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  1. I don't care how many NP schools there are. The crap graduates will not get hired. If there are too many NP schools, there will not be enough preceptors, so the crap schools won't get preceptors - no preceptors means no clinicals - no clinicals means students will not become NPs. Sometimes, doing nothing is the solution! We have a (somewhat free) market economy - supply and demand. If there are too many NP new grads, only the best will be hired. As other posters have indicated, there is funding enough for all the MD internships and residencies. If we can get funding for NP residences, these programs will increase. There is a glut of lawyers right now, but I doubt the new grad law students from schools like Harvard, Yale, Stanford, UCLA, etc have trouble finding jobs!
  2. The number of NP residency programs is increasing. The VA now has NP residencies in selected hospitals and applications are accepted nationwide. Here are links to NP residencies: Residency Programs for Nurse Practitioners 3
  3. In terms of schools providing preceptors, even for a top school like Hopkins, preceptors are hard to come by. While Hopkins finds preceptors and clinical sites for everyone, the school also asks students to help find more preceptors by asking NPs, MDs, DOs, and PAs if they would like to precept. As an NP community, we can help recruit preceptors for the reputable schools. Even as an NP student, I was proactive in finding new preceptors when I was on a rotation in a large facility ( I got an NP and an MD preceptors for subsequent cohorts and I was just a student!). NP students - do a great job on your clinicals and that is the best way to get other healthcare providers at your clinical site to precept additional students.
  4. The best way to be part of the solution is to go to a school that provides preceptors and clinical sites. If potential students only applied to such schools, the free market would drive the less reputable schools out of business. The best approach is for the nursing community to educate potential NP students and warn them away from such schools.
  5. It seems to me that the problems you are describing could be rectified by 1) the precepting organization having clear rules and regulations in place for transporting patients, storing personal effects, etc., and 2) the school being very clear on proper behavior and dress by students. In addition, the precepting organization should document these bad behaviors and have a no-nonsense meeting with the nursing school to state these are unacceptable behaviors and students that engage in them will be kicked out of the clinical for good. If the behaviors continue, tell the school that preceptorships for that school have been discontinued. Problem solved. I don't see how this has anything to do with MSN vs DNP students. During the course of my ABSN and MSN studies, I had 3 psych rotations and 3 additional clinical rotations that had a lot of psych issues in the patient population. The students from my school never engaged in this type of behavior in the BSN or MSN programs because our school gave us very stern warning about this and indicated this was grounds for failing clinical, and possibly, expulsion. This was Hopkins, so they are also highly selective of which students they let in.
  6. Thank you for this info. You are right about there being direct entry MSN programs, of course. I am sorry for my misstatement to the contrary. I also looked at the UCSF and Columbia websites. My analysis is below. UCSF Master's Entry Program Nursing (MEPN). UCSF is one of the best healthcare education institutions in the US. This is a 3 year program for people who already have a bachelor's degree in a non-nursing field. The first year is the equivalent of an accelerated BSN (and there are 13 month ABSN programs). After completion of the first year, students sit for the NCLEX to obtain an RN. The next 2 years are NP school and UCSF has very specialized tracks - primary care peds, primary care AGNP, PMH NP, etc. Some advanced practice tracks are NOT open to MEPN students, but only to traditional MSN students: acute care peds, acute care AGNP, acute care oncology, acute care critical care/trauma, neonatal nursing. This seems like a reasonable approach to me. Columbia - another top school. Their Masters Direct Entry looks grueling! Again, for people with a non-nursing bachelors. 15 months (yikes!) that cover the BSN curriculum plus additional requirements to meet master's degree standards. Graduates must sit for the NCLEX exam and become RNs. MDE graduates wishing to continue on to become an NP must apply for the DNP program. Again, this seems like a reasonable approach to me. Johns Hopkins used to have a 13 month (ouch!) and a 16 month ABSN program (I did the 16 month). However, last year they discontinued undergrad nursing education. There is now a Direct Entry MSN for individuals with a non-nursing bachelors. However, this is a rigorous program taking 2.5 years. Graduates are only able to sit for the NCLEX to earn an RN. Students wishing to become NPs must either do a post-master's certificate or a DNP. Again this seems reasonable to me. UCLA has a MECN which is 2 years. However, grads can only sit for the NCLEX and earn an RN. Those who wish to become NPs must complete 2 years of a post master's certificate at UCLA or a DNP elsewhere. Personally, I don't see the point of the Master's Entry programs to produce RNs. Grad school is more expensive than undergrad and RNs with an MSN don't make any more money than BSN RNs. I also don't buy into the CNL thing. However, people can spend their $ how they want. I am ok with 3 year MSN programs where the 1st year is the equivalent of an accelerated BSN and then the last 2 years are the NP school. Again, I am sorry for any confusion on my part.
