Why don't more NPs advocate for better training?

Specialties NP

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I've seen a lot of complaints on this forum about the quality of NP education and training. However, while I mostly see complaints here, other forums and media defend NP education. If NPs feel that their training is inadequate, why not tackle this issue at a higher level to advocate for better training (or a better model of care)?

1 hour ago, FullGlass said:

A student who goes to a crappy school, but puts in the work, can still get a decent education.

Patently false. You cannot teach yourself medicine.

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Specializes in Psychiatric and Mental Health NP (PMHNP).
54 minutes ago, Dodongo said:

Patently false. You cannot teach yourself medicine.

I don't understand your statement. Didactic content is the same no matter whether it is taught at Hopkins or Acme U.

For clinicals, it is the rotations that are key. A student who can get decent rotations with decent preceptors will be ok. There are people who go to for-profit schools who work hard and become good NPs.

This is why I discussed organizations having good hiring practices in a previous post.

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More NPs don't insist on better training because as a student, any complaint sounds like a whine. Once you get out of school, if you can get a job and minimally function, apparently the education was good enough. I don't agree with this, but there you have it.

It will be interesting to see if the profession goes the way of law, with the bottom 50% of the pile not employed as lawyers.

A friend of mine recently precepted an NP student in her early 20's. To begin with, the friend is a fairly recent grad. The young student was literally playing on her phone most of the time during clinical hours, but the friend passed her. The program director is not an NP, but a social worker.

And the PMHNP boards are not difficult enough to protect the public.

So, yeah, the situation is very scary.

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Adding my little opinion, this coming from a millennial right out of nursing school last spring, and going into NP school possibly in the fall. NP programs need to stop with the 100% online. It's a good way for those schools to make money because my age group are going all out for them; but they are providing poor education for us. How is it that PA programs are not online but NP programs can be? I understand a lot of them are designed so that nurses can still work FT, I respect that and I want to work FT still too, but then weekly campus visits should be required. This little issue alone can end the problem of poor education in NP schools. Because then we would demand better professors if we had to sit in front of them, it would also weed out those who just want what they think will be a fast and easy online NP degree.

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On 2/21/2019 at 10:06 AM, djmatte said:

While I don't disagree that involvement in our local organization is important, I don't find they (mine specifically) are particularly interested in the quality of NP education programs. Certainly not enough to potentially hold back the profession on the stage of legislation and improving NP autonomy. If they ever suggested that NP education was lacking, the AMA would be all over that and two decades of progress would be a wash (appropriate or not).

IMO improving education starts at the either the school accreditation or the two organizations that certify NPs. The problem with both is there are too many organizations in the pot. There are multiple school accrediting agencies ranging from national to regional and all are generally accepted by certifying bodies. And as evidence by some of those schools with accreditation, many of the "low performing" schools still maintain high level accreditation. AANP and AACN specifically are in competition (especially since they don't allow cross certifications anymore) and their bread and butter is adding new members and ensuring those members continue to pay dues. They sure as F aren't going to risk a steady increase of members by adding additional restrictions.

A good area they could start is by certification bodies forcing new nurse practitioner graduates to complete residencies prior to certification. This could at least slow down the flood of new NPs and provide a more structured hands on education that those bodies control and have a vested interest in. But as previously mentioned, it slows down numbers (money) and increases their work (cost) by adding more programs to manage.

I have to agree with your point...The NP organization meetings I attend are always talking about pushing independent practice and my school sends out emails about demanding full practice and we need to show up at the Capitol etc No one ever mentions the quality of education. I am fully aware that some healthcare organizations will not hire new np grads from certain online schools. Some practices won't even precept students from fully online programs. Also, I am hearing from previous grads that they are asking during interviews if you had actual class times, how was your exam done etc. I believe education is what you put into it, however, the school needs to give a good foundation.

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Specializes in Women’s Health.
On 2/22/2019 at 4:08 PM, FullGlass said:

Thank you. I am curious as to how many subpar for-profit schools are out there. When I reviewed the list of accredited NP programs in California, there were only a few for-profit schools listed.

I think there is a place for for-profit schools, but am in favor of reasonable accreditation requirements. Some of these schools are decent, such as National University in California. They do help students who have to work full-time and need more flexible schedules. A student who goes to a crappy school, but puts in the work, can still get a decent education.

