I found this article in my E-mail recently, it was a pretty good read, and if one goes around the site they will see several other complaints by preceptors pushing the same issue.
I have seen this in a few students I precept also (which I only do now from certain schools). I had a few kids from online universities (the for profit crap-wagons) as students a few times. It was awful. None of them had any clue how to diagnose, prescribe, or even really do a true physical exam. Basic stuff they should have learned in nursing school, much less an MSN program.
Get with the program people, you go to these for profit schools with no requirements besides a BSN degree, don't learn squat, and expect us to precept you?
Sorry this is real life.
This message is brief, and to all those people who attend these junky schools. Stop making our profession look terrible. If you cant get into a real school, then many you should just stay a nurse, you probably aren't cut out for the real deal MSN level thinking.
Yeah, yeah, I know I sound harsh, but your type are the reason that our profession is looked down upon by so many. Personally, I am pretty well respected, but every time I start a new job or meet a new doc or whatever, I have to prove myself, and it is because of sloths that attend these programs and lower our standards.
So the take-home is. Don't go to a crappy school and expect to find a preceptor, we know better than to waste our time with you. Go to a well respected school and we will be glad to help you out the best we can and accommodate you.
I already wrote a nice long, nasty letter to our credentialing agencies telling them this, of course they turn a deaf ear. The credentialing groups for nurse practitioners is weaksauce, and ran by a bunch of DNP- think they know it alls that are trying to I don't know what, by pumping as many nurse practitioners into the market, ignoring quality.
I cant wait for the flames from this one, people on this forum seem to resent the truth, and sit in their little happy-bubble world full of white coats, stethoscopes, and hopes for a big easy paycheck.
And to those who come here, from those, for profit schools and try to tell us that they were one of the students who "went above and beyond, because learning is about what you put into it" I have one thing to say. you already told us what you put into it by going to one of these programs. A lot of money and no thought. School is supposed to filter out those who aren't fit. PA and MD/DO schools do this. Yeah, every once in a while a junky one slipps by, but you know its a lot less frequent than NP schools.
Just fess up and admit that this is all true.. Preceptors are seeing it everywhere.
NP education is a lax joke with fluffy requirements.
I also gave psychguy and Jules A a personal spot to like this post. Why? Because they have great wisdom and common sense, and you all don't like what they say, because its the truth.
I like Diagnosaurus DDx. It is easy to use and helps to broaden my thinking. In addition to ddx for symptoms it provides ddx for various lab abnormalities which is helpful.
I downloaded DDx Teacher. I haven't used it much, but I like the concept and hope to spend some more time with it in the future.
I have to say, from the perspective of a current FNP student, this thread has been both enlightening and intimidating. My school is a large public R1 university in the midwest, and our FNP program has a traditional option and an online option. Both "tracks" are highly ranked. I am doing the online option, and while I did have concerns about learning in that format, so far I have learned quite a bit and I feel ready to begin hands on learning in my clinical courses, which actually start next week. I completely see the point of the importance of traditional classroom settings, and I agree that the for profit programs are largely a joke. For example, one of my friends received her nursing degree from the now-defunct Bohecker, and her clinical sites included watching babies at a day care. However, I am thankful, beyond thankful, for the online format of my program. I would love to not work or only work part time, but that's not an option for me (in my 30's mortgage, baby, etc). I am not sure I would have ever been able to achieve my goal of being an NP without it. I work from home full time doing "insurance nursing," and although it has been a few years since I have been at the bedside, I still learn a LOT every day at work. My schedule is flexible enough that I can play with my hours and I work weekends to make time for school during the week. I will say that the program I am doing is amazing, the instructors take it very seriously and monitor us very closely. They track how much time we spend in the course outside of class time, and expect us to come to class (we meet virtually once a week) prepared to go through patient scenarios and use clinical judgment to come up with differentials and treatment options. We will begin more in depth diagnosis and treatment skills this coming semester. We have a 100% boards pass rate. Not sure how that translates to the quality of nurses we put out, but I hope it does mean something.
