sometimes the biggest difference.

I meant to be downplaying the usefulness of so many hours studying Organic Chemistry-- not the other way around! I apologize for coming off as sounding the other way!

(I also apologize for so many exclamation points. I try to use them judiciously. )

And again, I curious why someone would want both an NP and an MD.

greygooseuria · Jun 7, 2012

I am leaning more towards a PhD in biophysics/physiology than an MD degree, but we'll see.

My preceptor this past semester was an MD and he was more a nurse than ANY nurse I have ever met; very holistic and patient-centered, and he went to med school in the 60s, so I definitely do not think nursing has a monopoly on that at all. I find my fellow nurses to be very lacking when it comes to scientific critical thinking skills on the floor, and it is appalling.

I find it funny how people use the justification that organic chem won't make someone a better nurse, but nursing theory somehow creates wonderful nurses. Hah.

MA_Davis · Jun 7, 2012

I live in Sacramento, and prerequisites for RN require that you take CHEM, Microbiology, BIO:Anatomy and Physiology I & II and no I do not think your crazy lol

This summer, I am taking Bio I and II together along with calculus, both for personal enrichment and because I plan to get a science PhD after my MSN or go on to med school once I have my loans paid off/finish the prerequisites. Anyhow, I am finding molecular/cellular biology to be INCREDIBLY useful to my current nursing practice and to my practice in NP school (I have one year left to go) and I'm only in the second week of classes! I am finding the material to be applicable to many things, and feel I almost missed out on something by not having this included in nursing school/NP school. I've also been reading some chemistry textbooks and physics textbooks and these also are giving me a much deeper understanding of pharmacology and how what I prescribe for patients or interventions that I perform as an RN "work" and I appreciate my practice that much more.
Am I crazy for thinking nursing and NP school, much like med school/physical therapy school, should include these as courses required in the curriculum? A year of physics, biology, chemistry and organic chemistry I feel would not only give greater knowledge to our graduates and a deeper understanding of the physical world, but also give greater creedence to our profession, ie: we have the science AND the heart! I am finding what I am learning to be SO much more applicable to my learning than theory, research, communication, and policy ever were, and that's comparing classes I've had for a whole semester versus ones I've been in for only 2 weeks so far. I can only imagine how useful biophysics will be when I get to it.
I subscribe to the "don't be a douchebag to your patients and listen to what they're saying" philosophy and did so LONG before nursing school so maybe that's why I find most of the current curriculum useless. lol

tigerlogic · Jun 7, 2012

I am leaning more towards a PhD in biophysics/physiology than an MD degree, but we'll see.
My preceptor this past semester was an MD and he was more a nurse than ANY nurse I have ever met; very holistic and patient-centered, and he went to med school in the 60s, so I definitely do not think nursing has a monopoly on that at all. I find my fellow nurses to be very lacking when it comes to scientific critical thinking skills on the floor, and it is appalling.
I find it funny how people use the justification that organic chem won't make someone a better nurse, but nursing theory somehow creates wonderful nurses. Hah.

Well, I know a lot of people who have taken a lot of science class and are horrible scientists too And ultimately, I agree with you. If/when I have to take "don't be a douchebag to your patients and listen to what they're saying" classes, I'm sure I'll feel the same as you.

Ultimately I think the quality of the program makes more of a difference than the classes when it comes to what meta-skills you get out of it. I think I got most of my good science thinking skills from working in research but feel pretty good about my undergrad degree also being some useful preparation. The pre-reqs I'm taking now I'm highly critical of and was very unhappy with the level of memorization vs understanding. The difference isn't just the courses-- it's the philosophy of teaching.

And from what I've seen so far, I agree that revamping would be wonderful.

I try to keep in mind that nursing is actually a pretty young profession and as more demarcations happen e.g. CNA vs LPN vs RN vs BSN vs NP vs PA vs MD work I think a lot of the revamping is growing pains. Personally, I would be in favor of an MCAT style pre-nursing school exam rather than GPA based competition, especially for 2nd degree programs. Personally, I think Univ of Washington's work experience/job shadow requirement is awesome (I use them as an example as they are often ranked #1 in the nation).

I'm glad you had a good experience with an MD preceptor and it sounds like you will do great in research if you choose to go that way.

Do you have any thoughts on how students could get more out of nursing school to better prepare them, as you see it?