I recently received a published form from the State of Florida showing that ARNPs increased 22% over the past two years. RNs only increased by 7.4% If you are a new grad wondering why you can't find a position here is your answer. Our NP mills have pumped out too many graduates for the demand of society. I don't have the data to back it up but if this is happening in Florida I would assume it is happening around the nation.
I'm licensed in Florida but moved to California years ago because I could see the tsunami of new graduates slowly starting to erode the wages of established NPs. It's now happening here in California and I have been directly affected. I can count at least another dozen of my NP colleagues around the nation who are complaining of wage deflation happening because new grads will accept a position at almost any wage. Starting wages are below those for RNs in some cases.
For those of you thinking of becoming a NP think and long and hard before you commit your money and your time. The job is enjoyable but the return on investment is declining year after the year with the flooding of the markets. Maybe one day the leaders of our nursing schools will open a book on economics and understand the relationship between supply and demand rather than stuff another useless nursing theory down our throats.
Ya'll need to leave the west coast. NP jobs vary greatly based upon region, as well as need in certain specialties...just like RN jobs. Other areas may not pay as well, but the cost of living is also more affordable so it ends up being no skin off your back. Seriously....huge country. I would just suggest steering clear of FL...the docs there are not aiding in passing NP friendly laws, so the pay and work sucks.
Except my quality of life is way better in SF - so while my rent is sky high, so is my pay and I can afford to live there. And there are RNs who make more than me so I take a the stories of nurses not being able to afford to live in the area with a grain of salt. There are lots of lower cost options for living than where I specifically live, and while getting a roommate will get you a bigger place, it may not be worth it to you.
Yeah that's why I feel that it needs to come from the national accreditation and certification side of the equation: increase the board difficulty and make programs maintain a upper 70% board pass rate to keep accreditation. This higher hurdle would force programs to be more selective and teach better, result in loss of accreditation by sup-par programs, while also decreasing the numbers coming into the APN role.
I know I'm late to this post, but just joined...
I am glad to hear that I am not the only person that has seen this as a possible issue in the coming years. I went to NP school at the same college I got my BSN. While I do think it was a good program, I think it was largely what the student made of it. All classes were online, we had to find our own preceptors for clinicals (which was a heck of a chore in itself). I honestly didn't really feel like my teachers were that worried about our success as NPs, and I wonder if that is part of why I constantly worry/doubt myself. I have been an NP in practice for two years. I do wonder if I should just go another direction with my nursing career.
Specializes in DPT, DNP. Ortho, Family Practice, Psych..
I'll say it and I'll say it again: the NP market is saturated, too many schools are opening up, and the entry requirements are too low. There is an exponential growth of NPs, many of which are unqualified to be in a provider position. Between 2014-2015, ~10,000 new FNPs graduated. Between 2017-2018, approximately ~20,500 new FNPs graduated (per AANP 2018 annual report data). That's more than double graduating every year, and it is only expected to get worse. New nursing schools are popping up like dandelions...because there are no checks and balances. Why? Because they want your money. That's all these schools care about. What's worse? The bottom of the barrel admission requirements. For DPT and PA school, you need a 3.5-3.75 to even be CONSIDERED for a spot (along with a good GRE score and clinical patient experience hours). Having all the above doesn't even guarantee you'll be accepted. When you set the bar low, you're going to get exactly what you asked for. As a physical therapist and a nurse practitioner, it saddens me to see so many ill-prepared NPs practicing at a level that they shouldn't be. There are bad apples in every profession, but we're really doing our profession a disservice. The over-saturation of mediocre NPs will only drive the compensation down, as new NPs will settle and take what they can get. The standardization needs to be better. The entry requirements need to be better. Less is more: stop creating new programs and refine the ones that are solid. Stop admitting any Joe-Schmo on the street. Only then will some of the unqualified applicants decrease and the number of qualified candidates increase. If we're going to continue on this exponential growth, AT LEAST strengthen the profession with better candidates.
Specializes in Neurology, Psychology, Family medicine.
5 minutes ago, ThePTNurseGuy said:
I'll say it and I'll say it again: the NP market is saturated, too many schools are opening up, and the entry requirements are too low. There is an exponential growth of NPs, many of which are unqualified to be in a provider position. Between 2014-2015, ~10,000 new FNPs graduated. Between 2017-2018, approximately ~20,500 new FNPs graduated (per AANP 2018 annual report data). That's more than double graduating every year, and it is only expected to get worse. New nursing schools are popping up like dandelions...because there are no checks and balances. Why? Because they want your money. That's all these schools care about. What's worse? The bottom of the barrel admission requirements. For DPT and PA school, you need a 3.5-3.75 to even be CONSIDERED for a spot (along with a good GRE score and clinical patient experience hours). Having all the above doesn't even guarantee you'll be accepted. When you set the bar low, you're going to get exactly what you asked for. As a physical therapist and a nurse practitioner, it saddens me to see so many ill-prepared NPs practicing at a level that they shouldn't be. There are bad apples in every profession, but we're really doing our profession a disservice. The over-saturation of mediocre NPs will only drive the compensation down, as new NPs will settle and take what they can get. The standardization needs to be better. The entry requirements need to be better. Less is more: stop creating new programs and refine the ones that are solid. Stop admitting any Joe-Schmo on the street. Only then will some of the unqualified applicants decrease and the number of qualified candidates increase. If we're going to continue on this exponential growth, AT LEAST strengthen the profession with better candidates.
