I was having lunch with several NP colleagues and as we were lamenting the lack of actual nursing experience in so many of the students we get asked, and refuse, to precept one of them shared something that of course I had always suspected but to know that it is a blatant direction makes me sick. Apparently his university, which is part of a very well known, enormous teaching hospital is pushing the direct entry programs because the philosophy is to keep the money coming in while the student is there rather than take the chance they will graduate and for whatever reason not return to grad school or go to another grad school. No consideration for the value of actually working as a nurse.
Not that I didn't suspect this with the whole push for DNP which is only at this point is only being driven by the universities not my board of nursing. Good business I guess but I'm worried about the quality of NPs going forward.
Your thoughts and experiences with direct entry practitioners?
The NP is an advanced practice role, which should not be undertaken with minimal experience. Clinicals and textbook knowledge is a very small piece. How can a practitioner be expected to develop sound clinical judgment without the bedside experience?
The NP is an advanced practice role, which should not be undertaken with minimal experience. Clinicals and textbook knowledge is a very small piece. How can a practitioner be expected to develop sound clinical judgment without the bedside experience?
All the direct entry graduates from Yale, Columbia, and other schools say hi
I am loving this debate! There is a similar thread where I got flamed for expressing my concern. It's down right scary that these NP are being churned out at increadible rates lacking basic education and skills. This is a serious problem in our healthcare system. We must stop and ask ourselves is this right? Is this safe? So glad other nurses are thinking along these same lines. There are many economic and political factors involved and I feel that patients are getting lost in the shuffle. I have been on the receiving end of a poorly trained NP and it was frustrating to say the least. It cost me alot of time and money. I had to see my PCP 4 times and a trip to the ED to correct what one NP messed up. We are dealing with lives here. And this is serious business!
It's down right scary that these NP are being churned out at increadible rates lacking basic education and skills. This is a serious problem in our healthcare system. We must stop and ask ourselves is this right? Is this safe? I feel that patients are getting lost in the shuffle. We are dealing with lives here. And this is serious business!
I love this! You are SO right! It should be all about the patients!
I've been an RN for only 4 years- but have always wanted to be an ACNP. So after lots of thought, research and discussion- decided to do it now. Man, oh, man! It's SO challenging!! I'm constantly worrying about being prepared enough to provide patients with excellent care! (And I'm attending an excellent school!)
There have been so many times, already, that I have been so grateful for the nursing experience I have. I can't imagine how tough this program would be without it!! And even then- I still worry it won't be enough when it comes time to find a job. (I gotta work on gaining more confidence, obviously, in the next year!) :)
Anywho- add me to the list of people who think that NPs should have RN experience before even beginning their program.
All the direct entry graduates from Yale, Columbia, and other schools say hi
Hey what about UPENN??? I think they deserve top billing too!
No one says these folks aren't bright. Bright and having experience are not the same. An IVY pedigree doesn't guarantee that a practitioner is the "best." I have have worked with some IVY League graduate physicians who are not as competent and caring as grads from Penn State, U of MD, and other state schools. Of course, some are fantastic, but it is not a given. Also, the direct entry CNM from prestigious "Vande" was much less competent that the Frontier and U of Cincinnati CNM's who had experience. We heard about the "Vande" experience a thousand times and just in passing about the other CNM's schooling.
I think that the status of having an IVY or other prestigious degree is not necessarily a ticket to greatness. You see on many threads here on AN that this is a belief held among many students. Certainly people are bright who get into these schools. Bright isn't everything. There is also aptitude and experience to consider. Many people who could be quite successful choose a very expensive school over a state or cheaper private school because they believe it will bestow great success upon them. In some cases, it does. Many times, they go into debt and are making the same salary as someone from a less prestigious school who has less student loan debt.
I have a daughter who graduated from Yale with a non-nursing MA. She has huge debt. Hopefully, it will help her to get into a PhD program in her field, but for right now she is working in an office job and making a very mediocre salary. She was an excellent student, even by Yale's standards. Given the debt and the availability of jobs and PhD opportunities, she doesn't know if she would do it again.
If you are dead set on that IVY degree, you know that you could have the experience, the degree, and some financial relief. You could get the BSN and work as "just a nurse," at UPENN, for example. Then they could have that nursing experience and financial support from the facility for that UPENN degree to be an APRN. I think other IVYs do this also.
Textbook knowledge and intellect does not trump actual experience at the bedside. The fact that someone graduated from an ivy league school does not make them competent in and of itself.
Hopefully with the oncoming glut, employers will be appropriately selective.
I doubt that v. much. I would expect that, as with most every other employee glut, there would be a "race to the bottom" -- employers will take advantage of the oversupply to cut salaries and increase workload -- well, if you don't like the offer, there are fifty people in line behind you who will be glad to take the job ...
I am so appreciative for all the participation! I wish NewBoy wasn't the only one with the cojones to add an opposing view because even though overall I am convinced of my assertions there is much value in considering other views especially because we can probably all agree this is not going away. Perhaps now is the time to come up with and lobby for additions to all NP programs that will ensure a better quality product?
I doubt that v. much. I would expect that, as with most every other employee glut, there would be a "race to the bottom" -- employers will take advantage of the oversupply to cut salaries and increase workload -- well, if you don't like the offer, there are fifty people in line behind you who will be glad to take the job ...
Yup and in a field where so few are actually business minded to begin with I expect NPs will just accept any crumb that is thrown their way. My plan, and you know I have a plan lol, is to keep my strong foot hold in this area and should my employer try to get squirrelly with me because of the glut of cheap new labor I can then cry ageism. How ironic would that be as someone who has complained for years that we need to know when our time has passed and gracefully retire? Hopefully I can continue for another 10 years.
joanna73, BSN, RN
4,767 Posts
The NP is an advanced practice role, which should not be undertaken with minimal experience. Clinicals and textbook knowledge is a very small piece. How can a practitioner be expected to develop sound clinical judgment without the bedside experience?