  7. I really don't understand why you won't name the programs. What you have said is public domain knowledge that is right on their websites. I have been very open about the schools I attended. If you name the schools, that will be useful for people who don't want to go to such schools that don't properly prepare people. I agree that if a person is direct entry MSN (no BSN) and after 2 years can sit for an NP license exam, that is a problem. That's why I'd like to know which schools do this.
  8. I truly do not understand why people are being coy about naming schools. Please just name the schools pertinent to an issue at hand. Juan, I don't know you. However, not attacking people personally has to go both ways. Again, I was attacked and I did not complain. You didn't jump to my defense, I noticed. Why is it adolescent to make a factual observation? I don't care if people attack me - I just want to have a useful debate. I will admit when I am wrong. In addition, this forum is not "owned" by posters that have been on here a long time. Just because someone has been active on this forum for a long time does not make their opinions more "valid." If you try to shut down people with differing opinions, this forum will cease to be useful.
  9. I am not familiar with the local schools in your area. UCLA and Johns Hopkins both have direct entry MSN programs for individuals with a BA or BS in a non nursing field. You are correct, graduates of these programs can indeed sit for the NCLEX. They cannot sit for an NP license exam without additional schooling. I do not understand why this is an issue. I will provide my understanding of this situation and look forward to your comments: 1) Jane goes to a BSN program. She graduates with about 1,000 clinical hours. She sits for the NCLEX. 2) Amy goes to a direct entry MSN program. She graduates with about 1,000 clinical hours. She sits for the NCLEX. I don't see why this is a problem. Both have covered the same academic nursing curriculum and have the same # of clinical hours in order to become an RN. If either Jane or Amy want to become an APRN, then they must complete additional schooling and clinical hours. I am looking forward to your response.
  10. Chip on my shoulder? No. I am quite happy and secure. I do get frustrated with NPs who do not let the evidence get in the way of their biases. My fear is that such NPs will discourage talented individuals. I do agree that RN experience is an advantage to acute care NPs. I have stated that repeatedly. However, the vast majority of NPs are in primary care. No one has yet explained to me why RN experience is such an advantage in this environment. Most RNs do not have primary care experience. The studies I cited were within the past 5 years. There are additional studies that support my position dating back to the 1990s. I am not aware of any studies that refute my position. If you have such evidence, I would be delighted to see it. I do thank you for your concern about my career. Since I had a previous career that was actually more demanding in many ways than being an RN or an NP, and that required excellent people skills in order to succeed, I am quite confident in my "skills" and ability to develop NP skills In fact, the 2 MDs precepting me on my last clinical rotation wanted to hire me, but I could not stay in Baltimore. Also, I had multiple job offers shortly after graduation, and headhunters contact me frequently. Oh, and I am doing very well on my new job. The clinic I work for hires new grad NPs and PAs, provides extensive training, and also believes in precepting NP and PA students. We're going to hire at least 10 NPs and PAs in the next year. This group has a long history of hiring new grad NPs and PAs, and because of the excellent training, has never had a problem.
  11. Correct, these are direct entry or master's entry programs. Of course they do not award a BSN! An MSN is awarded, but the students are NOT allowed to apply for an NP license. They are only qualified to apply for the RN license. If they want to become an NP, then they must attend a post master's certificate program, usually 2 years of FT study, to become an NP. I don't see why that is a problem.
