So disappointed with on-line program

[JBMmom]

There were a number of reasons that my only option for APRN education was an on-line program. I'm the primary wage earner in our household of five and have to be able to keep working full time during school. Proximity to a brick and mortar program was also an issue. I've taken on-line classes before and I very much believe that you get out what you put in. So, it is my intention to make myself prepared to practice competently, and I've lined up some people that I really think will be excellent preceptors to help me in that respect. However, I have to say that the quality of the education is poor at best. The "advanced" pathophysiology and pharmacology courses largely consist of multiple choice exams and a lot of meaningless busywork assignments that I find to be on par with any undergraduate course I have taken over the years. I have found my own resources for lectures and information, but I think it's a sad state that this is the level of education I'm paying for from an institution, which I researched ahead of time and found was decently rated as an on-line program. I'm in the AGACNP program, and conceivably I could be hired as an acute care hospitalist. The same position that physicians with four years of medical school, residencies and advanced training, hold in our local hospitals. When I started, that was one end goal I was considering as a career path, but now I have concerns about my own readiness for that position when I finish. And it scares me for patients. I still have my clinical courses to complete, so maybe it's just too early to say, but the academic courses I have taken so far are a joke. And I have seen posts from many classmates that are struggling, which makes me wonder about the admission process, which I found a little lacking and probably should have been my first red flag.

I'm not trying to insult all on-line programs and students, and again, I know that in this learning format I'm responsible for making sure that I will be a competent APRN. But the lack of lectures, or interactive experiences from faculty, make it feel like they're just taking my money. (For example, I handed in an 8 page paper and 8 hours later had a 100% with no feedback other than "excellent". Did the professor even read it?!) I think as a profession, we are doing a disservice to well trained APRNs by turning out potentially unprepared APRNs. I understand that everyone still has to get licensed, but if you know how to take standardized tests, I think many people can pass a multiple choice exam with less than comprehensive knowledge of any subject.

I'm not sure how to wrap this up. Looking for other people's experience, thoughts, and maybe whether any practicing APRNs (if they check this board), found that the on-the-job training after school really filled in the gaps to lead to competent practice. I think we all know that coming out of nursing school we weren't really prepared to be nurses right away, so is this the same thing and I'm just being a little paranoid? Any thoughts appreciated.

[SopranoKris, MSN, RN, NP]

Nursing theory adds nothing to our profession, takes up time that could be used productively, and should be completely eliminated at the BSN and MSN level.

I agree. For NPs, we could eliminate: Theory, Research, Healthcare Policy, and Informatics. Replace them with more clinical/didactic training. I'd much rather have more intensive courses that will make me a better clinician. I have no interest in the fluff courses, nor do I ever want to go into those fields down the road.

[Jules A, MSN]

Thanks for taking the time to share your thoughts and experiences. I think that there are many APRNs out there that are able to practice competently despite, rather than because of, the quality of their educations. While it may not be ideal, I'm determined to get the most out of what I've got.

No doubt there are competent APRNs and I'd even go so far as to speculate many who are as good or even better than some physicians however this doesn't make our subpar education ok. Nor is it acceptable that the overwhelming theme is now the schools aren't required to teach us-its about individual learning, or train us-the hospitals will need special 6 month orientation programs to get new grads up to speed.

Would it be ok if many physicians went to a terrible medical school but made the best of it?

[elkpark]

Thanks for taking the time to share your thoughts and experiences. I think that there are many APRNs out there that are able to practice competently despite, rather than because of, the quality of their educations. While it may not be ideal, I'm determined to get the most out of what I've got.

So, you're "so disappointed" in the school and feel you're getting a poor education there, but you're going to "get the most out it," keep paying them tuition, and figure out some way to teach yourself. Thanks for doing your part to help ensure that sub-par, inadequate nursing programs to continue to thrive. No wonder nursing education is in such a sorry state.

[Spadeforce]

No doubt there are competent APRNs and I'd even go so far as to speculate many who are as good or even better than some physicians however this doesn't make our subpar education ok. Nor is it acceptable that the overwhelming theme is now the schools aren't required to teach us-its about individual learning, or train us-the hospitals will need special 6 month orientation programs to get new grads up to speed.

Would it be ok if many physicians went to a terrible medical school but made the best of it?

I agree, med school has some of its own problems and variability but people always try to use the excuse "Oh i know some great NPs I would trust over any doctor." when trying to validate that NP=MD. I mean, yeah, it happens, there are some great NPs out there, but I can assure you it probably was not their education that made them great.

There are also terrible MD/DOs, but one could argue that it was not the education that caused this to happen.

I still cannot fathom that there are those out there that think NP education= MD. There are lots of complaints about medical school, but none of them are "my education was not good enough".. its more on the lines of "a lot of our time could have been spent better doing blah blah blah."

When nurses themselves come out and say their education was subpar is when we know we have a problem, since people tend to think whatever they do/have done is the hardest and most difficult thing ever. Which is false unless your in high level maths lol.

20 Years ago I would not doubt that the average NP was close to on par with a family doctor. You know, back in the day when the TOP nurses entered into advanced practice and usually the lowest ranked/lowest board scores/not top of class docs went into family medicine.

But now even family med can be competitive so excellent performing med students go into it.

On the opposite spectrum, every nurse on the floor is going into NP/other advanced practice school, not just those with dedication to patient care and the profession.

Just food for thought, even like 5-6 years ago when I got done with NP school it was starting to be watered down and popular to the nurses. NPs are just not of the quality they used to be.

