AnxiousRNtobe

A friend just declined admission today so who ever is #1 on the list will be getting in before orientation.

I haven't heard of any nursing program having thousands of applicants for 40 - 60 slots but it is competitive. The incoming second career BSN program at Univ Michigan had 355 applicants for 42 slots in 2010 (about 20% acceptance rate) (2010 Second Career BSN Profile | University of Michigan School of Nursing). The regular program for freshmen had 404 applicants for 123 spots (2010 Freshmen BSN Profile | University of Michigan School of Nursing). From information gathered here, it seems like Eastern Michigan's ABSN program accepts about a third of applicants, Wayne State accepts about half of theirs. Community colleges vary on their acceptances, some are straight waiting lists as long as pre-reqs are met with grades above a C-, others do lottery or point systems.

I'm afraid that I've done too much damage to my GPA. I feel like I started out badly and am having trouble recovering my confidence, let alone my interest. And even though I always thought NP training was pretty much the same as PA. I always read about the role of the "advance practice nurse" vs PA training. Now I see where taking people with such varied backgrounds and trying to make them the same is maybe not the best way to create a healthcare provider. My problems with school are basically with memorization. In anatomy, I had a lot of trouble with the rote memorization of all that material (arterial/venous/ducts paths, 150 or so muscle origin/insertion, bones, organs, etc). I eventually learned to make tables or draw the organs and write the out over and over and over in different colors until I could write it out from my head. The rest of my problems stemmed from trying to catch up grade-wise because it took me half the semester before I learned how to memorize. I don't know what the answer will be. I am in such a better position to see the strengths and weaknesses of each training. Why oh why didn't I become a nurse in my 20s???

Wow, you have all given me a lot to think about. In my mind, you were going to describe the lush green valley of nursing school (that's how my NP colleagues remember it from years back), where instructors have practical experience (and not dementia), you learn practical skills, hard work pays off with high grades, students don't resort to Xanax and Zantac for anxiety and ulcers that develop (one girls' secret to test taking is a half milligram of Xanax, I have CostCo sized bottles of Zantac). I do want the advance practice role and I have seen PAs and NPs doing exactly the same thing with exactly the same amount of "supervision" from the physician. I've always liked nurses at every level (LPN, ADN, BSN, NP, DNP) and maybe part of my shock was that I don't socially like my classmates. I felt so overwhelmed last semester and didn't make changes in my program or changes in my study habits until so late that I couldn't bring my grades up in the time left. I think for me it's this constant fear of failure that started on day 1 and all I see in front of me is more years of that fear. Maybe that Xanax girl is on to something!

Perpetual Student (I guess I am one too): your theory that I'm suffering a bad case of "the grass is greener on the BSN side of the fence" might be an element of what's going on. I imagine nursing school to not have the things that are driving me crazy about PA (spoiled, superficial classmates, disorganized teachers, cut-throat atmosphere). Calotter3: I'm facing another year and a half. I have invested a lot of loan money and either way would need a lot more loans. I guess my issues boil down to: - very high (20%) failure rate in this program and I am afraid of being one (I have addressed many of my study problems and have a pretty easy load this semester) - second thoughts about the amount of debt accruing. Would it make more sense to take out less loans and make a somewhat smaller salary? - does the PA philosophy make sense for me, someone without bedside experience? I realize this is how most PAs and physicians get trained, I'm just having second thoughts about my ability to practice at that level without having a more fundamental set of skills & experience

