NP education - a rant

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Jess RN

451 Posts

Specializes in Postpartum.
My understanding is that direct entry MSN-NP is fairly new. I have no problems at all with anyone who has no RN experience wanting to be an NP, but I'll tell you... when I see nursing schools churn out ill-prepared new grads year and year (and it's gotten so much worse) I really do not trust institutions that want to do something like this. Whether it be Yale or Columbia or whatever.

Yale's Graduate Entry Prespecialty in Nursing has been around since 1974. This is not a new thing.

-Jess

NYCRN16

392 Posts

Specializes in ER, PACU.

For those who have not even graduated nursing school yet and think that after 1 year they are going to feel confident enough to go out there on your own..You are going to get a reality check!

I am coming up on my 2 year mark, and although I have learned a lot, there is still so much that I dont know. That first year goes by so fast, and when you get to it, you are surprised how much you still have to learn.

I dont know about other parts of the country, but here in NY if you have one year of nursing experience and then get your NP, good luck finding a job in a hospital, because you will need it. You will find yourself working on the floor alongside with the staff RN's, not exactly what you bargained for. :o

DidiRN

3 Articles; 781 Posts

Specializes in ICU, step down, dialysis.

What amazes me is most of the ones defending this aren't even in nursing school at all yet.

For those who have not even graduated nursing school yet and think that after 1 year they are going to feel confident enough to go out there on your own..You are going to get a reality check!

I am coming up on my 2 year mark, and although I have learned a lot, there is still so much that I dont know. That first year goes by so fast, and when you get to it, you are surprised how much you still have to learn.

I dont know about other parts of the country, but here in NY if you have one year of nursing experience and then get your NP, good luck finding a job in a hospital, because you will need it. You will find yourself working on the floor alongside with the staff RN's, not exactly what you bargained for. :o

DidiRN

3 Articles; 781 Posts

Specializes in ICU, step down, dialysis.

I stand corrected. However the article does state also that there has been a proliferation of these types of programs in the several years, and I wish we had the opportunity to talk with some grads of this program. We've already heard from some who have worked with them, and the consensus here is not good at all. But there are very few grads of this type of program today, it is not common at all. Based on my own personal experience in this field and seeing graduates of traditional ADN and BSN programs over all these years, I still believe this is a poor idea.

Bottom line is that you choose to believe what you read from colleges who are trying to recruit applicants over experienced RN's and even some NP's who have posted concerns about this type of training in this thread. That's certainly your perogative, although I personally would tend to believe someone who is in the trenches so to speak than a website or school who are trying to attract (ie market) their nursing program to prospective students.

Yale's Graduate Entry Prespecialty in Nursing has been around since 1974. This is not a new thing.

-Jess

Gennaver, MSN

1,686 Posts

Specializes in Ortho, Med surg and L&D.
I stand corrected. However the article does state also that there has been a proliferation of these types of programs in the several years, and I wish we had the opportunity to talk with some grads of this program. We've already heard from some who have worked with them, and the consensus here is not good at all. But there are very few grads of this type of program today, it is not common at all. Based on my own personal experience in this field and seeing graduates of traditional ADN and BSN programs over all these years, I still believe this is a poor idea.

Bottom line is that you choose to believe what you read from colleges who are trying to recruit applicants over experienced RN's and even some NP's who have posted concerns about this type of training in this thread. That's certainly your perogative, although I personally would tend to believe someone who is in the trenches so to speak than a website or school who are trying to attract (ie market) their nursing program to prospective students.

Hi there,

So, for my specific program I could either take the ADN program which would take six classes, (that I need to complete it) over four semester OR go the graduate RN certificate route which would take twelve classes ,(that I need to complete it) over four semesters.

Where is the hype that you are talking about? Why does my RN graduate certificate cause so much worry whereas my ADN would not? What is the specific problem here? What, my six extra classes suddently make my RN status dubious and less valid? It is an RN certificate yet, if it was an accelerated, the only difference is that they give credit to prior courses earned in an undergrad degree, (so would you prefer that I re-take all my supplemental courses for the undergrad, you know, retake the english 101, 102, retake all my humanities and those other 130+ credit hours I've earned) or do you see how logical it is to transition into the final four semester towards completeion of the BSN? Where is your logic?

Gennaver

DidiRN

3 Articles; 781 Posts

Specializes in ICU, step down, dialysis.

