Need Candid Opinions re: NP Program

[Spleen27]

People of SDN, I need some candid opinions on MSN degrees from top brick and mortar programs. Give it to me straight.

I'm 32, with an objectively good job outside of healthcare that I do not enjoy. I bailed on preparing to apply to medical school in college because I was lazy back then and found a much less time-consuming route to a high paying career. But unfortunately, I realized a little late that money doesn't a happy person make if you spend 6-7 days a week, 51 weeks a year doing work you find boring. I thus want to go back to school to develop a career in healthcare. I have considered NP/PA, as well as just biting the bullet and working on DO/MD prerequisites and taking that MCAT.

Having crunched the numbers and calculated the extent of the spectacular financial implosion that would result if I pursued MD/DO, I've settled on pursuing a mid-level position - NP or PA.

I was originally leaning toward NP school because it would be less of a financial hit for various reasons and would be easier to begin (no prior HCE required for an ABSN degree), but then I compared the curricula of some of the top five MSN programs in the country (per USNWR, for what that's worth) to the PA schools at the same universities. The MSN programs had a few classes that sounded concrete - like pathophysiology. But then they also had a lot of very vague sounding classes that seemed to be of dubious value. The PA programs, on the other hand, had the types of classes I expected - like cardiology, pulmonology, etc.

I thought it was weird and concerning, and then I read all of the criticism of the NP profession on this website, which I am trying to evaluate. And my question is this: Is the criticism the result of the fact that there seem to be tons of crappy MSN programs out there where you can pay $15k and get an online "master's" degree? Is this where the incompetent NPs are coming from? Or is the criticism geared toward the NP profession as a whole?

In other words, if I went to one of the top five MSN programs - like Duke, Penn, or Emory and worked full-time as an RN while doing the MSN part time over threeish years, could I be comfortable that I would, with the requisite on-the-job training, be one of the "good" NPs that are competent and trusted by physicians? Or are even the top brick and mortar MSN programs churning out some duds?

If there's serious doubt that I would get good training at even the best brick and mortar MSN programs, I will bite the bullet and work as a phlebotomist or something to get HCE for PA school.

Your thoughts are much appreciated.

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[NYCGuy86]

You will find many opinions on this, depending on who you ask. The problem is that there is a vast surplus of NP programs, many of which are online and do not assist in setting up your clinical rotations (so, you'll find people reaching out to friends and colleagues that are NPs or MDs for rotations, and the quality may not be assured at schools that don't monitor clinical placements). There are many quality programs that offer online didactics, on-site visits, and set up clinical placements for students.

Another criticism is that NP programs have less clinical hours than PA programs, with many programs having the minimum 500 hours.

You also should understand that nursing courses often have vague titles that may not tell you what is actually covered in the course, such as "Primary Care of the Adult I" or "ACNP II". It is helpful to go to the course descriptions to find out more, though even that may not be enough.

Much of how you end up as a clinician is also dependent on you individually. You can go to a "top" program and do nothing, and turn out to be a poor provider. This is true for any type of program. Of course, going to a solid program presumably decreases chances of that happening, but, as an adult, much of this is on you as well.

I think you have a solid plan if you decide to go the nursing route (I also like nursing because there are many options available to you if you decide that clinical practice, whether as an NP, RN, etc, isn't for you down the road). Look for the rigorous programs (yes, they are there). Opinions differ but I believe that RN experience is definitely helpful in preparation for NP practice. As an RN you should be:

-performing physical assessments and understanding normal vs abnormal
-understanding common presentations of the diseases and disorders encountered in your specialty
-interpreting patient data (vitals, labs, etc)
-correlating that data with patient presentation
-understanding basic indications, contraindications, dosages, side effects related to pharmacological interventions

Some settings are more conducive to RNs functioning as clinicians (and not merely as a task managers/order fulfillers), such as ICUs and specialty areas with lower RN to patient ratios (and physicians and other providers will expect you to function as such in those settings). That provides you with the foundation to add on the graduate NP curriculum which should prepare you in advanced patho, pharm, assessment, diagnosis, and treatment.

Good luck

 

[762513]

There’s a strong anti NP lobby on this website. You should use this forum and allnurses if you want a balanced view of the NP profession. Asking that question on this forum is like asking Bears fans how good the packers are.

If you have a bachelors degree already I would go PA. If you don’t, the RN route is fine. As a NP student nearing graduation I can tell you the class names mean absolutely nothing if that’s the ruler by which you are measuring.

 

[Spleen27]

There’s a strong anti NP lobby on this website. You should use this forum and allnurses if you want a balanced view of the NP profession. Asking that question on this forum is like asking Bears fans how good the packers are.

If you have a bachelors degree already I would go PA. If you don’t, the RN route is fine. As a NP student nearing graduation I can tell you the class names mean absolutely nothing if that’s the ruler by which you are measuring.

Thanks! I know there is a strong NP lobby here, I guess my goal is to understand whether the criticism is directed at the field as a whole, or just the NPs graduating from the junky programs that seem to have popped up in more recent years. And also to understand exactly what the criticism is. I read Panda Bear MD's blog, and he seems to be saying that mid-levels in general are useful and definitely needed in many specialities, but that they can't replace physicians even in primary care. That all seems super reasonable to me.

