Current DNP Students Thoughts

[762513]

I am currently a DNP student at UW-Milwaukee in the Family NP route. I am in my second semester, about to start my third. Still doing what feels like my research and administration pre-reqs, which every DNP student has basically an identical first year. I am so far pleased with my education, knowing that I haven't gotten to the medical portion of my training. I can see the value in everything I have learned, and the courses have had rigor.

I am interested in other DNP students and their thoughts on their programs and any advice for the future. I am not interested in any other discipline's opinions on my field of study. Since DNP's arent allowed a forum, we can at least discuss a little here.

Hopefully we can start a discussion about expectations and thoughts on our emerging field of study.

Thank!

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[Boatswain2PA]

"haven't gotten to the medical portion of my training."

Don't blink when you get to it, otherwise you may lose it in all of the nursing leadership, nursing "research", and nursing administration classes.

 

[675151]

Go to Allnurses. I think you'll get more feedback. I'm there as well.

What is your emerging field of study?

 

[Mad Jack]

I am currently a DNP student at UW-Milwaukee in the Family NP route. I am in my second semester, about to start my third. Still doing what feels like my research and administration pre-reqs, which every DNP student has basically an identical first year. I am so far pleased with my education, knowing that I haven't gotten to the medical portion of my training. I can see the value in everything I have learned, and the courses have had rigor.

I am interested in other DNP students and their thoughts on their programs and any advice for the future. I am not interested in any other discipline's opinions on my field of study. Since DNP's arent allowed a forum, we can at least discuss a little here.

Hopefully we can start a discussion about expectations and thoughts on our emerging field of study.

Thank!

Given that there literally isn't a medical portion of your training, don't hold your breath.

 

[762513]

Pretty sure I said I wasn't interested in other disciplines opinions on my field of study. I guess 'haters gonna hate' tho. PsychNP I spent 10 years working in the army and on an ambulance as a Paramedic. I'm doing my research thesis on a qualatative study of patients who chronically overuse the emergency systems for primary care needs. If we can isolate a patient's perceptions we can work on developing education to change their decision making process.

 

[Boatswain2PA]

Nobody is "hating". But you should understand the NP education (including DNP) education has very, very little medicine in it. Your paramedic school very likely went into greater depth into topics like Cardiology than what you will find in your DNP program.

Instead of teaching the art and science of medicine, most NP (and DNP) programs focus on things like leadership, or "chronic overuse of emergency systems for primary care needs." These topics ARE important in the grand scheme of things, but they don't prepare you to deal with a sick patient sitting in front of you waiting for you.

 

[762513]

I'm going to reitterate for a third time in this thread that I am not interested in the opinions of other disciplines. The topic of this thread is current DNP students thoughts. So far you have only made disparaging remarks. I don't wish to engage with you any further.

 

[Boatswain2PA]

Good luck with that! lol

 

[Mad Jack]

If you're looking for the opinions of nurses, you'd find literally thousands more of them at allnurses.com's forums. They have a high quantity and quality of DNP posters. Just a thought.

 

[675151]

I agree, OP. Lime I said allnurses has a DNP specific forum as well as those for NPs, APNs in general, CRNAs, CNMs, all of the RN work niches (ED, CC, psych, etc), student forums, et al.

I think your study is prudent and has application. I was once an EMTP myself and did ED coverage as a RN. It'll be difficult to design and implement the education you want as those served by EMS and ED for primary care have poor health literacy to begin with.

As others have said, NP is unfortunately a medicine-lite field of study. The DNP coursework, as you may already know, won't add any clinical base to your education.

 

[762513]

Thanks for being a positive responder PsychNPGuy. In Milwauke County in the year 2014 7% of all 911 calls came from the same 50 people. I have read all the studies accessable concerning primary care concerns brought to the ED, and they all seem to have taken a convenience sample survey instead of a intensive interview based approach. I think my study has merit on an individual level to get these patients the help they need before they call 911.

 

[Makati2008]

I'm going to reitterate for a third time in this thread that I am not interested in the opinions of other disciplines. The topic of this thread is current DNP students thoughts. So far you have only made disparaging remarks. I don't wish to engage with you any further.

All posters are allowed to give opinions in threads as long as they are not inflammatory or derogatory.


Sent from my iPhone using SDN mobile app

 

[pamac]

Boatswain, opening up with an insult to someone that just wants to talk shop runs the risk of saying quite a bit about you that may not be true. Then you continue to drive that point home. Relax a bit.

 

[Makati2008]

Boatswain, opening up with an insult to someone that just wants to talk shop runs the risk of saying quite a bit about you that may not be true. Then you continue to drive that point home. Relax a bit.

You are welcome to your opinion. Have a goodnight.


Sent from my iPhone using SDN mobile app

 

[pamac]

Yeah, I am. And for some reason you seem seem to be going out of your way to state x2 that everyone has opinions. So I'll say it again... Boatswain looks small when he does what he did.

How lame is it to say right off the bat to someone who is in a program of study currently who is excited about what they are doing "hey, your career path is a joke!". Get real. And to have that come from a PA who is acting like he can waltz into the physicians lounge in most places and grab a red bull from the fridge without confused glances from the physicians who shake their heads at his 1 year of didactic and 1 year of clinical. Tell me one more about how you fly solo in your rural ER gig, and I'll tell you another about how your patients are missing out on not having a full on physician, and have to settle to see you. Everyone can be in a position to get put down.

There's nothing magic about what goes in to making a PA. It's still less than what it takes to become a physician. But for some reason, after 1 year of didactic, and 1 year of clinical, a new PA can go ahead and rip on anyone they like. To >95% of the physician world, you guys are lumped in with the NP's as "midlevels", and shouldn't be ripping on anyone.

You'd never step up and do that to someone in real life. Keyboards and anonymity create heros here.

 

[Boatswain2PA]

You think I insulted him? Sorry to offend you with micro-aggressions there cupcake, maybe you two should retreat to your "safe zone".

I have never insulted the NP profession. I work with many terrific NPs, and one of my mentors was a NP, and one of the best providers I've ever known.

You are absolutely correct that MD education >>> PA education. And everyone with half a brain knows that PA education >>>> NP education.

