NP education - a rant - page 15

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... Read More

  1. by   NHavenRN
    lilpeanut - thank you, thank you, thank you for your statements. i've tried to respond a couple of times, but i get so frustrated and long-winded i give up...

    i suppose i'm lucky, i haven't actually encountered nearly the negativity in the real world regarding my de education that i have here on these boards. maybe it helps that this particular de program has been around for about 30 years, so the nursing community in the area has had the chance to get used to us, and to see that we’re not all terrible practitioners after all…?

    i’m about 9 months short of finishing my de program; i've only received stellar feedback throughout, both from classroom and clinical instructors, and in my first 8 months as a new grad med-surg rn (where i'm working part-time while finishing the program full-time) the support and feedback from both managers and patients has also been overwhelmingly positive. ditto for most of my classmates, and ditto for most of the nps i know who have recently graduated and are practicing - as nps. these programs bring together extremely motivated, bright people, who have an amazing capacity for excellence. actually, i’ve had several graduates of our de program as clinical instructors and professors in the program, and i swear, they’re better teachers than even many of the physicians that are brought in to teach us.

    okay, i’m cutting this short now before giving myself the opportunity to ramble on again; just wanted to throw my opinion in with “de programs don’t all endanger the public” side of the discussion. thanks. :d
  2. by   Jess RN
    Thanks lilpeanut and NhavenRN for your input and for that great link to the aacn article. I guess my point in my earlier post was that I am in my DE NP program to become a nurse. When and whether I choose to work at the bedside as an RN or in an office in an NP role are secondary concerns to my primary goal of practicing nursing. I chose my program because it made the most sense to me taking into account my background, finances and timeframe.

    That is the pickle that many who want to go into nursing as a second (or third) career face- the best, quickest and cheapest (if you take into account the time-value of money) option for many is a DE program. Waiting around on a waitlist and wasting time taking useless humanities courses at a community college is just not an option. As a mom to young children, my childcare costs more than my tuition, and the longer I am in school, the more expensive the final tab will be. I certainly wasn't about to pay tuition and childcare on top of that to re-take gen ed courses. Also, many of the BSN programs don't want/can't take us bachelors-prepared non-nurses for just the nursing classes/clinicals. So that leaves direct entry programs.

    I'm not saying we are better, smarter, whatever. But when there aren't that many other options, you have to work with what you've got. I wish that there was more understanding from experienced nurses (RNs and NPs alike) that we are not back-dooring our way into the profession. If we aren't well preprared by our programs, we won't pass the boards or the certification exams. If we are sub-standard as clinicians, we will either not find or be unable to keep work as an NP. If we are dangerous and cause serious harm, we will lose our licenses.

    At this stage in my life I think I have a good enough sense of myself to know what my limits are. I'm not in any hurry to be a crappy RN or NP and endanger patients. If when I graduate I need to work at the bedside for a while, that's what I'll do. It feels like experienced RNs and NPs who hold this attitude have little faith in the licensure and certification exams and/or the marketplace to weed out graduates who are unfit to practice. And, honestly I wonder how many of those there really are...

    Last edit by Jess RN on Aug 26, '06
  3. by   Cyndee, MSN, NP
    Quote from lilpeanut
    1974 at yale, was the first direct entry nursing program. since then, many programs have grown and there may be people you practice with who were, once upon a time, a direct entry student. they may not share that tidbit with you because of your excessively negative attitude.

    "employers rated vanderbilt's msn graduates who did not have a nursing background equally high in terms of level of preparation for apn positions as those who entered with a bsn degree."

    "we know that employers love hiring accelerated graduates because they are bright, have a track record of success, and possess an understanding of the work world not always found in younger students,"

    no one in my nursing class has ever taken a "mental health day" as i've heard undergrads do. we all take our studies exceptionally seriously. we have higher pass rates for the nclex and our diverse backgrounds mean that we bring more to the table than your average 21 year old graduate.

    my degree is in spanish and international studies, so i can work as a bilingual nurse, in additional, i have a much deeper understanding of cultural issues that come into play with health care. i am also a nicu parent, which gives me a deeper insight to the struggles that families are going through when their child is ill. i don't talk about the difficult parents, because i know that when your child is sick, we all become difficult and they are scared out of their minds that their baby could die. too many nurses roll their eyes or get annoyed.

    in my class, we have: a forensic criminology graduate, two speech therapists, 2 respiratory therapists, 3 social workers (with masters of social work), a physical therapists, 2 people who were accepted into med school but decided they preferred the nursing framework, 3 language majors, one opthamologist, several chemistry type people, accountants and a few other things i can't remember.

    apart from degrees, our class speaks 12 languages between us, many have children, three gay students, men, immigrants, people with english as their second language, military families, grandparents, people from rural and urban areas, you name it, we've got it, it seems.

    we are highly intelligent and highly motivated. we work our butts off in not only the book learning, but the clinical components. we have received nothing but compliments and rave reviews from not only the staff that works with us in clinicals, but from patients themselves. we are critical thinkers from other fields that are learning to apply those to the nursing process.

