Stop the preceptor madness!

Aromatic · Feb 4, 2017

I literally have no idea what this myoglobin person is ranting about. Usually trail off around the 3rd or 4th line, but I did read one of the posts and it was enough to make me not want to read the others. lol when people wanting to go to NP school start throwing out the "NP are better than MD" argument in all aspects of care type garbage.

Its like cmon man, you aint even started, your opinion is worth as much as a fleck of turd on the wall. At least if your gonna type non-sense do it in a readable version so we can properly pick your posts apart like bostonfnp has.

myoglobin, ASN, BSN, MSN · Feb 4, 2017

There have been numerous studies that compare outcomes of NP's verses MD in terms of primary care outcomes. Virtually all have shown equivalent or superior outcomes for NP's. At the same time the standards for becoming an NP have both increased and become standardized. My point is that available evidence shows the current system to be working. Nurses being able to advance their education is a cause for celebration not denigration. Also my significant other is practicing and I am in school. However, I didn't realize that only those actively practicing had opinions worthy of consideration.

allnurses Guide · Feb 4, 2017

There have been numerous studies that compare outcomes of NP's verses MD in terms of primary care outcomes.

All those outcomes studies were done prior to the exponential influx of student NPs looking for the cheapest/fastest/easiest path to mediocrity.

It really does aggravate me, that not only to I go above and beyond to push myself in clinical practice, but to also push my students in clinic and the classroom to take the best possible care of patients while there are students out there doing the bare minimum to be adequate.

elkpark · Feb 5, 2017

At the same time the standards for becoming an NP have both increased and become standardized.

I still don't see where you're getting this "standards ... have both increased and become standardized." Please provide some actual evidence or documentation, other than your opinion, that it has become harder to become an NP than it was 20, 25, years ago. Those of us who have actually been in nursing, and advanced practice nurses, for many years can assure you (as we already have, but I guess you know better) that the standards have dropped significantly, thanks to the proliferation of low-quality schools that make it possible for anyone who wants to, regardless of their aptitude or potential (even those who aspire only to being mediocre :rolleyes: ), to get into nursing graduate school. Ditto with standardization. Those of us who are actually living and functioning in Advanced Practice World know that "standardization" of nursing graduate school curricula has largely meant standardization to a uniformly low level. There are still strong, great programs out there, but people have to know to go looking for them (and know what they're looking for). Schools are, like any other business, responsive to the needs of their "customers" (students), and the large majority of aspiring nursing students seem to be primarily interested in finding the easiest, most convenient program possible -- so many schools, unfortunately, are supplying that.

Completing a nursing graduate degree used to really mean something. Now, it's on its way to becoming sort of a joke. Certainly nothing special or remarkable. And, has already been noted, the studies showing the strong positive outcomes for NPs were conducted on the "old school" NP population -- it remains to be seen what the results of similar studies would be once advanced practice nursing is flooded with the "I mailed in enough box tops and got a degree" crowd.

Aromatic · Feb 5, 2017

You cast Banish- it was very effective. AAC disappears into the woods

A wild troll has appeared out of the woods, it appears AAC has mutated into a longer winded and slightly more understandable form

Myoglobin casts ignorance, it wasnt very effective.

You cast Logic, it wasnt very effective. Myoglobin seems to have full resistance to this

you retreat into the woods.

gotta catch em all.

I mean obviously if you are 100k in debt for an undergraduate nursing degree you arent very apt for taking advice from others, but honestly it just shows your monetary and financial knowledge is probably not very strong either.

Hey what do I care though, take on more debt from some sucky online for profit and go bankrupt, its not my problem. Keep drinking the coolaid and suffer the consequences and repurcussions. You aint gettin none of ma cownbread.

dude, myoglobin, I tell you what. Once you get done with NP school see if you can stand on par with a newly minted family practice physician. NPs are great, but the newer ones, new as in recent graduate without much experience, on average, cannot handle nearly as much as a family practice physician can without having to refer the patient out. The older NPs, for the most part, are pretty wicked and can handle much of anything, but that was before degree saturation and back when programs actually had admissions criteria and required previous nursing experience.

