NP education - a rant

Specialties NP

Published

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.

i was trying to get through the entire list of responses but couldn't. i wanted to respond to a couple points.

i am a bsn prepared rn who is working towards her master's. what i am learning in my master's program is completely different from what i do as a rn. the only thing that really crosses the line is critical thinking. why is it that many of the rns posting feel that tons of experience as a rn is necessary to becoming a good np?

second to didirn vbmenu_register("postmenu_1057391", true); who wrote: "i admire anyone with high ambitions, but please do not ignore folks who have been in this business for a long time who question this way of training. that is a very unwise thing to do. the op may have come rather caustic to you and insulted you, but others completely agree with the bottom line message of it. that to me gives it tremendous validity."

so basically you are saying that since experienced rns say it is so then it is so???? well, everyone used to believe that the earth was flat and the sun revolved around it. i thought we were taught critical thinking and not just accepting things as they are.

when the people who have been posting (who mostly seem to be rns and not apns) actually have experience with a np program and what goes into it, then they can make those statements. and fyi, np programs do weed out the people who aren't qualified and who can't handle it.

and lastly, maybe there are so many new grads who are quitting because of the attitudes of the "older" "experienced" nurses towards them. as a new grad i run ins with a couple "experienced" nurses who constantly made me feel stupid for asking questions. however, i was lucky that my preceptor and my unit was supportive.

Right or wrong I'm wanting to get into a NP program ASAP. I honestly don't believe that having an ASN-MSN degree is a defect. I've been an LPN for four years and imagine I will get some experience as an RN while I would be in an NP program. I do understand the concern about the wham-bam-thank-you-ma'am graduates who are taken in for the sake of filling up seats in schools, and I do object to non-nursing people holding a bachelor's degree in basket weaving being admitted to an accelerated RN program. quote] vbmenu_register("postmenu_1057391", true);

Are you serious? Do you even understand what an accelerated RN program is?!?!? It is a program in which in 18 months or so (full time, no time off in summers) you get another bachelor's in science. How is that different from a nursing student in a college getting a BSN when he/she graduates?

I did an accelerated RN program and held a BA in Art History before I applied. I spent over a year taking prereq courses - the courses a nursing student in college would take freshman/soph years before starting nursing classes in the junior year. I took chemistry, organic chemistry, A&P (2 semesters), statistics, and developmental psychology. All while working a demanding job.

You are dreaming if you think that accelerated students aren't motivated to learn.

Heck, even though I've been an RN for 20 years, I wouldn't feel I would qualify the way things are now in NP school to be a Neonatal NP or a Women's Health NP, I don't even know what a normal cervix looks like, LOL!! :) If you want to be an Acute Care NP, then perhaps you should have some unit experience.

BTW -- A NP program will teach you what a normal cervix looks like and believe me (I just finished my ob-gyn clinical) after seeing a couple thousand, you will get to know pretty well what is normal and what isn't.

What do you suggest for someone who wants to do primary care np? work in a clinic?

:banghead:

I give up. Even my 13 year old could understand what I am getting at when I explained this to him.

Just your response to me in regards to the CVC insertion story just completely proved my point...you believe my friend could have attempted a CVC insertion after being shown one time.....you have no idea about the scope of an RN practice, therefore, it's senseless to argue with someone with no understanding when they don't understand the basics of the profession. Do you even know what happens if you were to attempt a CVC insertion without knowing what you are doing? If you did, you would not even have questioned me or my friend's responses on it. You just invalidated yourself.

Yeah, wow, you know everyone has to do something for the first time. Perhaps the MD thought that this NP (with all this great nursing experience) had actually studied up on a procedure that she would do in the future and would be ready to do it. Doctors don't just suddenly know how do to do a procedure, they study it and learn it and then do it.

Almost every RN has agreed with the OP. Only students with no nursing background have argued against it. You don't have to be in the nursing profession at all, or even a high school diploma, to come to the conclusion that an RN, in the field, would have a more insight into it than a prospective student. I just don't know how more basic I can get with this.

Well, I am a RN and I don't agree with you. I think RNs are amazing but the impression I get from all of your posts is that you are experienced and so know best about a job that you don't do and are not trained to do.

Specializes in Med onc, med, surg, now in ICU!.

Well, I have the answer!

In Australia, every single RN who has graduated since the 80s has earned a Bachelor's degree, so we don't have the ADN vs BSN debate.

To become a NP in New South Wales, you have to be an RN. You also have to have at least - AT LEAST - 5000 hours of clinical experience in the field you wish to specialise.