    people will fail if you want them to fail. you say you don't treat them poorly, but i cannot imagine how you could have such a negative and vitriolic attitude towards de students that you would actually treat them as you would your precious traditional masters.

    this has ruffled my feathers a bit, i'll admit. these are exceptionally challenging programs and you act as though it is like a drive-thru masters. many days i'm in classes from 7am until 9pm. that is not easy. it's not particularly fun either. but i am willing to do it in order to achieve my goal.
    i never said that any of the "de" programs were easy. i spent a lot of time and money traveling to and from nashville and i also sat for hours on end in classes. and i'm going to repeat myself...when i went to the graduation festivities in may, there were several de students who were working as r.n.'s because they felt they needed that experience. also, when i started the vandy program the nnp program allowed rn's with no experience, but not any more. there is a reason for that change!!!

    i have a good friend who is a professor at the nursing program at ut-austin (ranked as one of the best np programs in the country). she said that this topic has been discussed at length among faculty members and they are adament that pre-np students have a minimum of 2 years of nursing experience. however, the students who are actually admitted to the program have far more than just 2 years of experience.

    nurse practitioner

    the ut austin school of nursing offers two np programs family nurse practitioner and pediatric nurse practitioner. both programs require a minimum of 2 years clinical experience as an rn. for more information on nurse practitioner programs contact the american association of nurse practitioners.

    by the way, there is no way you will ever convince me that these programs should be allowed to exist. as far as i'm concerned, the inexperienced rn's who want to practice as np's should go the pa route.
    Last edit by sirI on Aug 27, '06 : Reason: Getting too personal
  4. by   Cyndee, MSN, NP
    Quote from LilPeanut
    I'm also going to say that as you mentioned, the roles of the RN and APN are different. And I think there is an advantage to our schooling because from day one, we are taught how to deal with the nursing issues, but also prepared for the day when we will be the NPs. We are taught that we will not have the luxury of always relying on someone else to make the hard decisions and write the orders. That soon enough, we will be the ones directing the nurses and so we can't be too settled into the position of just waiting for orders from the NP or Dr.
    NP's without nursing experience have an advantage over NP's with nursing experience???? Explain that to the general ADVANCED PRACTICE NURSE WITHOUT ANY NURSING EXPERIENCE!!! LOL!!!
    Last edit by sirI on Aug 27, '06 : Reason: edit out personalization
  5. by   LilPeanut
    You haven't addressed the fact that these programs have been successful for over 30 years. They are not as recent as you claim or so adamantly believe.

    Most people work as nurses as soon as they get their license. And I am whole-heartedly in favor of needing the two years experience prior to advanced practice clinicals in critical care settings, such as in a NICU. But I'm still accepted to the grad school and technically a student, even while working. And some people need less time than others. Some people will never feel like they are ready to take an advanced practice role.

    btw, I have no desire to become a PA. I disagree with the medical model and think the nursing model is superior. The physician and med students in my class agree.
    Last edit by sirI on Aug 27, '06 : Reason: Getting Too Personal
  6. by   LilPeanut
    Yes. Because many nurses are trained to follow the nursing process and nursing dx's, but not to diagnose, treat and cure. That can be a hinderance because being an NP involves those things, and it is a completely different mindset.

    This doesn't make them superior to APN who go the traditional route, but it gives them an advantage in some aspects. Years of practice though can also be an advantage, but it doesn't make them superior.

    We all take the same licensure and cert tests. In clinicals we all have similar challenges. You have your strengths I'm sure, and I have mine.
  7. by   Cyndee, MSN, NP
    Quote from LilPeanut
    Yes. Because many nurses are trained to follow the nursing process and nursing dx's, but not to diagnose, treat and cure. That can be a hinderance because being an NP involves those things, and it is a completely different mindset.

    This doesn't make them superior to APN who go the traditional route, but it gives them an advantage in some aspects. Years of practice though can also be an advantage, but it doesn't make them superior.

    We all take the same licensure and cert tests. In clinicals we all have similar challenges. You have your strengths I'm sure, and I have mine.
    I've already heard from the moderator and I don't want them to close this thread. I'm just going to must crawl before you can learn to walk. Being an Advanced Practice Nurse without nursing experience is a complete contradiction. Enough said.
  8. by   mango-lo-maniac
    changed mind about post
    Last edit by mango-lo-maniac on Aug 27, '06
  9. by   Nurse2BMonique21
    hope this thread will come to an end..has been going on nearly 3 years!!
  10. by   sirI
    This thread remains a very passionate subject for many even after 3 years. I'm sure it will still be alive 3 years from now. As long as responses remain professional, civil, and flame-free, it will remain open.
  11. by   Nurse2BMonique21
    I just thought that we are going over and over the same thing, no need to get angry!
  12. by   sirI
    I'm sorry you viewed the response as anger. Just a generic response that this thread is a subject that comes up every single day and will do so for years to come. Would like to keep thread open for those who want to discuss the topic.

    Sorry if it appeared to be an angry post. Not my intention.