 

[762513]

Thanks! I know there is a strong NP lobby here, I guess my goal is to understand whether the criticism is directed at the field as a whole, or just the NPs graduating from the junky programs that seem to have popped up in more recent years. And also to understand exactly what the criticism is. I read Panda Bear MD's blog, and he seems to be saying that mid-levels in general are useful and definitely needed in many specialities, but that they can't replace physicians even in primary care. That all seems super reasonable to me.

If you pick a quality brick and mortar NP program you will be fine.

 

[AnnoyedByFreud]

OP you've had some good answers, but other important considerations include - what area of medicine are you interested in? Where do you want to live and what type of laws dictate NP vs PA practice? Do you care about independence or private practice? Are NPs or PAs preferred in your area, or is there no difference? Do you have any interest in teaching, research, or admin?

Frankly I don't think you can go very wrong either way. NP/PA is a great career choice, IMO.

 

[Spleen27]

I'm very tied down geographically. The hospitals here appear to hire both, from what I can tell. The postings are for "advanced practice clinician" and say "NP or PA," for most specialties. I haven't decided on a specialty yet - I am planning to shadow, though. I'm leaning toward ICU or EM.

I'm just concerned about going NP/PA and then getting **** on by DOs and MDs. I'm very competitive, and am basically at the top of my current field. I'm concerned that after ten years I'll just wish I had gotten the MD, which I know I can handle intellectually - I just don't think my family would enjoy it and it would be a true implosion financially. I'd wipe out all the money I've saved from my current job and we'd have to sell our house or take out loans. My undergraduate degree was in economics so I am acutely aware of and fixated on the opportunity cost of 6 years of prereqs plus med school, plus the tuition.

I will totally understand and be okay with not being an MD/DO, but I know I would become furious if I had to put up with unnecessary condescension from MDs my age. (And by unnecessary I mean that I'm not one of these people that is trying to get a back-door license to practice medicine, I will stay in my lane and let the MDs stay in theirs, so there should be no need for me to be **** on.)

 

[762513]

I'm very tied down geographically. The hospitals here appear to hire both, from what I can tell. The postings are for "advanced practice clinician" and say "NP or PA," for most specialties. I haven't decided on a specialty yet - I am planning to shadow, though. I'm leaning toward ICU or EM.

I'm just concerned about going NP/PA and then getting **** on by DOs and MDs. I'm very competitive, and am basically at the top of my current field. I'm concerned that after ten years I'll just wish I had gotten the MD, which I know I can handle intellectually - I just don't think my family would enjoy it and it would be a true implosion financially. I'd wipe out all the money I've saved from my current job and we'd have to sell our house or take out loans. My undergraduate degree was in economics so I am acutely aware of and fixated on the opportunity cost of 6 years of prereqs plus med school, plus the tuition.

I will totally understand and be okay with not being an MD/DO, but I know I would become furious if I had to put up with unnecessary condescension from MDs my age. (And by unnecessary I mean that I'm not one of these people that is trying to get a back-door license to practice medicine, I will stay in my lane and let the MDs stay in theirs, so there should be no need for me to be **** on.)

Toxic people are toxic regardless of education. Most MD/DO’s do not behave like the SDN militants. I think you will be fine.

 

[pamac]

Ok... here’s a novel. I’m an amazing typist:

As far as looking back in ten years with a sense of regret if you take the NP or PA path, keep in mind that in ten years you may just be finally settling ito your first couple years as a physician if you choose that direction. To become a physician, you have prereqs to complete, then med school, a residency of variable length, and then fellowship of variable length (if you want to be truly respected in your specialty as a doctor). In bare bones family practice I think you have 8 or nine years of training ahead of you, counting prereqs. If you specialize and do a fellowship, you are looking at quite a bit more. But you will be secure in the knowledge that you walk around both a hospital and a sterile medical office building commanding the respect of other physicians and a smattering of staff, which I guess is so important that you will spend almost 13% of prime family time and healthy years pursuing it at the expense of almost everything else in your life. Not to mention debt you will accrue that will require several years to repay under the best of circumstances. So when would you relax? When does your financial landscape finally show that you don’t have a negative sign in front of the balance? How long from there will your savings account be healthy enough that you can sit back and tell yourself that you don’t have to work long hours to have a nice cushion of cash to rely on?

And if you go to DO school, or don’t do a fellowship, or match to one of the less prestigious residencies in a less sought-out specialty, are you going to feel any less like a rockstar among the folks you want respect from? Not all physicians even look at each other as equals. I’ve seen hospitalist internal medicine docs chaffe at comments and lack of respect shown to them by specialists. And outside the hospital, physicians can be looked up to by the public, but typically it comes down to what kind of luxury items they are flaunting that catches folks’ eyes...the same kind of attention attracted by any other member of society with funds to show. You don’t have to go to medical school to get that. If anything, being a physician these days isn’t as impressive to the Everyman like it used to be, because everyone is entitled, don’t cha’ know. In fact, as a physician, you’ll probably be the one sitting across from countless patients who take the approach that you are the one who should be honored to be in their presence. That will make each of the important life events you sacrificed to get to that point all the more sweet to savor. Missing your child grow up to hang out in the library so that you can have a patient tell you they know more than you swhile they mistake you for their chiropractor will be worth it.

If you are choosing medicine based on a craving for respect from people that you know, or may not even have met yet, then you will certainly get the reward you deserve. My guess is that you’ll be the one telling others to respect you, because it probably won’t come naturally in today’s society.

