We Must Demolish NP Diploma Mills

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What is AANP doing with those programs??? I think we should unite to take an action on such diploma mills.

Specializes in Psychiatry.

I've never understood the "well normal school doesn't fit into my life schedule" defense for diploma mills. A few points:

  • Flexibility is not only available at diploma mills. Yes, they tend to be more flexible but there are part-time and online options even at reputable schools that DO screen applicants and ensure students receive high quality education.
  • The point of NP school is not to provide a "flexible" education to anyone who wants it. Corners should not be cut on providing a quality, hands-on education for the sake of flexibility. When facing a patient in urgent care with a massive gash, it's not fair to respond "Well I don't actually know how to do sutures because I had to go to a school that allowed me continue working full-time and taking care of my kids." The public expects physicians to work for peanuts 80 hours a week in residency to ensure they are competent but it's too much to ask that a nurse drop to part-time so they can learn how to actually perform the skills that should be basic entry level competencies?
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Specializes in ACNP-BC, Adult Critical Care, Cardiology.
14 hours ago, RN/WI said:

NP programs do have Advanced Pathophysiology, as well as Advanced Pharmacology. These build on undergraduate courses. Does anyone know of Advance Practice degrees that do not require these courses?

 

I think everyone knows that. My point was and this is my opinion, someone who took undergrad science courses, even A/P, must be retaken if they were 20 years old to enter advanced courses in the NP Program which are frankly in and of itself another issue.

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13 minutes ago, MentalKlarity said:

I've never understood the "well normal school doesn't fit into my life schedule" defense for diploma mills. A few points:

  • Flexibility is not only available at diploma mills. Yes, they tend to be more flexible but there are part-time and online options even at reputable schools that DO screen applicants and ensure students receive high quality education.
  • The point of NP school is not to provide a "flexible" education to anyone who wants it. Corners should not be cut on providing a quality, hands-on education for the sake of flexibility. When facing a patient in urgent care with a massive gash, it's not fair to respond "Well I don't actually know how to do sutures because I had to go to a school that allowed me continue working full-time and taking care of my kids." The public expects physicians to work for peanuts 80 hours a week in residency to ensure they are competent but it's too much to ask that a nurse drop to part-time so they can learn how to actually perform the skills that should be basic entry level competencies?

To be fair, few schools are actively teaching things like suturing to NPs regardless of the focus outside maybe acute care or ENP (that may even be a stretch). The type of suture you would use for type of wound will never be on an FNP board.  In primary care we rarely see it and if you go into an area like urgent care, it would be smart to get that in a hands on Cme for sure. My school taught it in person using cow tongues, but I would hardly consider myself competent and would get additional education if I felt I needed to use it more. 

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Specializes in ACNP-BC, Adult Critical Care, Cardiology.
14 hours ago, JKL33 said:

Not sure if this has been discussed yet on this topic, but another concerning practice is bare minimum instruction and bare minimum program standards combined with the exit exam. I'm not saying exit exams don't make sense on some level, but they have become the safety net (for schools) that enables them to get by with bare minimum instruction while preserving their first time board pass rates.

I totally agree. I precept ACNP students. Even in reputable institutions that arrange preceptors, I find it inadequate when students in Acute Care programs are only showing up to clinicals 12-hr shifts here and there. I know it can be a big sacrifice working as a nurse with a full time job to make time for clinicals but for the experience to be beneficial, the student must be there everyday 3 days in a row if it's 12-hr shifts or 4 days in a row if 10-hr shifts.

That's where they will experience admitting their own patients, collaborating with the NP preceptor to manage the patients' day to day issues, and hopefully getting them tee'd up for discharge and learning that process as well. To me, it's just not the question of the 500 hours of clinicals is too short, sure you can increase that to 1000 but the structure of how clinicals are done must also be looked into. Quantity and quality go together.

I know it sounds like I'm going for a total overhaul of how NP programs are done here but I'm shooting for ideal. I've seen new NP's show up not knowing what elements are needed in an admission order, takes hours to write that admission H&P, and have no time left to even put things together on how to manage that patient.

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Specializes in Psychiatry.
11 minutes ago, djmatte said:

To be fair, few schools are actively teaching things like suturing to NPs regardless of the focus outside maybe acute care or ENP (that may even be a stretch). In primary care we rarely see it and if you go into an area like urgent care, it would be smart to get that in a hands on Cme for sure. My school taught it in person using cow tongues, but I would hardly consider myself competent and would get additional education if I felt I needed to use it more. 

