How much did NP school prepare you?

Skippingtowork · Aug 5, 2017

I think whatever effort you put into school is really what you make out of it. Whatever effort you make in life is what you make out of your life. Same concept in once you graduate and get a job. Physicians/NPs/PA don't become successful without actually putting work into it. Perhaps NP schools are not based on a "medical model" as what most people say but I also know that not all med schools are perfect either. Medical students worked really hard to get their MD because they sat and read for hours trying to understand the materials and reading above and beyond what they are expected to read for class. Lots of residents I know have told me that they never learned about IV fluids in school, they were never prepared for it while in school, they learned that on the job and they read about it. I know this because I went to an online NP school but I studied everyday at a medical library in San Antonio and did my work there. I sat with MD students and MDs and watched how they studied and how focused most of them were and used what I saw as motivation for me to read more and learn more.
I think people are well aware before they go into NP school whether they have to set up their own clinical practicum. Most prospective students are also well aware that we are not based on a medical model. Many complain about how they are unprepared they are after graduating from NP schools. There are a few things that I noticed that NP students should be doing differently to get the best experience they can get out of school.
1.NP students usually work as RNs at the same time that they are going to school. Some work full time/part time. The more you work, the less time you have time to read the material that you are assigned. Some just barely survive and do the bare minimum of reading just to pass the test and do the pump and dumpâ€ information in their brain rather than really understanding the material and using critical thinking on interventions to stimulate why we would use one intervention rather than the other. Perhaps if one cuts back on work they would have more time to understand the material
2.NP students don't realize that the role of a RN and a NP is totally different. When we were students we thought we knew but we really didn't know once we had our first job. We are so focused on trying to balance between our RN job and NP school that we keep doing our jobs as RNs to make money â€“ which is what we have been doing most of our work lives, this is what we are used to, we are experts as RNs â€“ which in ways does help us sharpen our clinical skills. However, what are we actually doing to prepare ourselves for the role of being a NP other than going to clinicals and using the pump and dumpâ€ learning method? We could be going to NP conferences to network with other experienced NPs or going to NP course reviews way before we graduate but most students don't even take the time to do that. Then once we graduate we complain about how unprepared we were because NP school taught us nothingâ€, yet we blame all of it to the NP school program and we absolutely know that we are not the one to blame because we act like NP school is responsible for all that we know and don't know.
3.Most NP students want to stay in town for their clinical practicum so that they save money and they can keep doing their RN job. I get it! Who wants to travel outside of town and spend more money? Saving money is ideal, everyone's situation is different. I had to set up my own clinical practicums. A physician I worked with said it is important to pick a site that will give me good variety of experience even if I had to go out of town or state so a solid foundation could be made. I took that advice. My school did not allow me to work out of state. I did go out of town and spent my own money for accommodations for different clinical sites. I made sure that my preceptors have interviewed me in person and I have interviewed them as well to see if we are a great fit months before my clinical practicum with them started. If they said that it was not necessary to meet in person, I would request that we do so that I can â€¦ 1. See the clinical site, 2. Browse the bookshelf of their office to see what books they have (and perhaps read this on my own, for my own learning) and ask them any tips or how they want me to prepare prior to clinical that would make patient care go smoothly. 3. So that I can also ask them in person what they expect of me as their student. MD/PA students go out town and out of state to vary their clinical experience. NP students just sometimes settle with clinicals like retail clinics to stay in town which sometimes isn't the best due to their protocols of steering away from higher acuity patients which limits handling more complicated health conditions which won't really make good variety of experiences.
I am not against people who work in school nor I am judging but it is a hard balance to make. If you put more time towards one or the other the other aspect is going to suffer. I guess the question is what is your priority? No one can answer that for you but you only.
NP school is definitely NOT what it makes of me. NP school is what I make of it.
Life is definitely NOT what it makes of me. Life is what I make of it
I am the captain of my ship and I will steer the ship however and whichever I want to and I will do it successfullyâ€ --- this is my motto when I faced challenges in work and life balance while in NP school and it continues to be my motto today.

This is beautifully said and I thank you. Many comments clearly do not address the complexity of going to NP school. Everyone who attends graduate school realizes that much of the learning is up to you. That is why you study for hours before even attending lecture. The NP conferences and the pre-conference experiences are excellent. There are other types of workshops that can benefit the student. I agree that travelling to the best clinical sites is worth it. I did it and while it was expensive, it was the best learning experience. The student should also be willing to admit to deficits in knowledge and seek out opportunities to gain experience in those areas.

