ivanh3

No offense to the OP, but I think "broken" is a strong term. I do not feel that NP education is broken. Any program can be improved, and most quality programs (of any kind) constantly self evaluate to improve their product. I have to agree with the responder who stresses the importance of research and the avoidance of anecdotal experiences that may erroneously guide decision making. I have seen new grad NPs with plentiful nursing experience fail, and I have seen new grads with limited RN experiences excel. I have also seen the opposite occur. I have not stepped out of my fishbowl to research which is the norm. Instead I judge each NP by their actions. I learn from both. I "steal" techniques and knowledge from those I think are sharp and use this to develop my own style, and I learn what not to do from others. New NPs often bring new and fresh approaches and they keep me on my toes. In terms of NP vs PA education I can say this. I didn't want to go to PA school. I may admire the rigor of their programs, but I don't see a better or worse final product. In my region all job postings are "NP/PA" or "PA/NP" but never one or the other alone. I work with PAs and man are they sharp, but so are the NPs where I work. We have to be. It is a high acuity, high volume setting, and we all turn to each for help. I was full time in school, but I was able to work. I was able to be part of my newborn son's life. My wife went part time to NP school which was a bonus for our family. BTW she totally kicks ass in her "nurse practishery" skills. Let's continue to improve our programs and our practice, but strong language like "broken" is not helpful or accurate. My .02

To the OP, yes, there is high degree of probability that RNs going into advance practice contribute to the personnel shortage in some units. Here advanced practice broadly refers to NPs, education, and leadership. While there may or may not be a "national" shortage, certain areas of nursing seem to find a harder time recruiting and/or keeping staff. I have seen several units where 10-20 RNs at a time were pursuing graduate education or training that would eventually take them from the bedside. When those people left there would be new-hires, and then inevitably, a number of current/seasoned staff would enroll in school. I read several posts here that seem to use absolutist terminology: Units are understaffed due to management. Period. Low pay. period. Undue hardship/poor working conditions. Period. I don't find that language accurate or helpful. I think the etiology has a multitude of factors. Some jobs are just plain hard no matter how much support staff gets from their organizations. This is often patient population dependent. I am fortunate enough to work for a great hospital, but our market is tough. I leave my shift exhausted sometimes, and I don't blame any of it on my employer. I think there is a significant fluctuation of unit staffing because RNs can make a variety of lateral transfers within the same organization. This allows them to try something new yet not change employers. This looks good on a resume. Bottom line, our flexibility/portability can be both gift and curse. Just my .02

I completed the the associates to masters bridge program at Graceland. It was a great experience. I felt like everything went very smoothly. If I had one complaint it was that the program moves more slowly compared to others. I had to petition the board to double up on some classes so I could finish earlier. They have since changed the format some so I am not sure how long their program lasts. I was also a student at the University of South Alabama (USA) but that was a looooong time ago for some undergrad classes. USA is in my hometown, but I did not live there when I was in NP school. If it were me I would consider the following in this order: accreditation (I believe they are both fully accredited), cost (Graceland is private, and USA is a state school, but some states schools offer in state tuition+web fee for students that live out of state), program length, and required time on campus. I believe both schools require some on campus time. Graceland had 2-3 one week focus sessions. I'm not sure about USA, but this will require travel. A challenge for both schools would be finding clinical sites. This is a very challenging part of distance NP programs. Anyway, hope that helps. Ivan

I am not sure, but it is a great program. It is very well run. Very smooth. Good luck!

I went to Graceland University for their ADN to MSN program and then obtained my DNP from the University of Alabama. In each case didactic was mostly online and of course all the clinicals were traditionally done.

Former Excelsior grad, current nurse practitioner. Dig in, dig deep, try hard, and then try harder. You can do it.

Freedom or free health care? What? No one said healthcare was free, but if you are talking about universal coverage, then yes you can have both. How silly to suggest other wise. Did you actually say something to the effect of get a job? You do realize that many of the people who benefit from the ACA are the WORKING poor? And no, not everyone in America thinks they are entitled to everything. Absolutist thinking like that is not productive. And wow, a 1950s rant about communism. Priceless.

