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frustrated with "fluff" in my NP program

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Before starting my NP program I was so proud and enthusiastic about becoming an NP. But as time goes by, I am growing more and more frustrated with my curriculum. Completed my first year and do not see the end of theories, roles, paradigms and politics etc. "Paradigm" has become one of those words that raise my blood pressure.... Diagnosis, treatment, patho and pharm. are completely de-emphasized "we are nurses, not doctors". So, how in the world do you apply the "paradigm" when you do not even know some of the essential stuff? Do we completely rely on our previous nursing experience and pay price of obtaing "NP" title by enduring hours and hours of endless and useless "fluff"??? I got much more out of my associate RN program in terms of ability to perform basic patient care than out of "advanced" nursing curriculum. I expected that we'd study similar to undergrad. issues but on a deeper level, but so far, there is no end of "fluff". I have checked out other universities programs' descriptions and they are very similar to mine....Except, for some progressive schools that, I believe, would have 2 pathos and 2 pharm. courses. Where this education will take me? What is the school thinking? Are the professors' hands tied? I do not blame some physicians who are against removing collaborative agreement.

Has anyone gone through this frustration while enrolled in an NP program? I have seriously thought about defecting to med. or PA school as a result of being so extremely disappointed. Any thoughts?

Edited by Grnrn
mistake

PICUPNP

Has 12 years experience.

I agree wholeheartedly! I went to a Peds Crit Care NP prgm at UPenn with no fluff! They cut it out! If I were to do this again, I would definitely have gone PA for no other reason than the education they receive. No fluff. All patient management and hard science..you know...the stuff that actually helps us do our jobs? How does Orem's theory of BS help you manage a critcally ill pt...it won't. Good luck to you.

I totally feel your pain. I just graduated in January and feel like I wasted my money for 3/4 of the program. Seriously. I attended SLU online. The program itself was great and had awesome instructors but the program content sucked.

I kept thinking to myself "when are they going to get to the stuff that I actually need to learn to be able to take care of patients", there was very little of it.

In my opinion there should be two semesters of patho, pharmacology and absolutely two semesters of assessment. The hundred papers I wrote are of no help to me at all when it comes to working in the real world. They should certainly chuck all the theory classes and to be honest, they could get rid of things like community assessment, and even ethics. I mean, a WHOLE semester for this kind of stuff!! Had to write a paper for every one of these classes.

The only advice I can give you is get as much as you can out of your clinical experience because that is where you will learn the most of what you need.

Sugah Britches

Specializes in CCU,ED, Hospice.

A rather disheartening thread but not a complete suprise. I have just begun my NP education and have already begun to see that I am going to need to supplement with other resources. Patho has been interesting but not satisfying my "why and how" nature. ( Side Note- I understand that it was written by nurses but I have not been impressed with Huether & McCance.)

Ahhh you guys are scaring me!! :) i'm thinking of applying to

a fnp program. Are the majority of NP programs full of fluff? What schools do you attend if you don't mind me asking? Are there any out there ( particularly online programs) that have less to

no fluff? Should I become a PA??!

BCgradnurse, MSN, RN, NP

Specializes in allergy and asthma, urgent care. Has 12 years experience.

Yeah, the fluff was frustrating. But, as we were constantly reminded by the faculty, we were getting a Master's degree, not just working for NP certification. I could have done without the theory and the roles class could have been more practical. I actually had one of the premier nursing theorists as a teacher for my theory class and it was still awful. I was so disappointed! I ended up totally loving my ethics class, so I'm glad that was in there. I have to honestly say that I'm learning more on the job than I did in the classroom, but the classroom taught me how to think and how to go about the differential diagnosis process. My program was very accelerated, so fortunately, the fluff was kept to a minimum, but it still felt like too much. However.....my patients say I listen better than most MDs and they appreciate that I see them as a whole person and not a "condition". That didn't come from Patho and Pharm.....maybe some of the "fluff" seeped into my brain when I was daydreaming in one of those classes!!

gerry79

Specializes in ED, Cardiac Medicine, Retail Health.

Nursing education and fluff seem to be intimate bed fellows :(

( Side Note- I understand that it was written by nurses but I have not been impressed with Huether & McCance.)

Robbins and Cotran Pathologic Basis of Disease is your friend!

You have to remember that you are unfortunately in a masters level nursing curriculum. You must endure the theory, ethics, and psycho-social garbage that's fed you because 1-It's housed in a school of nursing 2-It's a MSN.

For the most part, you just have to grin and bear it. Use other resources to quench your thirst for scientific learning.

Good luck and hang in there. The fluff is a means to an end.

but I have not been impressed with Huether & McCance.)