There is not just one way to learn and decsions should be left up to the student. I still think clinical experiences should be set up by the schools. This eliminates needless time in searching for sites and ensures that preceptors are meeting standards for preparing students.

shibaowner, MSN, RN, NP · Aug 5, 2017

This is beautifully said and I thank you. Many comments clearly do not address the complexity of going to NP school. Everyone who attends graduate school realizes that much of the learning is up to you. That is why you study for hours before even attending lecture. The NP conferences and the pre-conference experiences are excellent. There are other types of workshops that can benefit the student. I agree that travelling to the best clinical sites is worth it. I did it and while it was expensive, it was the best learning experience. The student should also be willing to admit to deficits in knowledge and seek out opportunities to gain experience in those areas.
There is not just one way to learn and decsions should be left up to the student. I still think clinical experiences should be set up by the schools. This eliminates needless time in searching for sites and ensures that preceptors are meeting standards for preparing students.

Totally agree with you. During my NP program for Adult and Geriatric Primary Care, we did have some choices for clinicals. I did 2 rotations in SNFs combined with active retiree healthcare, 1 rotation in an Urgent Care, and 1 rotation in an outpatient orthopedic/sports medicine/pain mgt clinic. All were fantastic! My preceptors did give me the chance to learn procedures. In addition, I took advantage of supplementary clinical opportunities, such as working in a diabetes specialty clinic (option in addition to required hours) and in an occupational healthcare clinic (onsite in a large workplace). These were all excellent prep for general primary care. The school also provided additional optional seminars on suturing, EKG interpretation, reiki, LGBTQ and transgender health. There was also an optional track (included in tuition) for HIV management with associated clinical hours. It really is up to the student to take advantage of both academic and clinical opportunities. Med students eat, breathe, drink medicine before and during med school - very self-motivated, independent learners. The best NP students are the same.

AsianNurse1 · May 3, 2018

I wish I did the PA route. They both have a different route of preparation but end up at the same spot! And the lack of teaching and science being taught in NP school but we are expected to know as much as the MD. I did a clinic with a PA and learned how much well prepared they are. Sure NPs are "collaborative" and PA are "supervised by a physician" but at the end of the day, PA has the more flexibility to work elsewhere because they've been trained in all areas and had internship opportunities to help. THIS IS THE BIGGEST MISTAKE OF MY LIFE. I HATE NP SCHOOL! IT DOESN'T PREPARE YOU WHAT'S COMING. IM NEAR GRADUATION AND BEEN IN CLINICAL AND HAVE SEEN HOW THE NEW NP STRUGGLE COMPARE TO THE PA! And to the person who had stated you just have to read more and put in more clinical. It's not that EASY. YOUR LIMITED TO THE HOURS AVAILABLE GIVEN FROM YOUR PRECEPTOR. YOU CAN READ ALL YOU WANT, THAT IS STILL LESS EFFECTIVE THAN BEING IN CLASS BEING TAUGHT THE MATERIAL. NP SCHOOL IS 90% SELF TAUGHT. I have a friend in PA school and PA SCHOOL IS M-F 8 HOURS A DAY LECTURE. NP SCHOOL SUCKS!!!

Jules A, MSN · May 3, 2018

I wish I did the PA route. They both have a different route of preparation but end up at the same spot! And the lack of teaching and science being taught in NP school but we are expected to know as much as the MD. I did a clinic with a PA and learned how much well prepared they are. Sure NPs are "collaborative" and PA are "supervised by a physician" but at the end of the day, PA has the more flexibility to work elsewhere because they've been trained in all areas and had internship opportunities to help. THIS IS THE BIGGEST MISTAKE OF MY LIFE. I HATE NP SCHOOL! IT DOESN'T PREPARE YOU WHAT'S COMING. IM NEAR GRADUATION AND BEEN IN CLINICAL AND HAVE SEEN HOW THE NEW NP STRUGGLE COMPARE TO THE PA! And to the person who had stated you just have to read more and put in more clinical. It's not that EASY. YOUR LIMITED TO THE HOURS AVAILABLE GIVEN FROM YOUR PRECEPTOR. YOU CAN READ ALL YOU WANT, THAT IS STILL LESS EFFECTIVE THAN BEING IN CLASS BEING TAUGHT THE MATERIAL. NP SCHOOL IS 90% SELF TAUGHT. I have a friend in PA school and PA SCHOOL IS M-F 8 HOURS A DAY LECTURE. NP SCHOOL SUCKS!!!

Consider voicing your displeasure. The CCNE is accepting comments until May 8th.

https://allnurses.com/nurse-practitioners-np/ccne-accreditation-comments-1158522.html

elkpark · May 3, 2018

YOU CAN READ ALL YOU WANT, THAT IS STILL LESS EFFECTIVE THAN BEING IN CLASS BEING TAUGHT THE MATERIAL. NP SCHOOL IS 90% SELF TAUGHT. I have a friend in PA school and PA SCHOOL IS M-F 8 HOURS A DAY LECTURE. NP SCHOOL SUCKS!!!

