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.
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.
While I agree it doesn't need to be exactly the same I disagree that we shouldn't have similar expectations with regard to our knowledge and preparation for practice upon graduation. I'm not sure of your specialty but my scope of practice is no different than my MD colleagues. Although I do seek assistance when needed I'm under no obligation to phone up a MD so my unfortunate patients are often stuck with only my judgement and skill set.
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.
Personally I'm all for anyone participating and hopefully will learn something from a NP to MD member. Plus its probably against TOS to tell someone they aren't welcome here.
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. I think Ive said in many comments there are many great NPs who put the time in self-learning the needed material.
But I mean usually when people hear stuff they dont like (such as their profession not being the most difficult and nobel prize winning field in the world) they attack the poster. Which really medicine isnt the greatest field ever, hats off to those physics people, they are insane.
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.
Never said I despise NPs, so not sure where that came from. But anyway, its not an attack on NPs, if you read through previous posts, its an attack on the laxity of some NP programs and people who arent even NPs yet but think they will be Gods left hand once they graduate. I am sure there are plenty of people on this site that could go thru med school, so its not like im being haughty by saying MD education is better than NP education. I mean, it is, everybody knows that.
Plus how am I trying to act like an MD exactly, by saying my first year of med school is harder than anything NP school could ever dream of? I will admit though some of the stuff is unnecessary in regards to what we learn, but really who would you want monitoring your nuclear power plant. One who went through very little education and never had to take calculus and modern physics? or somebody who probably got too much science background in high level maths/ calculus based physics but made it through those courses (which are very difficult I would assume).
College is supposed to overtrain people because we all know we do not remember everything we learn... So one can take either side of this debate and admit that NP education needs some tinkering in order to bring it up to a national standard, or keep drinking the cool aid and state that 700 clinical hours and a lack of hard science is enough to prescribe medications and manage the thousands of diseases out there without somebody providing oversight.
TBH some of us should have more buff against some of the lacking NPs out there. It takes so much work to get credentialed at new hospitals nowadays since they have learned its hit or miss with new hire NPs. In contrast, Docs just walk in after a couple quick reviews of previous malpractice suits and if they are clean their credentialing is done. Its much more work for us since we have that black stain on our credentials with many of the poorly prepared new graduates and even many practicing NPs out there..
So even if you dont believe NP education needs some rehaul, understand that the state that it is in now will hurt us all in the future. Hence why I chose to get out of dodge.
Yeah, people with 3.5 GPAs get denied admission to CRNA programs, whereas my buddy with a 2.5 GPA had a NP program practically roll out the red carpet for him saying his bedside experience trumped his low GPA. Anesthesia is starting to have a problem with the # of schools opening though. However, it's more difficult to get a year of ICU experience, obtain CCRN, get > 300 on the GRE, and quit working for 2.5 years vs NP school which admits everyone and allows you to work full time.
Agree and yes dentists, who I'm not a fan of and question whether I'm coming out alive most visits, other MD specialties and CRNAs have rigorous admission process and previous experience requirements. Why not other NP specialties? At least I think CRNAs are still particular unless they have also started admitting anyone who can pay the tuition and fog up a mirror held directly under their nose.
Yeah, people with 3.5 GPAs get denied admission to CRNA programs, whereas my buddy with a 2.5 GPA had a NP program practically roll out the red carpet for him saying his bedside experience trumped his low GPA.
My guess is his wallet is actually what trumped all. I heard there is an online psych NP program with rolling admissions and according to someone who applied they will admit on probationary status if the gpa isn't what they have listed as a requirement.
We could probably start a pretty good NP program out of our garage. All we need is a skill lab (couple sets of medical equipment, exam table), assign readings, make youtube videos for them to require and be quizzed on, and have skill check offs, make our own tests, and have them do clinicals with us and our friends. Take like 5 students per year, 20k a pop, extra 100k in income per year. Unfortunately it would probably be better than half of the NP programs out there lol.
College is the biggest scam in the history of the world, if only we had the days of apprenticeship, journeyman, artisan, master as in the old days. I made a curriculum for what I think (take as a grain of salt) as a decent NP curriculum last semester in my down time, it would prepare people fairly well for primary care, and I'm not even that organized or creative in regards to "making" things.
I mean with the internets we can learn most anything, took the MCAT before my prereqs and did well enough to get into most medical schools that arent ivy league without ever stepping foot in the classroom. Probably because the classroom for many is a burden.
