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.

[Neuro Guy NP, DNP, PhD, APRN]

4 hours ago, ThePrincessBride said:

Interesting comments. I wonder how much my program would be raked through the coals here. There are two sections: online and brick-and-mortar. I chose online so I could work to afford the school, but it is identical to the in-class counterpart. I have online classes that are synchronous, meaning they are taught in real-time and I get a chance to interact with my classmates and professor. My school finds my preceptors for me (though it may mean going a few hours away from home to get to my clinical site). I get in-depth lectures that I can play as many times as I want in order to take notes and fully immerse myself in the material. Plus, I will have on-site campus visits to practice procedural skills.

I think working actually enhances my understanding of the knowledge that I am gaining in the classroom as I can apply it to real-life situations I have seen in practice as a floor nurse.

I think online gets a bad rep here; people need to remember that online schools are not created equal. I work with someone who is going to a brand new FNP school who doesn't get any lectures and has complained about the lack of instruction. She also had to find her own clinical sites. Meanwhile, I do not have to find my own sites (though I can approach a site if I want) and have hours of content that my school provides at my finger tips.

I think your program sounds wonderful. Sounds like Drexel if I had to guess. I like the connectedness with real faculty with real lectures. That's key for me.

[Zyprexa_Ho]

On 2/8/2021 at 9:24 AM, Neuro Guy NP said:

...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.

It is not cherry picking. You literally said that being an RN has nothing to do with being an NP and that is patently false.

[Neuro Guy NP, DNP, PhD, APRN]

1 hour ago, Zyprexa_Ho said:

It is not cherry picking. You literally said that being an RN has nothing to do with being an NP and that is patently . 

Well please explain the similarity in what NPs do and RNs. I don't find myself at the bedside doing Nursing care plans, assessments q4h in the ICU, doing ADLs, vitals, calling providers for orders, etc. Instead, I find myself rounding, writing orders, performing procedures, consulting other specialties,  leading multidisciplinary rounds, and talking about prognosis with families. 

Doesn't sound too similar from where I'm sitting. If the roles were so similar then we wouldn't have to work so hard on training RNs in NP school to present patients, formulate differentials, and shift their thinking towards making diagnoses, prescribing, and creating the medical plan of care. 

Very different roles and I stand by the position that the two in practice have little to do with one another other than NP being predicated on first having RN licensure. And there's nothing wrong with that! It's just a different avenue of nursing. But at its core advanced practice and bedside are dissimilar, yet equally important. It's akin to the difference between finance and accounting; accounting focuses on reporting of financial position according to government rules and finance concerns itself with generating money. Two different aspects of business. They're related but totally different fields, each of which has its own inherent value. Same thing goes from RN and NP. 

[Ace Savanahh]

3 hours ago, Neuro Guy NP said:

Well please explain the similarity in what NPs do and RNs. I don't find myself at the bedside doing Nursing care plans, assessments q4h in the ICU, doing ADLs, vitals, calling providers for orders, etc. Instead, I find myself rounding, writing orders, performing procedures, consulting other specialties,  leading multidisciplinary rounds, and talking about prognosis with families. 

Doesn't sound too similar from where I'm sitting. If the roles were so similar then we wouldn't have to work so hard on training RNs in NP school to present patients, formulate differentials, and shift their thinking towards making diagnoses, prescribing, and creating the medical plan of care. 

Very different roles and I stand by the position that the two in practice have little to do with one another other than NP being predicated on first having RN licensure. And there's nothing wrong with that! It's just a different avenue of nursing. But at its core advanced practice and bedside are dissimilar, yet equally important. It's akin to the difference between finance and accounting; accounting focuses on reporting of financial position according to government rules and finance concerns itself with generating money. Two different aspects of business. They're related but totally different fields, each of which has its own inherent value. Same thing goes from RN and NP. 

Damn homie.  This is what a checkmate looks like. LOL.   What you’re saying is golfing and boxing are both sports, but they are not the same.  The OP is saying that they’re the same because they’re both sports.  I agree with you.  ?. Also, what’s your stance on University of Phoenix NP Program.  I went to a state school for my BSN, but I don’t get what the advantage is other than the school not closing out of nowhere.  

[Neuro Guy NP, DNP, PhD, APRN]

6 minutes ago, Ace Savanahh said:

Damn homie.  This is what a checkmate looks like. LOL.   What you’re saying is golfing and boxing are both sports, but they are not the same.  The OP is saying that they’re the same because they’re both sports.  I agree with you.  ?. Also, what’s your stance on University of Phoenix NP Program.  I went to a state school for my BSN, but I don’t get what the advantage is other than the school not closing out of nowhere.  

Hahaha, well thank you. I'm a graduate nursing professor, director at a health system, and most recently as of some months ago I sit on a state BON, so I'd hope my head would be screwed at on at least half way correct!

At any rate, I'd advise against University of Phoenix. I am not well versed on their program, but there are plenty of people who have negative things to say. I cannot judge for myself the validity of their statements, but the pragmatist in me screams to just stay away from any institution that is commonly maligned because if the hiring manager happens to share the belief, you won't get a second look. Fair or not, that's the reality and if you want a paycheck, the first step is to get your foot in the door. 

