There has been a lot of criticism and heckling of APRN education in this forum. This is an essay to inspire people with opinions to take constructive action
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To the APRN hecklers, critics and malcontents.Many of you say that your MSN nursing education has too much "fluff", referring to classes like cultural competency, and management that have no relevance to your jobs. I have read very little about how you will address this with the people that accredit NP curriculums.
I am not sure of the credentialing process at all but I did find the American Association of Colleges of Nursing on the web and this seems like a place to start. In 2013 they developed NP competencies in which we are all expected to be proficient.
These competencies expect cultural competency, trauma informed care, as well as all the things you complain there is not enough of such as pathophysiology, pharmacology, physical assessment. I have been in nursing since the early 80's and have been through a few transitions in health care and in my own nursing career. Now I just try to keep up. I have no venom to toss at nursing leaders. I am very grateful to the nursing profession for my livelihood. I work locum tenens as a psychiatric APRN. My advanced practice nursing skills allow me to find work in interesting settings on a limited basis. This semi nomadic lifestyle is mine by choice. Everyone wants to hire me permanently.
The APRN role exists because of the dedication of nursing professionals with advanced degrees who have done the hard political work of fighting for the opportunity for all of us to practice to the full extent of our education. This means that our education prepares us to diagnose and treat illnesses in our respective specialties. We have a record of patient outcomes similar or better than MD's. We are not MD's and we are not junior MD's, we are nurses. If we were MD's we would be regulated by Boards of Medicine, physician extenders of some sort. As nurses, regulated by Boards of Nursing, we are eligible in many states for independent practice. There is an overlap between MD's and NP's and this is where a lot of NP's and MD's practice: Seeing patients one at a time in inpatient or outpatient settings. Since we are doing the same job as MD's in many cases we do need to catch up on their rich science background and the intense mentoring they get in residency.
Or we can wonder how much education do we or they really need to do this job? We probably do not need nursing theory at this stage of our development as a profession though I did like my theory classes. We probably do not need healthcare management classes though I learned in those classes also. In today's day to day NP jobs we need to keep our diagnostic and prescribing skills sharp to give patients the best care that we can. We often have MD role models and some are surprised we are doing the same jobs as them and many are happy to consult on cases and make use of their intense education. To my colleagues who are angry with the nursing profession that benefits you, I would encourage you to review the history of nursing (we were housecleaners one hundred years ago), and as science developed nurses had to fight the AMA to be professionals as opposed to handmaidens or servants.
At one time only an MD could take a blood pressure. Now we are fighting for the right to practice to the full extent of our education. We are nurses and we need to continue to define ourselves differently from physicians. That we are different from the medical profession has benefited us politically and gives us the responsibility to self-regulate our profession.The people with the energy and aptitude to criticize should learn to become political. Start by looking up the website I note above and figure out how to have input into curriculum development. You might have to join a committee. This is how hard work often starts. As in today's general politics it is possible the nursing leadership is losing touch with its base.
Those who see what needs to be done would benefit all of us by becoming active and help to maintain and improve standards and influence the direction of the nursing profession.Best wishes.