It's falling away because it is not the standard, but it should be. My advanced health assessment course included:

  • breast exams on models (actors) with skills check offs
  • prostate exams on models with skill check off
  • suturing on pigs feet, cow tongues, and "fake" skin kits with skills check offs for each different type of suture, as well as a required skills check off in practice
  • pap smears on fake patients, real model patients, and finally X number completed during clinical for check off

This is just the start. Reputable schools do exist and they do a good job ensuring they graduate competent providers who can hit the ground running and have at least a passing familiarity with hands-on skills. I have known more than one bedside RN who went to a diploma mill/for-profit and they had NO in person intensive skill sessions, did health assessment check offs by filming a video. It's not possible to tell if someone is palpating the lymph nodes or finding the thyroid etc from a video. The vast majority of grades came from discussion board postings and papers. And clinicals required no in person check off so they were was no verification they were even seeing patients versus answering phones in the front office while the doc signs off on hours.

We could go around for days, but it is very clear: the diploma mill schools are NOT doing enough because they don't need to. I'm very hopeful that a tougher Dept of Education (no longer run by someone who actually runs for-profit schools) will start cutting off federal loans for some of these schools and choke them out of existence.

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4 minutes ago, MentalKlarity said:

It's falling away because it is not the standard, but it should be. My advanced health assessment course included:

  • breast exams on models (actors) with skills check offs
  • prostate exams on models with skill check off
  • suturing on pigs feet, cow tongues, and "fake" skin kits with skills check offs for each different type of suture, as well as a required skills check off in practice
  • pap smears on fake patients, real model patients, and finally X number completed during clinical for check off

This is just the start. Reputable schools do exist and they do a good job ensuring they graduate competent providers who can hit the ground running and have at least a passing familiarity with hands-on skills. I have known more than one bedside RN who went to a diploma mill/for-profit and they had NO in person intensive skill sessions, did health assessment check offs by filming a video. It's not possible to tell if someone is palpating the lymph nodes or finding the thyroid etc from a video. The vast majority of grades came from discussion board postings and papers. And clinicals required no in person check off so they were was no verification they were even seeing patients versus answering phones in the front office while the doc signs off on hours.

We could go around for days, but it is very clear: the diploma mill schools are NOT doing enough because they don't need to. I'm very hopeful that a tougher Dept of Education (no longer run by someone who actually runs for-profit schools) will start cutting off federal loans for some of these schools and choke them out of existence.

I completely agree. I advocate just as hard because as a whole I feel my school (Frontier) went and goes above and beyond before anyone was expected to. But the nature of their business puts them at risk of being labeled as a “mill” due to them being *mostly* online. They have flexibility to allow some work while going to school, but for over a decade have taken extra steps to avert any stigma. 

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Specializes in Psychiatry.
10 minutes ago, djmatte said:

I completely agree. I advocate just as hard because as a whole I feel my school (Frontier) went and goes above and beyond before anyone was expected to. But the nature of their business puts them at risk of being labeled as a “mill” due to them being *mostly* online. They have flexibility to allow some work while going to school, but for over a decade have taken extra steps to avert any stigma. 

They're doing a good job, djmatte. I have never heard anyone disparage Frontier and I've known their reputation for years. They are considered one of the pioneers of distance education and have been doing it right from the start - and they are selective about who they admit. If the Waldens and Phoenixes of the world modeled themselves after Frontier we wouldn't be having this conversation, but of course that would require them caring more about students and the NP profession than their revenue stream and stockholders and we all know that's not who they're looking out for.

 

Edit to add: You are right though - the more the for-profits churn out a majority of NP graduates the more chance there is that recruiters eventually start writing off all "online" programs as diploma mills and it will hurt reputable schools like Frontier through no fault of their own.

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Specializes in Psychiatry.

I just want to post something so people can understand the extent of the problem. I looked at the commencement programs from two of the biggest for-profit schools in nursing, Walden and Chamberlain. The number of graduates is absolutely astounding:

Walden: 1,900 Master's of Science in Nursing graduates for Summer 2020 commencement alone.

