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]

1 minute ago, Hoosier_RN said:

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. It has evolved into whoever can pay the tuition, etc, can get accepted at some schools

You're absolutely right. I know when I started my nursing career, the NP's in our area were experts in their fields as an RN and then continued to be an NP. I hate that we have moved away from that.

[Neuro Guy NP, DNP, PhD, APRN]

8 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? 

I should clarify that I don't mean that RN experience contributes NOTHING, just not ad much as some would believe because it's an entirely different paradigm. The focus is entirely different that you really have to shift gears to step into the provider role. 

[JBMmom, MSN, NP]

13 minutes ago, Neuro Guy NP said:

I should clarify that I don't mean that RN experience contributes NOTHING, just not ad much as some would believe because it's an entirely different paradigm. The focus is entirely different that you really have to shift gears to step into the provider role. 

I mean this as a genuine question, I'm not trying to be confrontational. How is the focus as a NP entirely different from a RN? Over the course of my shift as a RN I have to assess my patient and note any changes in condition. If a change in condition is detected, I must notify a provider, but generally I'm expected to have an idea of what the appropriate intervention is going to be. I have to know the patient's medical conditions and allergies, their current medications and the role and potential side effects of those medications. I have to have a basic understanding of the pathophysiology of whatever disease process it is that my patient is experiencing and know expected versus unexpected courses of illness and recovery. 

In my clinical time as a NP, I go in and assess a patient. I usually clarify with the nurse whether the patient has experienced any changes in condition, and then I identify the appropriate interventions to change the course of care, or continue on the current course. I do have to write MUCH longer notes in the provider role. I have a more complete notation of the system focus, but it's the same general principle as what I did on the floor. At least that's how I've seen it so far. I really would appreciate your input on where the provider role differs dramatically. Thank you. 

[PsychNurse24, BSN, RN]

8 hours ago, TheMoonisMyLantern said:

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.

It is not a huge problem. I’m sorry but you all sound like a bunch of snobs!!  All of the universities, whether ion line or brick and mortar Or whether they have tough entry requirements or not, meet accreditation standards. And all the people who graduate from them have to pass the board certification. 

[Neuro Guy NP, DNP, PhD, APRN]

2 hours ago, JBMmom said:

I mean this as a genuine question, I'm not trying to be confrontational. How is the focus as a NP entirely different from a RN? Over the course of my shift as a RN I have to assess my patient and note any changes in condition. If a change in condition is detected, I must notify a provider, but generally I'm expected to have an idea of what the appropriate intervention is going to be. I have to know the patient's medical conditions and allergies, their current medications and the role and potential side effects of those medications. I have to have a basic understanding of the pathophysiology of whatever disease process it is that my patient is experiencing and know expected versus unexpected courses of illness and recovery. 

In my clinical time as a NP, I go in and assess a patient. I usually clarify with the nurse whether the patient has experienced any changes in condition, and then I identify the appropriate interventions to change the course of care, or continue on the current course. I do have to write MUCH longer notes in the provider role. I have a more complete notation of the system focus, but it's the same general principle as what I did on the floor. At least that's how I've seen it so far. I really would appreciate your input on where the provider role differs dramatically. Thank you. 

It's different because as an NP you are establishing a diagnosis and creating a MEDICAL plan of care for the patient. You are directing the patient’s overall care. As an RN you are not doing any of these things. RNs do not diagnose and create a nursing plan of care rather than medical. They generally are executing orders written by the provider, whereas the NP is writing those orders. That is where the focus is so much different. 

Furthermore, your assessment skills as an NP should be much more advanced than when you were an RN. Not only that, but you are coordinating care with consultants and other specialists in ways you simply weren't as an RN. The NP is functioning much more akin to the physician than a nurse. And I am sure I don't need to tell you how different those two roles are, so think of it that way.

[Neuro Guy NP, DNP, PhD, APRN]

1 minute ago, PsychNurse24 said:

It is not a huge problem. I’m sorry but you all sound like a bunch of snobs!!  All of the universities, whether ion line or brick and mortar Or whether they have tough entry requirements or not, meet accreditation standards. And all the people who graduate from them have to pass the board certification. 

You're entitled to this opinion. But the reality is that meeting minimum requirements does not automatically mean things are up to snuff. We've all met people from various health disciplines who have passed boards but still leave something to be desired. It's not snobby to identify an area of much needed improvement and want to make it better. I'm not sorry that I think certain types of programs are doing too little to let in quality students who will turn out to be quality NPs. I'm not sorry that I want existing programs to be more selective and rigorous.

