comparing apples to oranges

SnowShoeRN · Oct 20, 2013

I don't know how many total clinical hours I completed when I got my undergrad degree (I have an associates in nursing as well as a BA in psych), but in my master's program, we are required to complete a total of 600 clinical hours in the span of 1 academic year. This means that for about 22 hours a week I follow a NP as he/she does her job. I learn how to assess, diagnose, and treat patients within a primary care setting (I'm a FNP student). The goal is, by the end of the year, to essentially be practicing independently as primary care practitioners. In a student role, as an undergrad, we learned the basics of nursing by following other nurses. As NP students we learn how to diagnose and manage disease processes and formulate and implement advanced practice care plans.

For me personally, the biggest difference is the type of care that's provided. As nurses, although we use critical thinking, we follow doctor's orders. As NP's, we write the orders. That is not to say, I think, that NP's are the same as primary care physicians. We still use a nursing care model that implements a lot more education, holistic treatment, and community resources than most primary care MD's do. But our prescribing privileges and accountability are similar.

BritFNP · Oct 21, 2013

You're completely hopping to the provider side. It's vastly different. Clinical is nothing alike. Clinical for me in my NP program were going in with my doctor some and sometimes alone to see patients. They have their chief complaint and I begin to interview them (harder than you think to know what questions cover your bases). You then decide what needs to be ordered, if anything, Rx, Labs, imaging, referral, etc. There is a much higher level of critical thinking. Learning how to recognize signs of illness and diagnose, rather than that information already being figured out for you (like when you're a RN), and knowing how to treat it (instead of being given an order of what to do) are the task of the primary care provider/NP. As snowshoe mentioned, the goal is for us to be, for the most part, independent providers.

LarryCarter · Oct 24, 2013

Thank you so much for the replies. This is exactly what I was hoping for when I posed the question. Thank you for sharing your real-life experiences with me. I am looking forward to starting the program and eventually finishing it as well.

allnurses Guide · Oct 25, 2013

The didactic is more rigorous and you are taught a different way of thinking.

The clinic is a slow and steady advancement towards independent practice and is all 1on1 unlike undergrad. You will be expected to be proficient with a full history and physical prior to starting and your preceptors will expect you to start taking ownership of patients, which is largely new from undergrad nursing.

I always talk to my students from the beginning that the one thing I expect is that they apply what they know and ask about what they don't. First semester I expect them to begin to identify normal from abnormal, begin to know basic guidelines for rx, and form basic differentials.

LarryCarter · Oct 26, 2013

I have quite a bit of autonomy where I am now so I hope that will push through to my practice in the future. I am very quick to ask about things I am not sure about when presented with a new problem.