PA will involve more prereqs than NP school for you. However, the time invested in NP will likely even out given that you’d probably be doing an accelerated bachelors RN and then a 2 year NP program. NPs and PAs can frequently be interchangeable in the workforce, but in half the states and the federal government, NPs are their own masters, so there’s that to think about when deciding between them.

It sounds like you have some drive in you. I have just enough drive in me to not want to be required by my profession to set up an arrangement with a superior authority like a physician for me to practice my craft. That fact was enough form me to decide to forgo becoming a PA in favor of having more control over my own destiny as an NP. In my state, we don’t need any arrangement with a physician to practice, so the choice was easy, but I think I’d still make the same decision even in a state with significant requirements that demanded a physician overlord. In no state or territory do PAs have a better arrangement in that regard than nurses... at best for them there are a few places where there is essentially parity. But as time goes on, nurses will advance independence for NPs to all locations, and one or two states each year do just that, and each year PAs get nothing. It’s not a boast, it’s just the reality of the efficacy of the lobbies. The AMA announced they will work to fight NP independence, but even that isn’t going to yeild fruit. NPs are already independent and doing fine, and that fact will stare the AMA in the face any time they try to argue against it spreading, let alone turning back the clock. And again, don’t take this as a boast, just see it for the reality that it is. The time for the AMA to stop that train was half a century ago.... by now it’s crossed the continent several times. And the time for PAs to have made a move for their own independence was long ago too. Because they have waited so long to even discuss any form of independence means that we’ve come all this way with them doing what they’ve been doing up to now, and there isn’t an appetite for giving them more. I find that unfortunate, but i wasn’t going to try to fight that battle from within. I just moved on and have been glad I did.

HOWEVER.... for the most part, if you are the typical worker who wants to punch in and out every day for work, and want a secure and rewarding job that is generally very busy, with a degree of security and some potential for spontaneity, “midleveling” might suit you. If you wanted folks to salute you, the military would have given you that for a lot less time and a lot more return on your investment. If you try to get respect by doing medical school, keep in mind that it will come at the cost of your fantastic earning potential divided by the hours of study and training you will need to put into that quest, which probably will amount to being paid less than minimum wage for your trouble.

I don’t know what you do all day currently for work, but in my case, my work life ultimately morphs into being the thing I do in between the time that I’m able to do the things that I really enjoy doing. I work to live. My work enables me to help others to live as well (not to mention effects on the lives of my patients and their families). But what I crave most from my work is independence from administrative agents who complicate my workflow.... bosses. I mostly am referring to managers and being managed... I’m quite fine with natural limitations that exist in my work.

My desire for respect in my role basically boils down to simply being treated professionally. Respect is earned. If I don’t have that, I do what I can to obtain it, as long as what it requires is reasonable. If a physician or other employee doesn’t “respect me” that’s only my business if it gets in the way of me practicing according to my scope of practice and being treated the way that I want to be. If I go work for a physician owned practice, then I can expect my boss to be my boss, and with that comes the risk of being told what to do. I feel like being an NP gives me the most leeway to do the only thing that I really can do in that situation if I don’t like where I am, and that is to leave. As far as my concern about being s—- on by physicians, if they aren’t my boss, or have any control over me, they are entitled to think whatever they want about me. If they are my boss, I either take it, try to change it, or else leave. But I’m in psyche in an independent NP state, so it’s not like I’m a PA working for a surgeon, where my role is so closely tied to the value the physician provides.

 

[Spleen27]

Ok... here’s a novel. I’m an amazing typist:

As far as looking back in ten years with a sense of regret if you take the NP or PA path, keep in mind that in ten years you may just be finally settling ito your first couple years as a physician if you choose that direction. To become a physician, you have prereqs to complete, then med school, a residency of variable length, and then fellowship of variable length (if you want to be truly respected in your specialty as a doctor). In bare bones family practice I think you have 8 or nine years of training ahead of you, counting prereqs. If you specialize and do a fellowship, you are looking at quite a bit more. But you will be secure in the knowledge that you walk around both a hospital and a sterile medical office building commanding the respect of other physicians and a smattering of staff, which I guess is so important that you will spend almost 13% of prime family time and healthy years pursuing it at the expense of almost everything else in your life. Not to mention debt you will accrue that will require several years to repay under the best of circumstances. So when would you relax? When does your financial landscape finally show that you don’t have a negative sign in front of the balance? How long from there will your savings account be healthy enough that you can sit back and tell yourself that you don’t have to work long hours to have a nice cushion of cash to rely on?

And if you go to DO school, or don’t do a fellowship, or match to one of the less prestigious residencies in a less sought-out specialty, are you going to feel any less like a rockstar among the folks you want respect from? Not all physicians even look at each other as equals. I’ve seen hospitalist internal medicine docs chaffe at comments and lack of respect shown to them by specialists. And outside the hospital, physicians can be looked up to by the public, but typically it comes down to what kind of luxury items they are flaunting that catches folks’ eyes...the same kind of attention attracted by any other member of society with funds to show. You don’t have to go to medical school to get that. If anything, being a physician these days isn’t as impressive to the Everyman like it used to be, because everyone is entitled, don’t cha’ know. In fact, as a physician, you’ll probably be the one sitting across from countless patients who take the approach that you are the one who should be honored to be in their presence. That will make each of the important life events you sacrificed to get to that point all the more sweet to savor. Missing your child grow up to hang out in the library so that you can have a patient tell you they know more than you swhile they mistake you for their chiropractor will be worth it.

