Nursing students who want to be NP's

blackribbon · Apr 13, 2017

Bedside nurses are treated like they are a low-skill entry level job. We get no respect ... even the ones with years of experience and higher level degrees. I personally think that bedside nurses should be treated like the heart of the hospital nursing but instead, we are treated like we are lazy and just trying to slide by when we complain that staffing levels are not safe.

KatieMI, BSN, MSN, RN · Apr 13, 2017

Dear OP,

I am so sorry to tell you what you probably wouldn't like, but here is the reality:

- it is schools which lure students into nursing by promices of crisises-secure, well-paid jobs.

- it is schools which set uselessly high standards for admission.

- it is schools which spread lies about "job security" for nurses and thus attract adult, mature second-career seekers there

- it is schools which fill schedules with academuc fluff which takes a lot of time and brain to study but has zero practical importance

- it is schools which tell students about 500 things they can do with their BSNs

- and then it is workplace which treats these VERY bright, VERY highly motivated, still young, ambitious people like underhumans.

Do you really expect that someone bright enough to pass college stats with A (plus all other hard science classes) will allow himself to be treated like the worst crap in human history for long when he sees the same sort of dude drinking coffee and putting orders online 8 to 5 weekdays for twice more money? That someone who was a boss himself for years will allow someone twice younger yell on him for breathing 0.652 times/min more than "we always do here"? It's not gonna happen, and NP schools know it. That's why they are so darn successful.

My NP program did a test on my MSN class for a group of DNP students. The questionnaire was about NETY and lateral violence. 90+% students stated that they had experienced it, 70% of them "more than just a few times" or "systemically". Mean class GPA cumulative 3.89, mean nursing work stage 2.5 years at the moment of admission (the program requires at least 12 months). Does it tell you something?

Since, with healthcare as it is today, the standards of nursing education cannot be decreased, you can reasonably do only one thing: make students and new grads loving bedside. Make them welcome. Invite the brightest, the most daring and ambitious with open hands. Make academical achievement seen and matter. Weed out any remnants of NETY and lateral violence. Make job more physically and mentally tolerable. Make nurses more autonomic, more responsible, make their voices heard. Stop customers' and policies' kissing. And stop singing into school's lies.

There always will be some who go to nursing school with the single goal of getting advanced degree. Accept it. But for the rest, you can make this change if you and everyone else treats them good enough.

Sorry for being blunt. But when a majority of MSN class in a quite high-ranking institution openly states that all of them practically run away from bedside due to unhuman conditions there, it means something.

lebelesprit_ · Apr 13, 2017

You made a reference to something I said so Ill further explain. For me, its not about not being "bothered" to care for patients, its more about how I can best care for a patient. I never said that I would not work in either of the roles I named, rather its not my passion. As a matter of fact, at the end of each CNA class at the school I attended, the CNAs and the instructor get together for superlatives and awards and I received most outstanding in leadership and skills competency; I also had very nice things said about me to the instructor from two of the actual residents as it related to bedside care. I know I made a great CNA and I enjoyed the residents, but its not for me. Think about a telephone triage nurse that works in a call center for an insurance company. He or she went through the rigors of school and the NCLEX just like any other nurse. Its not about an ego, its just where you feel most comfortable so that you can do the most good for the patients.

I don't want an NP who has no actual nursing experience caring for me or anyone I love. I am not really worried if people feel bad that they can't be bothered to spend actual time NURSING---- it's about the patients, not our egos...... I am worried about good primary care for the patient and I believe it's become WAY too easy to be an ARNP/NP anymore. I don't think anyone should be able to even enter such schooling without 3-5 years' actual nursing experience first. No one would want a physician without his/her internship and residency. Same should go for nurses. The schools being willing to take such candidates in a way, dumbs down the whole profession of advanced nurse practice and makes it less respectable.

lebelesprit_ · Apr 13, 2017

PREACH!!!! My dad and grandmother recently spent pretty lengthy stays in the hospital/rehab facility. Once some of the younger nurses found out I wanted to be a nurse, they were very open to teaching me, explaining to me what they were doing, even letting me help with some things. I repeat, those were the younger nurses. When I asked questions of the older school nurses or even brought up other points, I was greeted with a "its worked this long" or "my way or the highway" attitude. Ive also heard new grads/students talk about how they preceptors all but ignored them. I can totally see your point and I agree.

