NP Education/Activism

[Skeptic, MSN, NP]

Hello, does anyone know of any activist groups within the NP community that are actively trying to make NP standards more rigorous? We have so many for profit programs and the amount of NP's that say they are equivalent to MD's is insane. These programs should at the least be similar to CRNA program standards. Which are as a whole tougher to get into, they have less programs, longer clinical hours, deeper understanding of hard sciences. We could go the route of DO's and maker ourselves stronger as a profession like they did. Instead we water it down with easy, for profit schools, with discussion posts instead of testing knowledge. Spending hours talking about founders of nursing and writing papers that could be better spent learning how to read x-rays more in depth, or interpreting labs, forming a differential etc. 

If a group like this doesn't exist, I'm down to start one with people that share my frustrations. 

[SDStudent1]

I couldn't agree more. I really like the PA education pipeline. Less fluff, more focus on the hard sciences one needs as a foundation. NP has unfortunately become a money grab of higher education. Long term I think this will dilute the quality of providers and hurt the trust in the profession overall. I am a NP and I am a little concerned when I personally have to see another NP rather than an MD or DO, or even a PA, because I know what a joke the NP education can be depending on where you go. In my experience, there are many high quality NPs out there, and they all held themselves to a higher standard than their NP programs did. If you just meet the standards of your program, you will generally be an incompetent Provider. Today I would say the biggest barriers to becoming an NP are time, effort, and money, rather than fitness for the actual profession. 
 

If you ever find, or start, a group advocating for change here I would enthusiastically sign up. 

[Skeptic, MSN, NP]

SDStudent1 said:

I couldn't agree more. I really like the PA education pipeline. Less fluff, more focus on the hard sciences one needs as a foundation. NP has unfortunately become a money grab of higher education. Long term I think this will dilute the quality of providers and hurt the trust in the profession overall. I am a NP and I am a little concerned when I personally have to see another NP rather than an MD or DO, or even a PA, because I know what a joke the NP education can be depending on where you go. In my experience, there are many high quality NPs out there, and they all held themselves to a higher standard than their NP programs did. If you just meet the standards of your program, you will generally be an incompetent Provider. Today I would say the biggest barriers to becoming an NP are time, effort, and money, rather than fitness for the actual profession. 
 

If you ever find, or start, a group advocating for change here I would enthusiastically sign up. 

I agree! I get nervous letting family members see an NP unless I know them well. I know that will ruffle some feathers but oh well. We have to do better and I know good and well we are not the only ones who feel this way.

[Corey Narry, MSN, RN, NP]

About a year ago, an experienced NP in Texas who works in Emergency Medicine made waves by attempting to publish a statement on the need for change in NP education. As one would expect, he made a lot of social media noise so that his statements reached the ire of AANP who allegedly blocked his progress.  His unpublished statement , however, was used as fuel by physician lobbying groups (such as the AMA) to restrict growth of full practice authority across more states. I will not mention his name here for fear of violating TOS. He is easily Googled. You can take a side on the matter and personally, as an experienced NP and preceptor of AGACNP students, the solutions are very complex and I fear I will be retired from clinical practice by the time I see significant change.

[NRSKarenRN, BSN, RN]

Check out the American Association of Nurse Practitioners  

 

2024: Identifying first steps for meeting the National Task Force Standards for Quality NP Education

[Corey Narry, MSN, RN, NP]

NRSKarenRN said:

Check out the American Association of Nurse Practitioners  

 

2024: Identifying first steps for meeting the National Task Force Standards for Quality NP Education

Thanks for that link for reference.

There is still a lot of contention since that was released. Even though AACN adopted those as standards of accreditation, Standard II (Institutional Commitment and Resources) is still clearly not widely implemented. 

Standard III (Curriculum) asked for increasing clinical hours to a total of 750 prior to graduation. This has not been applied across the board and the certification bodies continue to only require 500 hrs to be eligible for national certification.

These are really just the tip of the iceberg. What I always tell my preceptees (from a US News Top 5 AGACNP program) is to not rely on classroom learning and clinicals alone. The program is not long enough to cover everything. There will be a lot of self study, on the job learning, and mentoring by practicing and senior NP's as well as physicians. Many physicians are aware of the deficiencies of our education and new grads should not be expected to know everything from the get go. I have seen this with PA's too, it's not exclusive to new grad NP's.

[RN1987]

The standards to become an NP are very scary. Do standards even exist? The criteria for admission to NP programs should be as rigorous as getting into a CRNA program.  The quality of NPs  that I work with are scary enough that if I or my family members have something more than a minor illness, I want to see a real MD/DO/PA. 

[THAT Nurse., BSN, MSN, DNP, RN, APRN]

The answer isn't trying to copy CRNAs or the other professions. They are their own professions, and are different than us with different needs and pre-requisites. If the best we can do is copy others, we have no need to exist.

The first issue we need to address are the bad programs. Years ago I told our director to never again send me students from any of the online NP programs to precept. After precepting multiple students from different "Universities", I have found the online for-profit programs simply are all trash, and the students were universally unfit for advanced practice. The problem is they are also the most aggressive to throw money when needed to get publicity, attention, or political support. Look here at this forum, the ads are for quickest and cheapest NP programs. People don't ask about quality, they ask about quick and cheap, and that is leading the race to the bottom regarding quality. Until this malignant growth in our profession is addressed, we aren't going to be bettering ourselves as the cancer will simply grow faster than good quality healthy programs.

I have more than once advocated to my legislators to raise the standards (more hours in clinical study during the graduate programs including more mandated time in sub areas such as pediatrics, and even expanding into spending some time in public health, and the ED has been my main push), but the only thing I have ever seen them do is dilute standards for nursing. When I advocated a straight ban on online programs (to be clear I am talking about places like South University which I have absolute disdain for, and when I see that place listed on a CV, the CV goes straight to the trash), I was met with a pretty clear silence. We are fighting a culture (I suspect often driven by hospitals and large healthcare orgs who need the continuous train of new grads) which screams "we don't have enough nurses" or "we need more now." Until we see a cultural change desiring quality, this issue will not be improving, and it isn't limited to us. I have to be very picky regarding physicians, as more than a few in my area have effectively purchased their degree elsewhere and are not fit to practice. I have literally met MDs who did not know what basic things like differential diagnosis were.