NP education - a rant

Specialties NP

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I came to the site today and saw lot's of posts of wonderfully excited people interested in becoming NP's. The vast majority of the tones of education were: "I have the opportunity to become and NP through an advanced MSN program" or "I'm sales person at Target with a Bachelors in sociology, and with just one year of school I can become an RN then get my NP degree!!!"

Sorry about this but....Being a nurse practitioner is more than just getting the degree. The job requires experience. Not a year of med surg, not a two year Master's, but some real NURSING experience. We are NURSE PRACTITIONERS, that's nurses with additional skill to allow the diagnosis and treatment of patient problems. It requires the inate skill that makes a nurse magnified to the 'nth degree. What makes good providers as NP's is the same characteristic that made them good nurses. It's experience.

I'm not on a high horse, just an NP that has seen too many "rammed through the system, get their money" NP's. This job is serious. It's serious on several levels. First and formost, you are being entrusted with the care of people that put their complete fath in you to make good decisions and provide quality care.

This IS different that being a nurse. How many times have you sat back as a nurse and berrated a provider about their choice of treatment plan or pushed for the provider to make a decision and get on with it. That all changes when you're the one with the RESPONSIBILITY for the decision. Yeah, it's an ear infection, yeah amox should do the job. Are you ready to commit fully to giving someones most honored item, their child, a drug that could kill them??? It's not cook book. It requires a base of knowledge, experience, reponsibility, and a committment to furthering your skills. It's a lifestyle!

The second group you matter to is the professional community. As NP's, we let the schools go freaking haywire in putting out as much crud as they wanted. They saw dollar signs and began pumping out graduates without regard to job markets or the economy of NP's. Boom, a flood of NP's. Fully half of them are transfer's in from "associated science's". Read sociology, psychology, earth sciences...all able to take their bachelors in science, convert to an RN in one year, and complete their master's in two more. These people may ultimately make good NP's, but not in three years!!!! What makes anyone think that this is the way to put NP's on the map??? What kind of fodder is given to the medical community, especially, to denounce the practice of NP's as being amateurish, poorly skilled, etc. It really opens us up to all kinds of flaming by other medical groups.

If you're an RN, thinking about becoming an NP, don't do it for the salary, chances are you're going to make more as an RN in the right setting. If NP is for you, go out and work, get a job, get several and work in areas like the ER(still, in my opinion, the best experience), community health care, critical care, etc. Then after a couple of years, think about going the MSN/NP route. You will be a better provider, it gives more credence to the profession, and ultimately the little kid with the OM will thank you for your skills.

I know a rant, but it makes me nuts to think that being an NP is anything less than the greatest honor innursing you can become.

Specializes in ICU, step down, dialysis.

Never mind.

Specializes in ICU, step down, dialysis.

How can I say this? It's my observation. My own personal experience. Don't take this personally. Everyone is taking this stuff personally, and I'm not trying to insult you at all. Once again, I am concerned about the quality of education students are receiving. That's all.

Well, I'm just not quite sure what to say. You are lumping all recent grads together and saying that they are not prepared enough to practice on a basic level? You've seen it with your own eyes? You've never laid eyes on me. How can you say that? You can't just lump everyone together and make a generalization like that. You seem to be doing that quite a bit in this thread.
Specializes in Postpartum.

sherrimrn wrote:

As for the NP, I personally think you should be an RN for 3 to 5 years in the appropriate area (I actually was just going to say five years minimum).

and gennaver wrote:

So, if you do the math by the time anyone in any direct entry program graduates as an NP, (even like me as an ANP) they will have a minimum of three years working full-time as a Registered Nurse while attending classes part time.

See- I really don't think you are all that far off from each other in what is an "appropriate" amount of experience. I think the tone of the posts have gotten a little pissy and that's clouded the issue. Sure there are some wanna-be NPs who will plow though their programs at breakneck speeds doing the least amount of clinical work possible to start cashing in the big bucks as an NP ASAP- but I don't think they are here posting in this thread. Who becomes a nurse for the money anyway?!

-Jess

sherrimrn wrote:

and gennaver wrote:

See- I really don't think you are all that far off from each other in what is an "appropriate" amount of experience. I think the tone of the posts have gotten a little pissy and that's clouded the issue. Sure there are some wanna-be NPs who will plow though their programs at breakneck speeds doing the least amount of clinical work possible to start cashing in the big bucks as an NP ASAP- but I don't think they are here posting in this thread. Who becomes a nurse for the money anyway?!

-Jess

Granted I'm just a little old rural nurse with an ADN but I have read this entire thread and I have to agree here . .. you all are not that far apart.

steph

Specializes in ICU, step down, dialysis.

