I'm curious to see how practicing NPs feel about the proliferation of online NP programs, especially the diploma mill NP programs that accept applicants without prior NP experience. Do you feel like this is watering down your profession and/or possibly causing physicians and the public to have a negative view of your profession? OR, do you think that this is the future of education, and the current method of training NPs should stay the way it is?
I have no dog in this fight, but I constantly read physicians bashing the quality of online NP education, including the lack of clinical hours (<800). I'm curious to see how practicing NPs feel about this.
As an aside, I'm considering doing one of these online programs, so this post isn't meant to bash a specific field, but rather create a discussion on whether or not practicing NPs like the direction that their field is headed in.
"karen" is considered a derogatory comment. You should apologize to me. If I seem a bit upset by some comments about "undesirable" areas, it is because I also view that as being rude, as I previously explained. In addition, I also feel it is rather insulting to the people who live in those areas. Those are my "peeps" now and it makes me angry when people put down those areas, and by extension, the people who live in those areas. It is like someone telling you that members of your family are "undesirable." While I couldn't live permanently in a small remote rural town, my patients were awesome - just the nicest and most appreciative people. I miss them.
To be blunt, beggars can't be choosers. An NP that needs a job needs to go where the jobs are. End of story. Keep an open mind and they might just be pleasantly surprised.
Specializes in Psychiatric and Mental Health NP (PMHNP).
1 minute ago, ProgressiveThinking said:
I should apologize to you? Yeah...umm..no. Did you not read my last response? Entitled much?
Well, I guess you are just rude. Evidently, you think it is okay to make derogatory comments to people you don't even know. Expecting an apology when one is insulted is hardly entitled. If I accidentally bump someone in the supermarket, I say "I'm so sorry, excuse me."
I am actually defending millions of people and their homes, urging NPs to consider working in undeserved areas, yet you call me entitled? Talk about cognitive dissonance.
Specializes in Psychiatric and Mental Health NP (PMHNP).
7 minutes ago, verene said:
This is definitely something to be mindful of - residencies are not cheap - and most MD residents little money compared to their end pay scale. For NPs out there pushing for residencies - what pay scale you would be willing to accept as a new grad - bearing in mind a MD resident may only be making 75K/year - are we willing to accept that or less for the first 1-4 years of practice?
I have NP friends that did residencies and they were glad they did it. These are generally only 1 year, some are 2 years. The pay is $70 to $80K per year. That's not bad, considering the training being provided. MDs have a good point in arguing that they have to go through internship and residency and NPs don't. I'd rather have 1 year of a lower income than extending school, which would make school longer and more expensive. People can certainly live on $70-80K for one or 2 years.
I think that my personal overall take home from this thread is that the quality of NP programs vary widely, and for profit diploma mills dilute the quality of applicants and programs. Fixing this is difficult to do, and there's so many different factors that affect it, and there are so many NPs who have different thoughts on what should be required of their program requirements and curriculum. Some want a residency, others don't. Some think experience should be required for both primary care and acute care (which it already is), others don't. Some think 600 hours of clinical is enough, others don't. It's pretty unanimous that people think online education is the way of the future.
My initial thought process was that PA school was more rigorous because NP education by design was set to build on their nursing education and experience, but now I'm not so sure. I personally can't judge what level of difficulty is required in a program to produce quality primary care providers, but I will say that ICU coworkers at a local school have said that their NP program wasn't difficult at all, and they were still able to have a life and work full-time unlike a friend of mine who went to PA school. I think that's fine as long they produce quality providers who are able to excel clinically, and have great patient outcomes. This is an arduous thing to measure though since many NPs end up working in different specialties and varying levels of physician oversight.
The same NP program essentially rolled out the red carpet for my best friend with a 2.5 GPA saying that his 2 years of med-surg experience at the time made up for his lower GPA because there wasn't enough applicants (quality vs quantity). Albeit, another friend who went to a more difficult FNP program had to quit working because it was so difficult. Both programs were brick and mortar hybrid programs. I think that this speaks to the varying levels of quality in NP programs which I think gives physicians who dislike NPs ammo to criticize the education process of NPs.
As far as the job market goes, some say it's bad while others vehemently oppose that notion saying that flexibility and a willingness to relocate is crucial.
I just wanted to say thanks to the people who have contributed to this thread so far and helped educate me. None of the content I have typed was meant to bash the NP profession so I apologize if any of it came off that way! The CRNA world has some similar problems (although not to the same extent).
Well, I guess you are just rude. Evidently, you think it is okay to make derogatory comments to people you don't even know. Expecting an apology when one is insulted is hardly entitled. If I accidentally bump someone in the supermarket, I say "I'm so sorry, excuse me."
I am actually defending millions of people and their homes, urging NPs to consider working in undeserved areas, yet you call me entitled? Talk about cognitive dissonance.
Yeah, that’s the thing. This is an Internet forum. Pretty sure the people in these cities don’t care if you act like you’re their knight in shining armor. They don’t need you to defend them. Nobody ever called the cities undesirable. He just asked how these cities in particular were desirable, and you took extreme, over the top offense to it.
