Something has to change

Guest1144461 · Jul 22, 2022

This is just how it is, I went to a brick-and-mortar school and had to find 50% of mine. Education was meh, I did a residency which worked me to the bone but saved me from disaster. NP school alone would have gotten me eviscerated as a new inpatient provider.

It doesn't matter that your school was venerable or has a medical school. There is almost no correlation other than name between the SON and the other health professions at the same university. Most if not all NPs schools pull this lazy stuff. Easy way to make money since they don't need to cap admissions and put the onus on the students.

The only solution is to raise admission standards and force schools to take less students in order to focus on education.

JKL33 · Jul 26, 2022

On 7/15/2022 at 9:55 AM, CommunityRNBSN said:

Because of how disorganized the clinic is, I am going to be a good 100 hours short this semester. Which means I won't be able to move on to the next class. Which isn't offered the following semester, and it's like dominos, so my graduation is being pushed into 2024. The university is like *shrug* "Yeah, this happens every semester. I dunno."

Which semester is this? Is it just ending or just getting started?

Are you working in addition to grad school?

Is there anything you can think of to add hours?

Sorry for all the questions, it's just that I would go well out of my way to try to get the hours. For example, if working take vacation and spend as much time with the psychiatrist as you can beg him to allow.

**CommunityRNBSN, BSN, RN** · Jul 26, 2022

On 7/22/2022 at 4:54 AM, Numenor said:

that your school was venerable or has a medical school. There is almost no correlation other than name between the SON and the other health professions at the same university.

I know this is a small detail and I'm not sure why I feel the need to correct it, but there isn't a medical or other schools at this university. When I said "doctors and PAs don't have to---" I meant in general, in the world

**CommunityRNBSN, BSN, RN** · Jul 26, 2022

58 minutes ago, JKL33 said:

Which semester is this? Is it just ending or just getting started?

Are you working in addition to grad school?

Is there anything you can think of to add hours?

Sorry for all the questions, it's just that I would go well out of my way to try to get the hours. For example, if working take vacation and spend as much time with the psychiatrist as you can beg him to allow.

It's complicated, but believe me, if there was a way to just add more hours, I'd have already done that! The psychiatrist only works two days a week. I don't work at all at the moment-- I'm mostly a SAHM in the Summer, so I have all the time in the world to get hours and could be there 7 days a week if they'd have me. The arrangement was that I would be primarily with this psychiatrist, with an additional 40 hours with the director of the clinic. So there aren't any more hours I can chase down from the psychiatrist. Anyway, I'm sure that's more detail than you really needed, but I was using this forum to vent. The system is such a mess, and of course I know it's not just my university.

**CommunityRNBSN, BSN, RN** · Jul 26, 2022

On 7/22/2022 at 4:54 AM, Numenor said:

The only solution is to raise admission standards and force schools to take less students in order to focus on education.

Exactly. There should be competitive admissions, and the education for those who get in should be high-quality.

Freckledkorican, MSN, APRN · Jul 28, 2022

On 7/26/2022 at 6:22 PM, CommunityRNBSN said:

Exactly. There should be competitive admissions, and the education for those who get in should be high-quality.

I totally agree with you and @Numenor. I would do a total overhaul of the admissions process and curriculum. I was disappointed while going through my FNP program (a university in D.C.). Too many research classes and not enough hard/clinical sciences. 600 minimum clinical hours = joke; should be 2,000 minimum. Then, a mandatory 1-yr residency. I graduated last year and refused to practice until I go through a residency; starting one with the VA in late September.

JKL33 · Jul 30, 2022

On 7/28/2022 at 11:40 AM, Freckledkorican said:

Too many research classes and not enough hard/clinical sciences.

I suspect they receive heavy feedback about this on exit surveys. This is everyone, state universities and other brick & mortar universities, schools otherwise very highly regarded, not just diploma mills. The universities are behaving like diploma mills with regard to advanced nursing.

It is unconscionable to deliver 3-4 semesters of "translational research" bullcrap while patho and pharm go by like a relative blip on the radar, while heavily selling the idea that we should be advocating for ourselves to be regarded and paid the way physicians are. I joke (uh, sort of) that nursing causes brain damage, and this is an excellent example of why/how.

Al Kalosis · Aug 11, 2022

Your post highlights multiple issues with NP education. While schools placing the impetus of clinical placement on students compounds the issues, it certainly is not the only concern. Programs that neglect to support their students, too, seem to be all too common.

Supposedly in 2019 the CCNE added the requirement that NP programs must find clinical placements for students to be accredited. However, after speaking with a CCNE representative, my understanding is that a NP Program that does not find placements for students may still be accredited (for 10 years!) as long as they agree to document a "plan" to incorporate clinical placements in the future, whatever that means. So...worthless, basically.

Regarding NP rotations vs. MD/PA residencies, I think the major difference is that one is basically grovelling for a place at the table, while the other is mutually beneficial for both parties. My understanding of a residency is that a MD or PA is expected to provide direct patient care within their scope, albeit with guidance and supervision. This is beneficial for the practitioner, who gets to learn while doing, and for the organization, who is able to provide patient care via this (albeit less experienced) provider. By contrast, NP students are placed in rotations in which the provider or organization is basically doing them a favor. There is no incentive for the preceptor to allow the student to participate, to provide direct patient care, to gain the experience they will need upon graduation. The NP student is between a rock and a hard place, having to constantly advocate for themselves to participate, while not wanting to be adversarial or pushy, in order to stay in their preceptor's good graces and complete the rotation with positive feedback.

Not to get too deep in the weeds, but I think part of the problem here is the identity crisis of the nursing profession. Nursing takes pains to avoid following the "medical model," even aspects of the model that work well (such as mutually beneficial residencies). Nope, nursing is different, hooray for us! Since you are in a psych program, you already know that PMHNP residencies are far from common (there are currently 2 or 3 in my entire state), so that's another issue.

Regarding your current predicament, sorry to hear that. How much time is left in the semester? Have you discussed this with your preceptor? Maybe he has some ideas about getting additional hours. Are there any students in your cohort who are done with their rotation? Maybe you could get additional hours through one of those clinical sites. Good luck.