It's the barrier to entry that ensures good pay and quality of lifestyle by ensuring that only those who demonstrate superior ability are able to make the cut. Other professions have made peace with that and so should we. I care deeply about our profession and do not want it to be seen as the back up plan if you can't cut it elsewhere. I don't want our profession as NPs to be full of medical/PA/whatever other profession rejects. I don't want our profession to be diluted with those who just want an easy path without doing all the hard work we've done. If that makes me a snob, so be it.

[Zyprexa_Ho]

3 hours 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.

So if someone has no healthcare experience and only worked as a grocery store cashier, you're saying they would be equally prepared to be an NP versus someone with years of experience working as an RN in their prospective NP specialty?

Nah.

[Neuro Guy NP, DNP, PhD, APRN]

3 minutes ago, Zyprexa_Ho said:

So if someone has no healthcare experience and only worked as a grocery store cashier, you're saying they would be equally prepared to be an NP versus someone with years of experience working as an RN in their prospective NP specialty?

Nah.

I never said that. Re-read this and subsequent threads rather than cherry pick certain parts for comment. Of course the RN with years of experience will be better prepared. But that's all it is - preparation. On the other hand though, it is interesting that PAs never practiced anywhere before and do just as well. There's no evidence they give subpar care compared to NPs. Yet the educational model is very different. At any rate, I never downplayed the importance of RN experience, I'm just pointing out that it is merely a piece of the puzzle as it were. And it still doesn't change the fact that day to day NP practice is totally dissimilar to RN practice. And with a certain amount of NP years of experience, the RN experience matters less and less. 

[Ace Savanahh]

5 hours ago, Zyprexa_Ho said:

So if someone has no healthcare experience and only worked as a grocery store cashier, you're saying they would be equally prepared to be an NP versus someone with years of experience working as an RN in their prospective NP specialty?

Nah.

Yes, because you take an ATI or HESI to get into nursing school.  If you do well in school and pass the NCLEX, the information probably isn't that hard for the person.  Nursing is an easy profession.  Those are facts.  If you don't believe me, lay cement or work as a physicist or try boxing.  Be fortunate you were in a position where you do nursing without barriers.  If these people can't pursue NP school because of location, let them take it online.  School are trying to go online anyway.  At this point, schools are pushing brick and mortar schools to charge more tuition.  They should turn those places into communities and homeless shelters.  

[PsychNurse24, BSN, RN]

5 hours ago, Neuro Guy NP said:

I never said that. Re-read this and subsequent threads rather than cherry pick certain parts for comment. Of course the RN with years of experience will be better prepared. But that's all it is - preparation. On the other hand though, it is interesting that PAs never practiced anywhere before and do just as well. There's no evidence they give subpar care compared to NPs. Yet the educational model is very different. At any rate, I never downplayed the importance of RN experience, I'm just pointing out that it is merely a piece of the puzzle as it were. And it still doesn't change the fact that day to day NP practice is totally dissimilar to RN practice. And with a certain amount of NP years of experience, the RN experience matters less and less. 

Well said!

[TheMoonisMyLantern, ADN, LPN, RN]

10 hours ago, PsychNurse24 said:

It is not a huge problem. I’m sorry but you all sound like a bunch of snobs!!  All of the universities, whether ion line or brick and mortar Or whether they have tough entry requirements or not, meet accreditation standards. And all the people who graduate from them have to pass the board certification. 

But that's the point, just the fact that some of these schools are meeting standards show that our standards aren't high enough. I feel that the national nursing organizations that have decreed we have "critical shortages" for RN's and NP's have enabled the loosening of standards for accreditation and licensure.

[TheMoonisMyLantern, ADN, LPN, RN]

3 hours ago, Ace Savanahh said:

Yes, because you take an ATI or HESI to get into nursing school.  If you do well in school and pass the NCLEX, the information probably isn't that hard for the person.  Nursing is an easy profession.  Those are facts.  If you don't believe me, lay cement or work as a physicist or try boxing.  Be fortunate you were in a position where you do nursing without barriers.  If these people can't pursue NP school because of location, let them take it online.  School are trying to go online anyway.  At this point, schools are pushing brick and mortar schools to charge more tuition.  They should turn those places into communities and homeless shelters.  

Nursing isn't rocket science by any means but saying "it is easy, those are facts." is an opinion not a fact. Nursing is physical, that's not an opinion, nurses make up for one of the highest risk professions for back injuries, work place violence, that's not easy.