[Bill2211]

I can't believe how hard it is to find clinical rotations in my online FNP program. I'm supposed to start in 6 months and have called at least 50 practices so far with no results. Either they have preferred affiliations for local schools or they are booked out for one or even two years, and that is just for regular primary care! I have a friend in the same online program two semesters ahead of me who has called 100+ practices in four states looking for peds and women's health who still hasn't found anything. It is absolutely ridiculous, the school just offers an occasional obvious local suggestion that is no help whatsoever. If I knew it was going to be like this, I never would of done this program. I am really worried we won't be able to graduate and that even if we do, there won't be any jobs available with this many new grads being cranked out.

[elkpark]

I can't believe how hard it is to find clinical rotations in my online FNP program. I'm supposed to start in 6 months and have called at least 50 practices so far with no results. Either they have preferred affiliations for local schools or they are booked out for one or even two years, and that is just for regular primary care! I have a friend in the same online program two semesters ahead of me who has called 100+ practices in four states looking for peds and women's health who still hasn't found anything. It is absolutely ridiculous, the school just offers an occasional obvious local suggestion that is no help whatsoever. If I knew it was going to be like this, I never would of done this program. I am really worried we won't be able to graduate and that even if we do, there won't be any jobs available with this many new grads being cranked out.

Why should random local clinical providers be expected to do your school's job for them, and provide (for free, no less) the clinical education that your school should be providing?

If students weren't willing to put up with this, schools wouldn't be able to get away with doing it.

[JBMmom, MSN, NP]

So, you're "so disappointed" in the school and feel you're getting a poor education there, but you're going to "get the most out it," keep paying them tuition, and figure out some way to teach yourself. Thanks for doing your part to help ensure that sub-par, inadequate nursing programs to continue to thrive. No wonder nursing education is in such a sorry state.

Yep, it's all because of me. Sorry that I have a family of five to support while my husband is also in school, and kids with college educations coming up, and I actually want to be able to spend time with them. So I won't be throwing away the money I've already invested and taking on more debt and moving to a school that will at minimum require that I quit my job, find independent benefits, and commute who knows how far in order to get the degree I want. Yes, I will make the best of it, and I will become a competent APRN because it's what I want to do. I am not happy with my school, but I'm not responsible, individually for the state of education. It's unfortunate that many of us as a collective contribute to this problem, but I think we're all just doing our best to do what we can to become what we want. Thanks for your support.

[Oldmahubbard]

I don't think most of the good schools require you to quit your job. But yes, you would have to live within reasonable commuting distance, so you would have to get a different job and moving a family like that sounds almost impossible.

Don't feel bad about yourself, poor quality NP education is a very sore subject on this forum.

My only minor suggestion is maybe limit yourself to 2 classes a semester, one class if it is the meaty stuff, and do extensive self preparation. That is what I did and it made a big difference.

[JBMmom, MSN, NP]

I don't think most of the good schools require you to quit your job. But yes, you would have to live within reasonable commuting distance, so you would have to get a different job and moving a family like that sounds almost impossible.

Don't feel bad about yourself, poor quality NP education is a very sore subject on this forum.

My only minor suggestion is maybe limit yourself to 2 classes a semester, one class if it is the meaty stuff, and do extensive self preparation. That is what I did and it made a big difference.

Thank you. I've looked into two schools that are remotely possible because they're closer, and I'd have to quit my job because of the class schedules. They're structured in such as way that any shift work is nearly impossible (8am - 4pm alternating days). I'm currently only doing one course at a time, and I've invested my time and money into additional resources, so I can be prepared. I think one good thing about the exploding on-line education phenomenon is that there are good resources on sites like youtube to complement educations. It's just annoying that I'm leaning far more from these resources than from my school.

[Oldmahubbard]

I am a Psych NP. I went to a B and M school 20 years ago. Our department chair was just barely a psych NP, only on paper, and she believed very much in Freud.

In spite of that, people frequently remark on how knowledgeable and clinically effective I am. Many people have told me I am superior to the psychiatrists they know.

Which unfortunately is not that much of a compliment, so horrible are many of them.

And yes, 20 years ago at a private B and M school, I learned far more from my own efforts.

[Dodongo, APRN, NP]

Yep, it's all because of me. Sorry that I have a family of five to support while my husband is also in school, and kids with college educations coming up, and I actually want to be able to spend time with them. So I won't be throwing away the money I've already invested and taking on more debt and moving to a school that will at minimum require that I quit my job, find independent benefits, and commute who knows how far in order to get the degree I want.

Boohoo. You're right. You should just be handed whatever you want, because, gosh darn it, you want it!

[jboogs49, ADN, BSN, RN]

Boohoo. You're right. You should just be handed whatever you want, because, gosh darn it, you want it!

Well it seems the market has created this situation (poorly designed NP programs). Nothing like this changes overnight, so the OP can wait until the collective nursing/healthcare community gets their act together and create sweeping changes to NP programs. Probably take a few decades if it ever happens. Why would universities want to put in more resources to drive up costs and lower their consumer base for NP programs when the outcomes are adequate and the general public doesn't really care. There would need to be overwhelming forces to drive this type of change and look around do you hear that drive for change coming from anyone but some nurses and doctors not wanting NPs to practice solo. So we can get mad at nurses for going this route but people are just making decisions based on market conditions. Let the cream rise to the top I guess. And I think you are mature enough not to be going boohoo and trying to shame this person. But, you are probably better than the OP and everyone else around you. So I hope you keep moving in a positive direction and helping others in your community as well. Cheers