If you are choosing medicine based on a craving for respect from people that you know, or may not even have met yet, then you will certainly get the reward you deserve. My guess is that you’ll be the one telling others to respect you, because it probably won’t come naturally in today’s society.

PA will involve more prereqs than NP school for you. However, the time invested in NP will likely even out given that you’d probably be doing an accelerated bachelors RN and then a 2 year NP program. NPs and PAs can frequently be interchangeable in the workforce, but in half the states and the federal government, NPs are their own masters, so there’s that to think about when deciding between them.

It sounds like you have some drive in you. I have just enough drive in me to not want to be required by my profession to set up an arrangement with a superior authority like a physician for me to practice my craft. That fact was enough form me to decide to forgo becoming a PA in favor of having more control over my own destiny as an NP. In my state, we don’t need any arrangement with a physician to practice, so the choice was easy, but I think I’d still make the same decision even in a state with significant requirements that demanded a physician overlord. In no state or territory do PAs have a better arrangement in that regard than nurses... at best for them there are a few places where there is essentially parity. But as time goes on, nurses will advance independence for NPs to all locations, and one or two states each year do just that, and each year PAs get nothing. It’s not a boast, it’s just the reality of the efficacy of the lobbies. The AMA announced they will work to fight NP independence, but even that isn’t going to yeild fruit. NPs are already independent and doing fine, and that fact will stare the AMA in the face any time they try to argue against it spreading, let alone turning back the clock. And again, don’t take this as a boast, just see it for the reality that it is. The time for the AMA to stop that train was half a century ago.... by now it’s crossed the continent several times. And the time for PAs to have made a move for their own independence was long ago too. Because they have waited so long to even discuss any form of independence means that we’ve come all this way with them doing what they’ve been doing up to now, and there isn’t an appetite for giving them more. I find that unfortunate, but i wasn’t going to try to fight that battle from within. I just moved on and have been glad I did.

HOWEVER.... for the most part, if you are the typical worker who wants to punch in and out every day for work, and want a secure and rewarding job that is generally very busy, with a degree of security and some potential for spontaneity, “midleveling” might suit you. If you wanted folks to salute you, the military would have given you that for a lot less time and a lot more return on your investment. If you try to get respect by doing medical school, keep in mind that it will come at the cost of your fantastic earning potential divided by the hours of study and training you will need to put into that quest, which probably will amount to being paid less than minimum wage for your trouble.

I don’t know what you do all day currently for work, but in my case, my work life ultimately morphs into being the thing I do in between the time that I’m able to do the things that I really enjoy doing. I work to live. My work enables me to help others to live as well (not to mention effects the lives of my patients and their families). But what I crave most from my work is independence from administrative agents who complicate my workflow.... bosses. I mostly am referring to managers and being managed... I’m quite fine with natural limitations that exist in my work.

My desire for respect in my role basically boils down to simply being treated professionally. Respect is earned. If I don’t have that, I do what I can to obtain it, as long as what it requires is reasonable. If a physician or other employee doesn’t “respect me” that’s only my business if it gets in the way of me practicing according to my scope of practice and being treated the way that I want to be. If I go work for a physician owned practice, then I can expect my boss to be my boss, and with that comes the risk of being told what to do. I feel like being an NP gives me the most leeway to do the only thing that I really can do in that situation if I don’t like where I am, and that is to leave. As far as my concern about being s—- on by physicians, if they aren’t my boss, or have any control over me, they are entitled to think whatever they want about me. If they are my boss, I either take it, try to change it, or else leave. But I’m in psyche in an independent NP state, so it’s not like I’m a PA working for a surgeon, where my role is so closely tied to the value the physician provides.

Really excellent insight, I appreciate it.

 

[Spleen27]

Here's the rub. You're not going to get hired or paid based on your diploma or report card. You'll get hired to do a job that only licensed people can have. That being said, none of the academics may matter. Before you contest, yes, NP school (all of them) have a base and cognitively insulting curriculum.

You'll also have to deal with general nursing which may not suit your pallet. Coming from my background, hospital nursing (RN work) was a horrible job.

You might also hate being a NP so other things equal, reconsider what you have. I make about as much as a NP can make (>$200k). I didn't make this career selection based on hate towards my previous work but a general lack of fulfillment and continued upward progression. Frankly, I'm no more happy than I was in prior work, sans RN work, but I earn a much higher income.

There will come a time when everyone experiences career boredom. I have a good job and like what I do, but I can think of a few things I'd rather have had a hand at in life.

Thanks for the candid opinion on their curricula. That's what I was afraid of. Your advice is well-taken, though I should say that I don't hate my job. There are a lot of things I like about it, but I find it generally unfulfilling. (I represent large, faceless multinational corporations in litigation. Muhahahaha.) I would be making a step-down both in salary and in prestige, though there actually isn't as much upward progression for attorneys as people think. You basically have associates, and then you have partners, and that's it.

I'm going to shadow a critical care NP and a CRNA before I make any decisions, as well as a surgical PA. Also, I'm quite certain that I would hate regular RN work.

 

[pamac]

It sounds like you are an attorney. I can totally appreciate the mindset of wanting to shoot for the moon in your next career and essentially make what feels like a "lateral" move to be a physician (since our mothers always told us that lawyers and doctors were the pinnacle as far as prestige). The fact is, though, that becoming a physician is light years more difficult and time consuming than pursuing a law degree, even though TV and the presence of lawyers among those in politics and industry paint the picture that there is an equivalence. But back in the day, if your kid was a doctor or a lawyer, either one came out to be about the same as far as bragging rights and stability.