I'm relying on the anonymity of the great big internet and the general size of the universe, I'm nervous to go "out there" with myself. Here's my situation: I started a PA program (master's degree) last year and have not liked it in any way. I have struggled academically, psychologically, financially, etc. I excelled through previous graduate work with A- average through 90-some credit hours, I excelled in my pre-reqs with a 3.85 GPA. And I'm here, supposedly at a major goal and I'm miserable. I hate my classmates, I resent them teaching us outdated information, I hate the waste of time that is our patient lab of 40-some students who see our instructors for maybe 5 minutes (how do we learn how to do an exam in that time?). I'm afraid of the reality of taking out $150,000 debt at my age. At the same time, I am surviving on student loans so I'm going forward with winter semester (and who knows, maybe some miracle will happen?). My original plan was a second career BSN and go on from there to NP. But the DNP "thing" scared me off and I was seduced by the PA curriculum, more clinical hours, could practice in surgery/psych/internal med/pediatrics/etc. PA was a shortcut to what I thought was interchangable. Now I see from the other side what the "advance practice" advantage truly is: it's about PRACTICING as a nurse and then going on to advance that practice. Not taking a group of non-healthcare providers and making them fit into a square hole. Now I see what "holistic" care is (or maybe I imagine this is what nursing school is): discussing the impact of a diagnosis pulmonary fibrosis or tuberculosis or AIDS on a patient, their family, their lifestyle, helping guide them through those conditions even after writing the diagnosis on the chart and scribbling a prescription. As a long time lurker here, I know that PAs and nurses (RNs and NPs) don't always play together well. I am very well aware that nursing school is not a walk in the park and that the NP/DNP "thing" looms on the horizon in some way. I know that many of my classmates are equally stressed (one posted on FB about feeling "suicidal") but they're doing better academically then I am. If anyone is still listening, do you have any input? Experience? Rumors? I am in the process of applying to one nursing program - only you and two very close friends know about this so don't tell :-). How can I convince an admissions committee (and myself) that I can succeed in a BSN program and that I'm not a PA school reject? Thanks for your time.

a few pages ago i posted several links to scholarly articles and the cdc discussing flu vaccine effectiveness, here is more: article showing that flu vaccine resulted in less severe pneumonia and lower long-term mortality: http://journals.lww.com/clinpulm/abstract/2011/11000/fighting_pneumonia_with_the_flu_vaccine.8.aspx this article shows evidence for decreased flu in cancer patients: http://www.atmph.org/article.asp?issn=1755-6783;year=2011;volume=4;issue=2;spage=136;epage=137;aulast=wiwanitkit safdar a, rodriguez ma, fayad le, rodriguez gh, pro b, wang m, et al. dose-related safety and immunogenicity of baculovirus-expressed trivalent influenza vaccine: a double-blind, controlled trial in adult patients with non-hodgkin b cell lymphoma. j infect dis 2006;194:1394-7. ramanathan rk, potter dm, belani cp, jacobs sa, gravenstein s, lim f, et al. randomized trial of influenza vaccine with granulocyte-macrophage colony-stimulating factor or placebo in cancer patients. j clin oncol 2002;20:4313-8. ortbals dw, liebhaber h, presant ca, van amburg al 3rd, lee jy. influenza immunization of adult patients with malignant diseases. ann intern med 1977;87:552-7. goossen gm, kremer lc, van de wetering md. influenza vaccination in children being treated with chemotherapy for cancer. cochrane database syst rev 2009:cd006484. hsieh yc, lu my, kao cl, chiang bl, lin dt, lin ks, et al. response to influenza vaccine in children with leukemia undergoing chemotherapy. j formos med assoc 2002;101:700-4.

I agree, law school is not a bad choice {stirring pot} but the job market for new JDs is about what it is for new nurses. Yep, it's all about individual rights, not at all about those pesky sick patients!

Here are some studies I found with a quick Google search for reputable scientific sources: http://www.cdc.gov/flu/professionals/vaccination/effectivenessqa.htm, extensive information on flu vaccine, history, historical and current morbidity and mortality http://www.sciencedirect.com/science/article/pii/S0264410X11014435 showing effectiveness of about 56% in children (still better then 0%) http://www.sciencedirect.com/science/article/pii/S0264410X10000034 showing reduction in hospitalizations in Canadians who were vaccinated against the flu To be fair, here is a website that explains the view that the flu shot is a scam: http://www.infiniteunknown.net/2009/10/15/junk-science-and-the-flu-vaccine-scam-revealed/. It also reveals the secret plans to bar code all citizens of the UK by 2013 and recommends buying "a remote farm and learn to become self-sufficient" to prepare for the coming economic and financial collapse and tells of a plan to add lithium to drinking water in Ireland.

Sorry, te sarcasm in my post did not come across well. I don't know that Canadians or Mexicans or any other country has as much drama over vaccines as we do every year. I completely agree that a healthcare worker who is making a conscious (and "informed") choice to decline proven interventions like the flu vaccine or wearing a mask to protect against TB should be also be choosing a different career. To me, the drama is like teenage rebellion with the power of the Internet's anonymity vs proven science.

