question for EXPERIENCED NPs, please!

prairienp · Apr 21, 2006

I have been wading though the long PA vs NP thread, trying to extract usefull information. One issues raised is that NPs get fewer clinical hours of training than do PA.
Do those of you who are practicing NPs feel that you received sufficient clinical training?

I completed my FNP education in the mid-80s, I don't recall the exact # of clinical hours required. My program at the time was only 3 semesters long, with the summer semester devoted entirely to clinical (40 per week). I assure you if you want additional clinical in a specific area you can do an independent study. The reality is the individual student and preceptor determine the outcome for practice. Some NP/PA students providers never get "it", others are fine right away or in a few months.

Thus, to answer your question, yes I did receive sufficient education. I would have liked more, although at the time I was ready to get out of school and practice.

Good Luck

lalaxton · Apr 21, 2006

Think back to when you became an RN. Did you think you had enough clinical hours then? I remember thinking that I didn't get enough clinical time as a nursing student but actually once I started working it didn't take long to get up to speed. When I did my NP, I felt the same way. It actually felt much better because I anticipated an adjustment period and so was less stressed and it probably took me less time than it did with my RN!

APP · Apr 21, 2006

"Think back to when you became an RN..."

well, I haven't become an RN - I am considering a mid-life career change, and am looking at direct-entry NP programs, hence my concern.

My problem is that I have debts, mortgage and expenses that require my current income (in IT: $40/hour and benefits) to support. Left to my own devices, I'd sell off some real-estate to pay off debts and free up some cash, so an assoc degree, get my RN asap (I have a BA and Master's degree in non-health related fields), work for a few years as an RN (with no debt and fewer expenses, I could handle the cut-in-pay) and then do the NP. Problem is the husband does nto want to down-scale, sell off real estate etc. I am hoping he may re-consider once I've gotten a few pre-req classes out of the way, showing I can handle scool and like the field. The other issue is TIME: I am 47, and want to get through school and to my ultimatre goal, NO, asap.

Though I have no formal experience in nursing, I spent 6 months olunteering in a hospital and also cared for my father (with prof. hospice help) when he dies of cancer - so I have some idea what nursing entails, and can handle the 'ickies': I am just concerned that with NO experience as an LPN/RN and if I do a direct-entry program, I won;t be getting suffient clinical experience.

Thoughts?

aviator411, RN · Apr 22, 2006

APP,

Your question and responses are of great interest here as I too am planning a career change but at age 62 instead of 47.

I've just applied for an accelerated BSN program which can be completed in 4 semesters and then plan to enter a NP program. I really look forward to retiring from my present career and moving back into the medical environment.

Are you aware that there are substantial numbers of jobs for NP's for which the NHSC (National Health Service Corps) will repay $25,000 of your educational loans for each year of service. Many of the jobs are in prisons or on Indian reservations in the Dakotas but many are not. I plan try this route to get most or all of my graduate school costs covered. Of course you have to use loans to pay for schooling in order to take advantage of this program but the student budget process at most grad schools which determines the amounts you're eligible to borrow includes costs for food and housing so this might be a source cash to help with existing obligtions if you attend school full time. I'm certainly going to consider this when I get ready to enter a grad school.

I considered trying for some direct entry Physician Assistan master's programs but they seem to have such narrowly focused curricula and such inconsistent prerequisites that one could spend years picking up prereqs for several programs as a part time student that I've decided to just get into a nursing program and get started with some good solid clinical training.

Whether I go the NP or PA route, I'll have a LOT more clinical experience when I get there than most PA's do when they finish school.

Several of the PA programs here in Michigan and elsewhere no longer value or really condsider prior experience in the health care field when making admissions decisions. From that perspective, it seems to me that NP training has to be AT LEAST as good as any of the PA programs and in most cases far superior; and your IT experience can't possibly do anything but make you a better NP.