Maybe people need to be more selective about schools. At the school I attended (for a different advanced practice specialty; I'm not an NP), a well-known and well-respected B&M program, NP students were in class full-time with professors who were clinically active and leaders in their fields nationally (as were the rest of us in the other specialty tracks). Clinical practica were supervised by school faculty in facilities with which the school had long-standing, ongoing relationships. Students were certainly expected to be independent, self-motivated learners and seekers of information/knowledge, but we were by no means "90% self taught." Graduates were well-prepared to enter practice. There are plenty of strong programs "out there," but you have to look for them.

Riburn3, BSN, MSN, APRN, NP · May 4, 2018

I wish I did the PA route. They both have a different route of preparation but end up at the same spot! And the lack of teaching and science being taught in NP school but we are expected to know as much as the MD. I did a clinic with a PA and learned how much well prepared they are. Sure NPs are "collaborative" and PA are "supervised by a physician" but at the end of the day, PA has the more flexibility to work elsewhere because they've been trained in all areas and had internship opportunities to help. THIS IS THE BIGGEST MISTAKE OF MY LIFE. I HATE NP SCHOOL! IT DOESN'T PREPARE YOU WHAT'S COMING. IM NEAR GRADUATION AND BEEN IN CLINICAL AND HAVE SEEN HOW THE NEW NP STRUGGLE COMPARE TO THE PA! And to the person who had stated you just have to read more and put in more clinical. It's not that EASY. YOUR LIMITED TO THE HOURS AVAILABLE GIVEN FROM YOUR PRECEPTOR. YOU CAN READ ALL YOU WANT, THAT IS STILL LESS EFFECTIVE THAN BEING IN CLASS BEING TAUGHT THE MATERIAL. NP SCHOOL IS 90% SELF TAUGHT. I have a friend in PA school and PA SCHOOL IS M-F 8 HOURS A DAY LECTURE. NP SCHOOL SUCKS!!!

Better quit and go to PA school then!

lwsoccjs · May 4, 2018

I wish I did the PA route. They both have a different route of preparation but end up at the same spot! And the lack of teaching and science being taught in NP school but we are expected to know as much as the MD. I did a clinic with a PA and learned how much well prepared they are. Sure NPs are "collaborative" and PA are "supervised by a physician" but at the end of the day, PA has the more flexibility to work elsewhere because they've been trained in all areas and had internship opportunities to help. THIS IS THE BIGGEST MISTAKE OF MY LIFE. I HATE NP SCHOOL! IT DOESN'T PREPARE YOU WHAT'S COMING. IM NEAR GRADUATION AND BEEN IN CLINICAL AND HAVE SEEN HOW THE NEW NP STRUGGLE COMPARE TO THE PA! And to the person who had stated you just have to read more and put in more clinical. It's not that EASY. YOUR LIMITED TO THE HOURS AVAILABLE GIVEN FROM YOUR PRECEPTOR. YOU CAN READ ALL YOU WANT, THAT IS STILL LESS EFFECTIVE THAN BEING IN CLASS BEING TAUGHT THE MATERIAL. NP SCHOOL IS 90% SELF TAUGHT. I have a friend in PA school and PA SCHOOL IS M-F 8 HOURS A DAY LECTURE. NP SCHOOL SUCKS!!!

I'm slightly confused with your statement. You loosely state that reading is not sufficient but then relate that to PA school lasting 8 hours a day for a 40 hour work week. It would then be logical that maybe I dunno reading 8 hours a day or learning through the 1,000s of different sources that are available at-least gets the NP closer to the educational goal. So while I see the main summary of your topic small details I find weird. I by no means disagree with your settlement that the system is broken. But I am also tired of the excuses that if only people lectured to me I would obtain all the knowledge. At the end of the day a major problem that concerns the NP student is the fact that a majority work Full time/ and study part time. All other respectable programs go to school full time and their work is their clinical its as simple as that.

Rocknurse, MSN, APRN, NP · May 4, 2018

I wish I did the PA route. They both have a different route of preparation but end up at the same spot! And the lack of teaching and science being taught in NP school but we are expected to know as much as the MD. I did a clinic with a PA and learned how much well prepared they are. Sure NPs are "collaborative" and PA are "supervised by a physician" but at the end of the day, PA has the more flexibility to work elsewhere because they've been trained in all areas and had internship opportunities to help. THIS IS THE BIGGEST MISTAKE OF MY LIFE. I HATE NP SCHOOL! IT DOESN'T PREPARE YOU WHAT'S COMING. IM NEAR GRADUATION AND BEEN IN CLINICAL AND HAVE SEEN HOW THE NEW NP STRUGGLE COMPARE TO THE PA! And to the person who had stated you just have to read more and put in more clinical. It's not that EASY. YOUR LIMITED TO THE HOURS AVAILABLE GIVEN FROM YOUR PRECEPTOR. YOU CAN READ ALL YOU WANT, THAT IS STILL LESS EFFECTIVE THAN BEING IN CLASS BEING TAUGHT THE MATERIAL. NP SCHOOL IS 90% SELF TAUGHT. I have a friend in PA school and PA SCHOOL IS M-F 8 HOURS A DAY LECTURE. NP SCHOOL SUCKS!!!

