We Must Demolish NP Diploma Mills

[cprimavera]

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

[TheMoonisMyLantern, ADN, LPN, RN]

16 hours ago, umbdude said:

Intelligent people plan, make sacrifices, find scholarships, and do all the appropriate calculations to make things work in order to obtain the best education possible. Many of these folks do it for med, PA, PT, OT schools and all sorts of other full-time professional programs. The talk about accessibility and affordability is a cop-out common to many nurses who simply want to take an easy path. RNs want convenience, cheap tuition, ability to work full-time and complete education in 2 years, don't want to physically go in (at all) for on-campus skills, and then they complain about a sub-par education and don't feel ready.

I went to a 100% in-person reputable NP Program. People did fail out of classes because the exams were hard, and we were taught above what's required for the boards (which is the bare minimum). We were expected to role-play in therapy courses to demonstrate each modality's techniques; we had to take a full history with an actor (unknown person, without any information) and formulate differentials to pass our mid-term in Advanced Health Assessments; we had to demonstrate that we're actually percussing the liver span and we couldn't hide behind the camera because the professors stood right next to us; and we got tons of pearls from professors that weren't in the textbooks (real time back & forth dialogues and debates). Finally, I had my preceptor lined up 9 months before I even started clinical...didn't lift a finger. 

Was it a perfect program? No. But definitely worth my time, effort, and the $57k tuition. I had a great education that didn't break the bank. 

Maybe RNs don't realize this, but $100k+ salary a year is high by most standards. Many psychologists, MSW, psyD, MBA, OT etc. go back to grad school for much less earning potential. The only reason RNs think it's not good ROI is because many RNs already make near that amount. In that case, you must consider why you're going back to get your NP to begin with and what values you want to get from becoming an NP.

How long ago did you complete your education? To me, it sounds like you went to a school with the ideal method of instruction, especially for PMHNP.

I think it's important to remember that salaries for RN's and NP's vary widely depending on the region they are located. As a RN with several years of solid experience I make a good wage for my area but it is nowhere near 100k. NP's in my area aren't making 100K without 10 years or more of experience, so an education costing 50-100k is nothing scoff at when considering loans. That is a LOT of debt to take on especially factoring in other sources of debt, mortgage, car loan, credit cards. Add in some kids or dependent elderly parents and it can be difficult to justify pursuing such an expensive education. This isn't a problem just in nursing, but with higher education as a whole, these schools have gorged themselves with money from bloated tuition prices and that needs to change as well. I realize it's easy to say "well, not everyone is meant to continue with their education." and that is true, HOWEVER that philosophy means that we will miss out on really capable and competent clinicians who simply lack access or resources to continue their education.

B+M schools in my area have all gone online for their NP programs, no doubt to compete with schools like Walden, Chamberlain, etc.

[TheMoonisMyLantern, ADN, LPN, RN]

8 hours ago, JBMmom said:

Point well taken. My complaint is with the professors that don't seem invested in their teaching job. For example, my professor last semester was teaching four sections, worked full time and was also in school for her DNP. I know she was trying to support herself, but she literally gave me NOT ONE bit of feedback that positively impacted my potential to be a competent practitioner. She took points away for an inaccurate APA citation, would write that I had misplaced commas and should have used bullet points. She did not once address the therapeutic interventions I proposed for critically ill patients.

 She chose to take on all those responsibilities, I did not choose to have a professor who was in it to check some box and make some money. I do realize not a lot of money, the school took plenty, but if someone decides to teach, I would hope they would take the time to do something that will benefit the students. 

Now see, that's ridiculous. 

[TheMoonisMyLantern, ADN, LPN, RN]

6 hours ago, Neuro Guy NP said:

And if someone can't make the arrangements to do the curriculum, then they simply. Can't. Do. It. It's unfortunate, but that's what it should be. Do we see PA programs bending over backwards to accommodate folks? No. Either you take the time off to get through the program or you simply can't be a PA. I don't know why RNs can't grasp this. This is the attitude so many NP students have. They want me as the professor to flex on deadlines, clinical hours etc because they've got a baby, family, or work obligations. I won't do that. You have to calculate all costs - not just financial - before making the HUGE decision to go back to school. And if you can't balance it, then don't start the program. I don't believe nursing has less intelligent professionals than other fields.

We're simply suffering an ailment where watered down, convenient curricula or delivery options are permitted and it has to stop because it is leading to many people not putting forth the necessary effort. If you can figure out a way to work while in school, more power to you. But students can't expect that to mean something to the school or get an accommodation for it. I keep harping on this because if I had a nickel for every time a student hinted at this, I'd be richer than Jeff Bezos. We're not doing the right thing by making programs "more accessible". By the way, we should remember the basic economic concept of supply and demand. More accessibility = more supply. More supply = less demand, or at least less demand at the premium price.