You just do not know what you do not know, especially when you say standards have increased. I mean, cmon we stopped taking you serious 12 novel long posts ago. Especially when you want to be just average.

myoglobin, ASN, BSN, MSN · Feb 5, 2017

I am surprised that you are not acquainted with the Consensus Model for APRN regulation endorsed by the NCSBN board in 2008 which can be found at www.ncsb.org or The Essentials of Master's Education in Nursing 2011 at American Association of Critical-Care Nurses - AACN. These and other documents essentially spell out which courses and clinical elements must be met in order for someone who graduates from a master's level or DNP program to sit for certification. Of course individual state standards of practice differ and can be found at medscape.com/viewarticle/440315 . I didn't say that things were more "difficult" now only that they are largely standardized with regard to education, courses, clinical hours, and certifications that must be maintained for practice. What specific regulatory changes do all of the critics here propose and what mechanism would you suggest for their implementation? Any such changes are likely to take years to implement. Even if I agreed with you that changes were necessary and beneficial there are still many of us in the "here and now" working hard to acquire our degrees and we are endeavoring to find preceptors in order to fulfill that requirement. This website is one "tool" for possibly locating a preceptor and thus it shouldn't surprise or offend anyone that motivated individuals will utilize it as one aspect in their search. Even if my school (The University of Southern Indiana) and others like it decided to start assisting out of state students in finding preceptors they would essentially have to "cold call" potential preceptors in my area and thus would be doing essentially the same thing that I will be doing. At least under the current paradigm many students already know doctors or NP's who might make excellent preceptors from personal experience.

You are welcome to degrade our efforts to advance our education as "a joke", but we will never the less continue. When in ten years with God's grace I have implemented my 24/7, low cost, psychiatric medication tele- medicine management service (deployed over the many states with independent practice) employing dozens of providers from the convenience of their homes and also facilitating numerous clinical opportunities to future students, perhaps I will offer to invite you to my small Kauai abode where we can debate over a cup of tea and some poi the relative merits of our differing perspectives. By that time my fellow "mediocre" clinicians will no doubt be employing the latest Watson like AI expert systems (such as is currently being employed at Memorial Sloan Kettering in oncology) to offer individualized, genetically personalized medication management superior to what only the wealthiest clients currently enjoy and at a fraction of the price paid today by even the economically challenged.

Today, we live in a world where you can obtain an excellent education via free modalities such as Khanacademy.org or MIT OpenCourseWare or via the many high quality, low cost online schools of nursing such as the one I am blessed to attend. Never in the history of the world have so many lamented the presence of such intellectual opportunities for advancement.

Jules A, MSN · Feb 6, 2017

When in ten years with God's grace I have implemented my 24/7, low cost, psychiatric medication tele- medicine management service (deployed over the many states with independent practice) employing dozens of providers from the convenience of their homes and also facilitating numerous clinical opportunities to future students, perhaps I will offer to invite you to my small Kauai abode where we can debate over a cup of tea and some poi the relative merits of our differing perspectives. .

I think you forgot to add "if my girlfriend ever lets me move there". :)

As I mentioned before the schools are doing their own thing when it comes to what they require despite all the well laid ground work. Its like anyone who has been through a Jcaho inspection knows its all about polishing the turd.

myoglobin, ASN, BSN, MSN · Feb 6, 2017

So all of you say, but where is your evidence? If you have specific allegations against specific institutions or individuals them make them preferably with the appropriate authorities in the relevant jurisdictions. However, making broad-based statements against a huge swath of institutions is wrong. What specific legislative or administrative changes do you propose and what mechanism do you posit for their implementation? By and large the people here looking for preceptors are real people making huge sacrifices of their time and money to further their careers and education. When you denigrate them I assert that you are no better than the oppressors who litter nursing history with their dormitory housing of nurses who had to forswear relationships and family serving only the needs of their employers. Today, nurses have abundant opportunities to advance their careers and become clinicians who are in many places helping to bridge the access gap for patients in under-served population. Schools (whether for profit or otherwise) that go through the process of becoming accredited are a huge part of these opportunities. If you don't like the rules then lobby to change them (understanding that folks like myself will be opposing you at every step of the way with legislators and regulators), but don't just complain about people trying to improve their lives. You will also find yourself aligned with physician groups such as the AMA which has opposed greater independence for nurse practitioners at every step of the way. The rest of us will focus on making our own lives personally, and America in general greater thanks to the opportunities afforded by the abundant liberty we enjoy.

elkpark · Feb 6, 2017

So all of you say, but where is your evidence? If you have specific allegations against specific institutions or individuals them make them preferably with the appropriate authorities in the relevant jurisdictions. However, making broad-based statements against a huge swath of institutions is wrong. What specific legislative or administrative changes do you propose and what mechanism do you posit for their implementation? By and large the people here looking for preceptors are real people making huge sacrifices of their time and money to further their careers and education. When you denigrate them I assert that you are no better than the oppressors who litter nursing history with their dormitory housing of nurses who had to forswear relationships and family serving only the needs of their employers. Today, nurses have abundant opportunities to advance their careers and become clinicians who are in many places helping to bridge the access gap for patients in under-served population. Schools (whether for profit or otherwise) that go through the process of becoming accredited are a huge part of these opportunities. If you don't like the rules then lobby to change them (understanding that folks like myself will be opposing you at every step of the way with legislators and regulators), but don't just complain about people trying to improve their lives. You will also find yourself aligned with physician groups such as the AMA which has opposed greater independence for nurse practitioners at every step of the way. The rest of us will focus on making our own lives personally, and America in general greater thanks to the opportunities afforded by the abundant liberty we enjoy.

