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you decide
I know which one with whom I'd rather work...
I know which one with whom I'd rather work...
Not going after you per se, PV, but the similar sentiments on this thread (though it is now a month old). First, if there are subpar NP's out there (and there are), why not hire them to do basic H&P and discharge stuff to save the physician time if they are qualified to do it, even if they aren't qualified to see patients directly? That is sort of one of the roles the NP was designed to fill - more than an RN but less than an MD.
Second, there are tons of subpar MD's and DO's, and I've worked with some -- despite the rigor of the education. I hate anecdotes, but they are quite popular around here. FWIW, I work with two DO's who run circles around some of the MD's I work with. One MD spent four hours running diagnostics on a pt with a high temp and low BP, thinking possible sepsis but couldn't figure out the source. After me prompting the MD 3 times, he finally examined the obviously swollen/reddened post surgical wound on the patient that I had mentioned on admissions to the ER, but that he hadn't noticed on the his physical exam of the patient (despite being informed of the patients surgical hx). I could literally give a dozen more examples of this particular physician and many others, but it serves no purpose. Educational rigor does not ensure competence.
Maybe a few years back, but most schools now are highly competitive.
True to a certain degree, but I assume you make this conclusion based on online postings. These students will likely never get admitted or will never even apply. They are those that think they want to be NP's, but will never get in and/or make it through.
...about the DNP, it is an absolute waste of time for NP's. It is simply a way to, 1) generate revenue for the schools 2) give something to show legislators to expand APN scope of practice further and, 3) further the old, ongoing attempt to justify nursing as a profession independent of medicine.
The DNP is there simply to try to justify nursing as a practice/profession independent of medicine.
...but you do get relevant clinical exposure at the RN level, thus why the MSN is considered an extension of the RN. In a nursing, you get a lot of exposure to pharmacology, labs, therapies, treatment modalities, presentation/manifestations of disease, nonmedical management of illness, etc. all of which the smart RN can carry with them and build on in an advanced practice degree. In the end, however, it is advanced nursing practice....
...Likewise, when it comes to treating a sore throat, a URI, UTI, rash, etc., I don't think its that big of a deal...
The fact that even 1 school can get away without doing a personal interview just goes to show how competitive NP is not.
But from what I have seen of NP there are very few deterrents that stop people from applying. I have seen many fill out their application at work, submit it to the school, and tell me a week or so later that they got in.
An excerpt from a previous post (2008) from Sarj:
I condensed some of this (old) post.
http://shine.yahoo.com/parenting/parents-11-old-died-sepsis-hospital-sent-son-183800609.html
The point I was making (though not clearly made), was that (seemingly) 'simple' (read: zebra) stuff can walk into anywhere, and a diploma mill NP is so much more likely to miss that kind of thing.
I know, as I have worked in ERs for 20+ years, and we have caught many a minute clinic's failures (read: solo NP staffed). It is the nature of the beast. The 2nd doc is always the smart one.
But in my (anecdotal, 22 years, in over 10 ERs) experience, solo, inexperienced NPs (versus collaboration, experienced ones) miss the (diagnosis) boat far more often than anyone else.
Just reading this thread, and then scanning some of your old posts, I got a sense of you wanting the fast track to the NP highway.
And no one can convince you otherwise.
What, are you two years out of the RN program now?
I guess you have it figured out.
I have been teaching clinicals for many years (on the side), and have run into many students like you. You probably have a great bedside work ethic, and I'd likely enjoy working alongside you (as a staff RN)
But you seem to despise the profession itself.
1. I already said before you posted this that I am sure that MD's do in fact love NP's running around doing their scut work(H&P etc) while they(the MD) takes care of the pt.
2. I also agree that there are lots of sub par MD/DO. I agree that more education does not always mean a better provider. You are preaching to the choir. I too have about a billion stories of MD's flat out saying/doing stupid things. We are all human. None of us perfect. None of us can know everything. However, at least MD/DO schools seem to TRY and minimize the amount of dummies they get.
3. I know of a NP school right now that does not even interview applicants and accepts them with marginal to poor scores, and/or experience. The fact that even 1 school can get away without doing a personal interview just goes to show how competitive NP is not.
...My point is, experience is limited - it only goes so far. As you well know, 80+% of the time you and I spend in the ER is task oriented and has little relevance to what a family NP (for example) does...
I still don't feel I would be adequately prepared to see, diagnose, and treat patients.
Can (many) PAs and NPs do it?
Yes. But they're not the best at it. That's all I'm trying to say.
Sure these are anecdotes, but it's all I got!
the np/crna I know was an icu nurse for years, became an fnp and worked in the er for years, got burnt out and decided he liked people better who he didn't have to talk to so became a crna...seriously...he also works icu but most of his pts there don't talk either....And to stay on topic, NP/CRNA combo...I wouldn't
the np/crna I know was an icu nurse for years, became an fnp and worked in the er for years, got burnt out and decided he liked people better who he didn't have to talk to so became a crna...seriously...he also works icu but most of his pts there don't talk either....
Perhaps our definition of "competitive" is different. Competitive for me is a school that has more applicants than seats, by say, a 2:1 margin.
That would be a pretty poor definition of competitive, unless you assume everyone that applies is qualified to begin with, which they won't be. Along with applicants who have stellar grades / test scores / LOR's will be the applicants at the other end of the bell curve that basically suck and weren't really qualified to apply, but took a shot anyway.
Competitive is when you start having to tell even your really good applicants NO, sorry, not this time. That happens frequently in good schools - it happens rarely in lousy schools, and even less in online-only programs.
That would be a pretty poor definition of competitive, unless you assume everyone that applies is qualified to begin with, which they won't be.
However, since I am one I would like for all of us (RN, NP, CRNA) to look good. As everyone knows it only takes a few bad apples to ruin all of the others. So I think we need to push for higher standards and more rigorous curriculum at all levels...especially NP haha.
PA education at the undergrad level is already fairly streamlined to a future in medicine. most programs want bio, gen. chem, microbio, psych, and a+p. some want o-chem, biochem, and genetics. very little fluff in pa prereqs for most institutions. also very little fluff in a typical pa program these days. there are a few required touchy/feely courses but these are done by all health professionals nowadays. many pa students have done these courses in their prior training and just breeze through them the second(or third) time around...No disagreement from me. I think nursing (and for that matter, medical, PA, etc.) education needs to improve beginning at the undergrad level.
So, let me see if I understand. Per you, I'm assuming that the half that don't get in are competitive yet you know they are not? How is it that I am assuming, but you are not?
Typical liberal assumptions - now I understand.
Everyone is competitive because everyone deserves an A in class because they worked hard. Every kid deserves a trophy because they tried hard, even if they sat on the bench. There are no winners or losers in life.
Do you really believe that ONLY those who are competitive applicants apply to a given program, which would imply that all applicants are essentially equal?