NP education (including DNP education) is mostly made up of soft topics instead of actual medicine. Yeah, a NP graduate may know the statistics of patient satisfaction scores, but they weren't taught the difference in MOAs between aminoglycosides and macrolides.

I never said his "career path was a joke". I am warning him that his medical education in NP school will be a joke. I also tell him that his paramedic education will serve him well, because it covers MORE medicine on some topics than he will get in NP school.

That being said, I almost always encourage nurses to go NP vice PA, because you get to the same place (career-wise) at 1/4 the price and 1/10 the effort. And once you're a "mid-level" (if that term micro-offends you, then retreat to your safe-zone again for protection) then the only thing that determines how good of a provider you are going to be is YOU!

And BTW - to say that I'd "never step up and do that to someone in real life" is partially correct, because I'm not "ripping" anyone here. I AM ripping NP education because the lever of medical edu cation it offers is joke. And I would absolutely do, and HAVE DONE that, many times in "real life". I do that because the NPs, and NP students, I have worked with need to know their limitations (just like PAs need to know their limitations, especially compared to residency trained MD/DOs) so that they can overcome them.

 

[kauaibbygrl808]

LET'S BE CLEAR ABOUT A FEW THINGS HERE....

IknowImnotadoctor, congrats on choosing the DNP path. I'm currently a BSN and still cannot decide whether or not I want to advance further to an MSN or DNP and here's why....

THERE ARE TOO MANY INCONSISTENCIES THROUGHOUT THE U.S! Although the DNP degree has been around for some time now, only as of 2015, it's being taken more "seriously". There are still many programs out there that aren't much about "medicine" like you all say, and a lot of the programs don't incorporate much of it! You're right! However, we "only nurses" can see things within 2 minutes of seeing patients that most MDs don't even realize! I think it's SO SAD to see Medical Students, PAs and even RESIDENTS, putting down the NP professions! BUT, I can't blame them!!! In earlier years, becoming an NP required "just" an MSN but now (MORE respectfully, if you ask me) DNPs hold more value, AND THEY SHOULD! These areas are so gray, as it is still very young! Many things need to be worked out to get everyone on board and the educational standards across the nation to be similar. Which I think would make the most sense. If it isn't consistent, then you have people like this PA guy above who think the NP education is "a joke". It makes my program here in Hawaii, look like a joke, which I know it's not. I do agree, the way that entry into DNP programs are set up are a joke and I can understand how that is a slap in an MDs face, even for other NPs who've worked towards a DNP their entire academic career, geared primarily in healthcare just to end up at the same level as someone who has a BA in arts! Although they experience a rigorous tract themselves, we worked hard for YEARS to end up at the same place while they waltzed through easy liberals and faced 1 1/2 years of nursing into a graduate program. YES, that's a joke. Any-who...I had to give my 2 cents on here because I DID NOT appreciate the NP title and education being railroaded the way it was. NPs here in Hawaii are valued a lot more than a PA and also are paid more. Nonetheless, I DID NOT choose this profession for the MONEY! I want to give back to the community! If there was a medical school on MY island, I would surely consider that! Also, because Hawaii is considered "rural", I believe in the future NPs will be needed. I wish, this particular program got more attention so there would be less confusion. Let's hope they work out all the kinks! NPs are very independent here and can run clinics and such! I wish you nothing but the best of luck!!!! ONE THING you should consider is WHERE you'd like to work after you've completed your education AND what communities would you most likely want to target. It helps with narrowing it down to specifically WHAT SCHOOLS program you want to enter. RESEARCH RESEARCH RESEARCH! That's the best you can do right now as the emerging DNP is revamped and put up there with other doctoral degrees! Hope to hear positive news DR. IKNOWIMNOTADOCTOR!

 

[pamac]

Boatswain, I doubt you lack the insight to not recognize where you came off wrong, but here you go doubling down behind your keyboard. You wouldn’t call me “cupcake” in real life, either, so that one slides off my back. Talk is cheap.

If you rant on in public like you do in an online thread, then we’ve all met you in some form or another and rolled our eyes at you. Your honey badger attitude on here probably comes from working tons of hours and using SDN as an outlet between patients. But, maybe you are indeed the kind of character who goes on endlessly like a jilted lover that can’t get past a breakup (you definitely do that here whenever NP gets mentioned). It doesn’t take any kind of overreaction to “micro-agressions” to see how you roll with your own oversensitivity to the topic. Just relax man. Nobody needs you to grab your sandwich boards and hit the street corner preaching about how bad you think NP education is. I don’t think the OP got a lot out of benefit from the mission you took upon yourself to take every NP student down a notch.

 

[deleted480308]

LET'S BE CLEAR ABOUT A FEW THINGS HERE....

IknowImnotadoctor, congrats on choosing the DNP path. I'm currently a BSN and still cannot decide whether or not I want to advance further to an MSN or DNP and here's why....

THERE ARE TOO MANY INCONSISTENCIES THROUGHOUT THE U.S! Although the DNP degree has been around for some time now, only as of 2015, it's being taken more "seriously". There are still many programs out there that aren't much about "medicine" like you all say, and a lot of the programs don't incorporate much of it! You're right! However, we "only nurses" can see things within 2 minutes of seeing patients that most MDs don't even realize! I think it's SO SAD to see Medical Students, PAs and even RESIDENTS, putting down the NP professions! BUT, I can't blame them!!! In earlier years, becoming an NP required "just" an MSN but now (MORE respectfully, if you ask me) DNPs hold more value, AND THEY SHOULD! These areas are so gray, as it is still very young! Many things need to be worked out to get everyone on board and the educational standards across the nation to be similar. Which I think would make the most sense. If it isn't consistent, then you have people like this PA guy above who think the NP education is "a joke". It makes my program here in Hawaii, look like a joke, which I know it's not. I do agree, the way that entry into DNP programs are set up are a joke and I can understand how that is a slap in an MDs face, even for other NPs who've worked towards a DNP their entire academic career, geared primarily in healthcare just to end up at the same level as someone who has a BA in arts! Although they experience a rigorous tract themselves, we worked hard for YEARS to end up at the same place while they waltzed through easy liberals and faced 1 1/2 years of nursing into a graduate program. YES, that's a joke. Any-who...I had to give my 2 cents on here because I DID NOT appreciate the NP title and education being railroaded the way it was. NPs here in Hawaii are valued a lot more than a PA and also are paid more. Nonetheless, I DID NOT choose this profession for the MONEY! I want to give back to the community! If there was a medical school on MY island, I would surely consider that! Also, because Hawaii is considered "rural", I believe in the future NPs will be needed. I wish, this particular program got more attention so there would be less confusion. Let's hope they work out all the kinks! NPs are very independent here and can run clinics and such! I wish you nothing but the best of luck!!!! ONE THING you should consider is WHERE you'd like to work after you've completed your education AND what communities would you most likely want to target. It helps with narrowing it down to specifically WHAT SCHOOLS program you want to enter. RESEARCH RESEARCH RESEARCH! That's the best you can do right now as the emerging DNP is revamped and put up there with other doctoral degrees! Hope to hear positive news DR. IKNOWIMNOTADOCTOR!