So I always tell people to go to a well respected school, state, private, non-profit, profit, or whatever. Just as long as it is respected with a reasonable, rigorous curriculum with good board pass rates.

That's my humble 2 cents.

[MentalKlarity, BSN, NP]

100% agree with this.

It is embarassing how many for-profits programs who will take anyone with a pulse exist in the NP world. And it affects ALL of us, as the number of graduating NPs annually has shot up from 5-6K per year to over 30K (!!) per year thanks to every for profit school advertising all over the internet and pulling in young nurses with promises of "Get an NP degree in 20 months while working full time!!"

 

These graduates are flooding the market and lowering wages for everyone. There's no reason to pay the Johns Hopkins graduate with publications $120K when the Walden graduate says they'll take 65K after being rejected for their last 40 jobs. Every Chamberlain/Walden, etc graduate who gets desperate and takes a job with RN level wages and 2 weeks vacation per year is setting a precedent for all of us.

And then there are our colleagues. The other medical providers we work with daily see these diploma mills and wonder about our skills. We now have to "prove" that we aren't one of the "dumb NPs". PAs, MDs, DOs and PharmDs gain respect automatically because of tighter accreditation standards - NPs have to prove it. 

It's scary, and it is ruining our profession. Thankfully some of the diploma mills are under investigation (Walden!) and maybe stricter rules on federal loans for for-profits programs under Bidens Education Dept will stop the bleeding, but in the end it's really incumbent on the nursing boards who we PAY to protect our profession to actually start protecting us before we have 800K+ NPs out there fighting for minimum wage jobs and the diploma mills cranking out 50K more annually.

[Ace Savanahh]

13 minutes ago, MentalKlarity said:

100% agree with this.

It is embarassing how many for-profits programs who will take anyone with a pulse exist in the NP world. And it affects ALL of us, as the number of graduating NPs annually has shot up from 5-6K per year to over 30K (!!) per year thanks to every for profit school advertising all over the internet and pulling in young nurses with promises of "Get an NP degree in 20 months while working full time!!"

 

These graduates are flooding the market and lowering wages for everyone. There's no reason to pay the Johns Hopkins graduate with publications $120K when the Walden graduate says they'll take 65K after being rejected for their last 40 jobs. Every Chamberlain/Walden, etc graduate who gets desperate and takes a job with RN level wages and 2 weeks vacation per year is setting a precedent for all of us.

And then there are our colleagues. The other medical providers we work with daily see these diploma mills and wonder about our skills. We now have to "prove" that we aren't one of the "dumb NPs". PAs, MDs, DOs and PharmDs gain respect automatically because of tighter accreditation standards - NPs have to prove it. 

It's scary, and it is ruining our profession. Thankfully some of the diploma mills are under investigation (Walden!) and maybe stricter rules on federal loans for for-profits programs under Bidens Education Dept will stop the bleeding, but in the end it's really incumbent on the nursing boards who we PAY to protect our profession to actually start protecting us before we have 800K+ NPs out there fighting for minimum wage jobs and the diploma mills cranking out 50K more annually.

Quit your whining.  You sound like people who want to exclude competition because they want to continue being lazy and providing poor work.  NPs have the same rights as hospitalists in a lot of states and they are pushing for than in California right now.  The same comment you made can be made about traveling nurses who come to CA and take advantage of the great pay they receive here thanks to the hard work of unions in CA. 

[JKL33]

On 2/8/2021 at 12:52 AM, 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.

NP education (supposedly) builds on a preexisting foundation that is no longer strictly required. Reference direct entry programs.

And that whole thing about the nursing foundation never made any sense anyway, since RNs' experience and expertise varies widely such that it wouldn't ever make sense to say that solely by virtue of having worked as an RN one has laid down the foundation for becoming a provider.

The foundation never had anything to do with diagnosing conditions and prescribing treatment plans, anyway. Knowing medications on a class level or knowing what they are generally used for is not the same as knowing which one to prescribe for an individual patient's situation.  Having heard of a condition before or provided nursing care to a patient with that condition is not the kind of foundation that is very useful in starting from scratch with undifferentiated patients and properly evaluating them and diagnosing their conditions and knowing what to do about them on a level that can be individualized to a particular patient.

I am commenting as an experienced RN who as recently as a couple of years ago thought it was ludicrous that some NPs would state that their RN experience didn't help them too much with their provider role. And now...here I am in the process of learning that while there is a lot that being an RN does help with (the basic familiarity with meds, the history of interacting with patients, the knowledge of basic tests and treatments, etc., the observation of various disease processes from a nursing standpoint), being a competent provider requires so much more knowledge than what is strictly required to get by as an RN. It requires a substantially different manner of thinking and differentiating than the RN role does.

It's the difference between being able to guess that a patient might probably have a kidney stone based on the fact that you've seen 100 other patients with kidney stones restlessly moving about on a stretcher or dancing at the bedside vs. seeing a patient with back pain and figuring out that they have a kidney stone vs. dissecting AAA vs. everything else it could be ad infinitum.