Wow. People are talking about NP residencies only paying 80k per year. Where y'all live-- cause I've been working for 7 years in PHMNP in public health no less and it took 7 years to get above 80k. My initial hire salary was 30 per hour and that was without benefits. They offered 25 for FTE. our LPNs are hired at 10 per hour. The market is oversaturated here, no unions, and we are not an autonomous state , bad combo. I'd move tomorrow but family won't go. And don't you have to be fluent in Spanish to get a job in California? Or Arizona?
Yeah... and residency pay is averaging $61k, not $75k. Don't think you're working 40 hour weeks either, try 80-100+ hours a week, regardless of any hour restrictions.
Specializes in ACNP-BC, Adult Critical Care, Cardiology.
50 minutes ago, NPvampire said:
And don't you have to be fluent in Spanish to get a job in California?
I am not fluent in Spanish nor can I even speak a rudimentary form of it but I've never had a problem finding a job here. There is an advantage to being a Spanish-speaking provider and maybe even more if one is from a culture represented in the majority of the patient population but I've never seen that as a handicap in my case. Our NP fellowship pay starts out at low six figures but that's still lower than an experienced nurse would get paid for.
"karen" is considered a derogatory comment. You should apologize to me. If I seem a bit upset by some comments about "undesirable" areas, it is because I also view that as being rude, as I previously explained. In addition, I also feel it is rather insulting to the people who live in those areas. Those are my "peeps" now and it makes me angry when people put down those areas, and by extension, the people who live in those areas. It is like someone telling you that members of your family are "undesirable." While I couldn't live permanently in a small remote rural town, my patients were awesome - just the nicest and most appreciative people. I miss them.
To be blunt, beggars can't be choosers. An NP that needs a job needs to go where the jobs are. End of story. Keep an open mind and they might just be pleasantly surprised.
My last comment on this topic. Lets try to make this objective. Let us define "desirable" as the amount of people who want to live somewhere / the amount of people who don't.
These cities, although personally desirable to many people for many different reasons have a larger amount of people who don't want to live there than that do. Their "desirability ratio" is low. Therefore objectively undesirable.
The purpose of this discussion was to underline the point that the market is oversaturated with NPs. If the only good jobs for NPs are places most would rather not live, it is not a good market. Period.
I live in a large city with moderate housing prices. CRNAs make good money here and groups are begging for more providers. It is a good market for CRNAs. NPs in this same area can hardly find clinical preceptors let alone decent jobs. Bad market for NPs.
Specializes in Psychiatric and Mental Health NP (PMHNP).
20 minutes ago, murseman24 said:
My last comment on this topic. Lets try to make this objective. Let us define "desirable" as the amount of people who want to live somewhere / the amount of people who don't.
These cities, although personally desirable to many people for many different reasons have a larger amount of people who don't want to live there than that do. Their "desirability ratio" is low. Therefore objectively undesirable.
The purpose of this discussion was to underline the point that the market is oversaturated with NPs. If the only good jobs for NPs are places most would rather not live, it is not a good market. Period.
I live in a large city with moderate housing prices. CRNAs make good money here and groups are begging for more providers. It is a good market for CRNAs. NPs in this same area can hardly find clinical preceptors let alone decent jobs. Bad market for NPs.
See?
"Desirable" is a subjective judgment. For one thing, what one person considers important for desirability is just their personal preference. Some people place affordability as in their top 3, others might place being withing driving distance of a beach to go surfing in their top 3. A city with great nightlife might be very attractive to a single professional, while one with a family will place more importance on factors like a good school system. As I stated, if someone wants a good job and to gain experience, especially a new grad NP, then they need to go where they can get a good job. After 2 or 3 years of solid experience, they will be better able to obtain a job in a more competitive market. Or maybe they will decide they really like Sacramento, Fresno, wherever.
I agree with you that job markets vary by location. It is up to NPs to do the research to figure out where the good job markets are that they are willing to live in.
I just want people to keep an open mind and at least consider other places.
There is no surplus of NPs or primary care doctors on a macro level, and the primary care provider shortage is only expected to get worse. There is a maldistribution. But that is life in a dynamic economy. Ambitious professionals in any field know they will likely have to move multiple times to advance their careers.
The times they are a'changin . . . Millenials are increasingly moving to smaller cities and even rural areas:
Times are changing especially with technology, and online education is expanding more than ever. It is here to stay. I don't have anything against online programs at all. I'm doing one now. I did my BSN online, and I feel it has successful improved me as a nurse. I do believe online learning coupled with hands on experience is important for success. You will have nurses and NPs who successfully complete a program and do not perform as well in the "real" nursing/NP world. It happens, and these healthcare professionals will not be successful in their roles leading to various problems such as fast burnout and leaving the profession. The healthcare arena will most likely spit them out. Anyway, nursing experience prior to NP school should be a requirement for any specialty track in NP school. I don't feel that we need to eliminate online accredited nursing or APRN programs but prior experience should be a prereq. All nursing schools whether online or in person are in it for profit, therefore, they should be monitored to ensure they are providing the education and experience needed for Nurses to be successful in their new role. I do see more employers offering transition programs as well which will help weed out health care professionals who are not well prepared for their roles.
ProgressiveThinking, MSN, CRNA
456 Posts
I actually think that you should apologize to me.