Can you please elaborate on which things NPs can see in two minutes that doctors and PAs can't? I'm curious

 

[Boatswain2PA]

.... I guess 'haters gonna hate' tho. ....

Boatswain, opening up with an insult to someone....

....How lame is it to say right off the bat to someone...."hey, your career path is a joke!"....

So help me out here Pamac....where did I "hate" on NPs, insult the OP, or say his/her career path is a joke?


If you read back through my posts, I said the OPs topic of research IS important, and pointed out the strength of his/her military/paramedic experience.

Boatswain, I doubt you lack the insight to not recognize where you came off wrong, but here you go doubling down behind your keyboard. You wouldn’t call me “cupcake” in real life, either, so that one slides off my back. Talk is cheap.


If you rant on in public like you do in an online thread, then we’ve all met you in some form or another and rolled our eyes at you. Your honey badger attitude on here probably comes from working tons of hours and using SDN as an outlet between patients. But, maybe you are indeed the kind of character who goes on endlessly like a jilted lover that can’t get past a breakup (you definitely do that here whenever NP gets mentioned). It doesn’t take any kind of overreaction to “micro-agressions” to see how you roll with your own oversensitivity to the topic. Just relax man. Nobody needs you to grab your sandwich boards and hit the street corner preaching about how bad you think NP education is. I don’t think the OP got a lot out of benefit from the mission you took upon yourself to take every NP student down a notch.

I just might call you "cupcake" in real life if you wind up getting butt-hurt from the truth. Of course, in person the other 90% of interpersonal communication is also present, so the "painful truth" can be presented in a softer way.

For example: Brand new NP graduate orientating with me in the ED and EMS brings in a code, CPR started in the field by a friend. Only medical information we have is "renal failure". I'm letting new NP run the code. I ask her about possible causes of cardiac arrest in renal failure….blank stare. I suggest hyperK….blank stare. I ask what the treatment for hyperK is….she says “Kayexalate”. I suggest CA because it might work a bit faster in this dead guy. I ask CaCl or CaGluconate…..blank stare.


Later we discussed this case in detail. Despite working as an RN in a cardiac ICU for years, she had absolutely no understanding of how CA stabilizes the myocytes, or how renal failure can cause Hyper K. I used it to highlight the importance that, now she is out of school and fully licensed, she learn MEDICINE because she damn well didn’t learn much medicine in NP school. She knew that I wasn’t “attacking” or “offending” her because she knew that I wanted her to succeed.

Same thing applies to the OP here.

 

[NYCGuy86]

So help me out here Pamac....where did I "hate" on NPs, insult the OP, or say his/her career path is a joke?


If you read back through my posts, I said the OPs topic of research IS important, and pointed out the strength of his/her military/paramedic experience.





I just might call you "cupcake" in real life if you wind up getting butt-hurt from the truth. Of course, in person the other 90% of interpersonal communication is also present, so the "painful truth" can be presented in a softer way.

For example: Brand new NP graduate orientating with me in the ED and EMS brings in a code, CPR started in the field by a friend. Only medical information we have is "renal failure". I'm letting new NP run the code. I ask her about possible causes of cardiac arrest in renal failure….blank stare. I suggest hyperK….blank stare. I ask what the treatment for hyperK is….she says “Kayexalate”. I suggest CA because it might work a bit faster in this dead guy. I ask CaCl or CaGluconate…..blank stare.


Later we discussed this case in detail. Despite working as an RN in a cardiac ICU for years, she had absolutely no understanding of how CA stabilizes the myocytes, or how renal failure can cause Hyper K. I used it to highlight the importance that, now she is out of school and fully licensed, she learn MEDICINE because she damn well didn’t learn much medicine in NP school. She knew that I wasn’t “attacking” or “offending” her because she knew that I wanted her to succeed.

Same thing applies to the OP here.

How sad. We learned that in undergraduate nursing education. And amusingly, I'm currently doing my medical/surgical nursing II rotation in a cardiothoracic ICU, where one of the clinical nurse specialists on the unit, and our clinical instructor, educated us on the relationship between calcium and stabilization of the cell membrane/arrhythmias, and the use of calcium gluconate vs. chloride. And my school isn't even the top one in the region.

I generally agree on the rigor of PA school, in general, being higher than that of NP school, at least from what I observe from the outside. However some of these examples of the inferior clinical knowledge of NPs have me shaking my head, as they are often describing information that is usually obtained in undergraduate RN education.

 

[762513]

LET'S BE CLEAR ABOUT A FEW THINGS HERE....

IknowImnotadoctor, congrats on choosing the DNP path. I'm currently a BSN and still cannot decide whether or not I want to advance further to an MSN or DNP and here's why....