Having invested a lot of time studying the PA vs NP arguments, I reject the generalization that PA's receive more or better clinical training than NP's. The NP programs I've looked into appear to provide the opportunity to receive MORE clinical training than most PA's do if that's where your interest lies. Many of the PA programs I've checked out seem to have a very narrow curriculum and a very narrow focus on the type of applicant they are looking for; most are in their early twenties with very high grades and little real world experience in the medical field. The PA programs didn't start out that way but that's the direction more and more of them are going. As a patient, I would feel far more comfortable under the care of a well-trained NP than a twenty-something with maybe 2 years of medical training and nothing more.

I guess we'll both see, won't we. I've been married to a RN for 37 years so it's not entirely as if I don't know what I'm getting myself into. Best of luck. I would enjoy hearing how it goes for you. Welcome to email me.

Best regards!

John

ajsinla · Apr 22, 2006

I have been wading though the long PA vs NP thread, trying to extract usefull information. One issues raised is that NPs get fewer clinical hours of training than do PA.
Do those of you who are practicing NPs feel that you received sufficient clinical training?

I have been a Nurse Practitioner for 18 years. Prior to training for an NP I worked as an RN. I had over 20 years of experience in med-surg, oncology and critical care.

Most RNs have several years experience before training as an NP.

PAs don't have this background so, they probably do need more clinical training. I feel my clinical training was adaquate.

AJ

Papadoc · Apr 23, 2006

I have been a Nurse Practitioner for 18 years. Prior to training for an NP I worked as an RN. I had over 20 years of experience in med-surg, oncology and critical care.
Most RNs have several years experience before training as an NP.
PAs don't have this background so, they probably do need more clinical training. I feel my clinical training was adaquate.
AJ

Many PAs do. Also many PAs went to the PA school with already earned RN.

But don't we have this ping-pong here?

https://allnurses.com/forums/f34/clinical-differences-nps-pas-83016.html

Have Fun :monkeydance:

patnshan · Apr 24, 2006

PAs don't have this background so, they probably do need more clinical training. AJ

Way too much of a generalization here. Just trying to keep you honest:)

Pat, PA-C, RN, MPAS

patnshan · Apr 24, 2006

Many PAs do. Also many PAs went to the PA school with already earned RN.
But don't we have this ping-pong here?
https://allnurses.com/forums/f34/clinical-differences-nps-pas-83016.html
Have Fun :monkeydance:

Yep, it's all individual in terms of what one comes into a program having. I am one of the folks you elude to in the posts. The training is why I chose one over the other, everyone has different reasons. My part in the arguement has always been the training itself, not what you come into it with. Being an RN, RT, OT, PT, whatever is not being a "medical practitioner/provider/whatever you call it". You can't just jump into this without adequate training. Where the debate lies, I think, is what is adequate training? What I think is spelled out in the other post:D

Pat

taighwilliam · May 2, 2006

I think for a nurse it is irrelevant whether they practice as PA or NP...you can't remove the fact they have nursed. Nurses stay with the patient throughout their ordeal and take a much wider, holistic view of their patient. For a nurse, reversability of an illness is not always the appropriate action to take for the patient.

However unlike the MD or PA, the nurse must understand both nursing and medicine. This understanding allows her/him to unite these differing spheres to the benefit of all patients.

ERNP · May 18, 2006

To simply answer the original question, yes my clinical training was adequate. The number of hours set down by any program is a minimum number. Voluntarily, I put in 2 extra days per week.

Did I take 6 week rotations to every surgical experience the hospital setting had to offer? No. I wasn't interested in assisting in surgery. I was, however, very interested in ED and made sure I had a full 3 days per week there for a year in addition to the mandatory clinic day each week and the 2 days per week I just worked in the ED.

So my clinical education was VERY adequate, but it was because I made it that way.

Psychaprn · May 22, 2006

I think for a nurse it is irrelevant whether they practice as PA or NP...you can't remove the fact they have nursed. Nurses stay with the patient throughout their ordeal and take a much wider, holistic view of their patient. For a nurse, reversability of an illness is not always the appropriate action to take for the patient.
However unlike the MD or PA, the nurse must understand both nursing and medicine. This understanding allows her/him to unite these differing spheres to the benefit of all patients.

I agree 100%-GREAT ANSWER-Thanks!