ANYWAY, the point of my post is this: Knowing how many preceptors feel about online students, what advice can you give to help me prove myself to my preceptors from the start? What qualities in a student make you confident in their ability to take great care of their future patients, and make you want to invest your time in teaching them? I want to make the most out of this clinical year, it is going to be a very tough challenge making it all work with my schedule, but I want to learn as much as I can, and get my hands on as many patients as possible. My first clinical site is an urgent care with an NP, and my second site is in women's health with a WHNP. Would love to hear more specifics about what makes you confident your students are on the right track.
edit: I should also add that my program only accepts about 10% of applicants per year, and they do frequent OSCEs to assess our assessment techniques. They are not afraid to fail people. I am not sure my program is anything like some of the for-profit programs, but I have no experience with how rigorous they are.
I bought a gateway computer way back in the day. It sucked majorly. So I bought 12 more and went on allcomputers.com and complained non stop about how it didn't work and how my debt kept getting higher and higher and I couldn't do my job since the computers just kept sucking.
I kept posting on the forum that gateway should fix it but they wouldn't. But I kept buying their computers. IT JUST DIDNT MAKE SENSE???? How could they sell such terrible computers to poor old people like me who just wanted a computer to use for work? Those evil bastards!
Really folks, don't you understand economics? or are you so wrapped up in your altruistic nurse-bubble that you let people ream your wallet without second thought?
But they had nice commercials. That must mean something!
No, they were purchased by another cheap computer company, Acer.
I was going to make a comical analogy to other to PAs, but they aren't Acer quality. Nursing is t an Acer.
I think you are conflating the challenge of a RN starting NP clinicals with poor curriculum at for profit schools. I am not denying that most NP schools need to beef up their programs.
But I do think experienced NPs sometimes forget how difficult of a transition it is between RN and NP. I actually had a much better experience with my MD preceptors than my NP preceptors. They were more interested in actually teaching me and giving me time to learn and digest.
I was an ICU nurse prior to becoming a NP so there is a completely different perspective. Things that sent my NP preceptor into a frenzy didn't even concern me. Like she was militant about hga1c. It didn't matter how old the patient was, that damn lab had to be 6. Who cares if they black out from low blood sugar? But obviously because I "didn't know how to appropriately manage diabetes", I was a bad preceptee. Or because I didn't order a million dollar workup on a young, healthy female with nausea who wanted a work note, I was incompetent in her eyes.
There is somewhat an art to practicing. Some people are not effective teachers either. On top of that, some preceptors use their students to offload their workload which is wrong. It cuts both ways
well, yeah i suppose it can be difficult to make that transition. I mean going from a nurse to a nurse practitioner your moving from a position where you simply follow protocols, pass out meds, start IVs, and clean people. The only real decisions that need to be made is pretty much when to call the doctor.
Then your thrown into a position that actually requires independent judgement and stuff.
JUST FYI-Where I live they except 25 NP's per year PERIOD. the cut off date is Jan 15 of each year and its highly competitive. Personally I compared the local school to the "crappy schools" as you called and most of the learning is done with your preceptor. Have you been NP long enough that you don't remember your schooling days and your inexperience? Get off your high horse, YOU make the NP profession look bad ********. Remember there is a provider shortage and we all have to get there some how. Shame on you!
Remember there is a provider shortage and we all have to get there some how. Shame on you!
Actually no, we don't have to all get there somehow. There is a significant problem when people think that an NP is like the participation trophy of medical professions.
At least in my region NP is going the way of law school - you have to graduate with the right degree, from the right school, with the right mix of clinical experience and Pre-NP RN practice experience to be competitive for the job market (and no, the DNP doesn't set applicants apart out here). This is just going to continue as more for-profits open their doors and more people flood into the field.
BS-just because you didn't go to one of those "crappy" schools does not make you any more qualified or high and mighty compared to others who did.
I went the traditional route for my ASN and BSN and did not learn **** until I was in the work force. I was only as good as my preceptors that trained me-and thank god I had some excellent ones that did not carry your nasty opinion. You want high quality NP's coming into the work force, then I suggest you get off your soap box and precept if you are so damn good, but maybe you're not that good and no one should be learning from someone who has their ego and opinions so far up their ass.
Penguins10, MSN, RN, NP
18 Posts
I like Diagnosaurus DDx. It is easy to use and helps to broaden my thinking. In addition to ddx for symptoms it provides ddx for various lab abnormalities which is helpful.
I downloaded DDx Teacher. I haven't used it much, but I like the concept and hope to spend some more time with it in the future.