I'm just starting out in nursing school. I'm in my first semester, and currently at the tail-end of A&P I. On Tuesday night, one of my classmates asked our professor, who spent the bulk of his career prior to teaching as a scientist for Schering-Plough Research Institute, what a Trump presidency could possibly mean for the future of healthcare professionals. My classmate went on further to ask our professor what he thought a job market in the future would look like for NP's. Before answering the question, our professor went on and on about how MDs and PAs will always be needed, but that he doesn't see a job market for NP's other than as nursing instructors. He was even pretty much shrugging his shoulders and rolling his eyes! This immediately raised a huge red flag for me. I was pretty horrified by how dismissive he was of this career path. He actually said, "yeah, that's an avenue a lot of nurses are taking these days, mainly because it's the only way to advance their careers."
Can he possibly be serious?! And furthermore, is there any truth to his assumption? I personally know two women who were nurses for 20+ years who recently went back to school to pursue DNPs and are currently working in their specialized fields alongside a group of doctors, and they're very happy and successful. I follow multiple nurses on Instagram who have large social media followings who are recent grads/current NP students and none of them have been relegated to teaching because there is "no job market for NPs."
My lab instructor is a highly respected doctor and I plan on discussing this with him tonight, since I'm sure he knows a lot more about this sort of thing than my lecture instructor seems to think he does.
I would love to "hear" your thoughts on this. Personally, I was horrified and quite offended.
I would like to know the credentials of OP's A&P professor. By OP's post, he has extensive experience as a 'scientist' for a Big Pharm company and he is now teaching science in a university/college (which almost always requires a PhD with published research). I caution all to NOT underestimate the man's education & experience.
My sister (BSN, RN) also worked many years in clinical pharm research. (Not doing bedside clinical med pass and recording pt behaviors & side effects in control/blind studies (like I did for a Pharm study at my NH while I was UM). She monitored NIH & FDA protocols for drug research and approvals. Her colleagues were physicians, psychologists, epidemiologists, pharmacists, clinicians like RNs, PT/OT/RT and others. Many of her colleagues held advanced educational degrees and clinical licenses and all had extensive experience. Many of her colleagues were international professonals from Germany, Japan, France, Switzerland, etc. Many were published science authors..
So what I'm saying is that OP's professor may be making a very astute and knowledgeable observation about the FUTURE. Think about it - in 1990 or even 2000, who could have predicted that the state of healthcare and nsg would be as it is today, some 20 or so years later?!? I don't think he's tootin' gas!!!
I wouldn't be too all-fired sure that he's not right and may able to make observations based on what he knows about the 'BIG PICTURE'. To be so righteously self-assured may be one BIG mistake. Who'd've thunk about today in 2000; I wasn't thinking 'BIG PIX'.
Just keep an open mind about the possibilities. He may not be 100% about the future, but I wouldn't dismiss him.
"The proportion of ARNPs over the age of 50 years has decreased from 49.4% in 2008-09 to 41.5% in 2014-15. Conversely, the youngest ARNP age group has increased in size by about four percentage points in the same timeframe (3.7% to 7.5%). While this trend is indicative of a small shift to a younger workforce, the workforce will likely be reduced as a larger portion is aging and entering retirement in the next 5 to 15 years. The retirement of older, experienced nurses will result in a loss of highly skilled mentors with years of organizational and experiential knowledge."
(From Nurse Practitioner Supply 2014-2015 in Florida
https: //www.flcenterfornursing.org/DesktopModules/Bring2mind/DMX/Download.aspx?Command=Core_Download&EntryId=1196&PortalId=0&TabId=151 take out the space).
It looks like more are graduating from school, but not passing the test. (http: //healthaffairs.org/blog/2015/05/26/the-nurse-practitioner-physician-assistant-and-pharmacist-pipelines-continued-growth/ see Fogure 1).
Consider that NP training may have been an academic pathway for older besieged RN's. One issue is the cost factor is not improved using NP's as seen in England.
It may be that cost factors are what is going to power the future. Many have been convinced that Academics is the most important factor leading to more and more schooling for the same positions.
NP programs must be accredited by CCNE (Commission on Collegiate Nursing Education) and are regulated by NONPF (National Organization of Nurse Practitioner Faculties) and AACN (American Association of Colleges of Nursing) guidelines, in addition to individual states' offices of licensing and professions. Following graduation, NPs sit for a national credentialing exam in order to demonstrate their level of knowledge as a novice practitioner and to be able to bill CMS and insurers for services.
So while to the naked eye this might appear impressive what I would like to know is do any of these accrediting bodies do one single thing to monitor these programs once the curriculum with fancy named courses are approved? Do any of them have any clue as to the skill set, or lack thereof, of the instructors or preceptors? I have to wonder if these programs are cut loose to run however they see fit and as I do know to be true often by directors, instructors and preceptors with minimal if any clinical experience. There are instructors I know who started teaching NPs as a new grad without NP experience and NP preceptors who started precepting as new grads while they were still required to have their own mentor. Now that's exactly who I'd like to have teaching me the finer points of being a NP, not.