I don't think accessibility is necessarily the problem, the lack of standards for admission are the huge problem. RN's are going back without any experience, terrible GPA, no GRE, no references, just pay the tuition and you're guaranteed a spot. That's the problem.

[CommunityRNBSN, BSN, RN]

I agree that one of the primary changes that needs to happen is that schools must arrange their own clinicals. 
 

I have a friend who is in a pediatric nurse practitioner program. She is an incredible PICU and Pedes nurse, with years and years of experience. She is almost at the end of her PNP program. She just told me “I’m going to just switch to Psych and get that degree instead because I can’t find anywhere for Pedes clinicals but Psych is easier to find.” I was floored. Apparently, in her online program, the Pedes NP and the Psych NP classes are EXACTLY the same??  No actual content whatsoever for the specialty?  The only difference is the clinical placements, which the students arrange themselves. So this nurse, an incredible Pedes nurse with zero Psychiatric or adult experience whatsoever, is about to graduate and get licensed as a Psych provider?  How on earth does that make any sense at all?

[JBMmom, MSN, NP]

12 minutes ago, CommunityRNBSN said:

I agree that one of the primary changes that needs to happen is that schools must arrange their own clinicals. 

I think one of the best things about my program was that I did choose all of my own clinicals. Now, I had access to people that I consider to be experts in: hospitalist medicine, emergency medicine, critical care, pulmonology, nephrology and vascular surgery, so I was lucky. I'm also not the least bit shy about networking and asking people if they would take me as a student. So my clinical experiences have been fantastic for the most part (except that I realized I never want to work in outpatient). Now, if my school offered support I guess that would have been helpful, getting all of my own contracts signed and taken care of was a pain. But what if I was paired up with a preceptor that I just didn't work well with? Then I might not have gotten as much out of it. 

I am sorry for students that have had a hard time finding placements, I'm sure that's very frustrating. 

[CommunityRNBSN, BSN, RN]

12 minutes ago, JBMmom said:

I think one of the best things about my program was that I did choose all of my own clinicals. Now, I had access to people that I consider to be experts in: hospitalist medicine, emergency medicine, critical care, pulmonology, nephrology and vascular surgery, so I was lucky. I'm also not the least bit shy about networking and asking people if they would take me as a student. So my clinical experiences have been fantastic for the most part (except that I realized I never want to work in outpatient). Now, if my school offered support I guess that would have been helpful, getting all of my own contracts signed and taken care of was a pain. But what if I was paired up with a preceptor that I just didn't work well with? Then I might not have gotten as much out of it. 

I am sorry for students that have had a hard time finding placements, I'm sure that's very frustrating. 

The reality is though that there is no standardization of clinical experiences, which is why I am concerned. Yours was wonderful and enriching, because of all the factors you mentioned. But some students have clinicals that are a joke— the preceptors just sign the paperwork without actually doing much teaching, and the student’s only concern is to get enough hours in. That should not be the case. There should be a much more standardized and detailed system of oversight; I don’t necessarily think it has to be “here’s your preceptor, please be there at 8am Monday” but the current system employed by many online schools is a farce. 

[Hoosier_RN, MSN]

8 hours ago, Zyprexa_Ho said:

I'm not really sure why you guys keep comparing NP school to MD/DO/PA/Etc. NP school builds on a preexisting foundation that those other programs don't.

I've seen nurses come right out of school, pass their NCLEX and enroll in school to be an NP, and have 0 healthcare experience.  What preexisting foundation of experience are they building on?  This happens more often than not, and schools continue to take the students as long as they can pay the tuition and fees

[TheMoonisMyLantern, ADN, LPN, RN]

6 minutes ago, CommunityRNBSN said:

The reality is though that there is no standardization of clinical experiences, which is why I am concerned. Yours was wonderful and enriching, because of all the factors you mentioned. But some students have clinicals that are a joke— the preceptors just sign the paperwork without actually doing much teaching, and the student’s only concern is to get enough hours in. That should not be the case. There should be a much more standardized and detailed system of oversight; I don’t necessarily think it has to be “here’s your preceptor, please be there at 8am Monday” but the current system employed by many online schools is a farce. 