THERE ARE TOO MANY INCONSISTENCIES THROUGHOUT THE U.S! Although the DNP degree has been around for some time now, only as of 2015, it's being taken more "seriously". There are still many programs out there that aren't much about "medicine" like you all say, and a lot of the programs don't incorporate much of it! You're right! However, we "only nurses" can see things within 2 minutes of seeing patients that most MDs don't even realize! I think it's SO SAD to see Medical Students, PAs and even RESIDENTS, putting down the NP professions! BUT, I can't blame them!!! In earlier years, becoming an NP required "just" an MSN but now (MORE respectfully, if you ask me) DNPs hold more value, AND THEY SHOULD! These areas are so gray, as it is still very young! Many things need to be worked out to get everyone on board and the educational standards across the nation to be similar. Which I think would make the most sense. If it isn't consistent, then you have people like this PA guy above who think the NP education is "a joke". It makes my program here in Hawaii, look like a joke, which I know it's not. I do agree, the way that entry into DNP programs are set up are a joke and I can understand how that is a slap in an MDs face, even for other NPs who've worked towards a DNP their entire academic career, geared primarily in healthcare just to end up at the same level as someone who has a BA in arts! Although they experience a rigorous tract themselves, we worked hard for YEARS to end up at the same place while they waltzed through easy liberals and faced 1 1/2 years of nursing into a graduate program. YES, that's a joke. Any-who...I had to give my 2 cents on here because I DID NOT appreciate the NP title and education being railroaded the way it was. NPs here in Hawaii are valued a lot more than a PA and also are paid more. Nonetheless, I DID NOT choose this profession for the MONEY! I want to give back to the community! If there was a medical school on MY island, I would surely consider that! Also, because Hawaii is considered "rural", I believe in the future NPs will be needed. I wish, this particular program got more attention so there would be less confusion. Let's hope they work out all the kinks! NPs are very independent here and can run clinics and such! I wish you nothing but the best of luck!!!! ONE THING you should consider is WHERE you'd like to work after you've completed your education AND what communities would you most likely want to target. It helps with narrowing it down to specifically WHAT SCHOOLS program you want to enter. RESEARCH RESEARCH RESEARCH! That's the best you can do right now as the emerging DNP is revamped and put up there with other doctoral degrees! Hope to hear positive news DR. IKNOWIMNOTADOCTOR!

Kauaibbygrl808, thanks for your post. I currently work in an ICU at teaching hospital. It's great learning as the residents learn and our attendings love to teach and make it clear no question is off limits. I have learned more from them and the residents than I ever imagined. It's invalueble to work through a diagnosis with the resident and learn together. Once you make a few good catches over a couple years the physicians trust your judgment and give you a very long leash; deciding when the paralytics absolutely must go back on, titrating sedation and pressors around a septic CVVH patient, and countless other high level skills.

I am getting my FNP for a few reasons. I spoke to a number of ACNP who regretted their specializations, and said if they could do it again they would have gone FNP and then tooled their certifications for the role they were looking for. The second reason was through the UW system my education is free as a result of my war time service, and UW-Milwaukee is in the top 10% of nursing schools nation wide. I was given advice from my mentor that if I was going to go DNP go somewhere people have heard of and is respected as a program. I would like to work either ED, ICU, or hospitalist after a few years establishing a skill set in primary care. If you have any questions about the DNP application process through NursingCAS, the GRE, or the acceptance process I would be happy to share my experience. Thanks for your post!

 

[NYCGuy86]

In a few years I plan on applying to Columbia's BSN to DNP program, the AG-ACNP concentration. I have no interest in primary care, and there are many opportunities in my area for NPs in hospital medicine, specialties, specialty clinics, etc. I like Columbia's program because, in addition to the usual advanced physiology and pathophysiology, advanced pharmacology, and advanced physical assessment courses, you also take an acute and critical care pharmacology course, an acute/critical care clinical assessment and procedures course, a genetics/genomics course, and of course the diagnostic/clinical courses. The DNP specific courses do include the usual bioethics, research, policy, and epidemiology courses, but they also have a couple "fundamentals of comprehensive care" courses and seminars that discuss actual clinical content (the description says it builds on the advanced pharm, patho, and physical assessment courses to understand common acute and chronic disease processes across the lifespan, clinical decision making, etc). The DNP also includes courses that discuss evaluation techniques, clinical monitoring, therapeutic interventions, and coordination of care. They also include a couple clinical rotations "designed to provide the opportunity for students to apply knowledge of the diagnosis and management of patients with complex diagnoses and/or comorbid conditions who present with complex diagnoses and comorbid and chronic conditions in the context of family, community, and culture and patients with acute changes in health status requiring interventions available only in an acute care setting."

Quite frankly Columbia's DNP programs (including just the MSN to DNP program for applicants already NPs and the BSN to DNP program that includes the NP portion in addition to the DNP-specific courses) are probably among the best I've seen, including actual clinical/medical knowledge and clinical experience on top of that found in the NP programs.

 

[W19]

Can you please elaborate on which things NPs can see in two minutes that doctors and PAs can't? I'm curious

I think this particular poster was joking!

 

[deleted480308]

I think this particular poster was joking!

I think it was untrue but I don't think they were joking. It's not the first time I've heard something along those lines but no one ever seems to come up with an actual consistent example beyond anecdotes

 

[W19]

I think it was untrue but I don't think they were joking. It's not the first time I've heard something along those lines but no one ever seems to come up with an actual consistent example beyond anecdotes

I went to nursing school and I can attest that they do a good job in brainwashing nurses on how 'bad' physicians are, but this particular nonsense is new to me.

 

[762513]

I went to nursing school and I can attest that they do a good job in brainwashing nurses on how 'bad' physicians are, but this particula

I think it was untrue but I don't think they were joking. It's not the first time I've heard something along those lines but no one ever seems to come up with an actual consistent example beyond anecdotes

SB247, very little. I don't think the point is there are things an RN will see than an MD won't, but for example when a order is put in for a chest CT on a someone that the movement of the trip will literally kill them an RN will see that faster than an MD, for example. These situations are common and they revolve around the physical process of getting the tests done that while it would be great to help you come to a dignosis, diagnosing a corpse isnt very useful.

 

[deleted480308]

SB247, very little. I don't think the point is there are things an RN will see than an MD won't, but for example when a order is put in for a chest CT on a someone that the movement of the trip will literally kill them an RN will see that faster than an MD, for example. These situations are common and they revolve around the physical process of getting the tests done that while it would be great to help you come to a dignosis, diagnosing a corpse isnt very useful.

so your premise is that physicians don't know if patients can physically handle tests and that RNs can discern this visually in 2 minutes?

