How much do you remember from A&P? Pathophys?

Zero! If I were to take the courses again I'm sure if have a vague recollection of the topics but that's it :-/

In my second semester of NP school as well, and have been having similar fears!! Glad to hear I'm not alone.

No one remembers the biochemical processes that occur throughout the body. Except perhaps academics and I suppose pharmacists would at least tell you they know that type of thing. For example with Ddp-4i diabetes medication I really doubt most people that use that medication or prescribed it will have any idea what that is. However you'll find that you will recall more pathophysiology from the organ systems with which you work the most. For example I am in Psychiatry and so I do make efforts to increase my knowledge base regarding and Neuroscience neurobiology neurochemistry to some degree endocrinology and similar related fields. I do have outlying interests and other categories of medicine and so I make personal efforts to study those as well. However I will attest that neither I nor the typical nurse practitioner or physician will be able to tell you everything that large book that you mention will tell you. One of the downfalls of the education a nurse practitioner received is that typically they do not have the background to make learning pathophysiology easy. You really need some understanding of biochemistry to make all of the material and pathophysiology makes sense. To best understand biochemistry you really need an understanding of organic chemistry and general chemistry. In addition to biochemistry one also needs a fairly good working knowledge of cellular biology and genetics. In the end it is the basic use-it-or-lose-it scenario. I really think that people who specialize in an organ system will be your best educated on the pathophysiology of that system. For the typical family practice individual that's going to be very hard to do because they get to treat every organ system. I think Family Practice would be exceedingly difficult because I have a problem trying to be an expert in my field with having only received a nurse practitioner education. I know that the Family Practice people at my State University art more poorly educated than I am.

I want to add obviously that we are taking pathophysiology and many of us may have had that and undergraduate Nursing education as well. The fact of the matter is we never really got any and sound education in physiology let alone pathophysiology. I really couldn't care less about anyone's anatomical knowledge. The physiology is a necessity of Medical Science and as nurses there is never a focus on science. That is unfortunate because I think we should give up the psychosocial ship and begin concentrating more on science. So in summary I don't think that we can really test ourselves well and pathophysiology because first we liked the coursework that I previously mentioned and we never really had a good offering of physiology. I really don't care what you had an undergraduate. I took it to and several sewology courses but my understanding of physiology althoughkely better than any non clinical and non-biological person is still small in my mind.

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I agree with psychguy, but he most likely does not remember the mechanism of action to dipeptidyl peptidas-4 inhibitors because he hardly prescribes it therapeutically (outside continue home mess). Because we have no excuse not to remember the mechanism of action for mess we typically prescribe. Hold our selves to the same standard as PAs or MDs. That being said I doubt we will remember everything and most likely forget things outside what ever specialty we go into. The key is being a lifelong learned! Student for life!

I remember most of what I need to know. My anatomy is really really weak though, but it isn't as important to remember that. Most docs that aren't surgeons don't remember the anatomy stuff so much either. Just what is clinically relevant usually.

But yeah for a provider role regular undergrad a and p is a lol and i mean they give us a pathophysiology course in grad school which really should be coupled with a physiology course also.... A mixed biochem and organic chem course should really be required for nurse practitioners but that will never happen. I mean we don't need to get into the details of diels alder mechanism and all that stuff not directly related to medicine but i strong knowledge of the basic functional groups like alcohols, aldehydes, ketones, thiols, carboxylic acids, amines, amides, esters, ethers, etc etc really helps with biochem and pathophysiology. So do mechanisms of enzymes and such. I mean they tried to teach us the CYP system in grad school without any exposure (for most of us) to enzyme kinetics. What a fat bunch of help that is.

Most premeds have more physiology than a graduating nurse practitioner has had before they even start med school. Lol.

I also went home to visit my parents this weekend and was looking through my old stack of nursing books shaking my head the entire time.

Who writes this stuff? I am pretty sure that every nursing book is basically a psychology book that had the cover ripped off and the word 'nurse', 'wash hands', and other gobbledegook thrown in there.