A friend of mine told me during her clinicals the NP that agreed to precept her just pretty much cut her loose on day 1 and let her see half the patient unsupervised, tell the preceptor her findings and then the preceptor just ordered whatever based on the assessment. She said there was no discussion, no teaching, no verifying that her assessments were accurate. Those are the clinical experiences that need to be addressed.

Just now, Hoosier_RN said:

I've seen nurses come right out of school, pass their NCLEX and enroll in school to be an NP, and have 0 healthcare experience.  What preexisting foundation of experience are they building on?  This happens more often than not, and schools continue to take the students as long as they can pay the tuition and fees

That needs to be stopped. I know most of the posters on here say that RN experience doesn't really help as an NP. I just don't see how that could be true, I really don't!

[Neuro Guy NP, DNP, PhD, APRN]

8 hours ago, Zyprexa_Ho said:

I'm not really sure why you guys keep comparing NP school to MD/DO/PA/Etc. NP school builds on a preexisting foundation that those other programs don't. 

And accessibility issues don't only have to do with the quality of education. It also has far reaching implications such as only allowing financially well off people to advance their careers (decreased class mobility) and race issues. Without taking these into consideration, you're asking for more concentration of wealth and disparity between races. 

Because there is no similarity between RN and NP so I don't really buy into the train of thought that NP builds upon RN. In day to day practice, please explain to me how the NP role has anything to do with RN practice. This is why I compare it to PA school. And particularly in restrictive practice states, whether NPs like to admit it or not, the role of the NP and PA on the healthcare team is the same. Hence the commonalities rightly beg that we compare the two. And you didn't answer why it's OK for the other professions to restrict entry in this manner but not nursing. Does that mean the other programs are accessible only to the rich? I think not, as I know plenty who worked their way up. If anything, RNs ought to be better off since they generally worked first and had opportunity to save up, according to your argument.

[TheMoonisMyLantern, ADN, LPN, RN]

1 minute ago, Neuro Guy NP said:

Because there is no similarity between RN and NP so I don't really buy into the train of thought that NP builds upon RN. In day to day practice, please explain to me how the NP role has anything to do with RN practice. This is why I compare it to PA school. And particularly in restrictive practice states, whether NPs like to admit it or not, the role of the NP and PA on the healthcare team is the same. Hence the commonalities rightly beg that we compare the two. And you didn't answer why it's OK for the other professions to restrict entry in this manner but not nursing. Does that mean the other programs are accessible only to the rich? I think not, as I know plenty who worked their way up. If anything, RNs ought to be better off since they generally worked first and had opportunity to save up, according to your argument.

How can RN practice not contribute to the knowledge base of becoming an NP? As an RN my assessments are generally what help steer the provider towards the treatment that I've already anticipated initiating. We do a lot more at the bedside than just pass pills and clean up BM's. Not to mention years of working with providers sharing their knowledge, reading their H/P's, progress notes, consultations which includes their plans and rationales every single shift we are doing that. How does that learning not contribute to becoming a provider? 

[JBMmom, MSN, NP]

16 minutes ago, TheMoonisMyLantern said:

That needs to be stopped. I know most of the posters on here say that RN experience doesn't really help as an NP. I just don't see how that could be true, I really don't!

I know that for me I never could have started out and entered a NP Program so fast. Then again, I feel like I was meant to start out in LTC, go to med-surg and then to the ICU before starting NP school. For me, skipping any of those steps would have left me feeling less sure of my assessment skills, which I do think will be key to my success as a provider. However, there are many people that point out the provider role is completely different from bedside nursing, and I agree. I don't know how I could be an "advanced" nurse, if I didn't have a foundation as a nurse, but that's just me.  

[Hoosier_RN, MSN]

5 minutes ago, TheMoonisMyLantern said:

How can RN practice not contribute to the knowledge base of becoming an NP? As an RN my assessments are generally what help steer the provider towards the treatment that I've already anticipated initiating. We do a lot more at the bedside than just pass pills and clean up BM's. Not to mention years of working with providers sharing their knowledge, reading their H/P's, progress notes, consultations which includes their plans and rationales every single shift we are doing that. How does that learning not contribute to becoming a provider? 

It does, as we learn the nuances of change in condition, which is especially necessary for acute NPs.  For FNPs, it can be helpful for recognizing the "outside of the box" s/s plus add knowledge of the healthcare system.  Neuro Guy is right, RN and NP are 2 different disciplines, in the same spectrum of care. Back in the day, becoming an NP was for those RNs who had many years of experience, who wanted to evolve a little further, but management and education weren't what they wanted-read, it is an advanced nursing role. I'm not sure how it has evolved into whoever can pay the tuition, etc, can get accepted at some schools, except for money