Standardization of NP Education

[RN-dancer]

Hello All,

I'm probably going to get alot of backlash from this but what can I say. I live life on the edge. These are my thoughts on the subject.

Firstly, as I browse on Allnurses occasionally, I see alot of hate towards NPs with no bedside experience. Despite being a nurse and a NP as completely different roles, several reviewers see this experience as mandatory. I can see how one can say that nursing experience can help you anticipate what to order and certain conditions but it's not an all-in-all experience to fall back on. Furthermore PAs, MDs, DO, hell even other allied health jobs don't absolutely require bedside care in order to be accepted into these programs so why be in a tizzy about NP school. I feel like is a personal matter. This notion also confirms that nurses dont even agree with the preparation that current NP schools provided.

With that being said, this requirement is at the discretion at the school but I wish there was just a straight-black-and-white standard of admission requirements so this argument can dissolve.

Secondly, even some brick-and-mortar NP schools have students find their own preceptor which is ludicrous and insulting. I'm paying money for experience that I have to seek out myself ... does not make sense. I can't name any other healthcare profession that does this. I'm sure someone will rebutle this but that's a 1%. NP schools should supply their own preceptors despite being online or on campus.

Thirdly, raising the minimum clinical hours from a mere 500 to 1000+ will add more respect to clinical aspect of NP schooling and also give the student adequate time of exposure to practice in their the new role.

NP/DNP curriculum needs dramatic reforming. The 3 P's are great. But what else can we add gross anatomy? Cadavers? I want to know what you guys think on this subject matter.

I have also seen hundreds of posts on how the DNP has no clinical significance to the profession. Disclaimer *I do not have my DNP* but I will say is after looking at numerous MSN-DNP programs all the classes are just repeat masters graduate classes with varying names per campuses. I understand the doctorate is a scholarly degree but even the clinical doctorate has a bunch of "fluff". I really appreciate the new PA doctorate curriculum as it is definitely focused on scholarly aspects of improving speciality. So my question to DNP students and graduates, what would you change about the DNP program?

What will become of NP education and what are nurse educators and NPs going to do to advocate for these changes? I'd love to hear reccomendations.

[BostonFNP, APRN]

No doubt PA students are better prepared for their clinicals. Mainly because the first few classes in the NP curriculum are sheer nonsense courses, Nursing theory and Issues in Health Care, or whatever that nonsense was called. None of which teaches you a thing about being an NP.

Then, all of a sudden, you are expected to arrange your own clinical. Clinical? you say. What is that? I have been studying energy fields and health care controversies.

The coursework for the most part seems disconnected and random. This is not your imagination.

Major changes are needed, but the people who are currently teaching "energy fields" are not qualified to teach the appropriate content.

And qualified people would have to be paid double what the current "professors" are paid.

FWIW Program I work with doesn't start with those. Probably highlights the inconsistency.

[Oldmahubbard]

FWIW Program I work with doesn't start with those. Probably highlights the inconsistency.

My program from 20 years ago. But are similar classes still required?

[BostonFNP, APRN]

My program from 20 years ago. But are similar classes still required?

Lets just say there is no "new" nursing theory. There is still the classic "fluff" that hasn't changed in the past 50 years.

First semester students take advanced patho 1, advanced pharm 1, advanced health assessment, and primary care 1.

[Dodongo, APRN, NP]

I have very little surgical experience and surgery certainly is a PA-dominated specialty. I do find it strange that any amount of didactic intensity would better prepare a student for specialties that are primary dependent on technical skills. Here I would think that those NP students with RNFA experience would be leaps ahead of any other students, save for surgical techs perhaps. Again I know very little about major surgery. You would say that PAs of the same experience level are more competent than you at this point?

