For those of you who have say 5+ years experience as a NP what is your opinion on our profession now? Has it changed from when you were planning to become a NP?
As I've mentioned here many times before I am concerned about the future of our profession and at times embarrassed to be identified as a NP. When I decided to become a NP, not everyone and their 20yo baby sister was becoming one, and the few I knew from work were mature, professional and competent. My biggest gripes were their lack of polish, frumpy attire and affinity for excessive hand holding but now I long for the days when those were my complaints. The new trend of minimal if any admission standards as well as lack of RN experience makes me think our outcomes will tank. Regardless of one's philosophy on the admission requirements or experience prior to our short track to prescribing education if for no other reason than the sheer number of new graduates as anticipated in upcoming years there is cause for concern.
What I am seeing based on the postings here is a total lack of maturity and professionalism from more than a few of the newbies. I have seen multiple that come across imo as histrionic, narcissistic with glaringly poor writing quality and I'm not referring to text slang. My real-life experience as I previously posted, and if I recall correctly got cursed at and possibly called a hater? which made me "lol", is that institutions in my area are taking notice of the ill prepared new NP graduates and either shying away from hiring them or placing them in subservient roles. The pay rates in my specialty range from $90,000 to $185, 000 per year with no specification based on years of experience simply because so many have no clue how to manage their business and frankly while I think I'm an above average NP I doubt I'm worth $90,000+ a year more than some of my colleagues.
My professional opinion shaped patient care, my medical colleagues deferred to my clinical judgment...because of experience and expertise in my area.
Do you feel your RN experience contributed to your experience and expertise as a NP? What do you think of the current climate where RNs stay in school without ever working at the bedside before becoming a provider with prescribing rights?
What I am seeing based on the postings here is a total lack of maturity and professionalism from more than a few of the newbies. I have seen multiple that come across imo as histrionic, narcissistic with glaringly poor writing quality and I'm not referring to text slang. My real-life experience as I previously posted, and if I recall correctly got cursed at and possibly called a hater? which made me "lol", is that institutions in my area are taking notice of the ill prepared new NP graduates and either shying away from hiring them or placing them in subservient roles. The pay rates in my specialty range from $90,000 to $185, 000 per year with no specification based on years of experience simply because so many have no clue how to manage their business and frankly while I think I'm an above average NP I doubt I'm worth $90,000+ a year more than some of my colleagues.
I'm wondering how you became an NP without the ability to assess, reason, and analyze. I guess educational intelligence is not the same as IQ intelligence. With that being said, it doesn't take an IQ over 70 to realize that allnurses.com provides an outlet to vent for most folks because it's anonymous.
Moving forward.........I can not believe you think you are not worth what the market deems you worthy of. If you parents would have taught you the valuable lesson of a supply and demand free market then you might get it........It's NPs like you with your small minds that keep all of our wages beneath what we are worth! By the way, you made a couple of grammar mistakes, so please forgive me for not using Grammarly and also for my APA mistakes.......
My RN experience doesn't really impact my NP medical/clinical reasoning in a big way. Unfortunately, when u r a hospitalist NP, you are juggling multiple complex comorbidities in a primarily geriatric population....that takes good medical care, attention to detail and the ability to synthesize all the data to make your decision: right dx?, right plan? med dose and med review; ? new investigations? need for specialist consultation? readiness for discharge. Mostly medical decisonmaking here.
Where RN experience helped: because I know what the RNs face when it comes to carrying out orders(sometimes the orders were 2-3 pages), how to plan discharges for successful transitions etc. For example, I know Slow K/K Dur are horse pills and Micro K is more flexible and amenable to easy swallowing cause it is a capsule, it can also be opened and sprinkled onto food. I rarely prescribe liquid KCL(unless it is per NG) cause it is nasty tasting...that is an example of where RN bedside experience helps.
Or if I order a new med BID and it is after 1300hr...I know the patient will likely only get one dose not two....so I specify BID starting today!
Don't even get me started now that people no longer have to pay for their homes or their educations because they boo hoo that they didn't know and made poor choices...whole nother thread.
First, nice grammar......from previous posts, I would have thought I was speaking to a grammar expert in APA. (Matthew 7:1-5) Secondly, since the early 1980s educational expenses have risen 500% compared to 140% family income......Can that be explained? Boo Hoo only goes so far when real people are hurting from educational expenses........Lucky for me I was awarded a full-tuition FNP scholarship based on my merits.......With that being said, I'd be a fool not to be sensitive to the difficulties most folks have in pursuing their dreams as it relates to paying for it........
Moving forward.........I can not believe you think you are not worth what the market deems you worthy of. If you parents would have taught you the valuable lesson of a supply and demand free market then you might get it........It's NPs like you with your small minds that keep all of our wages beneath what we are worth!
