So disappointed with on-line program

Oldmahubbard · Oct 23, 2018

I am an old school NP. I have said many times I took one class a semester, and drove 2 hours each way.

That being said, my program was B and M but not high quality, but I still found after I had some experience, I could compete quite well with most psychiatrists.

The overwhelming majority of NPs I know enjoy working with MDs, and are very happy to refer when the issue is out of their scope.

They have certain strengths. Patient engagement, education and rapport, among several other things.

Jules A, MSN · Oct 23, 2018

You're so right. I should be more edifying. Go to a crappy school, be a crappy provider. Who cares, right? Why require schooling at all? Just study yourself and take the boards. We all know what to study. It's all what you make of it, etc. Silly physicians and their strict standards, and command of the market and salaries. What do they know.

OMG yes, THIS! I'm quite certain I could study for a few months and pass any nursing board exam out there. If they made it a one time deal sink or swim that might actually do some weeding out.

Cococure · Oct 23, 2018

What Representatives should we speak to what administrators of hospitals or healthcare systems could you reach out to voice concerns about new nps workout in experience or going to fully online programs. Even if outcomes aren't crappy compared to MDs we should be shooting for better outcomes than MDs and the foundation for that would be better standardized clinical education and more in depth residency programs. Now these additional costs would raise tuition and lower the amount of nps. With additional costs this must lead to barriers such as needing full reimbursement for all np activities from Medicare, insurances, etc and a path to full practice authority. Maybe 3 to 5 years once pass boards and with a review by nursing board and/or medicine.

MD's are becoming more aware of the lack of a standardized education. I was grilled at my last clinical as I was the only NP among PA/MD students. And yes they were open online education but only partially and needless to say most MD preferred the PA's over NP's ...a personal choice for the office due to failed NP's....from certain big named online for-profit schools. I was also advised that some offices/facilities won't precept or hire fully online programs one reason I opted for a hybrid program. But, needless to say I was questioned whether my program was online or not before I was accepted as a student. I was also told that some facilities are no longer hiring fully online NP program graduates due to incidents/issues that occured with past graduates. A few NP friends of mine was asked blatantly before the interview if they had actual on-campus classes. So, I am sure you can understand why this issue is such a hot topic on this board. I think online education is excellent as long as the school has a good curriculum and accountability like proctored exams etc. Yes you are correct change needs to be done but as long as students keep attending subpar schools they will continue to operate and be made richer for it. Hopefully, sometime soon some governing body somewhere will wake up realize the issue needs to be addressed and steps are taken to correct the problem.

Just my 2cents

Oldmahubbard · Oct 23, 2018

In another profession, there were plenty of foreign languages grads who couldn't order a sandwich in the language, and that was not considered strange

jboogs49, ADN, BSN, RN · Oct 23, 2018

Dodongo has a right to be salty. The NPs from bad schools make us all look bad. Its those ones that drove me to go bak to med school since the watering down of the NP profession killed salaries and legitimacy in my area.
I have no empathy for those juggling 20 different things and going to NP school. If somebody can juggle all that and get a provider license they are either ridiculously intelligent or the schooling is too easy. Somehow I doubt the former.
We have a few single moms in med school who make it, not sure how, they must be supremely dedicated in a way I could not imagine, but having five kids is not an excuse to go to a non legit school. But we are in 2018 where equality overrides truth and everybody gets trophy so I assume I am an awful person for not handing out all the runner up ribbons. Thats OK, i brought my fire pants so toss flames all you want.
And what is with all these RN/BSN people saying NP= physician, I mean what do you guys like google outcomes on NP vs physician studies and think a few studies over basic stuff written by the nursing propaganda party is legit? Its about as legit as those that sell weed and say it cures all sorts of cancer and is the next miracle drug. lmao.
I got truckloads of salt so keep typing people

Just when I thought I was out they pull me back in. Again my main point is if you want to make a change I don't know if being salty and shaming others will get you the results you are looking for. I hope you guys feel validated with every scathing post. This is current market conditions and individuals and institutions within the market will make decisions that will shift the market. I just don't see this major push by the market to standardized np education and add residency programs. And all the saltiness on allnurses isn't gonna move the needle. Now possibly if you guys put some research tiger that shows poor outcomes, reach out to State reps about concerns get s administrators on board and MDs you can get some traction. And I'm all for it. Nurses and the general public will be better off with more clinical training and residency type programs. But what the magnitude of change be relative to increases in cost and reduction of practitioners. I don't know how much of a benefit it would be if nps are gonna be primarily working with patients without complex comorbids in family/urgent care settings. When I go to the minute clinic oh that's great you went through 3 years of residency just stick me with those vaccines and can I pay for these pretzels here or do I have to go upfront. I like my pretzels salty just like my nps on allnurses

[h=1]Bad request![/h]

[h=1]Evidence Brief: The Quality of Care Provided by Advanced Practice Nurses[/h]Ellen McCleery, MPH, Vivian Christensen, PHD, Kimberly Peterson, MS, Linda Humphrey, MD, MPH, and Mark Helfand, MD, MPH, MS.

