nitenurse

Sure am and have been for years; I started in a level 1 trauma center ER and went from there. And I'm not following the rest of your statement. I asked questions that were and still not have been answered, however, you stated I dodged answers. . ..to what? my own questions? And the rest of your post, I really don't know what you're going with that so it may be weird how people who haver never done the job defend it with the most bizarre justifications, however, I am not one of them.

There is quite a bit missing from that broad critique. Are these new graduates? What is the population focus? Bloated with what? certifications? If a NP/AAP doesn't fit the bill as you claim, then why not just hire an MD to fill the void since clearly an NP wouldn't cut it. It sounds like a square peg in a round hole if your committee keeps trying to fill a position with no success -that should be the embarrassing part.

1. Seeing them and treating them are two different things. They see them to refer them so I don't count that as an actionable item since nothing diagnostically significant was performed. The exception would be the ER. 2. Yes, I sure do. I believe the thinking was save the actually sick people (I.e rare conditions, cancers, etc.) for the individuals with all of those years of schooling. Again, for the type of population that fits within the scope of practice for the NP, I don't see how adding more schooling and training will improve outcomes in any measurable form.

Then why bother responding? Find your previous post and copy and paste if you feel that strongly about it otherwise read and keep going. . . . Which they absolutely do, however, when you look at the data, those graduates no better than ones that went through the minimums. There are a number of similar studies in the MD space when the question was asked does it make a difference which medical school one attends.

No, I did not say that, imply that or anything close to it. I stated that minimum standards are set by nursing boards as demonstrated here: And the licensing boards determine what is easy is since it is subjective term. Anything task is easy if you know how to do it or have a natural knack for it. Take a math savant, they have natural affinity for completing what can be considered complex math with little to no effort -proper training and experience is not necessary to determine what is easy in this situation.

Each credential has its own standards, however, the a lot of the posters here are pointing finger at the schools for setting the 500 minimum clinical hour and its not the school, its the board that sets that.

Yes, I know. I just used this as example. I didn't have time to dig through the COA document to look for the specific guidance. The whole point of the mid-levels was so that the MDs can concentrate on patient care worthy of their long schooling. That does not make one better than the other, it just made sense from a financial perspective. https://www.coacrna.org/wp-content/uploads/2021/03/Guidelines-for-Counting-Clinical-Experiences-Jan-2021.pdf

Perhaps but that is any specialty in any discipline. There are hospitals and LTCs that will hire new nurse grads, put them through their 'boot camp' and send them on their way. Are they poorly educated? I don't think so just inexperienced. But this was the same thinking for MDs and we how that happened. They are in school for a decade and still have to pay through the nose for malpractice insurance. So, where is the line drawn? I was talking about NPs. .. .

Maybe but the scope of practice between the two are vastly different. Increasing the amount of hours and education defeats the purpose and point of a mid-level practitioner.

You could if you were just doing colonoscopies. A lot of posters want to point the finger at the schools, however, its the boards of nursing that set the standards. So, if the board says 200 hours are enough to be an CRNA, then what?

The average number of clinical hours for CRNAs are a bit lower (9300 sounds closer to anesthesiologist), however, they do depend on the school: https://www.nursing.arizona.edu/academics/doctor-nursing-practice-DNP/specialties/nurse-anesthesia https://www.aana.com/docs/default-source/practice-aana-com-web-documents-(all)/professional-practice-manual/standards-for-nurse-anesthesia-practice.pdf?sfvrsn=e00049b1_20

Actually its not that number comes from the states' respective boards of nursing: you can more than the minimum but that would have no bearing on licensing.