I don't doubt that with your work ethic, you'd achieve a career in medicine if you chose. My long winded response was mostly geared towards illustrating the costs of doing so at the expense of preconceived notions that most of us have navigated through in our lives when we have been considering career paths. Respect is important and worthwhile, but I'm finding my priorities have changed as the years progress.

Regular RN work is work. There are perks that come along with being an RN, but its never been my overall goal to stay in this realm either. Working in the medical nursing field is especially grueling, and I find a lot of parallels to being a waiter. Time management (and the fact that there really isn't quite enough time to do things the way one would want to do them) is one of the biggest issues I've dealt with as a nurse each day. I'm in a great job right now that I love, but when I'm in an ER or medical floor being a floor nurse, its being tugged in 50 different directions, and having your workflow be adjusted constantly by circumstances driven by someone else. I can be walking into a room with all my supplies to do a complex nursing intervention, and have a manager come to me and say "you need to drop what you are doing and do this". That's how all day is. If you are in a room doing something for a patient, especially for an extended period of time, you walk out and have a bunch of issues brought up to you to deal with, or a phone call to return. So you don't end up wanting to stay in one place on the floor for very long. When there is downtime, its usually spontaneous, unpredictable, and short lived. Lunch is whenever someone is willing to watch your patients while you take half an hour to eat. That often means your relief nurse is handling their patients AND yours, essentially doubling their workload. It sounds like you've come to the conclusion that RN ing isn't your thing, though. Its not really most nurses' thing either, and the ones that feel like they can leave, do leave. I started getting ready to make my move out before I even had my license.

Shadowing is tremendously valuable. I highly recommend it. Talking to as many people as you can in the field helps as well. Ask the questions and let them talk your ear off.

 

[Spleen27]

It sounds like you are an attorney. I can totally appreciate the mindset of wanting to shoot for the moon in your next career and essentially make what feels like a "lateral" move to be a physician (since our mothers always told us that lawyers and doctors were the pinnacle as far as prestige). The fact is, though, that becoming a physician is light years more difficult and time consuming than pursuing a law degree, even though TV and the presence of lawyers among those in politics and industry paint the picture that there is an equivalence. But back in the day, if your kid was a doctor or a lawyer, either one came out to be about the same as far as bragging rights and stability.

I don't doubt that with your work ethic, you'd achieve a career in medicine if you chose. My long winded response was mostly geared towards illustrating the costs of doing so at the expense of preconceived notions that most of us have navigated through in our lives when we have been considering career paths. Respect is important and worthwhile, but I'm finding my priorities have changed as the years progress.

Regular RN work is work. There are perks that come along with being an RN, but its never been my overall goal to stay in this realm either. Working in the medical nursing field is especially grueling, and I find a lot of parallels to being a waiter. Time management (and the fact that there really isn't quite enough time to do things the way one would want to do them) is one of the biggest issues I've dealt with as a nurse each day. I'm in a great job right now that I love, but when I'm in an ER or medical floor being a floor nurse, its being tugged in 50 different directions, and having your workflow be adjusted constantly by circumstances driven by someone else. I can be walking into a room with all my supplies to do a complex nursing intervention, and have a manager come to me and say "you need to drop what you are doing and do this". That's how all day is. If you are in a room doing something for a patient, especially for an extended period of time, you walk out and have a bunch of issues brought up to you to deal with, or a phone call to return. So you don't end up wanting to stay in one place on the floor for very long. When there is downtime, its usually spontaneous, unpredictable, and short lived. Lunch is whenever someone is willing to watch your patients while you take half an hour to eat. That often means your relief nurse is handling their patients AND yours, essentially doubling their workload. It sounds like you've come to the conclusion that RN ing isn't your thing, though. Its not really most nurses' thing either, and the ones that feel like they can leave, do leave. I started getting ready to make my move out before I even had my license.

Shadowing is tremendously valuable. I highly recommend it. Talking to as many people as you can in the field helps as well. Ask the questions and let them talk your ear off.

I am, yes.

I know many nurses, and they describe their work exactly as you did. I am confident that I would not enjoy it - I think it's just not an enjoyable job for most people.

Getting into law school is much easier than getting into medical school, that's why I went that route. I was lazy in college and knew I could do well on the LSAT with minimal effort, especially relative to the effort it takes to do prereqs for medical school and study for the MCAT. (Plus I'm white so I would have had to do a ****load of community service and other extracurricular stuff to get into a medical school that is as good as the law school I got into.) All you have to do to get into a good lawschool, even as a cis white male, is blast the LSAT pretty hard and have a somewhat decent GPA in any major. (I majored in music lol.)

And law school itself is much easier than medical school. You can't fail out, and smarter students could probably begin practicing after about a year of law school. The second two years are a money grab by greedy law professors and administrators suckling at the teet of the federal student loan program at the expense of naive 22-year-olds. With that being said, there are all kinds of lawyers, and I think that high-end legal work is probably as complex as medicine (though in a different way) and almost as stressful, though it pays much better. The lawyers I work with are all brilliant and could absolutely have gone to medical school and done quite well.

