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.

Direct entry programs have been graduating qualified NPs for 25+ years. I have worked with people who have gone thru these programs and most are intelligent critical thinkers who are caring practitioners that practice evidence based medicine. There are some less than stellar graduates, but that's no different from any other field.

No matter where a person goes to school - a hospital diploma program, community college, 4 year university, does an MSN thru distance learning, in a classroom, in 2 years or 5 years - they still have to pass the same exams, find a job (and keep it) and continue learning. Experience is the best teacher, but it always comes down to the abilities of the student. Just because someone worked as an RN for x number of years does not mean that they are good at their job.

I wonder what the motivation is for the original post. It is a sad rant and I hope no one considering a direct entry program is discouraged by it - yet, it's actually very informative for those who weren't aware of the attitudes still present in nursing.

Actually, there are accelerated "fast-track" CRNA programs now. You don't have to be an RN to qualify. Just a bachelor's of science degree (not a BSN).

Some people say it's OK and that there's no shortcuts with the requirements. But I have doubts. There seems to accelerated everything these days. It's worrisome.

:coollook:

I think the "fast-track" programs you are talking about really are not any faster than the other route (Columbia and Georgetown are the 2 I am thinking of). You merely are reserved a space in the CRNA class if you complete all requirements -- including the year of Critical Care. You do get the RN in 16 months or so, but that is the same amount of class time as if you did an ADN program -- just no summer off. I think very few people actually go through the programs that way. They remind me of the Med programs some colleges offer -- you apply for med school right out of high school and are guaranteed a spot in the med school class if you meet all requirements along the way. These programs are for the very focused individual!

I agree with CapeJaz. Working as an RN for years doesn't guarantee she is great in what she/he does. (When I was in hospital with my son the most experienced night RN set up the alarm for Oxygen Sat at a lower rate that Doc advised so she doesn't have to get up from her chair that often!!!).

I agree that some experience as RN is very helpful before applying for NP. However, most of the NP programs I looked require minimum one or two years of experience anyway. For example - CRNA - 1 year, NNP - 1year, Acute or Gerontology 2 years.

I am still in school for BSN and posted few messages about NPs earlier. And that is because I like to do my research early and possibly get my internship in the department I might get a job as RN later. And IF I like it I might do NP in that field. If I am asking questions about NPs responsibilities it is because I want to increase my knowledge and not because I'm applying for it tomorrow. I think first message on this thread is very angry.

It is not experience just as an RN, but experience of working in healthcare and seeing all of the options that are available. Look at the numbers of nursing students that want to become NNPs. You do not do any type of rotation in school in an NICU, it takes a year or two of training to just feel comfortable in that area, let alone making life and death decisions on these kids.

Suzanne, did you say "The drop-out rates from nursing school now is probably about 50%, meaning only about 50% of the students that started with you will finish with you."? Where did you get these numbers? It doesn't sound right.

Finally, someone who speaks the truth. I have been a nurse since 1996 and I am also about to turn 30yrs. I have thought about NP soo many times but felt that I did not have enough experience to be held with such a duty. When I came out the nurses were serious about nursing. I learned from the old heads and I did not look down at the LPN's because some of them were the ones who taught me alot of the tricks of the tread. I really appreciate that now that I have matured in nursing. Also, when I first came out, you could not get into ICU, CCU or ER without 1 or 2 years of MedSurg experience. Boy how things have changed. Thanks so much for reminding us of the value and the standards we much uphold as nurses. We have had to fight hard to be were we are today( esp as a historically women profession).

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 agree about experience issues to become an ARNP, but what about a PA who has no experience and 4 years of college? What makes him so ready to be a provider versus an ARNP with just a year or two of nursing experience? The PA doesn't have any nursing, medical, or anything experience, but walks into the same role.

I am a nurse practitioner student and there are "gemini" students I go to school with who have a Bachelors in something or another who are getting their masters in nursing in just 2 years.....HOW CAN THAT BE????? I can't understand how this happens. An RN degree yeah, okay I can see that, but I can't see how they can get a masters and be good nurses......actually, they will never be made to deal with the bedside issues because they will be MSN's, and in 2 years they could never function competently as a nurse practitioner...could they?

I completely agree with the problem of churning out NP's without any experience but I don't think the solution is previous nursing experience. Being a nurse and being a NP are so different, I don't see the correlation. It is like saying that to be an accountant for a trucking firm, you should have trucking experience. The NP programs should, in my opinion, have some form of residency. Popping them out without experience doing what they have a license for is trouble. RN experience is certainly a benefit, but not the solution. Just my opinion.

