Way too many NP programs and grads!

[momofm1998]

It seems every school in the USA has opened a NP program. Online, part online, 18 mos, 2 years, bridge type, transition, Carribean and on and on. To them it is good business and thats the bottom line. Quanity not quality seems to be their goal. Just churn them out and collect the tuition. If you have the money - you will have a degree.

And sadly, many students are not particuarly interested in nursing, just a good steady paycheck. A dilution of the market is definitely on the rise. I am not at all surprised that many old MDs are pushing back. These old men of medicine arent concerned about their pay being challenged by these mass produced NPs, their retirement is secure, their money making days are behind them, but are concerned that everything they have worked for is being slowly taken apart by greedy schools and money (not a passion to heal) driven individuals.

America is not as short on healthcare providers as media may report, look at the vast number of posts of people who cant find a job in healthcare. The market will become saturated due to huge numbers of RN's, NPs being cranked out of schools every six months. It is time for schools to return to making certain every graduate reflects well on that school and brings excellence to the field.

If you look at the recent chart of nationwide salaries of NP's, you will see several decreases in salaries across the board. Fifteen states have decreased NPs salaries and one by as much as almost 27%. Shortage? really?? If a shortage exists, dropping salaries is certainly no way to correct it. I personally know of colleagues who have told me their salary as an RN is better than if they invest time, and extraordinary amounts of money to obtain NP status. I know of CCU RN's making five to eight dollars more per hour than NPs in the area.

How long til NPs will go the way my early days of nursing did....agency work, night work, weekends only, just to put food on the table. Oh, wow! thats what I am doing right now! And wth dilution of quality, having to defend my every decision about pt care, and losing the respect of the community.

Mark my words, the nursing bubble is coming.

[Jules A, MSN]

I could not agree more!! I feel they should make all NP's have a DNP for entry level practice.This will help solve many of these issues!!

Yes because the admission criteria for the DNP program is so very rigorous and that Capstone Project thing on HandWashing which replaces actual clinical experiences is crucial to practice.

[RunNP]

The bottom line is that supply and demand will always dictate salary and the availability of jobs. I would like to see every school (for profit and non profit) have stricter qualifiers for admission into the NP program. Maybe if we test the overall nursing knowledge before granting admission it could deter some of the weaker applicants. I saw a thread here where someone turned to an online for profit program because their GPA was very low. What does that say about the overall quality of the online program?

I am not about bashing all online programs, but I think there needs to be a whole lot more scrutiny on these programs and the quality of applicants that they accept.

[orangepink, NP]

IMO some lessons are best learned the hard way. For example, my RN program used to accept anyone as long as they fulfill the pre-requisites UNTIL one incident happened in a local hospital where a patient complained about a student nurse (english was her second language and she could hardly communicate with the patient) so now from what I heard they required all applicants to pass TOEFL at a certain scoring point.

My NP school used to accept just about anyone who has a RN license as well UNTIL lately a lot of the graduates had trouble passing the boards so now they have been doing admission interviews.

Quite frankly all these should have been implemented in the first place but like I said people like to learn the hard way.

[HBrnGirl]

Yes because the admission criteria for the DNP program is so very rigorous and that Capstone Project thing on HandWashing which replaces actual clinical experiences is crucial to practice.

I almost peed my pants reading this. And some people on AN think that NP=MD. Wow!

[angel337, MSN, RN]

Please tell me you are kidding? People really think a DNP is equivalent to a MD?? This is so embarrassing. I know many NP's personally some went to online schools (mostly post MSN) and some went to the highly established brick and mortar with great reputations here in the Chicagoland area. I honestly cannot tell the difference. They all have good positions and had no problem securing a job. They also all have at least 5 years of acute care experience. The general consensus I get is no matter what school you go to you must apply yourself and want to learn. Work ethic and doing well as an NP should start way before you enter a program. Plenty of "A" students out there that could care less about patients and it shows.

[RunNP]

Please tell me you are kidding? People really think a DNP is equivalent to a MD?? This is so embarrassing. I know many NP's personally some went to online schools (mostly post MSN) and some went to the highly established brick and mortar with great reputations here in the Chicagoland area. I honestly cannot tell the difference. They all have good positions and had no problem securing a job. They also all have at least 5 years of acute care experience. The general consensus I get is no matter what school you go to you must apply yourself and want to learn. Work ethic and doing well as an NP should start way before you enter a program. Plenty of "A" students out there that could care less about patients and it shows.

I doubt there is anyone out there who really believes the DNP is equivalent to an MD. I believe the prior post just mentioned the DNP only route to eliminate all the glut of new NPs being pumped out at the moment.

[IsabelK]

I went to a brick and mortar ASN program. Bored in lecture for the most part. Slept through a lot of lecture. I don't learn well with someone yapping at me. I need to read it, takes notes, do hands on. Some people love the lecture and sitting in class. I'm not one of them.

So...fast forward. I did my BSN on-line. I went down for intensives. SUNY Stony Brook has both a brick and mortar program and an online program. Guess what--I did really well. Much better than in my ASN program because I could study when I was at my best. I read the things I needed to. I studied the stuff I was weak in. Graduated with a 3.69, which was better than the 3.18 or so I graduated with from the ASN program. Oh, and I did pass the RN boards after the ASN program on try one with 75 questions. Just for the record.

While I was in the BSN program Stony Brook came back and said, "Hey, wanna stay?" Stay for what? I went on to get the MSN in Adult health through the online program. I did clinical locally, I went down for intensives. I graduated with a 3.58. I worked full time. I did 967 hours of clinical, which was over the 720 hours required by the school. I passed the ANP boards on the first try. I worked full time for two years and then...