But for most, high-end legal work is VERY unfulfilling, since high-end legal work means representing massive international corporations.

 

[NYCGuy86]

The enjoyability of the bedside RN position depends on a number of things, including staffing, support by administration, autonomy, etc.

Although I am planning on NP school, I do like my RN position currently. I'm on a neuro step-down unit, and typically have between 3-5 patients, depending on acuity (5 would be the non step-down patients). We also have techs that help out with things that do not require RN-level intervention. We do have a good amount of autonomy, are valued as integral, knowledgeable, members of the care team, and are compensated well for a bachelors degree career. We have various nursing councils throughout the hospital, all of which have actual decision-making capabilities, such as unit practice councils, evidence-based practice council, nursing quality council, etc. Yes it's NYC, however salaries vary in the area. I turned down a 75K position at one hospital for my current position, where, in my first year, I make mid 90s. I'll make a year at this position soon, and that includes a raise, plus we're all getting a raise through the union, and I also recently became certified in my specialty, which adds on another differential (typically you'll see differentials for experience, certification, degree, preceptor, charge, etc), so I'll be making over 100K working three 12hr shifts at the start of my second year as an RN. We also get paid OT for attending council meetings.

As far as time management, you'd be surprised how very similar pamac's experience is to the providers. One of the PAs tells me how we're lucky to have a scheduled hour break, as she doesn't get a scheduled break, and while she's on "break" her phone is still going off with pages. The PA/NP/MD is often in the middle of a procedure or examining a patient and you hear their phone ringing with like 6 texts. At night they're often covering anywhere from 30-40 patients at time. So, objectively, all of our workflows are constantly driven by someone else (quite often it is due to the RN alerting the provider to a change in a patient condition/vital sign/lab result that the provider comes to the bedside or has to write an order), I don't think it's different whether you're an RN or a provider.

So my point is just that while yes, NP is probably more what you're interested in (me too) and fits your personality better (I think many get caught up in the idea of wiping ass and following "orders" (noting of course that many things are ordered because the RN requests it, and many orders are discontinued because the RN notes that it is not indicated for the patient)), the RN position doesn't have to be seen as horrible, if you work in a setting that values the role of the clinical RN, and supports them at the bedside to be clinicians and not mindless task-masters.

Good luck in whatever you choose.

 

[pamac]

Hospitalist and ER provider positions are going to be the closest analogue to what hospital nursing entails, but they still are a far cry from waiting hand and foot on a patient like a nurse does. Literally, bedside nursing in most places isn't the clinician role that some rare well appointed facilities have in place, which is sadly why you are seeing it become a pit stop for folks on their way to the NP field. The fact is that events come up that drive your day to an extremely high degree as an RN, just by nature of the job. Its not the wiping butts that is frustrating, its the fact that most of the time, wiping the butt has to be dealt with at a time that I don't control. Being busy isn't the bane of nursing, its being busy while other forces are making contrary demands on you. I've never had as many situations like I have in nursing where I literally have several equally important things to do all at once....and the thing I actually have to end up doing first is a BS item foisted upon me by a manager because they feel like their agenda takes precedence. Its not even a hostile environment thing that's unique to where I work (which is on the better side of the fence compared to many others)....its simply the reality of nursing management.

Arriving to clinical practice councils (we have tons of them too) doesn't get me excited because at the end of the day, success for an initiative usually requires convincing several peers and a supervisor, as well as any other stakeholder, that an idea is useful. And everyone has their own idea of how things need to run. Often their solution comes at the expense of another peer. Meetings like that frequently devolve into a zero sum game. And if your idea makes it past that gauntlet, someone else that is usually not present nor affected by the issue then looks at it in terms of cost, or risk, or competing regulations, or frequently (and most frustratingly) how it stacks up against the opinion of someone in management. My emotional state does much better if I avoid showing up to a meeting that is never conveniently scheduled, only to have my hopes of encouraging other units not dump patients on me at shift change dashed because (patient safety be damned) we need to ease the burden on someone's schedule. We'd hate to have a nurse stay late, or have too many nurses show up to work, so lets have that patient transfer take place at shift change so its seamless as far as staffing! Nope... shown up to too many of those where a good idea got butchered to the point where it was worse than it was if it had never been presented. Next thing you know there's a new checklist to manage. Hence, the exodus away from enlightened and often well meaning managers, and towards the NP career.

I can deal with busy when busy is important... I thrive on it. I cant deal with someone spot checking me to make sure my isolation gown is fully tied in the back after I throw it on to answer a call light. I can't deal with someone telling me that I can't leave some supplies in a room for a regularly recurring intervention because of a small risk that it will go to waste if the patient discharges early. Instead, I'll go walk to the far stockroom, because that's the only stockroom where the supply services want to stock that item, and we need to hear their concerns because we are trying to be inclusive. The sad thing is that my experience is vastly more familiar to hospital nurses.

The first year of nursing is a unique period of time where RNs have a lot to juggle, and a lot of issues don't loom as large as they will when you get some experience under your belt. I thought I had a lot of autonomy when I was brand new as well. With time, you'll see how much daylight there is between what floor nurses so and what the providers have on their plate (I do agree that providers are an incredibly busy breed). But I am impressed that you get an hour long break. I assure you, that's a unique perk among nurses. Most nurses could take an hour long lunch, but the question is who would have to take double the patients for that hour while the other nurse relaxes. If you say that you have a resource nurse to cover lunches every day, Ill tell you again how that isn't the norm.