Oh this is was from the VA I don't know if that is considered nursing propaganda. Its a great read and doesn't just give independent practicing nps a rubber stamp to do whatever. Its all based on outcomes in which for many reasons there have been few studies. Cheers.

JBMmom, MSN, NP · Oct 23, 2018

I stepped back from my own post for a couple days, I appreciate the discussion that has ensued. I don't really put myself in the "I want this because I deserve it, and gosh-darn-it-people-should-like-me" category, although if someone else feels it's accurate that's their perception. My initial post was aimed at my disappointment in a program, and as many pointed out, a very viable option is to change schools and not support the continuation of mediocrity. I don't expect anyone to feel sorry for me because I'm trying to juggle multiple things in life, we all are and I don't expect any special treatment. My end goal requires NP education, and I am confident that I will become a competent APRN because it's important to me, I probably shouldn't have bothered with this thread since I've seen threads in the past bashing NP education so this didn't add much new. I hope that other NP students are finding their programs prepare them well, and for those of us with similar experiences to mine, I hope that either these schools step up their quality of education or maybe their programs end. I'm not going to feel responsible for the downfall of an entire profession, and really I don't think that these challenges are unique to nursing. The advent of on-line education in many fields put universities in a position to get lots of money for very little value. For those that are disappointed in me as a person, someday I'll get over this deep hurt by strangers that know nothing of who I am or how I live my life. Oh wait, I'm over it now.

JBMmom, MSN, NP · Oct 23, 2018

One other point I meant to add. I work with a physician who went to medical school in Granada. I only know because we had a long conversation about school and training after I had known him for a while. It's not tattooed on his forehead nor worn like a scarlet letter. His education path is considered substandard to many, yet he's been a physician for 20+ years and has been quite successful. Did he have the ideal education? No. Has his practice as an MD, and may others that followed similar paths, lead to the downfall of the medical profession? No. Patients aren't dying in droves because their MD studied abroad, or at a lesser respected medical school, are they? If they were I'm pretty sure that study would be out warning patients away. But he and others are competent individuals who did what they could to fulfill career goals. And I've worked with PhDs from Yale and Stanford that couldn't do their job to save their life after their high quality education. We're all eventually going to be judged on our competence and abilities when we practice in our chosen professions, and the judgments of our peers, and patients, that have observed us as practitioners at any level, will be a better testament to success.

Dodongo, APRN, NP · Oct 23, 2018

I stepped back from my own post for a couple days, I appreciate the discussion that has ensued. I don't really put myself in the "I want this because I deserve it, and gosh-darn-it-people-should-like-me" category, although if someone else feels it's accurate that's their perception. My initial post was aimed at my disappointment in a program, and as many pointed out, a very viable option is to change schools and not support the continuation of mediocrity. I don't expect anyone to feel sorry for me because I'm trying to juggle multiple things in life, we all are and I don't expect any special treatment. My end goal requires NP education, and I am confident that I will become a competent APRN because it's important to me, I probably shouldn't have bothered with this thread since I've seen threads in the past bashing NP education so this didn't add much new. I hope that other NP students are finding their programs prepare them well, and for those of us with similar experiences to mine, I hope that either these schools step up their quality of education or maybe their programs end. I'm not going to feel responsible for the downfall of an entire profession, and really I don't think that these challenges are unique to nursing. The advent of on-line education in many fields put universities in a position to get lots of money for very little value. For those that are disappointed in me as a person, someday I'll get over this deep hurt by strangers that know nothing of who I am or how I live my life. Oh wait, I'm over it now.

One other point I meant to add. I work with a physician who went to medical school in Granada. I only know because we had a long conversation about school and training after I had known him for a while. It's not tattooed on his forehead nor worn like a scarlet letter. His education path is considered substandard to many, yet he's been a physician for 20+ years and has been quite successful. Did he have the ideal education? No. Has his practice as an MD, and may others that followed similar paths, lead to the downfall of the medical profession? No. Patients aren't dying in droves because their MD studied abroad, or at a lesser respected medical school, are they? If they were I'm pretty sure that study would be out warning patients away. But he and others are competent individuals who did what they could to fulfill career goals. And I've worked with PhDs from Yale and Stanford that couldn't do their job to save their life after their high quality education. We're all eventually going to be judged on our competence and abilities when we practice in our chosen professions, and the judgments of our peers, and patients, that have observed us as practitioners at any level, will be a better testament to success.

This is a nice sentiment, and on the surface seems to support your views, however, you're failing to mention that even FMGs have to pass the 3 USMLE step exams, complete a US residency, plus pass the specialty board exam. So no matter where you are trained, if you want to work in America as a physician, you have to show competence on one of the most stringent and difficult licensure processes there is. Then, you still have to complete a structured and intensive residency and pass another difficult, long, arduous board exam with written and oral components.