 

[762513]

so your premise is that physicians don't know if patients can physically handle tests and that RNs can discern this visually in 2 minutes?

I never used the words "2 minutes" thats foolish. There are physical realities that people actually doing the order understand that the provider would not understand as quickly. It's not that the doctor wont understand, it's that the nurse will understand those types of limitations faster. As I said, very very little.

 

[deleted480308]

LET'S BE CLEAR ABOUT A FEW THINGS HERE....

IknowImnotadoctor, congrats on choosing the DNP path. I'm currently a BSN and still cannot decide whether or not I want to advance further to an MSN or DNP and here's why....

THERE ARE TOO MANY INCONSISTENCIES THROUGHOUT THE U.S! Although the DNP degree has been around for some time now, only as of 2015, it's being taken more "seriously". There are still many programs out there that aren't much about "medicine" like you all say, and a lot of the programs don't incorporate much of it! You're right! However, we "only nurses" can see things within 2 minutes of seeing patients that most MDs don't even realize! I think it's SO SAD to see Medical Students, PAs and even RESIDENTS, putting down the NP professions! BUT, I can't blame them!!! In earlier years, becoming an NP required "just" an MSN but now (MORE respectfully, if you ask me) DNPs hold more value, AND THEY SHOULD! These areas are so gray, as it is still very young! Many things need to be worked out to get everyone on board and the educational standards across the nation to be similar. Which I think would make the most sense. If it isn't consistent, then you have people like this PA guy above who think the NP education is "a joke". It makes my program here in Hawaii, look like a joke, which I know it's not. I do agree, the way that entry into DNP programs are set up are a joke and I can understand how that is a slap in an MDs face, even for other NPs who've worked towards a DNP their entire academic career, geared primarily in healthcare just to end up at the same level as someone who has a BA in arts! Although they experience a rigorous tract themselves, we worked hard for YEARS to end up at the same place while they waltzed through easy liberals and faced 1 1/2 years of nursing into a graduate program. YES, that's a joke. Any-who...I had to give my 2 cents on here because I DID NOT appreciate the NP title and education being railroaded the way it was. NPs here in Hawaii are valued a lot more than a PA and also are paid more. Nonetheless, I DID NOT choose this profession for the MONEY! I want to give back to the community! If there was a medical school on MY island, I would surely consider that! Also, because Hawaii is considered "rural", I believe in the future NPs will be needed. I wish, this particular program got more attention so there would be less confusion. Let's hope they work out all the kinks! NPs are very independent here and can run clinics and such! I wish you nothing but the best of luck!!!! ONE THING you should consider is WHERE you'd like to work after you've completed your education AND what communities would you most likely want to target. It helps with narrowing it down to specifically WHAT SCHOOLS program you want to enter. RESEARCH RESEARCH RESEARCH! That's the best you can do right now as the emerging DNP is revamped and put up there with other doctoral degrees! Hope to hear positive news DR. IKNOWIMNOTADOCTOR!

I never used the words "2 minutes" thats foolish. There are physical realities that people actually doing the order understand that the provider would not understand as quickly. It's not that the doctor wont understand, it's that the nurse will understand those types of limitations faster. As I said, very very little.

yes, foolish

 

[762513]

yes, foolish

If you would like to know more about the discipline of nursing I suggest you visit the AACN article and defintion linked below:
http://www.aacn.nche.edu/publications/position/defining-scholarship

The article states "Within nursing, the scholarship of discovery reflects the unique perspective of nursing that "takes an expanded view of health by emphasizing health promotion, restoration, and rehabilitation, as well as a commitment to caring and comfort (AACN, 1998, p.1)."

If in are interested in real life examples of the contributions of the nursing profession please reference the cultural sensitivity and care models that have come from nursing without medical collaboration and have greatly increased the accuracy of medical diagnoses and patient care. There are also PhD nursing programs you can research to better learn the distinction between the disciplines of nursing and medicine. It would serve all physicians well to understand the discipline of nursing more clearly.

 

[762513]

In a few years I plan on applying to Columbia's BSN to DNP program, the AG-ACNP concentration. I have no interest in primary care, and there are many opportunities in my area for NPs in hospital medicine, specialties, specialty clinics, etc. I like Columbia's program because, in addition to the usual advanced physiology and pathophysiology, advanced pharmacology, and advanced physical assessment courses, you also take an acute and critical care pharmacology course, an acute/critical care clinical assessment and procedures course, a genetics/genomics course, and of course the diagnostic/clinical courses. The DNP specific courses do include the usual bioethics, research, policy, and epidemiology courses, but they also have a couple "fundamentals of comprehensive care" courses and seminars that discuss actual clinical content (the description says it builds on the advanced pharm, patho, and physical assessment courses to understand common acute and chronic disease processes across the lifespan, clinical decision making, etc). The DNP also includes courses that discuss evaluation techniques, clinical monitoring, therapeutic interventions, and coordination of care. They also include a couple clinical rotations "designed to provide the opportunity for students to apply knowledge of the diagnosis and management of patients with complex diagnoses and/or comorbid conditions who present with complex diagnoses and comorbid and chronic conditions in the context of family, community, and culture and patients with acute changes in health status requiring interventions available only in an acute care setting."

Quite frankly Columbia's DNP programs (including just the MSN to DNP program for applicants already NPs and the BSN to DNP program that includes the NP portion in addition to the DNP-specific courses) are probably among the best I've seen, including actual clinical/medical knowledge and clinical experience on top of that found in the NP programs.

Thats awesome NYC guy. It's good to know what direction you plan on going. I also would prefer in patient positions. It can be daunting to finally pull the trigger on graduate education, but so far it has been worth it although I have 6 semesters left. Let me know if you want any advice on the application process and how to deal with NursingCAS as I'm sure your program is going through them now. Keep me updated!

 

[deleted480308]

If you would like to know more about the discipline of nursing I suggest you visit the AACN article and defintion linked below:
http://www.aacn.nche.edu/publications/position/defining-scholarship

The article states "Within nursing, the scholarship of discovery reflects the unique perspective of nursing that "takes an expanded view of health by emphasizing health promotion, restoration, and rehabilitation, as well as a commitment to caring and comfort (AACN, 1998, p.1)."