There are still a couple problems with RNFA trained NPs (of which, I am one). We don't get any graduate level or gross anatomy education. So I had to do a WHOLE LOT of extra studying in anatomy. Because the surgeons expect you to have their level of knowledge when it comes to anatomy. The PA students absolutely blow away NP students in this area. AND, their use of even basic medical terminology is lacking. It's pulling teeth to get NP students to use words like, rostral, caudal, inferior, posterior, distal, proximal. The second problem is that most NP students do not have any RNFA training - so they don't go in the OR. They come to rotate with us, but only on rounds or to see patients on the floor throughout the day. And they can only shadow a few hours in the OR. This severely limits their understanding of the management of these surgical patients and their interactions with the patients because they can't even articulate what they had done from a procedural standpoint. I will admit that RNFA students know the OR itself much much more than PA students. Workflow, sterile technique, instrumentation, etc. But that actual contributes very little to participating as a provider in the OR. These things can be learned fairly quickly.

Now, to your last question. No. Multiple years out PAs and NPs are equivalent, but NPs have to over come their poor training. Straight out the gate NPs have a more difficult time by far in a surgical specialty. From what I've seen.

[Jules A, MSN]

Now, to your last question. No. Multiple years out PAs and NPs are equivalent, but NPs have to over come their poor training. Straight out the gate NPs have a more difficult time by far in a surgical specialty. From what I've seen.

I see this in psych with the NPs who have zero psych experience and the gap does often lessen over the years however the big issue is regardless of where everyone ends up the early years, initial encounters form lasting impressions on our physician colleagues and give NPs a bad name.

I will never understand why it isn't expected that we are able to practice to the full extent of our scope upon board certification. Not that a newly licensed provider can be expected to function at the same level as someone with years of experience but we should be able to work with a minimal orientation. In my specialty that is very rare in recent years with the exception of NPs who had solid inpatient psych RN experience.

[Jules A, MSN]

Lets just say there is no "new" nursing theory. There is still the classic "fluff" that hasn't changed in the past 50 years.

.

Loved this, it is so true and that is a big part of the problem added to the population health, public health, community health, underserved health...how many names can they give the same course and how many times from BSN to DNP should one be forced to rehash it?

[BostonFNP, APRN]

Loved this, it is so true and that is a big part of the problem added to the population health, public health, community health, underserved health...how many names can they give the same course and how many times from BSN to DNP should one be forced to rehash it?

That's the real "advanced" part of APN not that you have RN experience, you've had advanced nursing theory.

[Jules A, MSN]

That's the real "advanced" part of APN not that you have RN experience, you've had advanced nursing theory.

Well then I need to add a few more alphabets to the soup behind my name. At this point I'm a AAAPN. Between master's, post master's and doctorate I have wasted serious time and money on that silliness.

[BostonFNP, APRN]

Well then I need to add a few more alphabets to the soup behind my name. At this point I'm a AAAPN. Between master's, post master's and doctorate I have wasted serious time and money on that silliness.

DNT degree is the next big thing.

[Jules A, MSN]

DNT degree is the next big thing.

Please tell me you are kidding and if not what is it and where do I sign up? Despite accepting the fact that a smile and hair flip will no longer get me out of a speeding ticket it is clear my ego can't take not having the latest and greatest whatever that all the brand spanking new 25 year old NPs have. At least I can pay cash so no six figure student loan debt for me, lol.

[Oldmahubbard]

Advanced nursing practice = doing what doctors no longer deign to do in underserved populations, for 2/3 the pay, if you are very lucky.

[broughden]

It really seems that requiring a year long residency post graduation in your chosen field of practice (ED, primary care, OR, etc) would solve a lot of the problems fairly quickly.

For example, I was told by my provider that Mayo Clinic was no longer accepting student NP's from certain online/DE programs for preceptorship due to repeated past poor performance of other students from those programs.

If year long residencies became standard and you couldnt get into one due to having graduated from EZ University's NP program, people would quickly stop attending EZ NP's program and it would be shut down.

Otherwise I agree with Myelin:

I wrote a large reply but honestly I think it boils down to this: nurses want crappy/easy schools. We do. We want convenience, cheap, online, etc. We as a field have a huge problem and until this mentality changes NP schools have 0 incentive to make this change.

There are unfortunately a lot of nurses who graduated from questionable undergraduate programs and going forward with the same mentality into advanced practice. The sheer number of for profit RN schools that will accept students of questionable academic standing as long as they are able to pay the outrageous tuition prices, attests to this.

There are NUMEROUS threads on All Nurses from these failing students, who then manage to find positions in for profit schools, that attest to this.