Glad to see there are others finally taking notice, as this is almost verbatim what I said 2 years ago. I’m sure there were others noticing the changing tides long ago, but every passing year the numbers grow, scary stuff. I’d need to look back at my previous conversation history but I’d still bank on if you aren’t already practicing in the next 3-4 years there will be such an overflow of np , as a new graduate I’d highly advise seeking another profession because there will not be a job for you, just like how it is in pharmacy now.
I agree standards need to be tightened and schools like Maryville and Walden need to be phased out. Just a quick buck for these schools and they just churn NPs out, people need to talk to the boards and associations at their annual meetings...
Specializes in DPT, DNP. Ortho, Family Practice, Psych..
19 minutes ago, lwsoccjs said:
Glad to see there are others finally taking notice, as this is almost verbatim what I said 2 years ago. I’m sure there were others noticing the changing tides long ago, but every passing year the numbers grow, scary stuff. I’d need to look back at my previous conversation history but I’d still bank on if you aren’t already practicing in the next 3-4 years there will be such an overflow of np , as a new graduate I’d highly advise seeking another profession because there will not be a job for you, just like how it is in pharmacy now.
100% agree. My wife is a pharmacist and she graduated just before the bubble burst. She’s been practicing for quite some time, but 7-10 years ago it was the profession to pursue. Unfortunately, the DPT Is heading the same route as pharmacy, NP, etc. (the only difference is that the class sizes are smaller due to labs, simulation, hands on experience etc.).
It’s not just Walden and these other schools (although they are part of the problem). The large majority of all nursing schools need to raise their standards.
100% agree. My wife is a pharmacist and she graduated just before the bubble burst. She’s been practicing for quite some time, but 7-10 years ago it was the profession to pursue. Unfortunately, the DPT Is heading the same route as pharmacy, NP, etc. (the only difference is that the class sizes are smaller due to labs, simulation, hands on experience etc.).
It’s not just Walden and these other schools (although they are part of the problem). The large majority of all nursing schools need to raise their standards.
Raise their standards by how much? The average GPA at my school is like 3.7, (USI). How would you tell the Walden’s of the world that they cannot compete so long as they are playing by the same rules set by accreditation agencies as everyone else? Of course standards can and will continue to evolve, but I do not believe intellectual elitism is the answer. If 4.0 GPA’s and 1500 SAT’s were the key I would be an all star RN, and I barely survive on the floor mostly with the help of nurses who in some cases took the NCLEX several times and who struggled to maintain a B average. If trends toward oversupply continue then pay will decrease and fewer people will both enter the profession and maintain their current NP certification.
Specializes in DPT, DNP. Ortho, Family Practice, Psych..
34 minutes ago, myoglobin said:
Raise their standards by how much? The average GPA at my school is like 3.7, (USI). How would you tell the Walden’s of the world that they cannot compete so long as they are playing by the same rules set by accreditation agencies as everyone else? Of course standards can and will continue to evolve, but I do not believe intellectual elitism is the answer. If 4.0 GPA’s and 1500 SAT’s were the key I would be an all star RN, and I barely survive on the floor mostly with the help of nurses who in some cases took the NCLEX several times and who struggled to maintain a B average. If trends toward oversupply continue then pay will decrease and fewer people will both enter the profession and maintain their current NP certification.
I do not think the average student GPA going to NP school is 3.7. I could be wrong and I have no data to back my claim. However, having a 3.0 GPA requirement is a very low standard, in my opinion. Do you honestly believe that’s a good standard? I can’t tell the Walden’s of the world anything. More power to them. However, I have had friends who went to Walden who were not hired over candidates from other more prominent schools. At the end of the day, HR and other companies will take it into consideration where are numerous applicants. I’m sorry, but all things being equal, they will take NP who went to Vanderbilt or Georgetown.
I don’t think intellectual elitism is the answer, but I don’t see how you wouldn’t agree that the standards are too low. There has to be a middle ground and right now we don’t have one.
