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.

Specializes in NICU/Neonatal transport.

Well, I am one who is taking "the easy way out" or whatever you want to call it. I'm doing a direct entry MSN program to become an NNP. I have a BA in Spanish and International Studies. NNPs nationally now are required to have a min of 2 years NICU experience before beginning their masters level coursework. (so for us direct entries, we go to school, take our NCLEX, work for at least 2 years, come back, finish our MSN)

One of the reasons I chose this path was it was fastest way to get my RN, period. My husband was injured in the military and I wish I had the ability or patience to wait in a 2 year waiting list at a CC or do another bachelor's program, but the fact is: I don't. I'm going to be struggling enough as it is to get through my time until I can sit for the NCLEX. My primary goal was and is to become a nurse. If I can't finish my Master's program, so be it, but at least I'll have my RN and the ability to support my family.

Typically (not always, but often) the people in direct entry programs were not checkout girls at Target, or if they were, they were grossly overqualified. They are older adults who have a degree and for some reason or another have decided to pursue another career, and they are passionate about nursing. Our program requires you to have a specialty chosen when you apply, and you may never be able to change it once you've chosen. My speciality choice is the entire reason I'm back in school!

My children were both preemies - relatively late and mostly healthy preemies, but still, I spent 3 weeks in the NICU with my son and 11 months between the two of them on bedrest to try and prevent an earlier birth. I developed an absolute love and passion for neonatology and I decided I wanted to work in the NICU because I needed to give back to the world after all the wonderful nurses that cared for me and my children. Being an NNP gives me even more of an opportunity to not only care for preemies, but to care for my own family, with the potential of higher pay with a Master's.

Maybe instead of painting all direct entry students with the same brush, you could realize there could be incredibly bad nurses who have been nurses for 20 years, and incredibly good nurses, fresh out of school. Judge us each individually, not as a group, and we'll do the same. Instead of setting up an adversarial relationship with DE students, you could porentially educate them more and make a positive difference.

Specializes in NICU/Neonatal transport.

Oh, and my school's NCLEX/NP Licensure exam pass rate is 100% for Direct Entry. Why? Because we work our butts off. You want to tell me a 19-20 year old girl who has never lived life on her own is automatically better than a student that passed the same licensing test and then in addition has 10 or more years of life experience under her belt?

Specializes in NICU/Neonatal transport.

I'm not sure if I should continue to respond to this thread, seeing as my BA clearly did not impart me with any critical thinking skills - apparently they are only a skill that BSN students receive.

But, maybe some of you should take a look at the programs you are denigrating. I will officially start in August. Normal graduate student course load is 10-12 hours. The courseload for your normal DE student is 19-20. (Mine will be less because I've completed some courses ahead of time) I will go AU05, WI06, SP06, SU06, AU06, WI07 and at the end of WI07 or SP07, I will be able to sit for my NCLEX. 19-20 credits hours every quarter. When I receive my RN, my program gets put into a holding pattern, as I, and the 2-3 other NNP track students, go out to get jobs in NICUs. We must work for a minimum of two years in a level III NICU. After we complete that, we return to our hardcore school schedule. After an additional two years, including summers (AU10, WI11, SP11, SU11, AU11, WI12, SP12, SU12) we will be able to sit for licensure. So. The earliest I could be an NNP is in 2012. It's the beginning of 2005. That's not exactly churning out students at an alarming rate, at least in my book.

Of course, I'm just an idiot with a Bachelor of Arts, and apparently all we are qualified to work in is retail.

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

Clearly not and all apologies to all cashiers everywhere, (the original poster was using me to point to as a student who was completing her degree in sociology and the op must have thought I was a cashier at a hypothetical target.) While I was never a cashier at target I was a foodserver, nurse assistat, and a cashier at a restaurant and another retail store, (in my earlier years and yes, working for a poor wage takes a lot more integrity because you have to mange crazy issues."

There are two books, titled, "Nickled and Dimed" and "No Shame In My Game" that are both great chronicles of how hard it is and how cashiers and attendants and low wage job workers are indeed PEOPLE.

For the sake of this thread though I think the only defense agains being accused of this is in regards to not having or having any, (ANY) preporatory schooling before entering the direct entry programs, (entering cold adn unprepared.)

Apologies again to cashiers!! We really do KNOW that you have much more going on than this thread would assume.

Gennaver

I get that Gennaver. I just think it's important to point out that in a lot of communities people are working as cashiers because the job market is so rough, not because they aren't intelligent people.

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.