If in are interested in real life examples of the contributions of the nursing profession please reference the cultural sensitivity and care models that have come from nursing without medical collaboration and have greatly increased the accuracy of medical diagnoses and patient care. There are also PhD nursing programs you can research to better learn the distinction between the disciplines of nursing and medicine. It would serve all physicians well to understand the discipline of nursing more clearly.

expanded compared to what?

 

[762513]

expanded compared to what?

Expanded compared to medicine. You are aware that all the cultural sensitivity came out of the nursing discipline distinctly and has improved the accuracy of physicians diagnosis. This is one example of many in which more in-depth patient centric nursing research has contributed to medicine. Is this clear, or are you still alluding to the fallacy that nursing does not have an independent discipline, you have been skirting that topic for the last few posts now.

 

[deleted480308]

Expanded compared to medicine. You are aware that all the cultural sensitivity came out of the nursing discipline distinctly and has improved the accuracy of physicians diagnosis. This is one example of many in which more in-depth patient centric nursing research has contributed to medicine. Is this clear, or are you still alluding to the fallacy that nursing does not have an independent discipline, you have been skirting that topic for the last few posts now.

I do agree that nursing is different than being a physician. They are quite different and I've never come close to saying otherwise.

What I questioned before was the ridiculous claim that nurses can spot things "in 2 minutes" that physicians magically can't. And what I'm questioning now is your implication that somehow nurses have more "expanded view of health by emphasizing health promotion, restoration, and rehabilitation, as well as a commitment to caring and comfort" than other professions do...that's silly. All the professions have people who care and people who are crappy. Nurses aren't unique overachievers in caring. The phrasing of "expanded view" means someone else has a less expanded view and it's simply not the case

 

[762513]

I do agree that nursing is different than being a physician. They are quite different and I've never come close to saying otherwise.

What I questioned before was the ridiculous claim that nurses can spot things "in 2 minutes" that physicians magically can't. And what I'm questioning now is your implication that somehow nurses have more "expanded view of health by emphasizing health promotion, restoration, and rehabilitation, as well as a commitment to caring and comfort" than other professions do...that's silly. All the professions have people who care and people who are crappy. Nurses aren't unique overachievers in caring. The phrasing of "expanded view" means someone else has a less expanded view and it's simply not the case

I appreciate and agree with your statement that we are all here for our patients and to make their lives better and return them to their best state of function, however, the idea that a PhD nurse may see an issue an MD would miss and vice versa is completely valid. The nursing discipline has many theories; practice, mid-range, and grand. For example, if a nurse was educated in Lenz Theory of Unpleasant Symptoms, that nurse would take a different approach to care for a patient with multiple co-morbidities than a physician might. Perhaps the decision may be made to put off an important but elective procedure until some of the multipilicative symptoms are reduced in order promote resolution of the current issue.

Nurses do have a more expanded view of the holisitic care of the patient based on our research and doctrine, just as physcians are the experts in the diagnosis and treatment of disease. To say a physician has all the skills, knowledge and perceptions of a nurse trained in nursing theory and process is hubris, and vice versa.

 

[FutureD0C17]

Can you please elaborate on which things NPs can see in two minutes that doctors and PAs can't? I'm curious

They see things very, very quickly. For instance, they often see they're in over their heads within 1 minute, not two!

 

[675151]

So help me out here Pamac....where did I "hate" on NPs, insult the OP, or say his/her career path is a joke?


If you read back through my posts, I said the OPs topic of research IS important, and pointed out the strength of his/her military/paramedic experience.





I just might call you "cupcake" in real life if you wind up getting butt-hurt from the truth. Of course, in person the other 90% of interpersonal communication is also present, so the "painful truth" can be presented in a softer way.

For example: Brand new NP graduate orientating with me in the ED and EMS brings in a code, CPR started in the field by a friend. Only medical information we have is "renal failure". I'm letting new NP run the code. I ask her about possible causes of cardiac arrest in renal failure….blank stare. I suggest hyperK….blank stare. I ask what the treatment for hyperK is….she says “Kayexalate”. I suggest CA because it might work a bit faster in this dead guy. I ask CaCl or CaGluconate…..blank stare.


Later we discussed this case in detail. Despite working as an RN in a cardiac ICU for years, she had absolutely no understanding of how CA stabilizes the myocytes, or how renal failure can cause Hyper K. I used it to highlight the importance that, now she is out of school and fully licensed, she learn MEDICINE because she damn well didn’t learn much medicine in NP school. She knew that I wasn’t “attacking” or “offending” her because she knew that I wanted her to succeed.

Same thing applies to the OP here.

You provide an interesting example that I think is relevant for all.

First, NP education is generally crap. It's offered by NPs who themselves received NP education.

Second, individually, many NPs (and other health professionals) may have a textbook understanding of the situation you mention. However, without application and "doing it" most people are largely incapable of immediately applying classroom information into an actual patient scenario. Likely, your NP fell back on experience, not classroom teaching, because RNs learn about the implications of giving kayelate on the job.

In circa 2000, I was training as a paramedic and observed what was probably the earliest code I'd witnessed in the ED. A woman overdosed on what I don't recall, interventional cardiology was called in, and transvenous pacing began. The FP resident who had been previously running the code abruptly shouted something about giving more atropine. The two RNs and cardiologist all turned and looked at him like he was stupid and the cards guy then explained the situation much like you did to your NP. He then got it. I wasn't a medical guy then and was largely taking the course as a hobby and would've done what the resident wanted. However, the cardiologist provided both of us with the application of what the resident physician knew and what I had been merely introduced to. There's a lot to be said for clinical training. Unfortunately, that which most NPs get is, again, crap.

The good NPs complain and strive to correct any deficiencies by expounding on their tradecraft. I'd love to overhaul the field. I chose NP, after a tenure in law enforcement, because it was geographically accessible. There was nothing I deemed unique or enriching about "nursing," and I, like many NPs, left disappointed by what was offered academically given the required capital.

 

[pamac]

I am aware of three states that are contemplating revoking the prescriptive privileges of NPs based on their inconsistent education programs and lack of clinical training.