Chamberlain: Family Nurse Practitioner graduates for Summer 2020: 1,200. For Nov, July, and Sept commencements there were 400 EACH. That is 2,400 FNP graduates in 5 month span.

 

Think about that. Does anyone really think these schools are offering hands on skills, individualized training, clinical oversight etc when they are pumping out TWENTY FIVE HUNDRED family nurse practitioners in 5 months? They are clearly actively recruiting and accepting anyone they can get their hands on, and there is absolutely no way the job market can absorb 5,000 NPs per year from just TWO diploma mills.

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Specializes in Psychiatry.
18 hours ago, MentalKlarity said:

I just want to post something so people can understand the extent of the problem. I looked at the commencement programs from two of the biggest for-profit schools in nursing, Walden and Chamberlain. The number of graduates is absolutely astounding:

Walden: 1,900 Master's of Science in Nursing graduates for Summer 2020 commencement alone.

Chamberlain: Family Nurse Practitioner graduates for Summer 2020: 1,200. For Nov, July, and Sept commencements there were 400 EACH. That is 2,400 FNP graduates in 5 month span.

 

Think about that. Does anyone really think these schools are offering hands on skills, individualized training, clinical oversight etc when they are pumping out TWENTY FIVE HUNDRED family nurse practitioners in 5 months? They are clearly actively recruiting and accepting anyone they can get their hands on, and there is absolutely no way the job market can absorb 5,000 NPs per year from just TWO diploma mills.

For comparison, the LARGEST medical school in the US graduates about 400 physicians PER YEAR. 

NP education is going to become a laughingstock and we can lay the blame squarely at the feet of diploma mills. Already you can read the disparaging comments from other disciplines about unprepared NPs who go from application to starting classes in the span of a week. They're losing respect for us because so many students choose the easy path to becoming an NP. Now in many parts of the US, NPs are a dime a dozen and make RN wages.

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3 hours ago, MentalKlarity said:

For comparison, the LARGEST medical school in the US graduates about 400 physicians PER YEAR. 

NP education is going to become a laughingstock and we can lay the blame squarely at the feet of diploma mills. Already you can read the disparaging comments from other disciplines about unprepared NPs who go from application to starting classes in the span of a week. They're losing respect for us because so many students choose the easy path to becoming an NP. Now in many parts of the US, NPs are a dime a dozen and make RN wages.

Laughing stock that can prescribe drugs.  You think everyone has 30 grand to throw away and 2 years of their free time to give?  Mrs. me with that.

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22 hours ago, MentalKlarity said:

I just want to post something so people can understand the extent of the problem. I looked at the commencement programs from two of the biggest for-profit schools in nursing, Walden and Chamberlain. The number of graduates is absolutely astounding:

Walden: 1,900 Master's of Science in Nursing graduates for Summer 2020 commencement alone.

Chamberlain: Family Nurse Practitioner graduates for Summer 2020: 1,200. For Nov, July, and Sept commencements there were 400 EACH. That is 2,400 FNP graduates in 5 month span.

 

Think about that. Does anyone really think these schools are offering hands on skills, individualized training, clinical oversight etc when they are pumping out TWENTY FIVE HUNDRED family nurse practitioners in 5 months? They are clearly actively recruiting and accepting anyone they can get their hands on, and there is absolutely no way the job market can absorb 5,000 NPs per year from just TWO diploma mills.

And many of them might be athletic, bilingual, and work really fast.  It is also scientifically proven that young people process information at much faster rate.  Yikes,  I kind of see why letting every young bilingual phenom with drive, a chiseled physique, and nice hair into the NP profession might be despised by some who need antiquated laws to keep these people at bay.  Why make it possible for the person with the goods to succeed because institutional schools don't want to invest in their underserved communities.  I get it.  Take any advantage you can get it.   

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Specializes in Psychiatric, in school for PMHNP..
1 minute ago, Ace Savanahh said:

And many of them might be athletic, bilingual, and work really fast.  It is also scientifically proven that young people process information at much faster rate.  Yikes,  I kind of see why letting every young bilingual phenom with drive, a chiseled physique, and nice hair into the NP profession might be despised by some who need antiquated laws to keep these people at bay.  Why make it possible for the person with the goods to succeed because institutional schools don't want to invest in their underserved communities.  I get it.  Take any advantage you can get it.   

Hee hee 

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