As an American, I believe it is my God given right to refuse any intervention that "The Man" tries to force on me - whether it's the vaccine against influenza or a vaccine against old timey diseases like pertussis or seatbelts or helmets when I'm on my motorcycle. They infringe on my absolute right to absolute freedom. And it is certainly another God given right for me to come to an anonymous website and tell everyone that my neighbor thought about getting a flu shot once and then GOT THE FLU!!!! See, proof positive!Let alone all the websites I can dig up that also prove my point that the flu vaccine is a moneymaker/government run test/scam/contains live virus/etc/etc/etc. I worry about the health of the active, young nurses on this board so much more then I do about the patients that they encounter who are in the ED, the ICU, are on chemo or have HIV. The 30,000 or so deaths that the CDC estimates from the flu every year... who cares, I'm talking about MY rights here as a health care provider! Let's all refuse all the vaccines! And while we're at it, I'm too healthy to worry about TB so I'm going to stop wearing my mask!

that's like saying once nurses pass the nclex they can practice anywhere. true, but so what? any beginner at a low level can do that. pas are lower-level practitioners, not remotely comparable to advanced nurse practitioners. again, do not conflate (or equate) tasks with roles. aspiring nps pick specialties because at that point in their careers they have developed enough expertise to know their goals for advanced practice. this is in no way a limitation, no more than the unfortunate person who does a pediatric surgery residency cannot get work as a hospitalist. apples and oranges. i'm not going to get into a pa vs np argument because it's been done to death. in hospitals i've seen, pas and nps have done the same job in most departments. if you need to say that one is "lower level" then the other, that's your lack of awareness of pa training and responsibilities. good luck to op in making your decisions.

I should add that PAs can practice in emergency rooms, family practice, surgery, hospitalist, psychiatry, pediatrics, geriatrics, pretty much anywhere except labor & delivery and neonatal where it's really NPs. Nurse practitioners have to pick a specialty before starting school and stay with it or add on another certificate.

as a clarification, do not think that because you observed them to do many of the same tasks that they had the same responsibilities. they are certainly not "equals." a pa is not a "mid-level provider." s/he is a "physician assistant." most (not all) physician assistant programs require applicants to have previous health care experience and some (maybe) college education. an advanced nurse practitioner has earned a master's degree in nursing and takes extra coursework for prescriptive authority (prescribes medications). the pa is not licensed to be an independent, autonomous professional and cannot have his/her clinical judgment stand alone; s/he must, must practice under the license of a physician. the advanced nurse practitioner has a license that grants the right (and in most cases, the obligation) to be personally responsible for his/her own professional judgment and practice. therefore, the advanced np can practice without physician colleagues in many, many settings. the pa can never do that. that's a huge difference in responsibility right there. pas are also mid-level providers and have their own license to practice as a pa. at my old job, the mid level provider label fell over nps, pa, cnm, psych np, all the non-md/do medical providers. in my state (michigan), nurses are licensed as rns and nps have an additional "specialty certificate" to practice as an np. pas just have a license to practice as a pa. neither np nor pa has to have a specific level of oversight, chart co-signature. both professions can prescribe schedule ii-iv (though both are limited to a one week supply of schedule ii). you are correct that pas have not been able to start their own practice, but a few have started around the country, but it is easier for nps to do so.

These are my facts, for which I will not apologize nor retract: There certainly are good and bad nurses everywhere. I don't buy the crap about UM being "Michigan Difference", that's PR propaganda that most of us locals don't believe, only out-of-towners believe (go ahead and flame me, I have seen absolutely awful care there). I also know of an ADN nurse who is making close to $100,000 a year and most of the nurses I know are making well more then $60,000, a lot in this area. That being said, I work at a large, tertiary care medical center an hour from Ann Arbor. We have over 31,000 employees at all of the hospitals. We just got our first raise in 3 years, we had not had a cost of living or merit raises at all. I pay a 1.5% income tax for the privilege of working in that city. I pay over 20% of my benefit costs, I do not get the 2:1 401K matching that I got at UM. When I worked at UMHS I paid about 20% of my healthcare costs, paid for parking, etc because that is part of working there. Sorry, but I don't see why nurses should be exempt from what the rest of the University of Michigan employees are subject to in terms of benefits and pay. Faculty, researchers, support staff, scrub techs, aides, social workers, etc also perform important work. When we pit "my work is more important then YOUR work", it never turns out well.