Use..........'s much? This is priceless, a classic example of what I was referring to and it appears to me to have been written by a 12 year old. I was inclined to totally skip it because "Grammarly" or not I'm having difficulty understanding what you meant. This is possibly due to my low IQ, lol. However I was able to comprehend the above few lines and wanted to clarify that you are unequivocally clueless. Exactly how much do you make a year? I gross over $200,000 so take a minute to ponder that if you would.
700 clinical hours just isnt enough. 2k would be reasonable at minimum.
Exactly.........I complained to my professors in my BSN program that theory was a waste and more time should be spent in clinical real life situations......Likewise, my FNP program........This is one aspect where NP programs are falling behind PA programs.........With that being said, most new PAs don't have clinical experience prior to PA school as do RNs who are in NP programs........and if you have any doubt about NP clinical quality measures, please check this link out on a systematic review......
If you read the fine print of the studies, in most situations it is collaborative care vs physicians only. Only some of the out patient studies were only NPs and even then most were collaborative. I think anybody would expect a team of NPs and physicians would do better than physicians alone, since the group that has both has more time with patients. If studies were done where patients were admitted for complex care and NP vs physician outcomes were plotted with no physician intervention in regards to the NP cared patients it would be different. But that would be a dangerous and unethical study so it would never be done.
NPs are an important part of the healthcare team but will never replace physicians, the amount of knowledge acquired through residency and med school is magnitudes higher than NP school, and only somebody who has experienced both would know that. Its like some fairy tale joke that an NP education, even when adding in RN experience is equal to residency and medical school. Not sure why this is touted throughout NP education and NP students and nurses believe this stuff.
An NP could never replace an ER physician, neurologist, psychiatrist, surgeon, cardiologist, etc etc. They can replicate MOST of what a family practice physician usually performs and a decent amount of most IM, but a majority of medicine is and always will be lead by physicians. Pretty sure ill do more hours in one IM rotation than I did in FNP school.
Everything stated above is with all else aside also, there are some bad docs (mostly FMG) and great NPs, etc, but if one could isolate education levels alone its no comparison. My anatomy review textbook for boards is thicker than an NP board review book, just FYI. And ive got like 9 more stacked on top of that.
Not sure what is with all these nurses who have never prescribed a medicine or dictated an HP in their life come in here thinking day one out of NP school they are greater than physicians. if that were the case I wouldnt have to study at all in med school, but sadly ive put more hours in this one semester than all 4 in NP school. lol
I mean come on you have to be trolling right? Is this a joke, if so its a good one cuz you took away 10 minutes of my study time for me to type all of this out and you win lol!
I mean come on you have to be trolling right? Is this a joke, if so its a good one cuz you took away 10 minutes of my study time for me to type all of this out and you win lol!
Not to be too grandiose but in a way I'm flattered to think we possibly have attracted more than one. Mods might want to check the ISPs it seems like the last couple of months were heavy with "new" members.
If you read the fine print of the studies, in most situations it is collaborative care vs physicians only. Only some of the out patient studies were only NPs and even then most were collaborative. I think anybody would expect a team of NPs and physicians would do better than physicians alone, since the group that has both has more time with patients. If studies were done where patients were admitted for complex care and NP vs physician outcomes were plotted with no physician intervention in regards to the NP cared patients it would be different. But that would be a dangerous and unethical study so it would never be done.
NPs are an important part of the healthcare team but will never replace physicians, the amount of knowledge acquired through residency and med school is magnitudes higher than NP school, and only somebody who has experienced both would know that. Its like some fairy tale joke that an NP education, even when adding in RN experience is equal to residency and medical school. Not sure why this is touted throughout NP education and NP students and nurses believe this stuff.
An NP could never replace an ER physician, neurologist, psychiatrist, surgeon, cardiologist, etc etc. They can replicate MOST of what a family practice physician usually performs and a decent amount of most IM, but a majority of medicine is and always will be lead by physicians. Pretty sure ill do more hours in one IM rotation than I did in FNP school.
Everything stated above is with all else aside also, there are some bad docs (mostly FMG) and great NPs, etc, but if one could isolate education levels alone its no comparison. My anatomy review textbook for boards is thicker than an NP board review book, just FYI. And ive got like 9 more stacked on top of that.
Collaborarive NP/MD relationship: The MD is a phone call away and the reception on the golf course is good.
NP education vs MD education: Not the same, does not need to be the same, should not have the same expectations, different scope of practice.
FNP turned MD student: 1) may need to find another site, so your great education is not wasted on people you despise, 2)when you are finished with your training and realise it's easier to higher an NP than an MD to do all the "NP can do this" work, you can come back on this site and apologize for the haughty comments." If yo are not an MD don't try to act as if you are one. You have many exams to go, boards, Match, residency, fellowship and job interviews.
Jules A, MSN
8,864 Posts
Do you feel your RN experience contributed to your experience and expertise as a NP? What do you think of the current climate where RNs stay in school without ever working at the bedside before becoming a provider with prescribing rights?