Do you understand the difference between the responsibilities of an ADN and BSN as opposed to an NP? Isn't this what we are discussing? An accelerated NP program, correct?

It doesn't matter on the non-nursing courses at all. I am concerned about the lack of preparation in nursing courses as an advanced nurse degree with little to no experience in the field. That is my concern.

Hi there,

Why does my RN graduate certificate cause so much worry whereas my ADN would not?

Gennaver

Gennaver, MSN

1,686 Posts

Specializes in Ortho, Med surg and L&D.
Do you understand the difference between the responsibilities of an ADN and BSN as opposed to an NP? Isn't this what we are discussing? An accelerated NP program, correct?

It doesn't matter on the non-nursing courses at all. I am concerned about the lack of preparation in nursing courses as an advanced nurse degree with little to no experience in the field. That is my concern.

Okay, now there is something to discuss, good.

Firstly, the NP is not accelerated, only some BSN for non-nursing BA/BS degree holders. Many of these accelerated BSN programs do then allow direct entry to the NP program. Although, direct entry is somewhat of a misnomer because work experience as an RN is required prior to any specialty courses.

In an accelerated BSN the only portion that is accelerated is that the accelerated students skip their summer vacation breaks.

Yup, they take the exact same nursing portion classes. Theory, pharmeceuticals, physiology and everything else. Not accelerated on the nursing content. That is a misconception.

For the graduate entry programs there are some that have the above mentioned accelerated BSN, (merely the same as the final two years of the traditional BSN programs, minus that luxurious summer vacation) and there are the graduate RN certificates, (which is what my program will have).

The graduate certificate is like the final two years of a BSN program, (again, minus any summer breaks) four semesters straight through but, these are all 400 level classes, (not 500 like I wrongly posted before).

So, Like I asked earlier, (know that you know the difference), why does my four semesesters of 12 intense 400 level classes versus the mere six classes at the community college worry you so?

Oh, after those four semesters towards the RN certificate, then we are supposed to work for a minimum of a year before we can begin the Nursing Practitioner portion. NO, those are not accelerated, they are real, and in person, not online, classes with RNs from various backgrounds who earned their degree either from an ADN, Diploma, BSN or grad certificate. Wow, huh?

Do you understand your misperception now?

Also, once you have a BA/BS completed or an AS, (I know this) you are no longer elidgible for any financial aid or loans to take out to pay for a second one. Hence this is a very nice thing about the graduate RN certificate over the accelerated BSN. It is still the same content as a BSN versus the ADN yet, it is given in a graduate courseload and students are indeed able to finance their education through appropriate loans and financial assistance.

Gennaver

p.s. sheesh, the nursing stuff is not rushed, only the time frame excluding those wonderful summer vacations

Jess RN

451 Posts

Specializes in Postpartum.
Do you understand the difference between the responsibilities of an ADN and BSN as opposed to an NP? Isn't this what we are discussing?

Sherri-

What course of academic and clinical preparation would you suggest for someone with a bachelors in an unrelated field? Just curious- because I wonder if it is not all that far off from how some Direct Entry programs can be structured. Be specific if you would- how many years in school to be an RN- how many years practicing as an RN- how long should a masters program be and how many clinical hours should it contain to produce safe competant NPs?

-Jess

fergus51

6,620 Posts

I think the concern for me is the lack of required work experience. Being in the NICU I can't imagine anyone becoming a really competent NP without a few years working as a nurse. I don't have a magic number, but the NPs I have really admired for their abilities were all nurses for more than 5 years before becoming NPs so they had a lot to draw on. Many hospitals won't train nurses for the really intensive babies until they have at least a year of working under their belt. Plus they need to be trained for deliveries, for surgical procedures and recovery, etc. There is just such a wide range of things to learn. I suppose there are some people who could work for a year or two and be great, but I don't think that's the norm. I respect the students who say "I'll work for as long as I feel it's necessary", but I am concerned with the people who are just willing to put in the minimum time so that they can be NPs as quickly as possible. I don't think they understand what they are getting into.

smile123

630 Posts

I think the concern for me is the lack of required work experience. Being in the NICU I can't imagine anyone becoming a really competent NP without a few years working as a nurse. I don't have a magic number, but the NPs I have really admired for their abilities were all nurses for more than 5 years before becoming NPs so they had a lot to draw on. Many hospitals won't train nurses for the really intensive babies until they have at least a year of working under their belt. Plus they need to be trained for deliveries, for surgical procedures and recovery, etc. There is just such a wide range of things to learn. I suppose there are some people who could work for a year or two and be great, but I don't think that's the norm. I respect the students who say "I'll work for as long as I feel it's necessary", but I am concerned with the people who are just willing to put in the minimum time so that they can be NPs as quickly as possible. I don't think they understand what they are getting into.