Yes, you can do it. Just don't go all weddingzilla, and it should go well. You can have both a memorable and meaningful ceremony within the parameters you mentioned, but you will have to work as a team. Congratulations! Ivan

I am wondering what the demands are if someone is offering a new grad 100K. Ask about the work environment. Being too busy right out of the gate may be frustrating for both you and your patients. This can add a lot of stress. Also ask about what kind of support you are going to get as a new grad. I made sure at my interview to discuss that I was going to be perhaps a bit more "needy" because of my new grad status. The physicians were happy that I was up front about this, and we worked out how consultations with them were going to work (sometimes they were not physically on site). Another area is professional development. Will you get paid time off (above and beyond vacation) and reimbursement (or a budget) for continuing education? For example my first job offered 1 week paid time off and 2000 dollars for CE. Will they cover your liability insurance? Will you be taking call? In any case, the devil is in the details. For me the biggest issues was new grad support. Hope this helps, Ivan

The University of Alabama. This is not to be confused with the University of South Alabama. Both are good schools though.

I worked full time during my DNP. I was able to do my final project at my place of work and that helped quite a bit.

As a paramedic myself I would suggest you look into becoming a physician's assistant. I became an NP because I was already an RN, and it made made more sense for me. However, had I not been an RN, I would have gone the PA route. I have known several paramedics over the years who went the PA route, and it was good fit for them.

You say the PAs are "way" better than the NPs. Please quantify. What standards are you applying? What outcomes are you measuring? If the best articulation you have is "way", that will simply not suffice. Measure "every" variable? How about just one?

Ouch. My program was "online". My instructors were knowledgeable, challenged me, put me under the gun and all that stuff. But then...how can that be? Ironically, my wife is in a brick and mortar program and she seems to, and indeed has to, be self directed. But again, how can that be? It says nothing. Zero. Zip. Nada. Besides my DNP, I have a BSN and MSN. You know what the "S" stands for? Science. And science teaches us the follies of anecdotes being passed off as evidence of something. So it is a real shame to see people making generalizations that are meaningless and without any underpinnings of science or scientific method. Show me a program, any program, without faults, without room for improvement, or whose graduates are all masters of heart tones. Depends on what? Are you suggesting that the quality of preceptors or their motivations are influenced by the program's delivery method? In many cases the process for NP students to find preceptors is the same regardless of their school being online, hybrid, or strictly traditional. I did all of my clinical rotations in Atlanta side by side with NP students from other schools. We ALL had to find our own preceptors. All of our preceptors took students from multiple schools that used multiple formats. Again, these posters that are making all of these harsh conclusions without ANY evidence whatsoever would be laughable if they weren't so harsh and unfounded. You have numbers to back up what you say? Then post them, please. Otherwise, don't accuse online programs of lacking academic rigor while you clearly are not applying any scientific process at all. Ivan

I took the official Excelsior workshop back in 2005. Don't know what it is like now, but it was great then. I would say it definitely factored into my passing the CPNE. Ivan

Well almost three years after that last post I am happy to report that I just wrapped up my doctorate of nursing practice (DNP) at the University of Alabama. It has been a long journey, but it was worth every second of it. For those of you who are proceeding forward with Excelsior, just remember to keep your eyes on the prize. It will happen for you...and it will be just the beginning.

I am just wrapping up my DNP at the University of Alabama. They have an excellent program that can be completed in one year full time or two plus years part time. A portion of my clinical hours were done at work, but that was because my scholarly project was connected with my place of employment. If I had chosen something outside of that, my work hours would not have counted. Even as it was, not all of my work hours counted. Only the days when I collected data were counted. I even came in on some of my off days. So yes, it is possible, but I would check with someone at the programs you are considering.