Nurse practitioners in Australia are relatively new. They don't have total acceptance, and the scope of practice, it seems, is slightly more limited than our US counterparts.

I think we're doing things right as far as the requirements for actually becoming a nurse practitioner go. I aim to become a nurse practitioner myself, in paediatrics (hopefully, specifically medical). I am now 23, and I plan to be a NP before I'm 35. In addition to the requirements laid down by the state, I want to ensure that I will have the clinical judgement and skills required to practice at such an advanced level. Frankly, I am scared enough about graduating at the end of the year and practicing as an RN!

Well, I have the answer!

In Australia, every single RN who has graduated since the 80s has earned a Bachelor's degree, so we don't have the ADN vs BSN debate.

To become a NP in New South Wales, you have to be an RN. You also have to have at least - AT LEAST - 5000 hours of clinical experience in the field you wish to specialise.

Well look here, the downunders are on top of the game!:welcome:

Specializes in Ortho, Med surg and L&D.
I hear you amytheodd. I keep re-evaluating my decisions because of what people are saying here.

Hello,

As a direct entry masters's student who is incredibly secure in my choice I don't give a hoot about any gossipy trash-talk. Time will tell. We will all be new grad RNs and all new grad RNs have to start new, regardless of your degree of entry we all start green.

What is the difference if our degree of entry is a MSN with no qualifying bachelor's or a BSN? Possibly the BSN nay sayers are the same who trash-talk ADNs also? Maybe they are more concerned that the degree of entry is going to be raised and all their rants about ADN entry nurses is going to come back and nip them in their own rumps? Who knows.

If anything a MSN entry degree shows that not only are we able to complete the requirements for a BSN but, we can do it alongside the graduate work required for the MSN to boot!

Anyone who is misguided into thinking that a post bacc graduate can go from zero to NP in 3 years only proves that they are clueless about it an not worthy of our concern! Really, they are only showing their ignorance and misperceptions and demonstrating how they clearly are undeserving of our hand-holding to explain what our programs are all about.

Bullies do not respond well to hand-holding and coddling anyhow because they are all about controlling other's to maintain their shallow image and protect their own insecurities.

Who cares about the perceptions about bullies? Our actions and clinical abilities will speak LOUD and CLEAR. If we succeed or not will build our own reps.

Gen-thankfully halfway through a 2 year generalist MSN/RN!!

edited because my spelling is inconsistant

edited a second time to clarify: any reference to BSN nay sayers is not directed towards forum members at all. I haven't read this whole thread in a while and my suggestions were to hypothetical future nay sayers based upon words that I have heard in real life. Serious apologies if my post was vague or seemed accusitory in any way.

Specializes in Nephrology, Cardiology, ER, ICU.

I like the lively debate about this topic but we must keep on track. This is a very current topic and certainly lots of folks have strong opinions about it. Let's debate the topic and not the poster please.

Also - I wanted to add that I am so pleased with the number of opinions and responses about this. Personally, I wasn't too well-educated on what a direct-entry MSN program was and it does seem as though there are many options out there for new nurses.

Specializes in ER, Family Practice, Free Clinics.

Gennaver:

Don't worry, I'm not in the habit of second guessing life decisions based on posts on a message board! That would be pretty silly. I am very secure in my choice also!

I am however, disappointed in the lack of support I have gotten from RNs when they find out. Several have been very rude right to my face. "Who do you think you are? Huh, youre gonna crash and burn, hope you don't do it on my floor!" is the general response I get.

However, I did meet my nurse mentor from my externship program last week and she was VERY supportive and willing to help me seek out positive suportive role models to work with during my externship. Its just very hard to learn from people about thier jobs and attitudes about thier work etc when you have to be afraid of how you ask the question so as not to "out" yourself as a DE student! I don't want to make trouble for myself as a BSN student starting next week (so EXCITED!). I know from ROTC that the last thing you want to do when trying to get through something as difficult as this is to stand out in a crowd for the worng reasons! I saw too many people make that mistake, so I am laying low and putting my nose to the grindstone til I figure out who I can trust enough to ask questions about this kind of thing.

Specializes in ER, Family Practice, Free Clinics.

Also - I wanted to add that I am so pleased with the number of opinions and responses about this. Personally, I wasn't too well-educated on what a direct-entry MSN program was and it does seem as though there are many options out there for new nurses.

Thank you for being willing to learn about what the programs actually entail. I think this is one of the biggest problems: many people don't understand what DE means, or know that many schools do it differently from one another.