Dear OP,
I am so sorry to tell you what you probably wouldn't like, but here is the reality:
- it is schools which lure students into nursing by promices of crisises-secure, well-paid jobs.
- it is schools which set uselessly high standards for admission.
- it is schools which spread lies about "job security" for nurses and thus attract adult, mature second-career seekers there
- it is schools which fill schedules with academuc fluff which takes a lot of time and brain to study but has zero practical importance
- it is schools which tell students about 500 things they can do with their BSNs
- and then it is workplace which treats these VERY bright, VERY highly motivated, still young, ambitious people like underhumans.
Do you really expect that someone bright enough to pass college stats with A (plus all other hard science classes) will allow himself to be treated like the worst crap in human history for long when he sees the same sort of dude drinking coffee and putting orders online 8 to 5 weekdays for twice more money? That someone who was a boss himself for years will allow someone twice younger yell on him for breathing 0.652 times/min more than "we always do here"? It's not gonna happen, and NP schools know it. That's why they are so darn successful.
My NP program did a test on my MSN class for a group of DNP students. The questionnaire was about NETY and lateral violence. 90+% students stated that they had experienced it, 70% of them "more than just a few times" or "systemically". Mean class GPA cumulative 3.89, mean nursing work stage 2.5 years at the moment of admission (the program requires at least 12 months). Does it tell you something?
Since, with healthcare as it is today, the standards of nursing education cannot be decreased, you can reasonably do only one thing: make students and new grads loving bedside. Make them welcome. Invite the brightest, the most daring and ambitious with open hands. Make academical achievement seen and matter. Weed out any remnants of NETY and lateral violence. Make job more physically and mentally tolerable. Make nurses more autonomic, more responsible, make their voices heard. Stop customers' and policies' kissing. And stop singing into school's lies.
There always will be some who go to nursing school with the single goal of getting advanced degree. Accept it. But for the rest, you can make this change if you and everyone else treats them good enough.
Sorry for being blunt. But when a majority of MSN class in a quite high-ranking institution openly states that all of them practically run away from bedside due to unhuman conditions there, it means something.

SmilingBluEyes · Apr 13, 2017

The rigors of nursing school PLUS passing NCLEX makes you an entry-level nurse with no experience. No more than that. We don't know *what* we don't know as new nurses. Also telephone triage is not for the inexperienced, either. Did my stint there and you have to have good assessment skills and experience to know what you're talking about. It's a huge responsibility.

I still believe such people (with no prior nursing experience) should not enter advanced practice roles. Nursing experience can be all over, not just bedside. The absolute necessity for excellent assessment skills just does not come in school, all packaged up. The ability to pass NCLEX does not a good clinician make.

Experience does.

As an experienced nurse with 20 years under my belt, I know assessment. A new nurse out of any nursing school, no matter how great a student does not. This is the essence of advanced practice nursing; excellent assessment skills as well as a real good "Gut" feeling that goes with time and experience. A brand-newly-minted NP without the background is not equal to the NP with a few years' actual nursing under her belt.

I guess at this point we can agree to disagree. Have a great day!

SmilingBluEyes · Apr 13, 2017

Regarding "older nurses" Lebelspit:

you mean to say NOT ONE was helpful? Hmm you must be in the wrong place

.

A shame if so...... I mentor and help develop future and new nurses all the time. I don't hoard knowledge and want to see them succeed. Their success is MY success.

quazar · Apr 13, 2017

The rigors of nursing school PLUS passing NCLEX makes you an entry-level nurse with no experience. No more than that. We don't know *what* we don't know as new nurses. Also telephone triage is not for the inexperienced, either. Did my stint there and you have to have good assessment skills and experience to know what you're talking about. It's a huge responsibility.
I still believe such people (with no prior nursing experience) should not enter advanced practice roles. Nursing experience can be all over, not just bedside. The absolute necessity for excellent assessment skills just does not come in school, all packaged up. The ability to pass NCLEX does not a good clinician make.
Experience does.
As an experienced nurse with 20 years under my belt, I know assessment. A new nurse out of any nursing school, no matter how great a student does not. This is the essence of advanced practice nursing; excellent assessment skills as well as a real good "Gut" feeling that goes with time and experience. A brand-newly-minted NP without the background is not equal to the NP with a few years' actual nursing under her belt.
I guess at this point we can agree to disagree. Have a great day!

I agree. I had to work with a midwife who went to midwifery school with literally ZERO L&D experience and zero maternal child experience other than what she had in nursing school. She'd had approximately 1 year at the bedside out of nursing school, in med surg. She was very, very sweet, but very very frustrating to work with in that we (the nurses) had to hand feed her orders and teach her things like why she should be worried about a particular fetal monitor tracing, etc. etc.. Things that an experienced bedside nurse would know. It took well over a year of her working with us before we felt comfortable working with her in that we trusted that if the poo hit the fan in the delivery room (which when it does, things go south FAST), we had a competent provider there with us.

Experience matters.