Actually, I'd rather read Huether & McCance, than some of the theoretical material.

Thank you for your replies. At least, I have confirmed that I am not alone feeling this way. Hopefully, one day all the fluff would be condensed in one course and we will have more hands on, scentific and the inner workings of primary care practice (for those going into primary care) courses. Ethics was actually the least disliked, as I am aware that this will come in handy one day. However, even this subject was poisoned by studying and analyzing theories instead of learning the practical application. I was lucky to find a wonderful (and not too voluminous) book written for med. students on the subject of ethics. Short, sweet and to the point.

Nursing education and fluff seem to be intimate bed fellows :(

why but why????

Sugah Britches

Specializes in CCU,ED, Hospice.

Actually, I'd rather read Huether & McCance, than some of the theoretical material.

Well, since you put it that way...

meandragon: Thanks for the Robbins and Cotran Pathologic Basis of Disease recommendation!

I recall being incredibly frustrated the first semester of my NP program as we had not yet started clinicals. Our instructors were PhD's who had not seen patients in years, or who volunteered at free clinics without diagnostic capacity to keep up licensure. Very different from private practice or any other practice. Lots of speeding through power points that did not make a whole lot of sense or encourage dialogue.

I was thankful for my RN experience because I could see the BS... my patho instructor reported "how to diagnose ARDS" from articles, I was working in ICU at the time and knew that anyone trying that in the clinical environment would look like a nutcase. Oftentimes we were presented with the gold standard instead of how things are diagnosed practically. I naively thought at this level there would not be hoop-jumping but there definitely was.

Clinicals were the saving grace, I had some amazing preceptors and studied on my own to learn and then apply the guidelines. That is where the real learning occurred, in my opinion.

My cohort wanted more time spent on entrepreneurship, billing and coding, the role of the nurse practitioner (what is it that we do, or bring, that is NOT being a mere physician extender? what makes us different? how is that seen or proven practically?), and contract negotiation.

I think we were left with a lot of role confusion and inability to see how our practice is different from the medical model. Of course there is the whole holistic nursing model PHILOSOPHY, but many of us were not seeing that in our clinical settings (patients q15 minutes, etc.)... and how to make an argument that this holistic thing was something we had that other providers did not have. If anything our knowledge of health promotion was not that extensive or special. Sort've like how the ideal of being a holistic healing nurse practitioner meets actual job responsibilities.

wmrentz

Specializes in Cardiac, Trauma, Corrections. Has 14 years experience.

I can really identify with the frustration, especially during the early part of a program. I look at it this way. I'm about to graduate this December with my FNP. I'm in my last rotation prior to a "transitions" semester (think final practice and/or work for no money!) On thinking back to my first year, it seems to me that the annoying fluff does serve an obtuse purpose...it makes you stop thinking like a RN and forces you to reorient your noodle to accomodate a broader point of view. Kinda like its there to break you down before you are built back up. As you get past the endless parade of fluff-n-stuff, you start to piece together the patho, assessment and disease processes as a unit as opposed to the sequential order of learning. If you're in an NP program, your goal is to learn how to identify, assess and treat without assistance...quite an assimilation from where we all started. I found that once my clinical courses started, my learning has grown exponentially and the pieces are coming together better than I ever thought they could. And, whatever you do, thank your preceptors! So, what I guess I'm saying is, think of the fluff as a necessary evil. It distracts you from recognizing how much you are learning. That being said, I would love to see our programs increase their emphasis on patho, pharmacology and assessment. We will ultimately live or die by the nuts and bolts. Just remember, school is a begining and you won't know it all. After graduation the real learning begins.

Edited by wmrentz
spelling

Spacklehead, MSN, NP

Specializes in Emergency, Cardiac, PAT/SPU, Urgent Care. Has 24 years experience.

Just remember, school is a begining and you won't know it all. After graduation the real learning begins.

Totally agree with this. No matter what type of HCP one becomes, be it NP, PA or physician, no one hits the ground running right after they graduate. Some may think they do, but they most definitely don't.

I wholeheartedly agree. Our program did eventually get past the fluff, but PA programs I think have more hard science. So far I'm not impressed with DNP curriculums at all either.

traumaRUs, MSN, APRN, CNS

Specializes in Nephrology, Cardiology, ER, ICU. Has 27 years experience.

Totally agree with all of you!

A rather disheartening thread but not a complete suprise. I have just begun my NP education and have already begun to see that I am going to need to supplement with other resources. Patho has been interesting but not satisfying my "why and how" nature. ( Side Note- I understand that it was written by nurses but I have not been impressed with Huether & McCance.)

We used that for my BS program, but I confess I quite liked it. What specifically haven't you been impressed with? Is there another text you like better?

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