Most Rigorous NP Programs (worried about NP Curriculum)!

Nursing Students NP Students

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Hello everyone!

I'm very interested in becoming an NP soon (FNP or PMHNP), but I want to go to a very rigorous program. I'm very concerned with always providing the best care for my patients and so I want to go to a program where I will learn the most. It seems a lot of "diploma mill" type schools have opened for NPs, and I need help weeding them out!

I look through a few curriculums for NP programs and I'm kind of worried I won't learn enough. I see a lot of "fluff" classes on nursing theory/public health type things - and while these are definitely important, I feel that most of the NP program I've found just don't have enough strong science courses. I want to really work hard, take a lot of deep courses on diagnosis, pathophysiology, pharmacology, immunology, etc. Anyone go to a program like that?

Regardless of your program, do you feel you graduated with a very sound knowledge of how to diagnose and treat most patients on day one or did you feel completely lost?

Don't even try to go with the tired old argument of PAs get more or better education, sigh.

Please get a clue.

How do PAs not get more or better education? Not trying to be antagonistic, but I disagree and would like to understand your viewpoint.

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Oh here we go again, a pa student coming on a nursing board to tell us all how much better their education is. And of course these are the same guys that are on the pa forum dissing np education along with all the fluff of the last year or two of md education. Pa education is of course perfect. their clinical hours are so superior (despite the fact that np clinicals focus on one area vs. rotating throuh all the different specialties). Sorry to say, but it is all very program and student specific...that is the truth. I am trying to be polite here, but many np programs teach the sciences, and I am tired of hearing that an np practices nursing, not medicine. Diagnosing and treating illness is medicine, sorry. To say otherwise is degrading to the profession, but I suppose it keeps the AMA happy.

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Specializes in Hospice.

TreeJay the question is how do PA's get 'hands-down" better education? sorry ....just don't see it. I don't think most NP's would agree with your POV.

I do know there are more jobs for PA's in some specialties(and NP in others), but that seems to be facility dependent.

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Specializes in Critical Care.

Its not simply what school you go to its about your own initiative as well. Taking the time to read all you can on internal medicine, pharmacology, pathophys. I used study supplements in nursing school just because I wanted to know more including using board review books on whatever focus we were working on. You aren't limited to just the class or school you go to!

I would choose a non-profit program that has a good track record ie history not some new program that just opened up to cash in! Also the best financial aid program and most economical would be just as important! Interest now accumulates and capitalizes on day one of grad student loans and the interest rates are pretty high given that a car and home loan is now in the 2-3% range!

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As an NP with >10yrs experience in critical/acute care, both through teaching in academia, precepting, publishing, research, etc, I will honestly say that the hierarchy throughout the past 2 generations have not left the profession in an ideal setting...seemingly reconfiguring and reestablishing the semiotic standing and position of "nursing" within healthcare. To address the intent behind this forum, there are a myriad of questions (and not about the cost) one should inquire about: (1) academic and clinical resources at your disposal (2) academic assistance (3) faculty expertise within the program, and are they "still practicing clinically." (4) availability of alumni to speak with (it should be chosen randomly, and ask to speak with recent alumni). (5) will they discuss and analyze your clinical strengths and deficiencies and find your clinical placements throughout the program. (6) where are alumni working, how many are employed. (7) ANCC board certification passing rate (8) availability of corresponding academic hospitals and centers (ideal situation, i.e. Boston, New York, Philadelphia, Baltimore, etc,).

Now, understand that in no way shape or form will you become an adept clinician amendable to handling the expectations of the clinical setting you may find yourself in during and after the program (the same goes for PAs and MDs!, but they are far more developed from the onset). Far too often students are placed in less than ideal situations to learn, and trying to find jobs afterwards can be a precarious situation. I find that FNPs (Family Nurse Practitioners) have the broadest knowledge base of all the NPs coming out of school, but they fall short of understanding the principles of acute and critical care that may present subtly in the clinical setting. Vice versa for Acute Care NPs, who are not well adept in the primary care world. This is the problem nursing has placed themselves in.

We have made ourselves of less utility than our counterparts in the immediacy, requiring years of clinical development and continuing education to be on-par. Even at that, many of us may never be accredited to see pediatrics or adults. Now throw in some DNPs into the mixture, and develop a consensus model to stabilize the shortcomings we have positioned ourselves into over the past 10-20yrs. And to make matters worse, after years of promoting an advanced practice program for experience nurses, now we funnel 2nd degree students, or fast track BSN-MSN-DNP students throughout programs without an inkling of what the ideal situation or fit is for them.