I'd say so. A lot of folks are comparing MD training to NP training and those two are apples and oranges. NP only has one population focus whereas MD is the spectrum. An MD will spend 160 hours on a specific population the first year of medical school and never re-visit because they are rotating the next treatment group. The requirements (the 500 minimum hours a lot posters are complaining about) are state-specific and they are dictated by the respective boards of nursing, not the schools:

A lot of folks are saying that but not saying what better looks like

Yep, when you submit your paperwork to the board of nursing, your program and treatment population has to be in alignment. You can't do 500 hours in pediatrics and tell them you want to do adult gerontology. And those requirements are state-specific:

That position would make sense if all bikes were the same with differentiation for age or gender. Tricycle manufacturers make their product for a specific population. The folks that make bikes for kids, make them for children so forth and so on. NPs have a specific population that they are trained to see, however, the consensus is although they don't paid like MDs they need to be trained like one.

Remember Heather O'Rourke -the child from the Poltergeist? She went to the doctor with complaints of abdominal pain. The MD brushed it off and stated it was a stomach bug from well water. She was dead is less than a year due to intestinal stenosis. She too was young and relatively healthy right until she died. Mis-diagnoses can happen to any provider MD, NP or otherwise. This is why malpractice insurance cost as much as it does. So, there a lot of opinions stating that NP requirements should be higher but not a single person has posted what they should look like. .. . .

They don't need to. They do not diagnose and treat the same elements. I agree people are missing the forest through the trees; NPs are mid-level practitioners that are not designed or trained to handle the heavy level trauma and other advanced ailments that MDs do, hence the thousands of clinical hours with constant evaluation that they receive whereas NPs do not.

hmmm maybe but I don't think that's a fair comparison. The MD space has a lot more to worry about and their brains are full of a lot more information than the NP. So, it takes them a bit longer to get their groove since their rotation includes several disciplines whereas the NP is dedicated to just one.

I agree but not from a pure profit perspective; enforcement and litigation are usually are the biggest drivers. In the NP space, being board certified is starting to get some legs, so now FNP-BC or FNP-C are being reviewed for credentialing purposes in insurance networks -there's the money you made mention of o.k so what are acceptable standards?

More independence, yes -arizona was the most recent state to allow independent NP practice without an MD babysitter and I have not seen any efforts to relax standards in schools -nursing or otherwise. .. .

I don't believe understand a number of your statements on this one: "No one has proposed what you keep representing as basic knowledge of Chemistry as applies to humans." -what does this mean? this discussion thread pertains to NPs and not veterinary science so, if we're not talking about humans, then who is the target demographic and how would science apply from a mid-level practitioner perspective? "Also, I have never believed that because a school is accredited that means it is worth the tuition." -again, context? If you are attacking the system of accreditation as a whole, then that undermines your initial point -if the whole system is shoddy then it would not matter how much science or clinical hours an MD or NP possessed or completed since the tuition and accrediting body are worthless. . .. "500 hours is adequate for a toy NP." So, outside of being critical, this is where you propose how many hours are adequate and detail the level of care that would commensurate with that clinical experience.

hmmmm I believe that was the exact design. NP programs are for patients that do not require a high level care. Patients that require a few stiches from cutting themselves when slicing tomatoes or they stepped on a rust nail and need a tetorifice shot. So, 500 hours is more than adequate.

Exactly. You can't be an expert in everything. The sciences won't get you there. If you worked in a lab or went into research, then they would be useful. But knowing the specific heat capacity of mercury won't help diagnose hyperkalemia. Again, the sciences are not used in day-to-day patient care as you can attest from your own experience. And through your own admission, this has happened a few times with NPs and MDs so its not an isolated incident. Are for profit schools and the perceived lack of academic rigor the blame? pffftttt hardly

Kinda. I have a PhD and its a research degree. You have laser-like focus on a very specific subject (but it has to be broad enough to find information on it) and all of your attention is dedicated to that end. So, if my dissertation is on mitochondria then I would know all of the ins and outs of the mitochondria but have cursory knowledge of say the phosolipid bilayer or gogli apparatus and its inner workings (as stand alone cell elements, not how they relate to mitochondria). That's why I thought it was curious the poster appeared to lash out at for profit NP schools -they are accredited by the same accrediting bodies that are responsible for state universities and non for profit institutions. I agree. However, everybody is so terrified of litigation, they act with overabundance of caution even if its a detriment to patient care.