I do not think the average student GPA going to NP school is 3.7. I could be wrong and I have no data to back my claim. However, having a 3.0 GPA requirement is a very low standard, in my opinion. Do you honestly believe that’s a good standard? I can’t tell the Walden’s of the world anything. More power to them. However, I have had friends who went to Walden who were not hired over candidates from other more prominent schools. At the end of the day, HR and other companies will take it into consideration where are numerous applicants. I’m sorry, but all things being equal, they will take NP who went to Vanderbilt or Georgetown.
I don’t think intellectual elitism is the answer, but I don’t see how you wouldn’t agree that the standards are too low. There has to be a middle ground and right now we don’t have one.
You may be correct, but I know several Walden nurses/NP’s who have had no issues finding employment even in oversaturated Florida. Also, the Walden nurse can always go to an IP state and compete directly for clients where intellectual hubris is less of an issue. You talk about raising standards when many NP’s who don’t even have a Masters in nursing are grandfathered into practice. Also, I would wager my immortal soul against a dollar that the average GPA of NP students on average is significantly higher than 3.0.
Specializes in DPT, DNP. Ortho, Family Practice, Psych..
Haha only a dollar? ?
I’ve already shown you statistics of the increasing number of NPs graduating each year. Compound the new graduates with new programs that are opening in the next couple years. With all of that said:
1. Do you agree with this? Do you believe that the more programs the better? Why is this better? More for profit schools are opening up and it isn’t a good look for the profession. Walden students have to pass the same exam, but that doesn’t mean that they have a good reputation among many recruiters (or healthcare professionals for that matter). Do you go to Walden? I don’t hate the school by any means. I’m just sharing what I’ve heard and learned in person, online, in this forum and with people who went there. If it truly is the best school based on life circumstances I cannot hate on that.
2. You make it sound as if high intellectual IQ is inversely proportional to soft skills and emotional IQ. Granted, there are nurses and physicians who are book smart, but cannot practice well regardless of their GPA and test taking abilities. However, there are plenty who play both ends of the court. You’re comparing yourself as a 4.0 student to someone who has practiced on the floor for multiple years. Let’s compare apples to apples. When all is said done, if the emotional IQ is there, you’re going to take the smarter student on paper.
3. The idea that previous NPs shouldn’t practice without a masters degree isn’t a new issue. Pharmacists and physical therapists who don’t have their doctorate can still practice with their RPh and BSPT. Thats very common in practice, particularly when a profession progresses forward over time. Physicians back in the day could practice without a residency (or with less years).
I’ve already shown you statistics of the increasing number of NPs graduating each year. Compound the new graduates with new programs that are opening in the next couple years. With all of that said:
1. Do you agree with this? Do you believe that the more programs the better? Why is this better? More for profit schools are opening up and it isn’t a good look for the profession. Walden students have to pass the same exam, but that doesn’t mean that they have a good reputation among many recruiters (or healthcare professionals for that matter). Do you go to Walden? I don’t hate the school by any means. I’m just sharing what I’ve heard and learned in person, online, in this forum and with people who went there. If it truly is the best school based on life circumstances I cannot hate on that.
2. You make it sound as if high intellectual IQ is inversely proportional to soft skills and emotional IQ. Granted, there are nurses and physicians who are book smart, but cannot practice well regardless of their GPA and test taking abilities. However, there are plenty who play both ends of the court. You’re comparing yourself as a 4.0 student to someone who has practiced on the floor for multiple years. Let’s compare apples to apples. When all is said done, if the emotional IQ is there, you’re going to take the smarter student on paper.
3. The idea that previous NPs shouldn’t practice without a masters degree isn’t a new issue. Pharmacists and physical therapists who don’t have their doctorate can still practice with their RPh and BSPT. Thats very common in practice, particularly when a profession progresses forward over time. Physicians back in the day could practice without a residency (or with less years).
1. I go to USI, have a 3.96 GPA, 11 years experience as an RN, and with great effort can almost function at perhaps the 50 th percentile as an ICU RN. In my case I am a mechanical moron so anything involving equipment is a challenge.
2. I don’t believe that intelligence and education is inversely proportional to clinical success, however it does not tell the whole story either. I believe the law of diminishing returns applies. There have been a number of studies comparing primary care outcomes from NP’s vs MD’s and most have found equivalent (or superior in some cases such as patient satisfaction and less utilization of benzo’s). Why? I speculate that it may be that nurses lacking overconfidence in their educations are perhaps more likely to stick to evidence based protocols as published by Cochrane and UpToDate. In clinical most of the NP practitioners that I have known take refuge within and stick closely to these parameters while I’ve come across several psychiatrists who were not familiar with first and second line interventions for basic diagnoses such as insomnia and IED. Also NP’s owing less money for their educations may be inclined to spend more time with individual patients especially when they are in IP states with their own practices.