  12. I'd also be concerned if this is the case. NPs are not supposed to do this, but employers and state BONs are also at fault if this is happening. At my school, we had acute care and primary care tracks and then further specialization within acute care and primary care. Our faculty warned us repeatedly to only practice within the scope of our training unless the employer provides extensive training. It is true RNs are not in the diagnostic role. However, all the existing evidence indicates NP care is as good as PA and MD care. What I strongly support are nurse practitioner residency programs. More of these programs are becoming available, but the problem is funding. This would be a great area for NP political involvement.
  13. If they went to Yale, it's even more disappointing. I also went to Yale as an undergrad. On the other hand, I'm thinking the contents of the "rhymes with kale poster" posting demonstrates that this individual is indeed correct and that NP schools are not selective and rigorous enough. Oh, and my comments were civil and professional. Someone commented I had a chip on my shoulder and no one came to my defense. I also did not complain.
  14. I don't know what school you went to. Perhaps one that wasn't very good, judging by your attitude and lack of ability to think logically. Or even to do any research to back up your claims and provide citations. You also seem to think it is ok to make sweeping generalizations based on anecdotal evidence (your school). 1. This is why I say most NPs (not NP students) have RN experience - because RN experience was a requirement in many programs until relatively recently. Therefore, we have a large population of NPs practicing now that completed their MSN when RN experience was a requirement. I did try to find the % of current NP students that have RN experience, but was unable to find this information. See, unlike you, I actually perform research. 2. I can see how you might find one of my arguments inconsistent. Let's look at this more closely. PA schools require 1,000 hours of clinical experience before starting PA school (CNA, tech, EMT, RN, volunteer, etc). However, PA students do not have to have a BSN or other clinical education equivalent. NP students must have a BSN or a direct entry MSN prior to applying to NP school. 3. Let's take case 1 = Jane. Jane completed a BSN program (1,000 clinical hours). She then worked as an RN for 1 year before starting NP school (2,000 paid clinical hours). Her Primary Care FNP program required 700 clinical hours. Therefore, upon completing her MSN, Jane has 1700 academic clinical hours and 2000 RN clinical hours = 3700 clinical hours, certainly comparable to a new grad PA. 4. Let's take case 2 = Amy. Amy completed a BSN program (1,000 clinical hours). She then went into an MSN NP program in Primary Care FNP (700 clinical hours). So, 1,700 clinical hours before starting NP practice. Yes, less hours than a new grad PA. So, see below for further analysis. 5. PA schools generally provide 1500 to 2000 clinical hours, but they also cover everything - acute care, primary care, women's health, peds, geriatrics, etc. NP schools require specialization. So, a primary care FNP is not going to do any acute care clinical hours, and so forth. So I fail to see how PA schools are superior for a given specialization. 6. I am not aware of any studies indicating PAs provide superior care to NPs. Over 100 studies demonstrate NPs provide care quality equivalent to, or better than, MDs. Do you think PAs provide care better than MDs? I ask this because that is the logical extension of your argument. If A = B, and B = C, then A = C. 7. At Johns Hopkins, in my class, about 1/2 the students in the NP programs had worked as RNs prior to starting the NP school. JHUSON does NOT recommend that NP students work. Med school and PA schools are also designed as full time programs and they are very clear about that. That said, at JHUSON, the first semester is purely didactic, so some students did work. However, once clinicals start, it is extremely difficult to work more than 10 - 15 hours per week, as the academics are so demanding, in addition to 16-20 hours clinical per week. So most of the NP students who were working as RNs at JHUSON, either quit working or dropped to part time work. Remember, if an NP student does not perform satisfactorily in school, no matter how wonderful an RN he/she is, then that student will not graduate to become an NP. No ticket, no wash.
  15. I am not aware of any reputable direct entry MSN programs that produce NPs without a BSN. Direct entry MSN programs are clear that students will be able to apply for an RN and are considered clinical nurse leaders or some such. Such students must complete a post-master's NP certificate in order to became an NP, which usually takes an additional 2 years. As for ADNs having bridge programs to MSN, so what? These folks are RNs. As long as the curriculum covers all the material required for a BSN and MSN, as the reputable programs do, that's fine. I will address your other comments later.