Perhaps you should have chosen your school more wisely then. I've had the complete opposite experience. My school has been fantastic, set up all my clinical rotations at the top 5 hospitals in the state, all clinically active APRN faculty, excellent educational materials, classes alongside medical students. In my clinicals it's been the NPs running the show. The last rotation I did in the ICU I was with the surgical ICU team and it was always an NP in charge and calling the shots and my preceptor had medical students AND residents orienting with her. She was very well respected and none of the NPs I know struggle at all in comparison to PAs. Quite the opposite in fact. I can't help but wonder what goes on at these lesser schools because I have literally seen nothing of the like in my program. I feel very well prepared to practice.

Jules A, MSN · May 4, 2018

Perhaps you should have chosen your school more wisely then. I've had the complete opposite experience. My school has been fantastic, set up all my clinical rotations at the top 5 hospitals in the state, all clinically active APRN faculty, excellent educational materials, classes alongside medical students. In my clinicals it's been the NPs running the show. The last rotation I did in the ICU I was with the surgical ICU team and it was always an NP in charge and calling the shots and my preceptor had medical students AND residents orienting with her. She was very well respected and none of the NPs I know struggle at all in comparison to PAs. Quite the opposite in fact. I can't help but wonder what goes on at these lesser schools because I have literally seen nothing of the like in my program. I feel very well prepared to practice.

I agree with your and Elk's comments about seeking quality and it sounds like things are exponentially worse now that the As Seen on TV Universities are clamouring for our money. I also wonder if your superior experience has to do with your tract and that there are actually admission requirements?

I went to a high ranking well respected state school and my education was very much lacking. Although they offered preceptors most were new grads and the majority of faculty, including the director of the program, had minimal RN or NP experience.

Regardless how can one or two pharmacology courses actually be considered acceptable prior to allowing someone to prescribe medications? One of the physicians who has been very kind to me nearly spit coffee across the room when he asked me about our pharm credits. Unfortunately it has now gone from embarrassing to concerning with the glut of new grad NPs hitting the market.

subee, MSN, CRNA · May 4, 2018

No, actually it's not up to the students to pick schools more carefully. It is up to our "profession" to maintain a standard. It's really student abuse to make them pay so much form so little. I know that us boomers are putting a huge load onto the system, BUT since mist health care policy has been abandoned to the vagaries of private markets, the government abdicated It's responsibility to subside the costs

of salaries for faculties. We wouldn't have the faculty shortage if salaries were more attractive.

elkpark · May 4, 2018

No, actually it's not up to the students to pick schools more carefully. It is up to our "profession" to maintain a standard. It's really student abuse to make them pay so much form so little. I know that us boomers are putting a huge load onto the system, BUT since mist health care policy has been abandoned to the vagaries of private markets, the government abdicated It's responsibility to subside the costs
of salaries for faculties. We wouldn't have the faculty shortage if salaries were more attractive.

I completely agree that the accrediting bodies and national nursing leadership need to take a role in setting and maintaining robust standards. However, there are always going to be significant differences among schools and it will always be incumbent on the potential students to be wise and careful "consumers" (as much as I hate to use that term in connection with higher education).

How many people post on this site looking for advice about the quickest/easiest/most convenient pathway into advanced practice? How many of the people who post here about how unhappy they are with their graduate programs, and the sorry state of graduate education in nursing, are people who chose the quickest/easiest/most convenient grad school option for themselves?? How much research did they actually put into deciding on a program, and what were their priorities in making that decision? I got an excellent education in my advanced practice specialty because I sought out an excellent program, and was willing to invest the time, money, and effort necessary to get that excellent education.

Dodongo, APRN, NP · May 4, 2018

Ultimately it should be the accrediting bodies that set rigorous minimum standards to prevent poor quality applicants from gaining admission to NP schools. There will always be dummies who have a profound lack of self awareness who want to be MDs, PAs and NPs. The big difference being MD and PA accrediting bodies know this and prevent it by making it such that only qualified applicants gain admission to schools - because there is very little variation between programs within these fields. Nursing however, sets essentially no barriers to entry and thus we take these dummies because money is more important than ensuring the survival of our profession (and patients).