Here.I.Stand, BSN, RN · Apr 13, 2017

I agree. I had to work with a midwife who went to midwifery school with literally ZERO L&D experience and zero maternal child experience other than what she had in nursing school. She'd had approximately 1 year at the bedside out of nursing school, in med surg. She was very, very sweet, but very very frustrating to work with in that we (the nurses) had to hand feed her orders and teach her things like why she should be worried about a particular fetal monitor tracing, etc. etc.. Things that an experienced bedside nurse would know. It took well over a year of her working with us before we felt comfortable working with her in that we trusted that if the poo hit the fan in the delivery room (which when it does, things go south FAST), we had a competent provider there with us.
Experience matters.

I had four babies with CNMs. The thought of putting my and my baby's LIFE in the hands of someone so green is terrifying!! Thank God those patients had you and your colleagues.

allnurses Guide · Apr 13, 2017

I don't think that schools watering down the education by not requiring actual nursing experience to become a nurse practitioner, which is theoretically the top of the nursing ladder, is really anything to celebrate. Of course those choosing to go that direction are going to want validation from the rank and file and to feel it is all okay, no big deal, unrelated, etc. That is pretty transparent. However, it is more accurate to consider that said schools see a money trail not yet accessed. The better schools require acute care experience for admission and that really isn't debatable.

I see chasing passion as an important life calling and will bend over backward (not easy at 46 years of age) to help make that happen for those of us lucky enough to have it. I would simply encourage you to get out of LTC and into acute care or another specialty that will better tap into your passion while you pursue that goal. Nothing can carry someone through unpleasantry as well as passion can, if it is a means to an end.

I think seeing floor nurses as getting "no respect" is really not pertinent to this thread to be honest. I don't think it is a lack of respect that makes people want to skip actual nursing. Its a hard job and it can be unpleasant and quite the beat-down. I think most people want an elevator to the top if they can find one and it is human nature to want to skip the hard stuff. Whether the hard stuff is really needed to make good practitioners will certainly be coming to light as these schools churn out their new NPs who can't function at the bedside. My concern is that these less qualified nurse practitioners will make errors of the sort on a regular enough or sentinel enough basis to cause the advances in autonomy that are being fought for and oh-so-slowly made to undergo a serious backlash and revision. As mentioned above, people fresh out of school aren't even educated enough to know what they do not know. I simply do not buy the claim that there isn't enough cross-over from acute care nursing experience to practicing as an NP to be relevant. That is just ignorance speaking.

SmilingBluEyes · Apr 13, 2017

DANGEROUS. Bad for the patients. This is what I am talking about. It's a problem. It's counter-intuitive to have NPs without actual *nursing* background.

I agree. I had to work with a midwife who went to midwifery school with literally ZERO L&D experience and zero maternal child experience other than what she had in nursing school. She'd had approximately 1 year at the bedside out of nursing school, in med surg. She was very, very sweet, but very very frustrating to work with in that we (the nurses) had to hand feed her orders and teach her things like why she should be worried about a particular fetal monitor tracing, etc. etc.. Things that an experienced bedside nurse would know. It took well over a year of her working with us before we felt comfortable working with her in that we trusted that if the poo hit the fan in the delivery room (which when it does, things go south FAST), we had a competent provider there with us.
Experience matters.

quazar · Apr 13, 2017

I had four babies with CNMs. The thought of putting my and my baby's LIFE in the hands of someone so green is terrifying!! Thank God those patients had you and your colleagues.

Yes. It was very, very scary. It was a small community hospital, too, so we didn't have the luxury of things like in house attendings or residents, etc.. She was such a kind soul, and thank goodness she wasn't arrogant or rude and she really LISTENED to the nurses. I have also had the unfortunate experience of attempting to work with an APRN who had little to no experience who was the caregiver for my very sick parent. When I expressed my concerns about my parent's condition and the symptoms my parent was exhibiting, she was dismissive, condescending, and rude. She totally blew me off and didn't care at all. It later turned out that my fears were correct, and she should have taken my concerns more seriously. Fortunately no one was seriously hurt (we were lucky), but I already had a plan in my head of exactly what I was going to say to her and DO (legal-wise) if things went south. She was going to be the very FIRST person I threw under the bus.

KatieMI, BSN, MSN, RN · Apr 13, 2017

I had four babies with CNMs. The thought of putting my and my baby's LIFE in the hands of someone so green is terrifying!!

I just wonder what would you do if your Ob/Gyn introduced a first year, first rotation resident to you while you were in labor and asked your permission for him "just to be there" and the next thing you know is that this guy is actually preparing to help you in delivery. And you have no means to know if he ever saw a laboring woman in his entire life (contrary to popular opinion, there are options to avoid this experience during medical school, especially for male residents. But, if against their wishes they end up in less desirable FP residency, they are stuck with it).