National University alumni here, thanx for the shout out! But just FYI, National University is not a for-profit school. It is actually the 2nd largest private, not for profit University in Southern California.

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Specializes in Psychiatric and Mental Health NP (PMHNP).
1 minute ago, babeinboots said:

National University alumni here, thanx for the shout out! But just FYI, National University is not a for-profit school. It is actually the 2nd largest private, not for profit University in Southern California.

Well, I stand corrected. ?

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Specializes in Nephrology, Cardiology, ER, ICU.

I'm on the bandwagon of the need for more APRN residency programs. I know that when I graduated (2006) there were none at least in my area. I entered a specialty practice with no experience in that specialty. However, I was afforded a 4-5 month orientation with both didactic education provided by the physicians as well as clinical education provided by very experienced APRNs.

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Specializes in Adult Internal Medicine.
On 2/23/2019 at 2:33 PM, direw0lf said:

NP programs need to stop with the 100% online. It's a good way for those schools to make money because my age group are going all out for them; but they are providing poor education for us. How is it that PA programs are not online but NP programs can be? This little issue alone can end the problem of poor education in NP schools.

What makes you think that the problem is solely related to online education?

There are quality online programs. There are junk online programs. The same is true of brick and mortar programs. I have never seen compelling evidence that a junk online program is any better/worse than a junk brick and mortar program.

The problem of having junk professors is not isolated to online programs either, in fact the online programs might have more incentive to have quality faculty. To make matters worse, students and prospective students don't seem to have any qualms about sitting in front of junk professors because these students want the advanced degree and they go to whatever junk school will accept them with the minimal amount of effort/cost. The free market is not doing anything to correct this problem; the solution needs to be at the regulatory level.

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On 2/26/2019 at 10:29 AM, Hyperflycemia said:

What makes you think that the problem is solely related to online education?

There are quality online programs. There are junk online programs. The same is true of brick and mortar programs. I have never seen compelling evidence that a junk online program is any better/worse than a junk brick and mortar program.

The problem of having junk professors is not isolated to online programs either, in fact the online programs might have more incentive to have quality faculty. To make matters worse, students and prospective students don't seem to have any qualms about sitting in front of junk professors because these students want the advanced degree and they go to whatever junk school will accept thm with the minimal amount of effort/cost. The free market is not doing anything to correct this problem; the solution needs to be at the regulatory level.

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To make matters worse, students and prospective students don't seem to have any qualms about sitting in front of junk professors because these students want the advanced degree and they go to whatever junk school will accept them with the minimal amount of effort/cost _<<----- 100% true I have co-workers asking me how hard is my program, because they want an easy school. When I try to tell them about why it is hard they are like... "I will get trained on the job, I just need the degree" The education needs to be standardized and everyone is on the same playing field...but people will always try for the shorter easier programs no matter the cost. My school is a state school and it is not perfect by any means...but there is always room for improvement.

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Specializes in Adult Internal Medicine.
22 hours ago, Cococure said:

When I try to tell them about why it is hard they are like... "I will get trained on the job, I just need the degree"

This is a different topic all together perhaps, but this also shows what one of the other "problems" with NP education is: experienced nurses assuming that their expertise/experience as an RN qualifies them to be an APN (or judge NP education/preparation, or understand what its like to work in the provider role). It is part of the confusion of the term "advanced practice nurse" because the path to expertise for the RN role and APN role are separate.

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1 hour ago, Hyperflycemia said:

This is a different topic all together perhaps, but this also shows what one of the other "problems" with NP education is: experienced nurses assuming that their expertise/experience as an RN qualifies them to be an APN (or judge NP education/preparation, or understand what its like to work in the provider role). It is part of the confusion of the term "advanced practice nurse" because the path to expertise for the RN role and APN role are separate.

That thought is debatable. The point of creation of the APRN role was to capitalize on the expertise and knowledge of the RN and adding advance training in medicine to improve access. That expertise is what differentiates us in general.

What that scenario screams to me is the necessity to increase access barriers to minimize attitudes that suggest they only needed the degree. The nurse who thinks like the above thought the same way through RN school and probably thinks similarly in other facets of life. No care in the why or how, only the do. And is probably doomed to be mediocre in life or to potentially harm someone in their care.

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