Direct-Entry NP Success Stories

[arockenhaus1]

I am currently applying to several direct-entry nurse practitioner programs. I have my bachelor's degree in biology and I fell in love with nursing after I graduated. I am, obviously, very interested in becoming a nurse practitioner, specifically an AGACNP.

I have seen, only on this forum really, several nurses talk about how direct-entry programs can't produce very good nurses because of the lack of actual nursing experience you have while going through the program. This frightens me a bit, but I consider myself very motivated and smart enough to get through the rigors of the program.

Are any of you products, or know someone who is a product, of a direct-entry program, and if so, is it something you recommend? Would you do it the same way, or would you go the more traditional route if given the choice? Also, where did you go to school, and how difficult was the program?

[BostonFNP, APRN]

In upcoming years I suspect a majority of all NPs will be direct entry thanks to the universitities' ingenious retention plans and number of As Seen On TV schools offering anyone a degree who can pay tuition. I would agree direct entry students appeared to be established, educated professionals who were likely designed to be more successful than the fresh faced 23 year olds they are graduating now. The direct entry NPs of recent years will likely become concerned about the lack of standards in upcoming years also.

I think all practicing NPs are concerned about dwindling standards and sup-par programs; this has almost nothing to do with direct entry programs. The fastest growing group of novice NPs are those with 2-4 years of RN experience, not those with no experience or extensive experience. You can see evidence of this on the forums here regarding people posting about moving directly into NP education part time as they work as a RN full time after graduation.

Consider the authors of many of these "nursing research articles". Work full time for universities much? I don't feel most nursing research articles pitting NPs against MDs are impressive in particular because many focus on patient satisfaction. It is sad that we pride ourselves so much on the handholding factor when that seems to overshadow a world of incompetence in some cases. Thankfully it is difficult to actually kill a patient which supports, across the board, less than competent providers managing to stay in business.

The studies on NP role socialization are done by those in nursing academia; that shouldn't be a big surprise they are the ones using the generated data. Could there be bias there, sure, but most of these programs can fill their roster without regard to RN experience so not sure why they'd be invested in altering data.

Re: NP vs MD studies; this is an entirely different topic, but the vast majority of the major studies have dealt with objective outcomes not patient satisfaction, which we know is inversely correlated with M&M.

Regardless of the program I suspect overall NP quality will decline because so many are being admitted with little to no admission criteria. If only considering the increased number of NPs and states with full practice authority it is likely our percentages of malpractice suits and adverse outcomes will increase. I think we need to take the time to allow this new trend to settle in before we congratulate ourselves on our great quality.

This may very well be true; and practicing NPs should be working with their local and national professional associations on this issue. I suspect many are not because I don't see many at the meetings on the topic.

Although rarely acknowledged here there is data indicating we are lacking in some areas:

There are absolutely deficits that can/need to be addressed. The Mayo article was an excellent one which should really make NPs consider how they practice in a collaborative way. Over-referral has been a common thread in the literature regarding places where NPs are less competent then their colleague physicians.

[BostonFNP, APRN]

Some of the programs required students to take a break after the BSN portion and seek acute care employment as an RN for at least a year and then return for the NP portion later.

For the OP, this is an important thing to research. Many programs traditionally require a set number of completed RN work hours as stipulation for progression or graduation from the graduate portion of the program. This isn't always readily advertised you have to discuss with admission reps.