You realize most ACNP's are experienced ICU/ER nurses? How can a PA be any more prepared than those RN's who spent years at the bedside? (in regard to acute care).
I am talking about advanced education. Yes having bedside experiences great but it can't make up for a crappy for-profit online graduate degree with sub-par clinical experience.
There are too many nurses going into NP school that aren't preparing them for advanced practice and quite a few only have a year or two of bedside experience. PA schools are ridiculously difficult to get into, have high standards and more than triple the clinical hours prior to graduation. If I were an employer, knowing what I know about NP education and the differences between NP schools and entry requirements, I would most likely hire a PA.
Neonatal NPs and CRNAs are the ONLY specialties that require relevant experience prior to matriculation. FNP, ACNP need to follow suit.
Neonatal NPs and CRNAs are the ONLY specialties that require relevant experience prior to matriculation. FNP, ACNP need to follow suit.
That's incorrect. ER NP programs require a year of ER experience before being admitted. ACNP programs require a year of ICU or ER before being admitted.
For-profit PA schools exist. Healthcare experience hours have declined quite a bit for admission requirements to PA programs. Some require as little as 500 hours now for PA school, doing something as simple as a PT tech. Many new PA programs have come about, not just NP. This is a trend that extends to CRNA and MD/DO also. For profit programs lowering admission requirements for more students and more money for the schools.
Yes, we are both talking about advanced graduate education. I was referring to the ACNP requirement to have bedside experience.
That's incorrect. ER NP programs require a year of ER experience before being admitted. ACNP programs require a year of ICU or ER before being admitted.
For-profit PA schools exist. Healthcare experience hours have declined quite a bit for admission requirements to PA programs. Some require as little as 500 hours now for PA school, doing something as simple as a PT tech. Many new PA programs have come about, not just NP. This is a trend that extends to CRNA and MD/DO also. For profit programs lowering admission requirements for more students and more money for the schools.
Yes, we are both talking about advanced graduate education. I was referring to the ACNP requirement to have bedside experience.
Not all ACNP programs require any bedside experience. My alma mater's grad program, a state university, doesn't and I can name more. Only neonatal NP programs universally require relevant experience.
That is a problem.
600 hours of clinical experience isn't enough. Your typical PA has thousands. I don't say this to diss NPs but with the exception of CRNA and NNP, every other advanced degree in nursing varies wildly in requirements. Even other NPs and experienced nurses on this forum have attested to the lacking in NP education.
And how many PA students are required to find their own preceptors? That is madness! A student should not have to find his or her own preceptors but in NP education that is the norm. The PA model follows most closely to the medical model.
I disagree with your professor's comments. I am a nurse and health law attorney who represents a national healthcare system. Many, many of our hospitals staff with hospitalist nurse practitioners. In my own experience, my PCP is a nurse practitioner. My brother is a NP and has never had any trouble staying very busy.
The health care marketplace is in a constant state of flux but unfortunately there will always be health issues and therefore a need for providers. With the decreasing reimbursement rates, many physicians are hiring NPs to increase their practice's efficiency and economics.
So instead of relying on anecdotal musings by someone who has not been at the bedside for a while, I recommend you research sources such as DOL statistics, the Kaiser Family Foundation data, or other more reliable sources. Also, the demand for NP will depend upon the specialty. As for salaries, MGMA and Sullivan Cotter are sources of information for NP salaries at recognized fair market value.
Yes I remember that and it makes me sad. The truth is I do know a few excellent, skilled clinicians who still continue to teach despite the wages being poor as compared to what they are making as a NP however they are few and far between and do it only very part time. A majority of the career educators I know fit in the negative stereotype I picture in my mind. They are largely sporting a long list of ABCs after their name and not a speck of dirt under their loafers.
amoLucia
7,736 Posts
I would like to know the credentials of OP's A&P professor. By OP's post, he has extensive experience as a 'scientist' for a Big Pharm company and he is now teaching science in a university/college (which almost always requires a PhD with published research). I caution all to NOT underestimate the man's education & experience.
My sister (BSN, RN) also worked many years in clinical pharm research. (Not doing bedside clinical med pass and recording pt behaviors & side effects in control/blind studies (like I did for a Pharm study at my NH while I was UM). She monitored NIH & FDA protocols for drug research and approvals. Her colleagues were physicians, psychologists, epidemiologists, pharmacists, clinicians like RNs, PT/OT/RT and others. Many of her colleagues held advanced educational degrees and clinical licenses and all had extensive experience. Many of her colleagues were international professonals from Germany, Japan, France, Switzerland, etc. Many were published science authors..
So what I'm saying is that OP's professor may be making a very astute and knowledgeable observation about the FUTURE. Think about it - in 1990 or even 2000, who could have predicted that the state of healthcare and nsg would be as it is today, some 20 or so years later?!? I don't think he's tootin' gas!!!
I wouldn't be too all-fired sure that he's not right and may able to make observations based on what he knows about the 'BIG PICTURE'. To be so righteously self-assured may be one BIG mistake. Who'd've thunk about today in 2000; I wasn't thinking 'BIG PIX'.
Just keep an open mind about the possibilities. He may not be 100% about the future, but I wouldn't dismiss him.