Clarification on NP Curriculum?

[DO_question]

Hello allnurses,

I'm a DO student dating a RN who is looking into obtaining her DNP in the near future. Currently, she's interested in FNP due to the flexibility and her interests. We try to support each other as best we can, so she has asked me my thoughts on pros & cons of various programs. I feel woefully inadequate for this task just due to unfamiliarity with graduate nursing education and I hope some of you can help me out. So now to the questions...

1. I note the courses at several institutions cover stats, leadership, roll transition, and research but I don't see courses in anatomy, microbiology, immunology, or biochemistry. Are these integrated into other courses? Or is this varied enough that it would be on a school by school basis? I ask this specifically wondering if the undergraduate courses in these subjects are considered adequate for FNP practice or if they are covered at the advanced level. Keep in mind, I'm familiar with her undergrad courses, I took most of them.

2. Is there a general expectation of established clinical sites? To what level does this vary? I'm not finding much on school websites about clinical sites.

3. For those of you in practice, can you offer any resources that would benefit her in making the most of her education? Anything you wish you had done prior to enrollment?

4. Any pitfalls that might not be so obvious to a significant other? Any pitfalls you see that a medical student or resident might need to understand specifically?

I appreciate your time and forgive me if this is some beaten horse, I did try to some rudimentary searches on the site and did not see these questions addressed. Please, if I seem ignorant, just know I'm trying to understand to the best of my ability and support her in her career moves.

[DO_question]

To be honest I thought the same thing as BabyNP and was hoping your girlfriend wouldn't think you are being intrusive.

I'm not sure how this is intrusive, I felt I was ignorant (relatively) and wanted to gain some knowledge. You'd think my interest would be seen as positive? I mean when she asks me, should I instead just respond based on my own experience?

That said, this is the internet, I'm sure someone could assume I'm asking in place of her or in the stead of her finding her own answers, which would be less than positive.

So I'm gathering it is not so much a decade + of nursing experience being necessary so much as a few years being beneficial. That's awesome. Don't NPs use NP preceptors?

[Corey Narry, MSN, RN, NP]

Juan,

Can you talk to me more about what procedures you do in the ICU? How is the team dynamic in that ICU? Are there residents? There's variety in how I've seen NP/PA used in the ICU so I would love to see how you guys do it.

Were you trained in these procedures during your training or only after?

Guys, great info. Thank you again.

I work at an academic medical center in Northern California but previously was in the Midwest in a teaching hospital that's also now affiliated with a medical school. We had sim labs for procedures in my ACNP program and did one or two lines while a student NP in clinicals. That wasn't enough to make me competent. In most cases, ICU NP's must be supervised by an attending for a number of lines or procedures before being allowed to do the procedure on their own. That's how the credentialing procedure and staff by-laws are written at least in the hospitals I've worked at and that's pretty standard everywhere. ICU NP's are no longer a new thing. You can find stuff about it with a PubMed or google search.

[DO_question]

Thank ya!

[wondern, ASN]

I'm learning from this thread. I wake up ignorant everyday and hope to learn something new. It's inspiring to me that someone cares that much about the person they love.

[wondern, ASN]

...on weighing risks vs benefits that I never really had to worry about as much as a bedside nurse. Also, as a nurse, I have a good idea what physical examination findings would look like as nurses routinely assess patients, the NP program helped me focus in on tying together that patient presentation into a unifying syndrome that could lead to possible diagnosis which I also never practiced or paid much attention to as a bedside nurse.

A lot of the fine tuning in the role such as being more efficient, being more elegant in my choices of therapy and how to adjust doses accordingly, and procedures (central lines, arterial lines, sedation management, etc) were things that I was taught basics on as an NP student but got to practice more and develop as a skill in depth on the job.

Wondering, do you diagnose or do you present your findings to the MD? Meaning are you allowed to in your scope of care?

Thanks and btw your avatar is awesome! It makes me want to go to the beach maybe even all the way to California.

Edit~~~May as well add an awesome video here...

[DO_question]

I sure hope they can diagnose. That's the point I think. Or at least, that's how my grandmother practiced.

[wondern, ASN]

I graduated from Texas Tech's Adult/Geri Acute Care NP program after having been an ICU/CCU/ER nurse for 10 1/2 yrs. I was trained in school to do central and art lines as well as lumbar punctures. Spent an entire day at my clinical site going from OR room to the next just doing intubations. On the job as far as getting privileges I had to be again precepted with another provider doing 15 intubations, 10 central lines, 15 art lines here in Dallas. The NP's usually run the night shift in the ICU but we can call a resident or our attending if we need to...

Rock n' roooll!!!

[wondern, ASN]

I sure hope they can diagnose. That's the point I think. Or at least, that's how my grandmother practiced.

Oh, thanks. Is that the point?

[Jules A, MSN]

I'm not sure how this is intrusive, I felt I was ignorant (relatively) and wanted to gain some knowledge. You'd think my interest would be seen as positive? I mean when she asks me, should I instead just respond based on my own experience?

That said, this is the internet, I'm sure someone could assume I'm asking in place of her or in the stead of her finding her own answers, which would be less than positive.

So I'm gathering it is not so much a decade + of nursing experience being necessary so much as a few years being beneficial. That's awesome. Don't NPs use NP preceptors?

Like you said the internet and sometimes written word loses something in translation. My thoughts, and this coming from a female who's husband has had minimal input into any of my decisions, were that you might be one of these super bright, curious types who likes to know everything which isn't a bad thing. On the flip side I hoped you weren't just one of the overbearing controlling types who wanted to show your superiority in conversation or unduly influence her decision. Regardless, and in no way do I want to make you feel unwelcome, it is kind of odd that she isn't the one here searching for feedback.

As for preceptors I chose MDs who I knew were incredibly skilled because in my opinion their education is far superior and I wanted the best base possible.

[DO_question]

Oh, thanks. Is that the point?

By "the point," I suppose I meant that they're qualified to. I am curious to hear, but I'm betting in some institutions NPs interchange with residents and in others they run plans by the attending when they are unsure.

Of course, my background is rather focused toward EM, so maybe it's different elsewhere?

[FullGlass, BSN, MSN, NP]

I'm not sure how this is intrusive, I felt I was ignorant (relatively) and wanted to gain some knowledge. You'd think my interest would be seen as positive? I mean when she asks me, should I instead just respond based on my own experience?

That said, this is the internet, I'm sure someone could assume I'm asking in place of her or in the stead of her finding her own answers, which would be less than positive.

So I'm gathering it is not so much a decade + of nursing experience being necessary so much as a few years being beneficial. That's awesome. Don't NPs use NP preceptors?

NP student preceptors can be NPs, MDs, or DOs. I'm not sure about PAs

[FullGlass, BSN, MSN, NP]

To clarify: FNP is now a primary care role. FNPs are not supposed to work in acute care and they do not receive any acute care education or training. NPs who are interested in acute care must specialize in either Adult and Geri AC or in Peds AC. Someone who wants to be able to work in both an acute care and primary care environment should go the PA route.