Y'know, using a lot of big, fancy words and unnecessarily complicated sentences just for the sake of using big, fancy words and unnecessarily complicated sentences doesn't make you sound smarter. Just pretentious.

I would propose that those of us who lament the general watering-down of nursing education, at both the pre-licensure and graduate levels, are not nearly as much of a threat to the future of advanced nursing as the hordes of nurses (or would-be nurses) who, like yourself, are openly interested only in the easiest, most convenient path to what you perceive as a cushier job, not some personal pursuit of excellence (or even more than minimal competence).

I can't speak for anyone else here, but I am not wasting time lobbying for higher standards, or to have nursing accreditation go back to actually meaning something, because the larger nursing community has obviously sold out and no longer has any interest in excellence -- it's about cranking out the largest number of people in the shortest amount of time, with the minimum acceptable standards and preparation. As Jules notes, it's mostly about "polishing the turd." At this point in my career, I'm just gritting my teeth and hoping to hang on until I can retire.

I do find it ironic that the point in history in which there is more clamor than ever for greater independence for nurse practitioners is the same general period in which the market is being flooded with minimally-prepared practitioners, and the people often making the loudest arguments are the people, like yourself, who are also open about how they are only interested in taking "the path of least resistance" to licensure, rather than seeking out a strong, rigorous program that cares about what kind of clinical supervision and education they get and turns out excellent graduates.

But don't worry -- your "side" is obviously winning on this issue. Mediocrity will carry the day. I fail to see how that "makes America in general greater," though.

Jules A, MSN · Feb 6, 2017

I can't speak for anyone else here, but I am not wasting time lobbying for higher standards, or to have nursing accreditation go back to actually meaning something, because the larger nursing community has obviously sold out and no longer has any interest in excellence -- it's about cranking out the largest number of people in the shortest amount of time, with the minimum acceptable standards and preparation. As Jules notes, it's mostly about "polishing the turd." At this point in my career, I'm just gritting my teeth and hoping to hang on until I can retire.
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I'm also weary and have in fact spoken with two Deans and an associate Dean who I know at 3 local universities and bent the ear of every faculty member I cross paths with, trust me they are sick of hearing me rant. I have contacted the ANA, CCNE, NONPF with absolutely no results. In fact one of the mentioned organizations actually said these decisions are better made by the schools themselves, roflmao. My state's board of nursing is of no help and recently said they don't get involved in scope of practice issues, WTH? I'm also active in the District's NP organization which is a powerful entity however the majority of them are also older, not as interested in the next 30 years of outcomes, and largely scrambling to get their DNP at 60 years old so's as to not get bested by the youngins. Sad state of affairs all round.

What I'd also like to offer to Myoglobin although my financial advice isn't worth anything more than my career advice is to trade out the time spent poking-off on message boards and pick up an extra shift or two which would significantly reduce the impressive debt he's got going on. I'm surprised girlfriend isn't all over that nonproductive activity.

allnurses Guide · Feb 6, 2017

But don't worry -- your "side" is obviously winning on this issue. Mediocrity will carry the day. I fail to see how that "makes America in general greater," though.

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myoglobin, ASN, BSN, MSN · Feb 6, 2017

Being mediocre and is nothing to be ashamed of by definition most if us are. The only difference is that I am honest enough to admit it and refuse to make myself miserable in the pursuit of some unobtainable standard. I always do my best, but my best is at best mediocre. The program I attend is considered one of the better national programs around. Basically I seek to deemphasize competition and focus instead on the unique, wonderful contributions we can all make in our own way. As nurses for some that may be in how we advocate or make patients feel cared for and for others it may be pathophysiological knowledge or IV skills. We all have great things to offer and shouldn't be characterized as lacking just because overall we may be average. Personally I'm trying to enter a field where my lack of clinical skills such as being able to start IV's will be less of a liability thereby hopefully making me slightly less mediocre.