I understand your position about being the NICU and the needed experience. However, this is one extreme. In some accelerated programs, once a NO candidate gets their RN, they often defer for a year and work as an RN before going on for the last two years of the master's portion. Plus, there are new grad programs for RNs in hospitals. In addition, many NPs candidates work part time as RNs while they are doing their master's portion. So it's not like the NPs candidates are getting any real world experience. And if for some reason a new NP cannot get a job as an NP, they can work as an RN and get more experience working on the floor. True, being an RN is not the same as a NP, but they are getting more experience working with patients. I know a woman who graduated from an NP program and could not get a job as an NP, so she worked as a floor RN on the weekends and at night. (She needed to pay back her student loans.)

People also come up to speed at different rates. Some programs offer only 600 hours of clinical vs. 900 hours. That would make a difference as to how comfortable they would be in the real world of nursing.

:)

fergus51

6,620 Posts

Working part time while pursuing the NP portion is still only really one year of full time work, if the NP portion is 2 years and the nurse is working 1/2 time. So even if they defer for a year to work, that's only 2 years of work experience. That isn't much for this one area. Orientation programs are more than 3 months full time at my hospital and that doesn't prepare the nurse to look after the sickest babies. After those 3 months, they are expected to work for about a year before being trained for the most intensive kids, including surgeries and deliveries. That training is another 3 months and at the end of it, they are still nowhere near being ready to practice at the expert level. Doing the math, that means we invest more than 18 months in a nurse before she starts to look after the sickest kids on her own and she'll still be asking plenty of questions. NPs are expected to practice as experts the moment they take the job, so it I am somewhat skeptical that most people could do that with only 2 years of work experience.

I am not commenting at all on other types of NPs because I only work NICU, and I realize the NP students CAN work longer if they choose to and that there are always exceptions. What concerns me is the person who really doesn't think she'll need to work long as an RN. It's the person saying "Well, if I start in September 2005 and work the minimum number of hours as an RN, I can be an NP by...." before they've even set foot on the unit.

smile123

630 Posts

Working part time while pursuing the NP portion is still only really one year of full time work, if the NP portion is 2 years and the nurse is working 1/2 time. So even if they defer for a year to work, that's only 2 years of work experience. That isn't much for this one area. Orientation programs are more than 3 months full time at my hospital and that doesn't prepare the nurse to look after the sickest babies. After those 3 months, they are expected to work for about a year before being trained for the most intensive kids, including surgeries and deliveries. That training is another 3 months and at the end of it, they are still nowhere near being ready to practice at the expert level. Doing the math, that means we invest more than 18 months in a nurse before she starts to look after the sickest kids on her own and she'll still be asking plenty of questions. NPs are expected to practice as experts the moment they take the job, so it I am somewhat skeptical that most people could do that with only 2 years of work experience.

I am not commenting at all on other types of NPs because I only work NICU, and I realize the NP students CAN work longer if they choose to and that there are always exceptions. What concerns me is the person who really doesn't think she'll need to work long as an RN. It's the person saying "Well, if I start in September 2005 and work the minimum number of hours as an RN, I can be an NP by...." before they've even set foot on the unit.

I understand your concern for NICU and NPs who choose that route. Two years may not be enough time, but who is to say how many years you really need to feel competent in a particular area of nursing? There are people who catch on quickly and can to a great job working part time for 2 years. Others may have been working fulltime for longer than that and struggle.

If the hospital hires a NP in the NICU, then they must feel that person is appropriate for the job. With any new job there is ramp up time and initial and others on the team will be helping that person along. The accelerated programs that they do graduate NPs. Then the new NPs can compete with other more experienced people for the real world jobs. I think the supply and demand will balance it out. People with and NP degree and more experience on their resumes will be more competitive for job than someone who has less.

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