3. I’m neither a fan nor an opponent of Walden, but if they are playing by the rules then they should not be excluded. If you tighten the rules, I speculate that the for profits will simply adapt (and of course raise prices).
Specializes in DPT, DNP. Ortho, Family Practice, Psych..
2 hours ago, myoglobin said:
1. I go to USI, have a 3.96 GPA, 11 years experience as an RN, and with great effort can almost function at perhaps the 50 th percentile as an ICU RN. In my case I am a mechanical moron so anything involving equipment is a challenge.
2. I don’t believe that intelligence and education is inversely proportional to clinical success, however it does not tell the whole story either. I believe the law of diminishing returns applies. There have been a number of studies comparing primary care outcomes from NP’s vs MD’s and most have found equivalent (or superior in some cases such as patient satisfaction and less utilization of benzo’s). Why? I speculate that it may be that nurses lacking overconfidence in their educations are perhaps more likely to stick to evidence based protocols as published by Cochrane and UpToDate. In clinical most of the NP practitioners that I have known take refuge within and stick closely to these parameters while I’ve come across several psychiatrists who were not familiar with first and second line interventions for basic diagnoses such as insomnia and IED. Also NP’s owing less money for their educations may be inclined to spend more time with individual patients especially when they are in IP states with their own practices.
3. I’m neither a fan nor an opponent of Walden, but if they are playing by the rules then they should not be excluded. If you tighten the rules, I speculate that the for profits will simply adapt (and of course raise prices).
Myoglobin, I really appreciate you sharing your thoughts on this subject. I value what you've shared, and even though we don't agree on everything, I think it has been a fruitful discussion.
Do you currently practice as a psych/PMHNP? Or are you still practicing as an RN? I was just wondering what your background is.
My understanding is that the CCNE is attempting to "clamp down" on schools that aren't assisting with clinical rotations/finding preceptors. I don't think much has been done so far, but that would make a tremendous impact. Students are paying schools, and yet they are responsible for finding their own preceptors (in some cases, or in many cases, using websites to find and pay for instructors). Shutting down these schools would be amazing, in my opinion. PTs, PAs, PharmDs, MD/DOs, do not need to find their own preceptors; you pay the tuition and it is the school's responsibility to hold their end of the bargain. That's how it should be.
I don't think it's a lack of overconfidence that leads NPs to use evidence-based resources: it's desperation and necessity. Many of our colleagues HAVE TO rely on it because they were never taught it (or it wasn't discussed in detail). I'm not sure who these psychiatrists are that you work with, but I do know that the ER docs that I work with frequently use evidence-based resources to make sound decisions in the department. I think this is obviously influenced by age, experience, preferences, etc. We've already heard countless NPs who have confessed and admitted that the education needs to be better. There is no reason that NPs should not have more classes pertaining to differential diagnosis, imaging, pharmacology, etc. These classes would undoubtedly make NPs better at what they do. I don't think having lesser quality education is a valid reason for NPs to be dependent on on these resources. All providers use these resources, the difference is that some of have a better educational foundation. That's an important distinction.
At the end of the day, our profession is shooting themselves in the foot by opening up all these new schools. History has already shown what happens to other professions who do the same thing (ex. pharmacy). At least they can lessen the blow to some degree, because they have higher requirements and there are less schools relative to nursing/NPs. There's a gluttony of NPs and the higher nursing institutions need to do something. Fast. Again...
-Why not raise the requirements slightly? Why not a 3.5 instead of a 3.0? How about requiring a GRE like every other profession? That would help to eliminate some people from the applicant pool.
-If we're going to make a gluttony of NPs, why not improve the education across the board so that they are more prepared for practice? Why not increase the clinical hours required prior to practicing? That would allow for more competent entry-level NPs.
-Why not make it a mandate (a legitimate mandate) that NP schools MUST provide clinical sites to their students? This would undoubtedly shut down schools that shouldn't be open to begin with. This, in turn, would condense the number of schools that currently exist, and keep the best schools open.
This problem is multi-factorial in nature. I've already opened a discussion topic on why I believe there should only be one certification board available to the public (i.e. AANP for NPs). Having two certification boards hurt our profession; there are no other disciplines that do this. I have never seen a profession with greater variance in skill and knowledge than our own. I’m proud of who we are but absolutely ashamed at the same time. Ignorance is bliss, but when you come from another healthcare profession and reflect on the differences, it’s easy to see all the gaps that truly exist.
LilPeanut, MSN, RN, NP
898 Posts
Except my quality of life is way better in SF - so while my rent is sky high, so is my pay and I can afford to live there. And there are RNs who make more than me so I take a the stories of nurses not being able to afford to live in the area with a grain of salt. There are lots of lower cost options for living than where I specifically live, and while getting a roommate will get you a bigger place, it may not be worth it to you.