To improve APN education, we are going to have to change everything we do - how we educate our NPs students, how they are exposed into the clinical setting, and provide them the breath and depth of experience throughout the human lifespan while they are in school, and then allow them to select their clinical pathway from then - translated...2-3yrs or more of graduate schooling. I'm not even going to get into the ridiculous aspect of programs that mandate 4-6yrs for a PhD. And have faculty that are engaged actively in the clinical arena (meaning active patient care), and change the nomenclature, perhaps as a generalized “Nurse Practitioner - FNP-BC, Nurse Practitioner, NA-BC, etc).

And as a side note, change our predisposition to credentialing and substantiating ourselves, which borders on the upsurd sometimes, i.e, John Doe, Phd, RN, MS, MSN, FNP-BC, MPH, ACRN, FAAN, FRCN.

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Specializes in Anesthesia, Pain, Emergency Medicine.

I'm not going to list the myriad of reasons why there is really no difference at all between PAs and NPs. For one, you are just a student and really have no experience to base an argument on.

Get out of school, get some experience working with other PAs and NPs and you will find there are good and bad in both professions.

The education models are different. NPs rely much more on prior education and experience vs a clean slate start with PAs. Is one better than the other? Not really as all the learning will be after school anyway.

Yeah this is too bad in my opinion, because the NP profession really had a chance to fix some of the problems with current NP programs such as limited clinical hours.
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Specializes in Anesthesia, Pain, Emergency Medicine.

DragonNP,

You very eloquently stated how I feel.

Thanks, :)

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How do PAs not get more or better education? Not trying to be antagonistic, but I disagree and would like to understand your viewpoint.

Lot's of variables here but in the military PA program students have a 3 week block of observing, yes observing, psych providers. One of my work buddies was a PA before going back to school for her NP. She's considering trying to set up some type of more formal training for the PAs. In contrast the FNP's at the NP school I went to had to take a separate psychopharm course as well as a course in psychopathology which was great considering so many primary care patients have mental health problems.

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There are so many variables, as mentioned. PA programs may have more clinical hours built in, but I would guess the majority of NP students have had significant experience as RNs. When I applied for my program, there was a minimum requirement of 1000 hours worked. Just a thought.

I feel like there is just *so* much to learn. No matter which program you choose, you have to supplement, review case studies, seek out learning opportunities in your desired field, etc.

I'm just excited to get started with clinical!

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It always surprises me when the whole "PAs get more training" topic comes up. PA schools have more hours because their scope of practice is wider. PAs are generalists and NPs specialize. Also, their training is absolutely not superior in every circumstance. A psych NP, for example, receives far more psych training than a PA. I'd rather see a CNM for OB care than a PA, as well. It's a different educational approach and one isn't necessarily better than the other.

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I've worked with many PAs who are specialized, and namely in psych. PAs came into the hospital to complete psychiatry fellowships, just as NPs did. I think we need to stop pointing fingers at what's better or worse in our fields and within this field.

Let's face it, there are some lousy RNs, worthless MDs, and will be NPs who are much better prepared than others. I believe your education and experience can be as rigorous as you make it. I went through the same RN and BSN programs as 100 other students. We are not all equally competent nurses.

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Specializes in Mental Health.
Yeah this is too bad in my opinion, because the NP profession really had a chance to fix some of the problems with current NP programs such as limited clinical hours.

I agree. From what I have seen of DNP programs, the extra credits are mainly theory/research/public policy courses. For example, take a look at Yale's DNP program for post masters. Ethical Analysis in Healthcare, Tranformational Leadership in Professional Education, Healthcare Policy Politics, and Process, the Business of Healthcare, Leadership Theories -- oh come on. Are they serious? Interesting topics to learn but I see nothing clinically relevant which will produce more prepared healthcare professionals...

Each DNP program creates their own curriculum, but they follow a set of guidelines written by AACN. These are the guidelines and I see nothing that helps NPs become better trained. If you scroll down to Appendix B, you'll see who made up the "DNP taskforce" that wrote these guidelines. Check out those credentials. All PhDs who I doubt have any actual clinical experience :down:

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