Lots of posts here. Some good thoughts. And then there are some that are, well, not so well thought out. Before anyone goes and trashes "online" or "brick and mortar" anything, maybe you should do some research. If you have some stats that show that patient outcomes suffer at the hands of online educated folks then bring it. If you don't then go get your grant and figure it out. It is 2012. Many state and "respected" schools are offering online options. Cash cow? That is so ugly and ignorant. They are institutions trying to stay current and relevant. Meanwhile people like me who never would have had a chance (not because I am stupid, but because I was raising a child and trying to support a family) get to go to school. Am I glad that I didn't have to miss work, drive to a campus, park, walk to class, and then listen to a lecturer read out of book or watch a power point? You betcha. I can do that online. Instructor and classmates interaction? I got that out the yin yang. Phone, email, and classroom software (Blackboard, web ct, etc). For the record: nurse practitioner students in distance programs complete the same amount of clinical hours as their brick and mortar counter parts. These clinicals are not online! And my goodness, a physician or a PA threatened by the growing emergence, prevalence, and power of NPs?!?! Say it isn't so! (How's that for snarky?) In reality, most physicians, PAs, and NPs respect each other and get along quite nicely. The physicians I work for are completely supportive and respective of my role. They have stated that they need me, and I am a member of the family so to speak. Yes, we can improve NP education. We strive for that all of the time. In fact that is why NP training is constantly evolving. A static profession is one that will be irrelevant one day. That is not what I signed up for. Just my .02 Ivan

As I recall, Graceland mailed all books to me, and I never really questioned if I had a choice. Probably should have. At the University of Alabama for my DNP I get all of my books from Amazon new, and they are usually less expensive.

I will echo some sentiments on this thread. If you are not a nurse and you want to be a provider then perhaps PA training would be more appropriate assuming you have all of the pre reqs. Ivan

Sorry I missed your question in another thread. Looks like you start today, so let me say congrats! Ivan

I am a Graceland RN to MSN graduate (2009), and I have nothing but positive things to say with one caveat (below). The instructors were excellent, and the dean was very involved. I did a lot of writing and research during my time there which has been helpful to me in my job and as a current DNP student (University of Alabama, will graduate in three months). Now as on online student you must be capable of self direction and disciplined, but that is true of any school I suppose. Now, to be very clear, you will learn much at school, but you will learn more during your clinical rotations, and those are preceptor/location dependent. I lived in Atlanta at the time so I was doing my rotations at the same places and with the same preceptors as Emory University and Georgia state students. This leads to the caveat. There was an issue that was not particular to Graceland: I had to find my own preceptors which was nerve wracking. You have to find a preceptor and then establish a site contract with the facility. This can take months (and months) because it involves lawyers/legal departments in some cases (mostly larger facilities...smaller private offices not so much). There were two rotations where I didn't get my paperwork completed until almost right before my rotation. Meaning I would've had to miss the class and wait until the following semester. Many traditional brick/mortar schools often already have those set up, but some do not. Hope this helps, Ivan

Very little difference in pay, and I am not aware of differences in patient outcomes. There is a big difference in pre reqs and student loan burdens with PA programs having/resulting in more of both. PA schools are often very competitive and may require relocation. I would think PA school is harder on the family life. Additionally, it is harder to work a "day" job while in PA school. NP school can be full time, part time, traditional brick/mortar, or online. All of these give NP students far more flexibility, again, to get a job with similar, if not exact, job descriptions, and very similar pay. Now if you are single, don't mind relocating, and have the time/money for the pre reqs and going through a program that may be difficult to work while in school, then PA may be for you. I work with PAs, and I think they are great. The other thing to consider is that some markets prefer to work with PAs just as some markets prefer NPs. That may be hard to determine if you don't live in a given area. Where I live it is fairly mixed, but there are some local practices that prefer one or the other. Hope I am not coming off as "anti-PA". I am not. It is just IMHO far more practical for RNs to become NPs than PAs. Ivan

It really depends on your job market, location, etc. As an RN I was working in an ICU setting doing the typical 12 hour shifts. I have had two NP jobs since graduation. They were both great, but the employer expectations of me have risen dramatically from my bedside role. I am more likely to stay late, and I am more like to get called at home. Calling off sick (either for myself or to care for my child) is allowed, but it hurts the practice, and everyone lets you know it (including yourself). If a nurse or tech calls off it is far easier to make do than if a provider calls off. Now that is just my experience, but I don't think mine is particularly unique. As an NP you really are stepping up in terms of responsibility, and that often means more time on the job and not less. Ivan

You can certainly learn more about holism through formal and informal training (IMHO, most nursing programs incorporate holistic concepts into their BSN, MSN, and doctorate programs). Although there are actual certifications for holistic nursing you don't have to be certified to incorporate holistic care into your practice both as an RN or NP. Ivan