 

[762513]

Hospitalist and ER provider positions are going to be the closest analogue to what hospital nursing entails, but they still are a far cry from waiting hand and foot on a patient like a nurse does. Literally, bedside nursing in most places isn't the clinician role that some rare well appointed facilities have in place, which is sadly why you are seeing it become a pit stop for folks on their way to the NP field. The fact is that events come up that drive your day to an extremely high degree as an RN, just by nature of the job. Its not the wiping butts that is frustrating, its the fact that most of the time, wiping the butt has to be dealt with at a time that I don't control. Being busy isn't the bane of nursing, its being busy while other forces are making contrary demands on you. I've never had as many situations like I have in nursing where I literally have several equally important things to do all at once....and the thing I actually have to end up doing first is a BS item foisted upon me by a manager because they feel like their agenda takes precedence. Its not even a hostile environment thing that's unique to where I work (which is on the better side of the fence compared to many others)....its simply the reality of nursing management.

Arriving to clinical practice councils (we have tons of them too) doesn't get me excited because at the end of the day, success for an initiative usually requires convincing several peers and a supervisor, as well as any other stakeholder, that an idea is useful. And everyone has their own idea of how things need to run. Often their solution comes at the expense of another peer. Meetings like that frequently devolve into a zero sum game. And if your idea makes it past that gauntlet, someone else that is usually not present nor affected by the issue then looks at it in terms of cost, or risk, or competing regulations, or frequently (and most frustratingly) how it stacks up against the opinion of someone in management. My emotional state does much better if I avoid showing up to a meeting that is never conveniently scheduled, only to have my hopes of encouraging other units not dump patients on me at shift change dashed because (patient safety be damned) we need to ease the burden on someone's schedule. We'd hate to have a nurse stay late, or have too many nurses show up to work, so lets have that patient transfer take place at shift change so its seamless as far as staffing! Nope... shown up to too many of those where a good idea got butchered to the point where it was worse than it was if it had never been presented. Next thing you know there's a new checklist to manage. Hence, the exodus away from enlightened and often well meaning managers, and towards the NP career.

I can deal with busy when busy is important... I thrive on it. I cant deal with someone spot checking me to make sure my isolation gown is fully tied in the back after I throw it on to answer a call light. I can't deal with someone telling me that I can't leave some supplies in a room for a regularly recurring intervention because of a small risk that it will go to waste if the patient discharges early. Instead, I'll go walk to the far stockroom, because that's the only stockroom where the supply services want to stock that item, and we need to hear their concerns because we are trying to be inclusive. The sad thing is that my experience is vastly more familiar to hospital nurses.

The first year of nursing is a unique period of time where RNs have a lot to juggle, and a lot of issues don't loom as large as they will when you get some experience under your belt. I thought I had a lot of autonomy when I was brand new as well. With time, you'll see how much daylight there is between what floor nurses so and what the providers have on their plate (I do agree that providers are an incredibly busy breed). But I am impressed that you get an hour long break. I assure you, that's a unique perk among nurses. Most nurses could take an hour long lunch, but the question is who would have to take double the patients for that hour while the other nurse relaxes. If you say that you have a resource nurse to cover lunches every day, Ill tell you again how that isn't the norm.

The biggest issue in nursing and healthcare in general that leads to burnout is our reliance on press ganey “satisfaction” scores as part of our payment. There’s a growing body of research that shows that the more “satisfied” a patient is with their care, the higher their mortality. What makes a diabetic non compliant “happy”? Mountain Dew. That COPD patient would just feel great if they could have that cigarette, etc. Its made RN mean Refreshments and Narcotics.

I highly doubt you could go from autonomy in your profession in the law to the complete lack of control in nursing and feel any better about yourself at the end of the day. The grass is NOT greener.

 

[762513]

I moved from autonomy to nursing. The transition was tumultuous and unsatisfying. I like what I do now, as a NP, because I do it by myself, i.e. with autonomy. If the opposite were true, I'd find a new career. Read: not job, career. Unlike what many in healthcare will admit, I'm fully capable of achieving fulfillment outside of "healing."

Regarding satisfaction, I submit it's the most ridiculous healthcare endeavor to date. The similarity of "hospital" and "hospitality" should end there.

Succinctly, often the things that make people happy also makes them sick.

I’m not here to kiss the patients ass, I’m here to get them better and get them home.

To the OP, you’ll have to do your share of servitude. I would think long and hard before I would go back to school.

 

[pamac]

What psych np guy said about his work conditions as an NP really speaks to the heart of where I’ve wanted to go with a career since before I even became a nurse, which was itself a way forward toward my central goal of becoming a provider. It’s not about respect or authority....the autonomy I crave is centered on being left alone from meddling. I’m not a cowboy who chaffes at help from others, but so much “help” I recieve as a nurse is unsolicited, and arrives via email from the desk of someone who makes suggestions while being several years removed from the actual rigors of patient care. That’s why it’s a simple matter for folks like that to insist on a process that is onerous. I’m fine with rules, regulations, procedures, timelines, and limitations, but I don’t feel like I need an active supervisor breathing down my neck because they need to justify their own existence. The best boss in the world is a boss with their own workload apart from making other employees “better”.