What states? Given that such measures would probably require legislation, how far along the process is such action, and who is it that is contemplating it? It's tough to get legislation on a topic, but it's even tougher to roll it back. If a couple of legislators are complaining about conditions, that's a lot different than a proposal making it through the labyrinth of a statehouse. I guess we could be dealing with states that have a medical board overseeing NP's. But let us know, I'm curious.

 

[675151]

I am aware of three states that are contemplating revoking the prescriptive privileges of NPs based on their inconsistent education programs and lack of clinical training.

Oh yeah? Which ones?

 

[762513]

You provide an interesting example that I think is relevant for all.

First, NP education is generally crap. It's offered by NPs who themselves received NP education.

Second, individually, many NPs (and other health professionals) may have a textbook understanding of the situation you mention. However, without application and "doing it" most people are largely incapable of immediately applying classroom information into an actual patient scenario. Likely, your NP fell back on experience, not classroom teaching, because RNs learn about the implications of giving kayelate on the job.

In circa 2000, I was training as a paramedic and observed what was probably the earliest code I'd witnessed in the ED. A woman overdosed on what I don't recall, interventional cardiology was called in, and transvenous pacing began. The FP resident who had been previously running the code abruptly shouted something about giving more atropine. The two RNs and cardiologist all turned and looked at him like he was stupid and the cards guy then explained the situation much like you did to your NP. He then got it. I wasn't a medical guy then and was largely taking the course as a hobby and would've done what the resident wanted. However, the cardiologist provided both of us with the application of what the resident physician knew and what I had been merely introduced to. There's a lot to be said for clinical training. Unfortunately, that which most NPs get is, again, crap.

The good NPs complain and strive to correct any deficiencies by expounding on their tradecraft. I'd love to overhaul the field. I chose NP, after a tenure in law enforcement, because it was geographically accessible. There was nothing I deemed unique or enriching about "nursing," and I, like many NPs, left disappointed by what was offered academically given the required capital.

I'm not impressed with your anecdotes of new NP's not knowing what they are doing. I could sit down with a coworker and write a book entitled "Things Residents Don't Know" and they went to medical school. I've seen dozens of residents stop insulin drips before anion gaps were closed, refuse to put in central lines on sick patients because they were unskilled in the process, not know when to consult nephrology on a CKD patient or the treatment of hyperkalemia, have no idea how to run a code, miss glaring parts of their assessments, approve unsafe discharge plans, refuse to treat patients in obvious pain just because they have a history of substance abuse, the list goes on for hours. Again, not interested in your anecdotes.

I'm also not interested in your apparent omnipotence in knowing the rigor of every NP program in the county. You state NP educatin is "generally crap." I'm not sure how you would know this definitively. I know you went to Psych NP school, so you may know about psych NP education, but unless you went to the other schools I'm not impressed that you are really the definitive authority in this matter.

I do appreciate your take on the issues and I know I will have a lot farther to go to get up to speed in medicine than PA's for example, but I will let you know how well prepared my education has made me when I am nearer graduation. I do go to one of the top 10% of graduate nursing schools in the nation, and all the NP's I have spoken to before I started there informed me the program has plenty of rigor. I look forward to the education and will supplement what is needed along the way.

 

[W19]

I do appreciate your take on the issues and I know I will have a lot farther to go to get up to speed in medicine than PA's for example, but I will let you know how well prepared my education has made me when I am nearer graduation. I do go to one of the top 10% of graduate nursing schools in the nation, and all the NP's I have spoken to before I started there informed me the program has plenty of rigor. I look forward to the education and will supplement what is needed along the way.

 

[762513]

Please describe your graduate nursing school experience so that we can compare and contrast our different programs

 

[675151]

I'm not impressed with your anecdotes of new NP's not knowing what they are doing. I could sit down with a coworker and write a book entitled "Things Residents Don't Know" and they went to medical school. I've seen dozens of residents stop insulin drips before anion gaps were closed, refuse to put in central lines on sick patients because they were unskilled in the process, not know when to consult nephrology on a CKD patient or the treatment of hyperkalemia, have no idea how to run a code, miss glaring parts of their assessments, approve unsafe discharge plans, refuse to treat patients in obvious pain just because they have a history of substance abuse, the list goes on for hours. Again, not interested in your anecdotes.

I'm also not interested in your apparent omnipotence in knowing the rigor of every NP program in the county. You state NP educatin is "generally crap." I'm not sure how you would know this definitively. I know you went to Psych NP school, so you may know about psych NP education, but unless you went to the other schools I'm not impressed that you are really the definitive authority in this matter.

I do appreciate your take on the issues and I know I will have a lot farther to go to get up to speed in medicine than PA's for example, but I will let you know how well prepared my education has made me when I am nearer graduation. I do go to one of the top 10% of graduate nursing schools in the nation, and all the NP's I have spoken to before I started there informed me the program has plenty of rigor. I look forward to the education and will supplement what is needed along the way.

I think "generally" was the qualifying word to derail any omnipotent comments. Also, I think the pacing scenario indicates that all degrees and licenses need proctored experience before connecting all the dots.

 

[762513]

I think "generally" was the qualifying word to derail any omnipotent comments. Also, I think the pacing scenario indicates that all degrees and licenses need proctored experience before connecting all the dots.

I respect your opinion but I don't think you are even "generally" in a position to paint with so broad a brush. I completely agree there should be a minimum of a 1 year residency for NP students before they start working. Navigating the healthcare sector is too complex a system and the risks too high as a provider to not have a robust residency.

On a side note, I've finally figured out what this thread is; a bunch of medical students, residents and mid levels who feel inferior at their jobs and so feel the psychological need to crap all over someone else. It's typical stuff, I should probably have known better than to make a post in here to begin with. Before any of you start to justify "oh I only said this;" you all know what you did and why you did it.

 

[675151]

I respect your opinion but I don't think you are even "generally" in a position to paint with so broad a brush. I completely agree there should be a minimum of a 1 year residency for NP students before they start working. Navigating the healthcare sector is too complex a system and the risks too high as a provider to not have a robust residency.

On a side note, I've finally figured out what this thread is; a bunch of medical students, residents and mid levels who feel inferior at their jobs and so feel the psychological need to crap all over someone else. It's typical stuff, I should probably have known better than to make a post in here to begin with. Before any of you start to justify "oh I only said this;" you all know what you did and why you did it.

