How much did NP school prepare you?

Specialties NP

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I have heard that Nurse Practitioner school is not as rigorous as other grad schools (such as CRNA school). I would like to become either a ACNP or a CRNA in the future. I am very interested in science-based learning, and am wondering which option would be best for me. I have such a strong passion for cardiac disorders, and could really see myself becoming a Surgical Cardiac ACNP. However, CRNA interests me for the hard-core science that is taught. CRNA students get such in-depth pharmocology and pathophysiology classes.

For any ACNPs out there, did you feel confident in your pathophysiology and pharmocology knowledge after graduation? Or did you attend a fellowship after?

Read/study these texts and you will be golden:

Netter's Atlas of Human Anatomy

Guyton and Hall Textbook of Medical Physiology

Robbin and Cotran Pathologic Basis of Disease

Andreoli and Carpenter's Cecil Essentials of Medicine

And the pharmacology text of your choosing. I read Lippincott's Pharmacology. I guarantee if you read these you will be light years ahead of any NP or PA student and more on track with a medical student. Were these assigned to me during NP school? Nope. Did I read them anyways? Every word - well, half way through Cecils.

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Specializes in Neurology, Psychology, Family medicine.

Lol, halfway through Cecil. That is forgiven. It is a thick book with dense reading. Atleast you didn't mention Harrison's as basic reading ;). I would argue that physics is the least useable of the core sciences regarding practicing but you are on track with most of your other assertions and I agree :).

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Lol, halfway through Cecil. That is forgiven. It is a thick book with dense reading. Atleast you didn't mention Harrison's as basic reading ;). I would argue that physics is the least useable of the core sciences regarding practicing but you are on track with most of your other assertions and I agree :).

Haha, maybe some day! 4000 pages vs 1100 pages. I think for now the 1100 pages will suffice!

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Specializes in Family Nurse Practitioner.
when you go to graduate school it is EXPECTED that you will be a motivated and independent self learner, no grad school will ever prepare you for the real world.

When the expectation is preparing people to accurately and safely diagnose and prescribe medications I find this unacceptable. They absolutely should prepare us to practice in the real world.

I get what everyone is saying about independent study but that should be for those who want to go above and beyond not just for basic competence which in my opinion is not being met by current NP education. Med schools and PA programs seem to be able to graduate professionals who feel prepared to practice why not nursing schools?

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When the expectation is preparing people to accurately and safely diagnose and prescribe medications I find this unacceptable. They absolutely should prepare us to practice in the real world.

I get what everyone is saying about independent study but that should be for those who want to go above and beyond not just for basic competence which in my opinion is not being met by current NP education. Med schools and PA programs seem to be able to graduate professionals who feel prepared to practice why not nursing schools?

I completely agree. What, however, can be done? Posting on this forum isn't changing these programs or the BON's approval of them. How do we go about, as a profession, changing our profession's educational process? I would be an active participant in changing things if there was a movement to do so.

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Specializes in Family Nurse Practitioner.
I completely agree. What, however, can be done? Posting on this forum isn't changing these programs or the BON's approval of them. How do we go about, as a profession, changing our profession's educational process? I would be an active participant in changing things if there was a movement to do so.

I'm not really sure and now the profit potential is so extensive things are unlikely to change. As the numbers of schools and NP graduates keep increasing while the requirements for admission and graduation decrease I'm wondering if it isn't too late. I have attempted to address it on a state level and the NPs in academia, many who btw have minimal if any NP experience, turned on me like a pack of rats. Although I understand that is where their bread is buttered as a former professor at two well respected universities I became disillusioned with the quality of students and their increasing demands to be coddled. It has become virtually unheard of for a student to be removed from a program and if a course actually was failed they simply return the following semester. I believe becoming a RN or NP is a hard earned privilege not an inalienable right.

Myself and a few colleagues have contacted organizations like NONPF and our concerns were passed around like a hot potato with no answers or suggestions of alternative approaches to explore. I'm open to ideas if others have them but am not confident much will change at this point.

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I'm not really sure and now the profit potential is so extensive things are unlikely to change. As the numbers of schools and NP graduates keep increasing while the requirements for admission and graduation decrease I'm wondering if it isn't too late. I have attempted to address it on a state level and the NPs in academia, many who btw have minimal if any NP experience, turned on me like a pack of rats. Although I understand that is where their bread is buttered as a former professor at two well respected universities I became disillusioned with the quality of students and their increasing demands to be coddled. It has become virtually unheard of for a student to be removed from a program and if a course actually was failed they simply return the following semester. I believe becoming a RN or NP is a hard earned privilege not an inalienable right.

Myself and a few colleagues have contacted organizations like NONPF and our concerns were passed around like a hot potato with no answers or suggestions of alternative approaches to explore. I'm open to ideas if others have them but am not confident much will change at this point.

Extremely discouraging... It will come down to employers only hiring from certain programs. Supply and demand is the last barrier. Once the supply of NPs reaches a critical max employers will become more particular in their hiring. For profit/online NP grads will return to the bedside. Hopefully that will back up to the subpar programs at some point as well. Time will tell.

In the mean time NP students need to STOP working full time, complete clinical hours full-time and read more.