Well...

you may not need to be a truck driver before you can work as an accountant, but you had better ride in the truck long enough to see how much fuel it uses!

I agree about experience issues to become an ARNP, but what about a PA who has no experience and 4 years of college? What makes him so ready to be a provider versus an ARNP with just a year or two of nursing experience? The PA doesn't have any nursing, medical, or anything experience, but walks into the same role.

They work "under he direct supervision of the MD" we work on collabotion, huge difference of responsibility and role. Also they go througha miniature medical model f a full time 40 hour plus week of education with much more clinical than NP's. that's why experience is important, there isn;t enough clinical in the NP programs. S

Specializes in Pediatrics.

go catskill!! so glad you had the b@lls to say it. i was the queen of knowing what i wanted while i was in nursing school. ten years later, i finally figured it out. now i'm sure people will put me down and say "well i'm not as indecisive as you", but things change. i did not get the job of my dreams out of school. and due to other personal circumstances, my path to bsn took much longer than i anticipated. now i am back on track to my msn. i decided not to be so focused with dates and specific goals. i take it one day at a time (or one semester at a time). i don't regret the time it took me to get where i am, (i'm 31, so i'm not old). in my 10+ yrs of nursing, i've seen a lot. and i'm not finished exploring yet (i'm looking to change specialties as we speak).

yes everyone is different. i never expected to be working where i am now. i beleive everything happens for a reason. everyone would tell me, 'you're young, what's your hurry?'. sure it's easier to go to school before you have kids (if that's your goal). but i value every experience i've had as a nurse, because it has helped me in my graduate study. and i don't think anyone is faulting anyone for wanting to go back to school. you just might not want to put all your eggs in one basket.

Specializes in Ortho, Med surg and L&D.

Hello there,

I hope your rant helps you gain some perspective. I feel it was a good rant and cannot imagine anyone trying to become a nurse practitioner without some serious desire to work as an NP, (versus just for salary or because they are on a whim.)

Hopefully also you will find out that it is not so easy to go from BA in anything towards the MSN, it takes years. It is another route...not an easy or quick route but, another route towards the MSN.

I am most likely the enthused person you are talking about, (the one completing her BA in Sociology.)

Lest you think I am on a whim let me share some more about myself, your potential cohort.)

I am 38 and have been working in health care for over 15 years. I started out as an ambulance technician, then also became a nurses assistant and later a phlebotomist and medical assistant.

I have worked in over four hospitals through the years, (hard worker and usually always had a part time job on the side, although, never worked at target.)

As an adult I returned to school to pursue my RN degree but, found so much more that I also wanted to pursue. My associates is in Biology, my BA will be Sociology and my minor is Psychology, (have a minor in Spanish too.) All the while I have been completing the nursing pre-reqs at a gpa of 3.8. Meanwhile I continued to watch the waiting lists for local programs grow and yes, I am very happy to find this masters entry program.

Meanwhile I was wracking up years of hands on hospital care experience. I am very secure in my choice to work as an Adult NP and to continue to certify as a nurse colposcopist. I worked in oncology and hospice for a year, in ortho and ortho day surgery for about a year, in med/surg and physical rehab for about three years and in a women's health care office setting for just under a year.

The graduate entry program I am applying for is intense and competitive. We should be prepared to take the NCLEX-Rn after a rigorous 15 months courseload. Then we can begin the core courses while we work as nurses. After we have a year of clinical experience we can start our NP portion, approximately three to four years to become NPs.

Do you still feel that all of us are flippant about our desires to become NPs? I hope not, and hope that you will find that those of us who gain acceptance and complete our degrees like this are indeed going to be able, caring, dedicated NPs.

If your attitude stays so restricted, that is your perogative,

Gennaver

Specializes in Ortho, Med surg and L&D.

Sorry about this but....

I'm not on a high horse, just an NP that has seen too many "rammed through the system, get their money" NP's...

Hi,

I do want to note this, I hope you report these rammed through the system dangerous NPs. If someone is not capable, or is a risk wouldn't they loose their ? This is tragic.

Then again, you were only ranting. Aren't NPs are answerable to governing bodies as are the universities that grant them their certificates.

Personally I have always been leary of any online education but, that is where my 'chicken-littleness' comes out. Can't say that online ed would work for me, but, I will not say that anyone who has an online degree is not legitimate, as you seem to think Graduate Entry NP are not.

You did qualify your post as a rant, and we all should be allowed to rant so, I hope you take my posts as what they are, a response to your unquantified, (not citations or stats) rant.

Gennaver

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