BLAMMO went back to school. Did the online DNP program through Loyola University New Orleans. Two years of hell. A lot of money. Graduated with a 3.9. I only found one class to be fluff (cause I'd had it about 6 times before that). I learned how to really read research articles. I learned more about taking that research and applying it in the clinical setting. I learned about the impact of health policy on my role as an NP. I got some great clinical skills cause yeah I had to see people. My Capstone was about educating informal caregivers of dementia patients. I learned how to correlate my data with what was already out there and what the sample needed. And how to take it out into the field. I also learned a hell of a lot about integrated behavioral health (hey, didn't get that in the ASN, BSN, or MSN program). Learned I didn't like the instructor, but the coursework itself was useful. Went for intensives twice, to defend once, and then for graduation. I learned a lot about myself, too, and how I want to practice. Oh, graduated with a 3.9. The one class I got a B in was when my mother-in-law to be was in and out of the hospital and ultimately died.

So...not all online programs are bad. No all brick and mortar schools are good. That said, the entrance requirements are sometimes too lax. I don't like any of the "completion" programs for people who have never worked in nursing. REALLY? You can't be a nurse without putting your hands on people and you can't be an advance practice nurse without having a good grounding as an RN. I'm all for eliminating the crap schools. I'm all for really rigorous interviewing and entrance requirements. I'm also all for good, solid online schools.

[Aromatic]

probably the only way to make stuff more regulated is to add a board exam prior to starting np clinical. at least that will force students to at least be somewhat knowledgably competent prior to see real people. and make the board exam after graduation harder. it was wayyyyy too basic and also had wayyyy too much non clinical stuff on it (which was actually the harder part)

[Jules A, MSN]

probably the only way to make stuff more regulated is to add a board exam prior to starting np clinical. at least that will force students to at least be somewhat knowledgably competent prior to see real people. and make the board exam after graduation harder. it was wayyyyy too basic and also had wayyyy too much non clinical stuff on it (which was actually the harder part)

My preference would still be to have at least 2 years full time experience in the specialty you are attempting to start prescribing in. Although I have repeatedly heard a board exam is an easy method to measure minimal competence, supposedly, they don't impress me. I studied for all of them but found them ridiculously easy and agree loaded with non-clinical fodder that imo only serves to limp along less than competent nurses. I guarantee I could take and pass any of the NP specialties with only a few months and a review book which in no way indicates I'm all that intelligent or would be anywhere near competent to treat.

[Aromatic]

My preference would still be to have at least 2 years full time experience in the specialty you are attempting to start prescribing in. Although I have repeatedly heard a board exam is an easy method to measure minimal competence, supposedly, they don't impress me. I studied for all of them but found them ridiculously easy and agree loaded with non-clinical fodder that imo only serves to limp along less than competent nurses. I guarantee I could take and pass any of the NP specialties with only a few months and a review book which in no way indicates I'm all that intelligent or would be anywhere near competent to treat.

or both, i think they do that in some european counties, the experience part.

[hmatthewcooper]

I can relate to the OPs frustration, but I've met my share of competent/incompetent people in every profession. In the hospital people quickly flock together into "good" and "bad" interdisciplinary groups. It doesn't take long for doctors to figure out who the good nurses are, and for the nurses to figure out who the good people providers are. Often, credentials don't matter at all. Some people get it and others simply don't.

There absolutely is a global shortage of nurses and healthcare providers. The fastest growing segment of the population is people over the age of 65, and they have medical issues. The only reason the NP role exists is to extend the coverage of providers in light of this shortage. I can provide a citation for that if you like. The problem seems to be that the university medical centers where people are getting advanced practice nursing degrees are not the places experiencing provider shortages. I think you have to either relocate or wait for the right opportunity.

As far as the pay, I don't think any of us expected to get rich in nursing. Nursing is an ancient trade and a very young science (profession). One of our main virtues from an employer perspective is the lower cost vs hiring another physician. The NP role was created to fill the gaps where medical school graduates weren't going -mostly primary care.

[Aromatic]

I can relate to the OPs frustration, but I've met my share of competent/incompetent people in every profession. In the hospital people quickly flock together into "good" and "bad" interdisciplinary groups. It doesn't take long for doctors to figure out who the good nurses are, and for the nurses to figure out who the good people providers are. Often, credentials don't matter at all. Some people get it and others simply don't.

There absolutely is a global shortage of nurses and healthcare providers. The fastest growing segment of the population is people over the age of 65, and they have medical issues. The only reason the NP role exists is to extend the coverage of providers in light of this shortage. I can provide a citation for that if you like. The problem seems to be that the university medical centers where people are getting advanced practice nursing degrees are not the places experiencing provider shortages. I think you have to either relocate or wait for the right opportunity.

As far as the pay, I don't think any of us expected to get rich in nursing. Nursing is an ancient trade and a very young science (profession). One of our main virtues from an employer perspective is the lower cost vs hiring another physician. The NP role was created to fill the gaps where medical school graduates weren't going -mostly primary care.

the expense of medical school sorta of forces people to go into specialties. i mean who wants to make 220k as a pcp employed by a hospital while getting dumped on by specialists while they bring in 400+ with (usually) less headache per dollar.

of course the salaries vary greatly, theres plenty of family practice peeps pumping 400k+ in BFE with loan repayment but thats not the norm.

i sure the heck don't plan on doing primary care lol, woulda stayed where i was at for that without a doubt

good explanation though