DragonNP

Interested in comments regarding the need for NP residency programs after graduation - think its needed, why or why not? The answer may surprise you!

The DNP degree needs to be clarified. Its initial intent was for clinical practice, but I can't see the utility of having administrators without any premise for clinical practice (which is far too often the case with nursing) be allotted a clinical degree, unless it is clearly delineated.

As an NP with >10yrs experience in critical/acute care, both through teaching in academia, precepting, publishing, research, etc, I will honestly say that the hierarchy throughout the past 2 generations have not left the profession in an ideal setting...seemingly reconfiguring and reestablishing the semiotic standing and position of "nursing" within healthcare. To address the intent behind this forum, there are a myriad of questions (and not about the cost) one should inquire about: (1) academic and clinical resources at your disposal (2) academic assistance (3) faculty expertise within the program, and are they "still practicing clinically." (4) availability of alumni to speak with (it should be chosen randomly, and ask to speak with recent alumni). (5) will they discuss and analyze your clinical strengths and deficiencies and find your clinical placements throughout the program. (6) where are alumni working, how many are employed. (7) ANCC board certification passing rate (8) availability of corresponding academic hospitals and centers (ideal situation, i.e. Boston, New York, Philadelphia, Baltimore, etc,). Now, understand that in no way shape or form will you become an adept clinician amendable to handling the expectations of the clinical setting you may find yourself in during and after the program (the same goes for PAs and MDs!, but they are far more developed from the onset). Far too often students are placed in less than ideal situations to learn, and trying to find jobs afterwards can be a precarious situation. I find that FNPs (Family Nurse Practitioners) have the broadest knowledge base of all the NPs coming out of school, but they fall short of understanding the principles of acute and critical care that may present subtly in the clinical setting. Vice versa for Acute Care NPs, who are not well adept in the primary care world. This is the problem nursing has placed themselves in. We have made ourselves of less utility than our counterparts in the immediacy, requiring years of clinical development and continuing education to be on-par. Even at that, many of us may never be accredited to see pediatrics or adults. Now throw in some DNPs into the mixture, and develop a consensus model to stabilize the shortcomings we have positioned ourselves into over the past 10-20yrs. And to make matters worse, after years of promoting an advanced practice program for experience nurses, now we funnel 2nd degree students, or fast track BSN-MSN-DNP students throughout programs without an inkling of what the ideal situation or fit is for them. To improve APN education, we are going to have to change everything we do - how we educate our NPs students, how they are exposed into the clinical setting, and provide them the breath and depth of experience throughout the human lifespan while they are in school, and then allow them to select their clinical pathway from then - translated...2-3yrs or more of graduate schooling. I'm not even going to get into the ridiculous aspect of programs that mandate 4-6yrs for a PhD. And have faculty that are engaged actively in the clinical arena (meaning active patient care), and change the nomenclature, perhaps as a generalized “Nurse Practitioner - FNP-BC, Nurse Practitioner, NA-BC, etc). And as a side note, change our predisposition to credentialing and substantiating ourselves, which borders on the upsurd sometimes, i.e, John Doe, Phd, RN, MS, MSN, FNP-BC, MPH, ACRN, FAAN, FRCN.