I read a recent post regarding new graduates who cannot find work jumping on the NP bandwagon.
At work the other day, a new grad co-worker (less than 5 months experience) launched into a bitter tirade against a well known school for having the gall to expect her to have 2 years experience, have been involved in EBP, Committees and to have precepted before being allowed to even apply to join their ACNP program.....
Mind you, this nurse can barely handle her assignment... what makes her think that the NP is going to be an easy way out of floor nursing.... The courses take time and dedication and contrary to popular belief, graduation and subsequent employment are not a given..
Neither are we "sad" we didn't get the chance to become NPs, nor does our criticism of someone with no experience going straight into NP school equate "NETY."
There is a researched phenomenon in the literature on NP role socialization termed "role resistance" that is directly related to this topic, so there is some evidence it does exist, at least on a subconscious level.
If I want cookbook medicine I have a copy of an Emergency Medicine manual on my ipod.
I said, "We don't want to see the PA; my family member has a lot of medical problems; we'll go to the Urgent Care." Suddenly the receptionist asks me to wait while she speaks to the doctor.
Are you implying that you + emergency medicine manual ipod app are equivalent to an NP?
I just go by my experiences working with both and by my colleagues who are finishing NP school and wish they had a residency because they don't feel prepared.
Not to discount your experiences and the experience of some student friends/colleagues that have yet to enter practice, but there are now a half-dozen major studies that show there is very little difference in outcomes.
1. First I challenge you to cite a paper demonstrating that physician outcomes are any better for MDs vs NPs or PAs. I would like to know how you judge outcomes on your own family members?
Ah, I was expecting this response from you. From my previous post on this thread:
"If someone is holding themself out as a medical authority to me or my family I insist that they are trained as a medical doctor. Physician training involves first obtaining an undergraduate degree, usually in a science, then generally four years of medical school and 3-8 years residency. Nurse practitioner training at a master's degree level, according to one prominent university web site that I checked, has around 600 hours of clinical training. Obviously there is no comparison between the education and training a physician and a NP/PA receive. I have found this very large difference in education and training directly reflected on the quality of care I and my family have received, including outcomes, from a physician versus a mid-level provider. Whenever possible, which is almost all the time, my family and I only receive our medical care from physicians."
Your 600+ hours of clinical training versus a physician's. I judge outcomes for my family based on the quality of the care they receive (I am present when they receive care) and on the outcomes of their treatment. As an RN of 19 years I do have clinical experience and am able to judge the care my family members receive. As far as judging outcomes for my family members, I feel pretty confident that my judgments were correct when my own internist and my family members internist concur with our observations and complaints about our experiences with NP's/PA's.
I am referring to the vast difference in education and clinical training between a physician and a NP.
Really, interesting, I sure read that as an insinuation that using an iPod app with your nursing education was equivalent to the "cookbook" medicine provided by "mid levels". I guess I misinterpreted?
So show me a study that demonstrates all that extra education and experience produce better outcomes. Shouldn't be hard right?
I am not sure how that was a response to my post as you did not cite a study nor explain how you measure outcomes on your family members?
Here is my reply to you again. Try using the critical thinking you have presumably been trained to do.
My first comment to you was:
"If someone is holding themself out as a medical authority to me or my family I insist that they are trained as a medical doctor. Physician training involves first obtaining an undergraduate degree, usually in a science, then generally four years of medical school and 3-8 years residency. Nurse practitioner training at a master's degree level, according to one prominent university web site that I checked, has around 600 hours of clinical training. Obviously there is no comparison between the education and training a physician and a NP/PA receive. I have found this very large difference in education and training directly reflected on the quality of care I and my family have received, including outcomes, from a physician versus a mid-level provider. Whenever possible, which is almost all the time, my family and I only receive our medical care from physicians.
Your 600+ hours of clinical training versus a physician's. I judge outcomes for my family based on the quality of the care they receive (I am present when they receive care) and on the outcomes of their treatment. As an RN of 19 years I do have clinical experience and am able to judge the care my family members receive. As far as judging outcomes for my family members, I feel pretty confident that my judgments were correct when my own internist and my family members internist concur with our observations and complaints about our experiences with NP's/PA's."
I'd say it is hardly necessary to cite a study, but perhaps you need a study to validate your every experience. It is more than enough for me that my own internist and my family member's internist agree with both of us in regard to our experiences of the care we have received from NP's/PA's.
Really, interesting, I sure read that as an insinuation that using an iPod app with your nursing education was equivalent to the "cookbook" medicine provided by "mid levels". I guess I misinterpreted?
So show me a study that demonstrates all that extra education and experience produce better outcomes. Shouldn't be hard right?
Here is my reply to you again. Try using the critical thinking you have presumably been trained to do.
I'd say it is hardly necessary to cite a study, but perhaps you need a study to validate your every experience.
First off, you can lay off the personal attacks as they don't phase me (plus they are violations of the ToS, and really just demonstrate that this is personal not professional to you).
It actually is necessary as you are trying to equate a direct relationship between education and experience with clinical outcomes. You can assume that this is true without a study to prove it; that is science and evidence-based practice.
Exactly as I suspected. Well I disagree with you that an RN with an app is able to diagnose and treat medical condition and so does the law and every board of nursing in this country and most others.
I also wonder where all these NPs are going to find jobs. Going straight to NP school because the RN market is saturated? The NP market where I live is also saturated with new grads. Is it the same elsewhere?
We have 4 brick and mortar schools churning out NPs, plus all the online programs. The unit I work on staffs roughly 25ish full-time RNs. Five of those RNs are in NP school right now. I chat with other RNs who are either in NP school or have graduated and it's all the same mish-mash of information that new grad RNs get. Go rural. Be willing to relocate anywhere. Take any job. Accept that you may spend over a year looking for a job. Acute care swears that family practice is where all the jobs are at and vice versa.
Instead, I work with many NPs who are still working full-time as RNs because they can't find a job. Or working part-time because the only NP job that they can find is PRN. Or working PRN because they aren't making nearly as much money as they thought they would as a NP.
BostonFNP, APRN
2 Articles; 5,584 Posts
There is a researched phenomenon in the literature on NP role socialization termed "role resistance" that is directly related to this topic, so there is some evidence it does exist, at least on a subconscious level.