You know I was just thinking this last night...that I make more money as a staff RN than I would as an NP (I looked into local programs and at one point in my life that was a goal of mine), at least in my area, and would have much more responsibility as an NP. Money isn't everything of course, it's best to do what you are happy at, but I guess I decided for myself it wasn't worth it.

You are right, it's gotten into a p*ssing match. I'll agree to disagree here :)

sherrimrn wrote:

and gennaver wrote:

See- I really don't think you are all that far off from each other in what is an "appropriate" amount of experience. I think the tone of the posts have gotten a little pissy and that's clouded the issue. Sure there are some wanna-be NPs who will plow though their programs at breakneck speeds doing the least amount of clinical work possible to start cashing in the big bucks as an NP ASAP- but I don't think they are here posting in this thread. Who becomes a nurse for the money anyway?!

-Jess

Specializes in ICU, step down, dialysis.

hey, I'm an ex little ole' rural nurse with an ADN too....I do miss my old rural hospital :)

When I was going to reply to her, I was looking back to see if I did miss something, she said something about seven years, which I hadn't seen before. But I just got tired of arguing. Sometimes it's just best to let things go, which I am going to do :)

Granted I'm just a little old rural nurse with an ADN but I have read this entire thread and I have to agree here . .. you all are not that far apart.

steph

Have you worked with graduates of every program? Maybe the people you are working with are in a program that needs some reworking. What area of the country are you working in? I can't see how getting your training here in Boston at some of the best teaching hospitals in the country would make you ill trained and ill prepared for nursing. I think unless you have worked with nurses all over the country from every program out there -- yes you are generalizing.

How can I say this? It's my observation. My own personal experience. Don't take this personally. Everyone is taking this stuff personally, and I'm not trying to insult you at all. Once again, I am concerned about the quality of education students are receiving. That's all.

I have seen these crazy programs. 1 year for BSn and 1 year for NP. I am sorry but after 2 years in a nursing program ,i don't even think I would be ready to be a RN let alone be a NP. I have alot of respect for the people who work long and hard as a RN and then become an NP. How would you feel if you just graduated as an RN and went to an NP for advice on pt only to find out she just graduated as well, and 2 years age she was a cashier at target???????????? I think that would scare me. these degrees should be left to people with LOTS of nursing experience.

Specializes in Pediatrics, Nursing Education.
Have you worked with graduates of every program? Maybe the people you are working with are in a program that needs some reworking. What area of the country are you working in? I can't see how getting your training here in Boston at some of the best teaching hospitals in the country would make you ill trained and ill prepared for nursing. I think unless you have worked with nurses all over the country from every program out there -- yes you are generalizing.

Exactly!

I have seen these crazy programs. 1 year for BSn and 1 year for NP. I am sorry but after 2 years in a nursing program ,i don't even think I would be ready to be a RN let alone be a NP. I have alot of respect for the people who work long and hard as a RN and then become an NP. How would you feel if you just graduated as an RN and went to an NP for advice on pt only to find out she just graduated as well, and 2 years age she was a cashier at target???????????? I think that would scare me. these degrees should be left to people with LOTS of nursing experience.

I think you are distorting the direct entry BS to MSN programs. They consist of a very accelerated year to 1.5 years for the BSN year (they don't take summers off and have very short vacations between semesters so the total time is the same as a 2 year program) AND the master's portion is 2 years for NP, not one. Plus, the remark about a cashier at Target is totally erroneous. Please give the direct entry candidates some credit. They are usually older students (they already have a bachelors degree, have been working longer (not as a Target cashier) and have had some volunteer/paid health care experience. So please don't make extreme generalizations on this. Thanks.

Specializes in Pediatrics, Nursing Education.
I have seen these crazy programs. 1 year for BSn and 1 year for NP. I am sorry but after 2 years in a nursing program ,i don't even think I would be ready to be a RN let alone be a NP. I have alot of respect for the people who work long and hard as a RN and then become an NP. How would you feel if you just graduated as an RN and went to an NP for advice on pt only to find out she just graduated as well, and 2 years age she was a cashier at target???????????? I think that would scare me. these degrees should be left to people with LOTS of nursing experience.

I've never heard of a program like that. Anyway, if this hypothetical person did go through this intensive program, and she did pass her NCLEX and she did pass her NP licensure exam... I'd think she was an exceptionally bright cashier! And, she must have had a four year degree and from a closely related background to have her pre-reqs done in that amount of time... the sciences, maths, etc.

I don't know of ANY programs that will let someone with non-bachelors come in without taking the sciences, math, etc.

From what I have heard, the pass rates on the NP licensure exam are about 50%. So, if someone became an NP in one year, had all RN/NP crammed into their little brain into that amount of time... I'd say they were a genius!

One of my nursing student friends had a bachelor's in women's studies and worked as a cashier at Walmart before getting into nursing. Being a cashier doesn't make someone uneducated or unmotivated or unintelligent.

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