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Specializes in CVICU, MICU, Burn ICU.
Read/study these texts and you will be golden:

Netter's Atlas of Human Anatomy

Guyton and Hall Textbook of Medical Physiology

Robbin and Cotran Pathologic Basis of Disease

Andreoli and Carpenter's Cecil Essentials of Medicine

And the pharmacology text of your choosing. I read Lippincott's Pharmacology. I guarantee if you read these you will be light years ahead of any NP or PA student and more on track with a medical student. Were these assigned to me during NP school? Nope. Did I read them anyways? Every word - well, half way through Cecils.

While I agree with Jules and others (yourself included) that the rigor SHOULD be built into NP education, I really appreciate lists like these. Thanks for posting.

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I'm not surprised about NP schools leaving NP's to scramble after they graduate; as usual, nursing school fails to teach the student what they actually need to know. Nursing programs, for whatever reason, have been doing it wrong and failing the students (and the patients) forever, and I don't see that changing anytime soon, unfortunately. CRNA school being the only exception that I know of. Anyway, all that being said, the NP's I work with in ICU are absolutely fabulous and expected to function at a very high level, and they do. I don't know what kind of suffering they had to endure, if any, when they first started as I wasn't there, but I'm sure there was a serious learning curve. We have PA's as well and while there is a difference in how they "look at the patient" the general care is the essentially the same. Anyway, PA school might be better in regards to preparation, but I was told recently that PA school is harder to get into than medical school right now. That would rule out a lot of people looking to go into mid level care. :(

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Specializes in ER, Pediatric Transplant, PICU.
Did you only find preceptors who worked casually? Or did they just flat out refuse to have you follow them for more than the bare minimum required? Or was it that you worked full-time and found it hard to coordinate your schedule with your preceptors? Should NP programs find you preceptors? Yes, of course. That's another issue. But your radius for searching should be as wide as you need to find an acceptable preceptor. If you made the choice to go to a program that doesn't find you preceptors, do what you have to do.

Bottom line: Work less and do more clinical hours. Again, MD and PA students do not work during their programs so I have little sympathy when nurses work during their programs and then decry the low amount of clinical hours they got in their programs.

And like what was said before, dedicate more of your time to reading and studying. If you are only taking 1-2 classes you can be reading SO much more each semester. Again, MD and PA programs require an incredible amount of self teaching which entails multiple hours of reading and studying on their own outside of class time.

Sorry its taken me a few days to respond, I've been working (although it seems like thats probably frowned upon by you).

To answer your questions, i'm saying that even if I didn't work, it would've been really really difficult to to obtain the kind of hours that you are suggesting. Because its so difficult to find good preceptors and there are plenty of students, theres always another student in line to begin a rotation once I have finished "x" number of hours for that term. And I can say I am an exceptional student - I come prepared and I'm a quick learner. But my preceptors have students booked for a year and a half out and quite frankly, almost nobody wants a student all the time. Who would? Theres no compensation and for me to really see patients and write notes and develop plans, its kind of a headache for them logistically for us to see patients around each other and it slows them down.

I can also say that in Georgia (where I live) and to do a pediatric program (in which I am completing), the ONLY program that fully finds placement for you is Emory, and who in the hell can afford that? They also are required to do 100 hours LESS than what I'm doing. So how is that any better, really?

Another point that I would like to make is - of course PA's and residents dont work in their programs. Whatever work they do WOULD NOT BE MEANINGFUL in their career because they only have a degree to fall back on, not anything they can actually do anything clinically with. My work in the PICU along with school is ABSOLUTELY helpful in my future career. I learn things every day that will ultimately help me in my future practice, but where would a PA work with their science degree that provides them with patient interaction?

While I understand your point (work less and do more clinical hours), I still feel like you are dismissing that barriers that would allow a person to reasonably do so. Of course I could quit my job and try to do more clinical hours, but what happens when I can't get them and I just sit at home instead? At least what I'm doing for money is expanding my brain and contributing to my knowledge.

As several NPs have said to me before - you can be a bad student at a good school or a good student at a bad school. It really doesn't matter where you go, just how well you are suited for it and how hard you are willing to work.

2 Votes
Specializes in Neurology, Psychology, Family medicine.

I would argue that PA school does require 2,000 hours of on hand patient interaction at any respectable school. So there are many that a paramedics and nurses that go to PA. If you need any example look in University of Florida's requirements. That is a good example of what I find acceptable. So weird to generalize like that. They have higher admission standards, a tougher curriculum, a stronger science base, and many health care professions go into the field with a "degree" to fall back on.

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Specializes in ER, Pediatric Transplant, PICU.
I would argue that PA school does require 2,000 hours of on hand patient interaction at any respectable school. So there are many that a paramedics and nurses that go to PA. If you need any example look in University of Florida's requirements. That is a good example of what I find acceptable. So weird to generalize like that. They have higher admission standards, a tougher curriculum, a stronger science base, and many health care professions go into the field with a "degree" to fall back on.

I am by no means minimizing PA programs or anything of the sort. I do think they come out (generally) better prepared on the textbook side of things. But, regardless of what that reason is, I don't think its because people don't work during those programs. Maybe it is because of admissions standards or because they find good clinical placement or for whatever the reason. But for Dodongo to essentially say its because people are lazy because they dont devote their whole life a "go above and beyond!" is a little unrealistic given the current restrictions of NP programs. That was my only arguement.

I respect PAs a lot. I feel like I can learn a lot from them and by no means think their clinical experience is less valuable to mine.

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