Like psych guy said we need more science if we want to be held to the same standard as the docs, not this other garbage. I mean somebody wrote a 1000 page textbook on community health nursing. Is that really needed. None of it was any different than a med surg text book really. Oh and don't get me started on the theoretical foundations of nursing book.. another 500 page paper weight.

While all these pious women are writing these books the other healthcare professions are sitting there sipping their coffee laughing at the sad excuses we use to try to distance ourself from medicine. Medicine is science, nursing is not, at least not in its current form.

A lot of the items will not pertain to a specific role in your practice nor is it really applicable to everyday practice. For example, lidocaine for numbing up an injection area. We know lidocaine numbs up an area but do you or the patient really care that it blocks voltage gated sodium channels in the neuron? All the patient cares about is that their finger is numb before the sutures are placed! While I do find it important to know the background of things, it becomes irrelevant in clinical practice. Sure you have to worry about allergies but in the scope of what you plan on using the drug, the amount given is probably not going to cause system toxicity.

The big takeaway from this class should be what types of systems both at the cellular and above are going to affect how you provide care. You dont want to prescribe your patient who takes MAO's something that will overload them with neurotransmitters and cause a potential fatal event (because you're already blocking the breakdown pathway to flood the junction). You dont want to prescribe your patient a 3A4 inhibitor when they are routinely on a 3A4 substrate that could be toxic to the patient should that enzyme be blocked (clarithromycin/atorvastatin). You dont really have to know what the CYP enzymes and their subsets are from a chemical standpoint, you just need to know how it will impact the care you provide. Does this make sense? You'll learn the how's and the why's and they are good background information but ultimately your practice will be on a more practical sense.

@Twozer, what you just said, no, not really following. But I have a feeling that I will learn all those soon, if not then in another lifetime, but soon.

In any case, thank you all for giving out your insight. Yeah, I was getting worried how we're just going through this course fast and I am not the only one who shares this sentiment. Glad to know all of these. I'm passionate about learning patho but at this rate, it seemed to suck my enthusiasm. Hopefully it'll get better as I go through the program.

PS: I do agree about nursing needing more science. I hate fluffs. Medicine IS science and much of what we do are grounded in science.

Is it not ironic to argue for more science courses when someone also states there is already insufficient time to learn what is already required? This is the exact reason why I support the terminal DNP. Take out some of the courses as you all suggest, and replace them with in depth science courses like physiology, and lastly extend the program to a doctorate.

On a unrelated note. You all who are responding on the thread are the reason I like allnurses. I highly value your opinion

It is ironic in a sense (and I wholeheartedly agree with you too). However, I really wasn't clear when I said it earlier. What I meant is that, adding more science courses throughout the program and not condensing pathophys for one semester (similar to what pace med students go through) can be one thing and thereby giving students to fully absorb the material.. but I guess one can contend that pathophys should be integrated through the different clinical rotations classes as well which is what we're going through, but we're digressing.

But I guess the point is that the more important thing is to learn pathophys in a clinical context.

Here's how my NP program roughly panned out:

A year of vapid, base nursing mantra.

A year of 3 freaking P's and practice management.

A year of clinical training.

In my mind, that should be a year of clinically applicable sciences, a year of general clinical training (medicine, peds, surg, neuro, etc) during which we are the provider and not a nursing student hand puppet, and a year of specialty coursework.

I don't believe anyone on any level really needs 4 semesters of chemistry and 2 semesters if physics. However, there are some relevant concepts to learn that would make learning other clinically relevant material easier and more enduring.

For example, since CYP was brought up? Who knows why the 450 is added, I.e. CYP450? Likely this group because we're into this stuff. Additionally, who actually knows what a substrate is? As you see a lot in physiology, who can actually tell us what it means when you read about oxidation and reduction? Rather than continuing to read about and not know why not have that as part of the required curriculum. In all seriousness, one combined course of relevant biochem, cell bio, and genetics would probably be sufficient for us - not to retain and regurgitate later in life but to provide the base knowledge requires to grasp physiology that we'll use to a further degree. Then use that to actually learn patho before trying to shove a patho wothout prereqs down our throats.

As it happens, those that champion nursing experience before NP training aren't retaking their little undergraduate A&P courses. They may not have had that in a decade.