I think you do make light of a true issue. I believe institutions, even nationally renown universities, are accepting subpar candidates for nurse practitioners to fuel their own greed and make more money-- I would know, I went to school several. The very poor candidates would continue to fail and continuously pay the next semester to try the course again...Then there were those who were lazy but not inherently dumb, those who worked full time and did not properly study to be able to function independently as a nurse practitioner and lastly those who piggy-backed on hard workers.
I graduated top of my class as a NP and RN and both universities are ranked top 5. This really means nothing as far as my ability to be a NP, it does, however, imply I work hard and tirelessly. I am embarrassed to say, some of my peers whom I graduated with should definitely nOT have prescribing privileges and definitely should not be managing the care of patients...
I have been an employed working NP for about a year and while I am getting the hang out it, I am by no means confident or even that good. I do not trust myself and am so frightened to do something wrong. The culture where I work is based upon the attending/surgeons preferences--subsequently I feel as though I am working to please them. As a result, I am frightened to of their wrath and generally need to ask them first rather than making my own decisions. Do you think this means a.)I need to study more at home; b.) with more time and thus experience, they will begin to trust me and I will already know their prefrences; c.) leave...
I have been an employed working NP for about a year and while I am getting the hang out it, I am by no means confident or even that good. I do not trust myself and am so frightened to do something wrong. The culture where I work is based upon the attending/surgeons preferences--subsequently I feel as though I am working to please them. As a result, I am frightened to of their wrath and generally need to ask them first rather than making my own decisions. Do you think this means a.)I need to study more at home; b.) with more time and thus experience, they will begin to trust me and I will already know their prefrences; c.) leave...
My guess is because you sound so conscientious that you probably are better than you are giving yourself credit for or at the very least not unsafe, kudos. It sounds like your facility culture is more of a subservient role for NPs and truthfully I'm not necessarily against that especially if the physicians you work with are excellent and you are learning how to practice skillfully in a specialty you enjoy. Are you "afraid of their wrath" because they are rude or are you a timid person who doesn't like confrontation? In my experience it is often the physicians especially surgeons who are not warm and fuzzy who are the brilliant rock stars and as long as someone isn't constantly belittling me I'll eat more than a plate or two of crow to spend time and learn from them. This is something you will need to figure out if you can be happy and thrive in this environment because if it makes you too anxious then you won't benefit from the experience. In my specialty I'm very independent but I will most often defer to one of my uber smart psychiatrist colleagues recommendation if we aren't in agreement over a course of treatment. The benefit to this is both that #1 their education and knowledge is superior to mine and #2 from a legal standpoint there is no way I'm not going to defer to a MD, unless they are an idiot and I have a serious concern about the recommended course in which case I wouldn't have sought out their input anyway.
I have postioned myself squarely up the posterior of more than one brilliant but boorish MD and in almost all cases have benefited in the long run by establishing a good working relationship and in a few cases friendship. It can take time for them to trust you and respect your skills. Consider seeking their feedback without being a pest as well as watching and emulating their style.
I have been an employed working NP for about a year and while I am getting the hang out it, I am by no means confident or even that good. I do not trust myself and am so frightened to do something wrong. The culture where I work is based upon the attending/surgeons preferences--subsequently I feel as though I am working to please them. As a result, I am frightened to of their wrath and generally need to ask them first rather than making my own decisions. Do you think this means a.)I need to study more at home; b.) with more time and thus experience, they will begin to trust me and I will already know their prefrences; c.) leave...
I can so relate to your comment. One of the physicians in my practice who happens to be brilliant but very intimidating. He loves to make snide comments about other physicians and then talk about how wonderful he is. Anyway, along the way I followed one of his patients and changed a few meds. The patient called back a week later with questions regarding frequency and he happened to overhear and grilled me about the changes I made (in front of the support staff).
Thank God I remembered this patient because I agonized over the changes but current guidelines supported what I changed and that is exactly what I told him. I even offered to email him the journal article I used to make the changes. I told him you know I would not change it unless I could back it up and then blurted out "DUH". I guess I caught him on a good day cause he laughed and she says "DUH" to me every chance he gets.
Jules A, MSN
8,864 Posts
While I agree it doesn't need to be exactly the same I disagree that we shouldn't have similar expectations with regard to our knowledge and preparation for practice upon graduation. I'm not sure of your specialty but my scope of practice is no different than my MD colleagues. Although I do seek assistance when needed I'm under no obligation to phone up a MD so my unfortunate patients are often stuck with only my judgement and skill set.
Personally I'm all for anyone participating and hopefully will learn something from a NP to MD member. Plus its probably against TOS to tell someone they aren't welcome here.