My program:

Requires a previous BS and all the same pre-reqs as a traditional BSN applicant. I spend four semesters (Fall/Spring 2 yrs) in traditional Jr. and Sr. yr nursing classes, not accelerated. I can (and have choosen to) work as an extern/PCT from the beginning. [At first, I just do shadowing, then, after my first two semesters they work me into patient care as a regular extern to continue full time in the summer and part time suring school].

Once I have the BSN, my program is designed to allow me to work full time as an RN for 2-3 yrs. while completing my masters part time. The MSN portion is not accelerated, and has all the same required credit hours and courses.

The benefit: I can concentrate on doing well in school, and eventually, being a good nurse without the pressure of reapplying for entrance into the MSN program. Financial aid benefits are also significant.

I have sought out mentoring programs and this shadowing/externship to allow me to get as much experience in addition to school clinicals as possible, which I think can only enhance my chances of success.

Specializes in Ortho, Med surg and L&D.
Gennaver:

Don't worry, I'm not in the habit of second guessing life decisions based on posts on a message board! That would be pretty silly. I am very secure in my choice also!

I am however, disappointed in the lack of support I have gotten from RNs when they find out. Several have been very rude right to my face. "Who do you think you are? Huh, youre gonna crash and burn, hope you don't do it on my floor!" is the general response I get.

However, I did meet my nurse mentor from my externship program last week and she was VERY supportive and willing to help me seek out positive suportive role models to work with during my externship. Its just very hard to learn from people about thier jobs and attitudes about thier work etc when you have to be afraid of how you ask the question so as not to "out" yourself as a DE student! I don't want to make trouble for myself as a BSN student starting next week (so EXCITED!). I know from ROTC that the last thing you want to do when trying to get through something as difficult as this is to stand out in a crowd for the worng reasons! I saw too many people make that mistake, so I am laying low and putting my nose to the grindstone til I figure out who I can trust enough to ask questions about this kind of thing.

Hi again,

I have also gotten strongly divided reception about this. Some BSN nurses are thrilled ot hear about msn entry level programs.

It make so much sense that as masters students our functional and clinical roles and responsibilities may be very foggy to our coworkers and preceptors too.

A way that is very comfortable for me to explain it is to say that I am a "pre-nclex" student with a year to go. Simple, to the point and doesnt discuss which degree I am working towards.

In regards to clinicals the MSN isn't relevant just the NCLEX. :)

Gen

EXCELLENT POST!!!

During my senior year in nursing school we took a management class. One of the things the instructors drilled through our heads was that we should work for at least two years before we went any further into things like NP and such. Basically told us outright that while it might be possible to get a masters or practitioner's degree sooner than that, it would be a HUGE mistake. And I agree. I would have no respect for a nurse practitioner with less than two year's nursing experience - most of the people I work with are just getting into the groove of things after two years and finally getting clincal skills down pat - and forget about a nurse manager without work experience!!!

I don't understand how you can even KNOW that you want to be a nurse practitioner or manager or CRNA or whatever UNTIL you've spent time working as an RN first. That alone is a huge responsibility! One step at a time!

At first, I thought I wanted to get my NNP, but you know, I've since decided that I much prefer bedside nursing. I had stars in my eyes as a new grad, but time and experience has shown me just where I fit in. And that's something I'd never have known had I not taken the time to just enjoy my job as an RN first.

I agree 100%. I'm just blown away by the fact that someone can become a NP with absolutely NO nursing experience. The school I went to has a "direct entry" program. More than half of the students in the NP specialties had never worked as a nurse! You won't believe this, but they actually started the NP program BEFORE TAKING THE NCLEX! I remember they were in such a rush to take the NCLEX, so they could begin their clinical rotations in the NP program! HOW INCREDIBLY INCREDIBLE IS THAT?

The direct entry students took a lot of flack from LVN's/RN's when they were doing their clinicals. Get this, one of the professors was a direct entry NP and one day she was talking about using an 18-gauge needle for an IM injection!!! Obviously, she had never even given an injection before - HA HA HA!!

I worked as a BSN for 10 fricking years before beginning that program. I'm now licensed as both an adult and geriatric NP. I CAN'T...ABSOLUTELY CAN'T imagine going into a NP program without ever working as a nurse. I'm SO glad that NNP's are now required to have 2 years of neonatal nursing experience before getting into the program! Over HALF of the NNP students at my school HAD NEVER WORKED AS A NURSE MUCH LESS A NEONATAL NURSE!

I work with a NP who graduated last December. She thought I was JOKING when I told her about direct entry NP programs! I had to print out the requirements from a website to prove to her that these programs exist! What's even MORE amazing is that some of those programs are at the top tier schools!

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