It's the difference between guessing that a patient with ear pain could have an "ear infection" vs. figuring out it's likely trigeminal neuralgia or the prodrome of herpes zoster. Or, again, any other thing including something mild that just requires reassurance and supportive care.

It hurts quite a bit to admit it (?), but the whole pattern recognition thing is actually a bit of a hindrance to learning the provider role. It hurts to admit that alllll my past experiences independently amount to me being able to make a few "educated guesses" about what something "could be." And that, outside of the education I am now involved in, I have very little experience with systematically using a significant body of knowledge to think (rather than guess) my way to a correct answer.

[MentalKlarity, BSN, NP]

33 minutes ago, Ace Savanahh said:

Quit your whining.  You sound like people who want to exclude competition because they want to continue being lazy and providing poor work.  NPs have the same rights as hospitalists in a lot of states and they are pushing for than in California right now.  The same comment you made can be made about traveling nurses who come to CA and take advantage of the great pay they receive here thanks to the hard work of unions in CA. 

That's quite a charged statement - but quite frankly, wouldn't it be the people who want to go to easy for-profit diploma mills with no entry requirements be the lazy ones?

Also - wanting the "norm" for your profession to be higher salary, better benefits, more PTO and better quality of life does not mean being lazy. The American ideal that people need to work themselves to death for peanuts is a ridiculous notion, and providers of all persuasions (MDs PAs, and NPs) deserve a work-life balance.

Meanwhile, yes I do expect the nursing lobby and nursing organizations to "protect" our profession from over saturation. It's their job. No one wants to let greedy schools or lack of standards dilute their field to the point that even the most excellent candidates are making lower wages than they did a decade ago - and that's what will happen if the boards don't tighten up the standards.

[Neuro Guy NP, DNP, PhD, APRN]

3 hours ago, MentalKlarity said:

That's quite a charged statement - but quite frankly, wouldn't it be the people who want to go to easy for-profit diploma mills with no entry requirements be the lazy ones?

Also - wanting the "norm" for your profession to be higher salary, better benefits, more PTO and better quality of life does not mean being lazy. The American ideal that people need to work themselves to death for peanuts is a ridiculous notion, and providers of all persuasions (MDs PAs, and NPs) deserve a work-life balance.

Meanwhile, yes I do expect the nursing lobby and nursing organizations to "protect" our profession from over saturation. It's their job. No one wants to let greedy schools or lack of standards dilute their field to the point that even the most excellent candidates are making lower wages than they did a decade ago - and that's what will happen if the boards don't tighten up the standards.

Yup. But do realize certain states don't permit certain out of school programs to operate in the state, I.e certain schools can't have their students do clinicala in that state. Some states don't allow certain types of schools to even enroll students who reside in that state.. It does exist. Not many, but there are some. Thats all I'll say on the subject.

[PsychNurse24, BSN, RN]

3 hours ago, MentalKlarity said:

That's quite a charged statement - but quite frankly, wouldn't it be the people who want to go to easy for-profit diploma mills with no entry requirements be the lazy ones?

Also - wanting the "norm" for your profession to be higher salary, better benefits, more PTO and better quality of life does not mean being lazy. The American ideal that people need to work themselves to death for peanuts is a ridiculous notion, and providers of all persuasions (MDs PAs, and NPs) deserve a work-life balance.

Meanwhile, yes I do expect the nursing lobby and nursing organizations to "protect" our profession from over saturation. It's their job. No one wants to let greedy schools or lack of standards dilute their field to the point that even the most excellent candidates are making lower wages than they did a decade ago - and that's what will happen if the boards don't tighten up the standards.

I would like somebody to provide data that so-called “diploma-mill” prepared nurse practitioners are worse than other nurse practitioners. Oh wait, there’s no proof. It’s just all your esteemed opinions!  Why don’t you do some studies on nurse practitioners from your self identified diploma mills one year, five-years,  and 10 years after graduation and compare them to the nurse practitioners from other universities (That you approve of!) And then get that study peer-reviewed and then show the data.  Can you all say “Narcissistic Personality Disorder”??

[MentalKlarity, BSN, NP]

20 minutes ago, PsychNurse24 said:

I would like somebody to provide data that so-called “diploma-mill” prepared nurse practitioners are worse than other nurse practitioners. Oh wait, there’s no proof. It’s just all your esteemed opinions!  Why don’t you do some studies on nurse practitioners from your self identified diploma mills one year, five-years,  and 10 years after graduation and compare them to the nurse practitioners from other universities (That you approve of!) And then get that study peer-reviewed and then show the data.  Can you all say “Narcissistic Personality Disorder”??

We could instead look at how many diploma mill schools have shut down or "gone out of business" leaving their students high and dry? The number of preceptors who say they won't work with them due to incompetence? Or perhaps we could look into Walden University, the diploma mill poster child, and their current US Justice Dept Investigation for potentially misrepresenting their Master's in Nursing programs to students and regulators? 

A school cannot take anyone with a pulse and student loan check, stick them into self-guided online modules with monthly start dates, allow them to complete clinicals with no oversight, and then expect them to be equal to peers from more reputable programs.