THANK YOU for that post! I agree wholeheartedly! I KNOW I want to be an NP, and have some experience in at least mental healthcare (though I want to go for FNP), but I've been SO discouraged on this site because of the lack of support from those already in the field. I know this is what I want to do. I'm a hard worker, but I'm extremely nervous because it seems that I'll be going into a field full of hostility. I don't want to despised and disrespected because I went through a direct entry program. I respect bedside nurses immensely and hope to learn from them, but I don't want to be treated like dirt just because of how I chose to enter the field. :o

Hi meagain. I just thought I'd say I feel the same way. This thread makes me so sad. Everywhere online that I've gone trying to hear about people's experiences as I figure out what route into being a health care provider have so much negativity. The female doctors (and the ones I know IRL) all say don't do it, it's horrible; the PAs are smart but defensive and tend to slam NPs; and the RNs and NPs seem so nice but some give the impression they'd rather be caught dead than working with a person like me (a person for whom it makes way more sense - in terms of schooling - to do a masters entry NP program than wait around for a spot in an ADN program and then eventually probably go back for the MSN anyway).

My background is in mental health (and research) too, btw.

Good luck to you.

Hello Mingus:

The female doctors are all saying "don't do it", which refers to what? Don't become an NP, or don't go the direct entry route? What is it that is horrible? And what setting are these women working in? Hospitals?

I have one year of NP education left. I'm excited, I love it. You could not pay me enough money to ever think about becoming a medical doctor, however. I attended school to become a Naturopath before deciding to become an NP. I have researched my deciisons every which way, as I am very analytical. Becoming a PA was out of the question, as the autonomy could never be there. Go to the PA forum if you want to get a taste of the frustration over lack of autonomy of the part of PA's.

Hi Brown Rice. Actually, the female MDs (the ones who've voiced an opinion anyway) and med students I know are saying don't go to med school and that medical training is inhumane. They're encouraging me to go the NP or Pa route instead, particularly because I have a child. I agree that is very likely a better choice for me and am leaning toward becoming an FNP.

I'm glad to hear that you are enjoying your training so much. :)

Specializes in ER, Family Practice, Free Clinics.

Because of comments like those on this thread, which, I have received in person, I have completely stopped telling people I am a direct-entry student.

I am very discouraged by the lack of support I have gotten, and fear that staff nurses where I work and clinical instructors will act differently around me because of my choice, so I keep it quiet and will try to blend in with the rest of my class. (My BSN portion is the same as everyone elses at my school, its just that I start my MSN program directly after while working full-time as an RN that makes my course different)

Because of comments like those on this thread, which, I have received in person, I have completely stopped telling people I am a direct-entry student.

I am very discouraged by the lack of support I have gotten, and fear that staff nurses where I work and clinical instructors will act differently around me because of my choice, so I keep it quiet and will try to blend in with the rest of my class. (My BSN portion is the same as everyone elses at my school, its just that I start my MSN program directly after while working full-time as an RN that makes my course different)

I hear you amytheodd. I keep re-evaluating my decisions because of what people are saying here.

Hi Mingus:

I can only imagine what the training for MD's must be like. At least they recently put a limit to the number of residency hours that can be accomplished within a certain time frame. I find the current Western medical model a bit odd, and the practices that are required of it's workers even more odd. Consider that during my hospital clinical rotations, I would hear nurses say "I don't have time to go to the bathroom when I need to, or I don't drink much water/etc. because I don't know when I'll get to go to the bathroom". Well, hello, guess what a contributor to UTI's can be? Not drinking enough water OR, not "going" when you first need to. Hmmmmmmmmm. We are not taught (in nursing school or at work) that we need to respect and take care of our own mind/body/spirit first, so that we can be strong and healthy enough to attend to the needs of others. Without the strength, we are only going to cause disease within ourselves. Consider this as well: Research is reflecting that breast cancer rates are higher in women that work at night. (it is somehow interfering with hormonal cycles) In addition, working under flourescent lighting adds another dimension to this problem. And I haven't touched upon the 12 hour shift thing. Three of those in a row and you need the other four days just to recover. Is this why so many nurses are overweight? They are so exhausted, and the lack of a regular schedule prevents a regular exercise routine... Yes, someone must work at night, someone must be there when they're needed, BUT there are solutions for these issues. Unfortunately, they bite into corporate profits too much for administrators to implement them. Afterall, there is always that new round of recent community college graduates that will take the lowest pay, and work nights.

Luckily, I realize these pitfalls of the profession, and know how to avoid them. Until hospitals treat nurses with the dignity they deserve, I would never consider working in one. I will not sacrifice my body long term to take care of someone else. It is sad to see this happening to nurses. They deserve the best, and get the least. But it will never stop or change if we just keep accepting it.

I can absolutely see why the female MD's recommended NP/PA! I will say this: consider where (state) you will be working, and what type autonomy you desire. Your state board of nursing will be a big help in that regard. Good luck with everything!

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