Ellen NP

I’ve never been harmed or seriously threatened by a psychiatric patient. I’ve been threatened by antisocial people in the ED....”if you don’t give me xyz drug (opioid, benzodiazepine) I’ll tear tbisplace apart.” I assure them that we will not allow it, promise that they’ll be medicated if they try but that it won’t be the drug of their choice OR that I’ll call police, will press charges and will show up in court. That’s usually sufficient. The ED is far more dangerous than a psych unit. Patients with dementia and/or delirium are more dangerous than psychiatric patients.

All new nurses have clinical experiences during school. They do not count for ‘experience.’ If the hospitals are truly looking for experience, you do not qualify.

Nevertheless, what we really need as NP's is more clinical training. If you want to teach, write, develop policies or do research, a DNP may well advance your career. If you want to have a 100% clinical practice, you need more clinical training hours. The 'old' MSN programs had real research and leadership coursework. We translated research into practice through rigorous 12-18 month projects. We had more clinical training hours. WE had performance exams with mock patients before we could advance to the next course. Those programs have been replaced by others with fewer clinical hours and less rigorous prerequisites for entry into the programs. The DNP programs are bringing back that work that we had in the early MSN programs into their curricula. When the DNP was first planned, the idea was to add a few additional courses to our already rigorous curricula to meet a doctoral standard. Today, a post MSN DNP can easily take several more years of study.

This would make it a clinically valuable degree. Of course, as it exists now, the DNP is open to non-clinicians.

This was my experience 20 years ago but this has changed. Medical education is more holistic and NP education has become less rigorous and less standardized in terms of clinical training. Too bad that clinical nursing background is no longer required for NP education.

My internist does all of these things and has superior medical training as have my past internists. Current medical training is much more holistic than in the past. Physicians are receiving more holistic training and NPs are having even less standardized clinical training. This is not a winning strategy for our profession.

I did take all those hard sciences as well as 2 full years of Calculus (Calc 4). I can actually understand statistics, pharmacokinetics, read and interpret research. I use those sciences (that too many nursing leaders dismiss) every single day. I am distressed when I see nursing programs that have 'Chemistry for nursing students," and other science lite courses. no wonder we can't have more advanced sciences in graduate school. We do not have adequate basic science education. I'm skipping the DNP. If I want more management, leadership, etc., I'll either finish the MBA that I've half completed or get an MPH/DPH.

I work in a state with FPA after 2 years of full time practice with supervision from either and experienced NP or physician in the same specialty. We have a good number of psychiatrists so FPA is not a barrier to finding psychiatrists as someone suggested. Very few NP's have gone back for their DNP in this area. There is no monetary incentive to do so in my organization, a large academic medical center. The local university attempted to transition to a DNP entry for NP training. Applications fell considerably and they reinstated the MSN track. Most DNP programs do not add clinical training beyond that in the MSN program. Capstone hours are usually focused on a project and do not involve actual clinical training. It's unfortunate that the DNP is leadership and policy focused in most programs rather than adding more advanced clinical training. That said, if you plan to teach at the graduate level or yearn for a position in nursing leadership, the DNP makes sense. I'm happily teaching undergraduates in the clinical setting and my MSN is fine. It's unfortunate that nursing educators chose not to develop a clinical doctoral degree. Many of us would have jumped at that opportunity.

I love my position as an NP on our Psychiatry Consultation Liaison service. I work in an academic medical center which has an inpatient med-gero-psych unit, and Acute psychiatric Unit (ED) and an active CL service. I work midnight to 0800, Sun-Wed, no weekends, holiday or call. I see whomever is most emergent and that may be on the inpatient unit, in the ED, or on the consult service.

many physicians have no understanding of NP education. We cannot just jump from specialty without training. An NP with 20 years experience may have no neuro expertise. Physicians often believe that we are trained like PAs as generalists. It's unfortunate that the physician and NP in this case did not discuss her actual experience and training needs prior to hiring.

Just an FYI, in an independent state, were are NOT supervised by physicians. In fact, in my state, new grads can have their two year supervisory requirement met with an NP or physician. I happen to love both PAs and NPs. Neither is 'better' than the other.

Family PMHNP is now the only option. The adult only track is no longer offered just as the adult np (ANP) track has been discontinued. They are trying to prepare all specialties across the lifespan. I did my training at Drexel. It was a great program.

They won't be identical questions, just similar. Every test is a bit different.

I actually passed the first time but know others who passed on the 2nd.

My understanding is that it will be essentially the same. They always vary from test to test.