You're right in that it is replete with med students and residents. I think "inferior" is the wrong word. Arrogant perhaps.

I base my statements off being a NP, seeing the curricula of many different NP programs, and talking with other NPs.

I have suggested to ay least twice that AllNurses will provide a better population of NPs for you to discuss via web forum. I'm there as well. And I will continue to complain that NP program training is insufficient, and I will continue to complain that most NPs are generally uninformed on healthcare as a business.

I come here to shadow the midlevel and psychiatry forums.

I don't really care if you're offended individually although I would prefer we be friends or at least collegial. I do think you're taking my statements too personally.

 

[W19]

Please describe your graduate nursing school experience so that we can compare and contrast our different programs

I only did a BSN... The graduate programs I looked at in FL @ the time had mostly fluff classes in their curriculum.



This is your program: I wouldn't talk highly of a program like that.


Full Time (3 years)


NURS 720 Biostatistics (That is a 6 hrs course in med school along with epidemiology)

NURS 735 Theoretical Foundations of Advanced Nursing (fluff)

NURS 729 Organizational Systems (fluff)

NURS 725 Evidenced Based Practice (fluff)

NURS 753 Physiologic Basis for ANP

NURS 727 Epidemiology (see above)

NURS 825 Evidenced Based Practice II (fluff)

Specialty Theory Elective (Fluff)

NURS 707 Advanced Pharmacology: Application to APN

NURS 750 Outcomes and Quality Management (Fluff)

NURS 754 Comprehensive Assessment of Health

NURS 810 Leadership for Advanced Practice in Healthcare (Fluff)

NURS 803 Health Policy (Fluff)

NURS 767 FNP Specialty Theory (Fluff)

NURS 757 FNP Specialty Practicum I

NURS 768 FNP Specialty Theory I

NURS 758 FNP Specialty Practicum II

NURS 769 FNP Specialty Theory II

NURS 759 FNP Specialty Practicum III

NURS 773 Information Systems for Clinical Decision Making (Likely fluff)

NURS 995 Residency (500-700 hrs probably)

 

[762513]

You're right in that it is replete with med students and residents. I think "inferior" is the wrong word. Arrogant perhaps.

I base my statements off being a NP, seeing the curricula of many different NP programs, and talking with other NPs.

I have suggested to ay least twice that AllNurses will provide a better population of NPs for you to discuss via web forum. I'm there as well. And I will continue to complain that NP program training is insufficient, and I will continue to complain that most NPs are generally uninformed on healthcare as a business.

I come here to shadow the midlevel and psychiatry forums.

I don't really care if you're offended individually although I would prefer we be friends or at least collegial. I do think you're taking my statements too personally.

I actually value your opinion Psych NP guy and we have points of agreement, although not everything.

 

[W19]

Please describe your graduate nursing school experience so that we can compare and contrast our different programs

This is a PA curriculum: Nova Southeastern University. Can you see the difference?

Curriculum Timeline
Didactic Phase
SUMMER I (19) FALL I (20) WINTER I (31) SUMMER II (16)
Jun, Jul, Aug Sep, Oct, Nov, Dec Jan, Feb, Mar, Apr, May Jun, Jul, Aug
Anatomy (5) Microbiology (3) Clinical Behavioral Medicine (3) Life Support Procedures & Skills (3)
Physiology (3) Legal & Ethical Issues in Health Care (2) Interpretation & Evaluation of Medical Literature (2) Clinical Procedures & Surgical Skills (5)
Clinical Pathophysiology (3) Pharmacology I (2) Pharmacology II (4) Health Promotion & Disease Prevention (2)
Physical Diagnosis I (3) Physical Diagnosis II (3) Physical Diagnosis III (3) Core Competencies (2)
Medical Terminology (1) Clinical Medicine & Surgery I (7) Clinical Medicine & Surgery II (8) Clinical Pharmacology (4)
Biomedical Principles (1) Clinical Laboratory Medicine I (1) Clinical Medicine & Surgery III (7) Clinical Genetics (2)
Introduction to the PA Profession (1) Electrocardiography (2) Clinical Laboratory Medicine II (2)
Complementary Medicine & Nutrition (2)
Clinical Phase
FALL WINTER SUMMER
Aug, Sep, Oct, Nov, Dec Jan, Feb, Mar, Apr, May Jun, Jul, Aug
Family Medicine (6) Emergency Medicine (6) Clinical Elective-I (6)
Internal Medicine (6) Surgery (6) Clinical Elective-II (6)
Prenatal Care & Gynecology (6) Pediatrics (6) Clinical Elective-III (4)
Graduate Project (3)
*Clinical rotations vary in sequence

 

[762513]

I only did a BSN... The graduate programs I looked at in FL @ the time had mostly fluff classes in their curriculum.



This is your program: I wouldn't talk highly of a program like that.


Full Time (3 years)


NURS 720 Biostatistics (That is a 6 hrs course in med school along with epidemiology)

NURS 735 Theoretical Foundations of Advanced Nursing (fluff)

NURS 729 Organizational Systems (fluff)

NURS 725 Evidenced Based Practice (fluff)

NURS 753 Physiologic Basis for ANP

NURS 727 Epidemiology (Look above)

NURS 825 Evidenced Based Practice II (fluff)

Specialty Theory Elective (Fluff)

NURS 707 Advanced Pharmacology: Application to APN

NURS 750 Outcomes and Quality Management (Fluff)

NURS 754 Comprehensive Assessment of Health

NURS 810 Leadership for Advanced Practice in Healthcare (Fluff)

NURS 803 Health Policy (Fluff)

NURS 767 FNP Specialty Theory (Fluff)

NURS 757 FNP Specialty Practicum I

NURS 768 FNP Specialty Theory I (Fluff)

NURS 758 FNP Specialty Practicum II

NURS 769 FNP Specialty Theory II (Fluff)

NURS 759 FNP Specialty Practicum III

NURS 773 Information Systems for Clinical Decision Making (Likely fluff)

NURS 995 Residency (500-700 hrs probably)

You have absolutely no idea what you are talking about.