Not the same as someone attending a cr*ppy online NP school then passing a single board exam consisting of 135 questions, and thinking they've learned what they needed to practice independently. *Again* you can't think that despite a poor education, you're going to be a great NP, all because "it's important to you" and you want it just oh-so badly. Make sure you study really hard for your open book, no time limit tests and discussion boards. That'll really cement the material into long term memory. And don't exhaust yourself when completing those 500 clinical hours.

And of course you're not solely responsible for the downfall of the entire profession. But students attending these programs are diluting the NP talent pool, so to speak.

Jules A, MSN · Oct 23, 2018

And of course you're not solely responsible for the downfall of the entire profession. But students attending these programs are diluting the NP talent pool, so to speak.

This is where I have the most concerns. The numbers of NPs who are graduating now is staggering and simply can't be compared to the minimal percentage of physicians who attended what might be considered a 2nd rate medical school. Nursing is so eager to increase their numbers to "get a seat at the table" they don't seem to realize we are embarrassing ourselves.

allnurses Guide · Oct 23, 2018

My end goal requires NP education, and I am confident that I will become a competent APRN because it's important to me,

If you are disappointed in a subpar quality program, and being a competent APRN is important to you, then you should change to a quality program where you will get a good education as a foundation of your practice. Competence and quality as an entry NP comes from your graduate education and your graduate clinical experience, with perhaps some small components of your prior experiences. As a novice NP, it comes from your clinical mentors and strength of your employer's training program.

You won't automatically be a great NP just because it is important to you, even with extensive amounts of self-directed study. You need a fund of knowledge matched to clinical experience as a provider.

allnurses Guide · Oct 23, 2018

And what is with all these RN/BSN people saying NP= physician, I mean what do you guys like google outcomes on NP vs physician studies and think a few studies over basic stuff written by the nursing propaganda party is legit? Its about as legit as those that sell weed and say it cures all sorts of cancer and is the next miracle drug. lmao.

The studies don't say NP=MD/DO. They do show that on many quality indicators, and in a variety of settings, there is no significant difference in the quality of care. These include major landmark studies by multidisciplinary research teams published in journals like JAMA, the Annals, BMJ, Lancet, NEJM, etc.

In fact, rather than the nursing propaganda party googling basic stuff, why don't you cite some major peer-reviewed studies which show physicians have better outcomes?

I am not arguing that NP is equivalent to MD/DO, especially in regards to education and formal training. Outcomes are a completely different issue, and have been studied in depth for almost 50 years. To outright deny the existence of (or attribute to the "nursing propaganda party") a considerable body of research that shows the care provided by NPs is on-par with that of their physician colleagues is laughable. If the argument is in regards to the validity of those studies, then that is up for debate, but you can't deny that the data exists because it does, it has since the late 1970s, both domestically and abroad.

jboogs49, ADN, BSN, RN · Oct 23, 2018

And of course you're not solely responsible for the downfall of the entire profession. But students attending these programs are diluting the NP talent pool, so to speak.

I understand the frustration and the passion. We all want the nursing profession to continue to advance and the current conditions of NP education is not allowing this growth to happen. If nurses want to be a more integral aspect to primary care and delivering excellent health care to everyone in this country a more robust credentialing and rigorous standard education would be awesome and would help those efforts.

Now do I see this happening in the near future. Probably not. What I've seen is a push for DNP being the standard NPs to practice because the Doctoral level of education would raise our credibility. I'm a Doctor of Nursing and I'm on the same level of a MD just the medical community wants to hold us down but I'm just as good mentality. The problem with this push is it doesn't even address the real issue of NP education, credentialing, clinical hours, etc. But, the drive for DNP has more traction than the education/residency overhaul and the DNP push won't happen anytime soon if ever. I think its been a thing for over a decade. But not as long as making BSN as the entry level for RNs (that got shot down so many times)

So as the NPs on allnurses look to express their truth regarding working as an NP and the overall direction of the NP profession I understand why there is a drive to attack those in sub par programs (you feel that if you can stop people from going to these programs you can save the profession). I wonder has it occurred to everyone that Allnurses seems to advertise many online nursing programs and NP programs. But, it is an interesting dynamic. Come to a website that generates ad revenue from schools providing online NP programs which generates leads that schools convert to student enrollment to yell at people who are going into online/sub par NP programs in hopes to save that profession from students enrolling in online NP programs .

However I try look to learn from every opportunity no matter how peculiar the circumstances so are there any great programs for NP. You can give bullet points to look for or refer to your own or colleagues experiences. And if their aren't any excellent programs what would an excellent program look like if you could snap your fingers and create one (curriculum/clinical hours).

And I would disagree with a few folks regarding the OP. I don't know the person but what I know about life passion/want for greatness is a prerequisite for greatness to occur. Greatness won't be inevitable, but passion for it is a prerequisite which is typically followed by working harder/smarter than the majority. Very seldom are people great at a profession without a desire to be great in that profession. Now if all of the NP programs had that desire for greatness we would have nothing to chat about. Cheers.