I feel like our society’s experiment with patient satisfaction has been one of the most dangerous endeavors undertaken. I get that there are abuses and areas that need improvement, but those can be dealt with directly without mandating hospitality. Indeed, studies show that the most satisfied patients tend to have the worst outcomes. We run the risk of turning evidence based medicine into the most expensive hospice service known to man if we keep putting patient survey results front and center as the prime concern. Hint: evidence based technique is just another name for market research when it’s used in the context of using patient satisfaction as a driver for care. I’m an advocate for including patient input to direct patient care as long as it’s not featured prominently. Unfortunately, our empathetic approach to treating pain as a vital sign (something pounded into us in nursing and medical school, and at every facility and university in the nation) has led us to ruin. We’ve given out an entitlement and are now shocked that it has become a right that anyone can demand, even if they aren’t truly in pain.

 

[Spleen27]

I moved from autonomy to nursing. The transition was tumultuous and unsatisfying. I like what I do now, as a NP, because I do it by myself, i.e. with autonomy. If the opposite were true, I'd find a new career. Read: not job, career. Unlike what many in healthcare will admit, I'm fully capable of achieving fulfillment outside of "healing."

Regarding satisfaction, I submit it's the most ridiculous healthcare endeavor to date. The similarity of "hospital" and "hospitality" should end there.

This--and the comment you are replying to--are really helpful, thanks to both of you. In my position now, all that matters is that I do good work and meet deadlines. Other than that, I do what I want whenever I want. I show up to the office whenever I feel like it and I leave when I feel like it. I work from home if I feel like it. If I ask a paralegal or secretary or other member of our support team to do something, it gets done with no questions asked. If I want to approach a problem a certain way, I am generally given the freedom to do so unless the partner thinks there is some hidden danger I am missing and asks me to do it a different way, which is rare. Working as bedside nurse will be a giant change of pace that I may not be equipped to handle.

On the flip side, I actually have developed a lot of bad work habits as a result of this broad autonomy, so maybe some more structure would be good for me. I actually liked the structured aspect of high school - where you're forced to be in X location at Y time throughout the day.

 

[W19]

I'm very tied down geographically. The hospitals here appear to hire both, from what I can tell. The postings are for "advanced practice clinician" and say "NP or PA," for most specialties. I haven't decided on a specialty yet - I am planning to shadow, though. I'm leaning toward ICU or EM.

I'm just concerned about going NP/PA and then getting **** on by DOs and MDs. I'm very competitive, and am basically at the top of my current field. I'm concerned that after ten years I'll just wish I had gotten the MD, which I know I can handle intellectually - I just don't think my family would enjoy it and it would be a true implosion financially. I'd wipe out all the money I've saved from my current job and we'd have to sell our house or take out loans. My undergraduate degree was in economics so I am acutely aware of and fixated on the opportunity cost of 6 years of prereqs plus med school, plus the tuition.

I will totally understand and be okay with not being an MD/DO, but I know I would become furious if I had to put up with unnecessary condescension from MDs my age. (And by unnecessary I mean that I'm not one of these people that is trying to get a back-door license to practice medicine, I will stay in my lane and let the MDs stay in theirs, so there should be no need for me to be **** on.)

This is something you should definitely consider...

 

[pamac]

"I just don't think my family would enjoy it"
"It would be a true implosion financially"
"I'd wipe out all the money I've saved from my current job and we'd have to sell our house or take out loans"
"My undergraduate degree was in economics so I am acutely aware of and fixated on the opportunity cost of 6 years of prereqs plus med school, plus the tuition"

Its up to you whether your competitive nature and/or the lack of condescension of complete strangers (who you don't even currently know) is worth that sacrifice.

How is a physician going to treat you poorly if you don't work for them? Its up to you whether you will allow someone to treat you bad without a response from you. I'm a nurse. I don't permit physicians to treat me poorly, and have never personally been treated poorly by a physician. (At the same time, I make it a point to not invite any ire, but I would posit that condescension from someone less able than myself like a CNA would feel much more frustrating to me than from a physician). That latter point is a mantra that goes a long way towards not being treated like a punk.... which I think that a lot of nurses and PA's and NP's might not fully appreciate when they get called out. It means you need to be right, not powerful. I don't work for physicians. If I mess up in my work, I deal with the consequences of that, but even if that's the case, a physician taking in on their own to rebuke me is out of the chain of command (but I have no doubt that their political pull can be make or break if there is a conflict). I don't look at power or position as if it will give me a license to insulate me from being accountable. Being a physician will only amplify the consequences of mistakes and enhance the level of scrutiny... from your peers, as well as staff such as nurses and non medial stakeholders.

Everyone has a boss they answer to... whether its a spouse, a client, a judge granting alimony, circumstances, lawyers, creditors, human resources, the law, other business partners. I mentioned in another post that the military is really the next best thing if you want to demand unrequited respect from others, but even that is an illusion. If respect from those who would otherwise be willing to act condescendingly towards you would drive you to take on significant burdens that would affect those you love, then your victory will be hallow. You are basically hoping to command respect from a holes. You probably already know that a holes respect nobody... not even their equals. They may even be worse towards those that are their betters.

 

[Spleen27]

"I just don't think my family would enjoy it"
"It would be a true implosion financially"
"I'd wipe out all the money I've saved from my current job and we'd have to sell our house or take out loans"
"My undergraduate degree was in economics so I am acutely aware of and fixated on the opportunity cost of 6 years of prereqs plus med school, plus the tuition"

Its up to you whether your competitive nature and/or the lack of condescension of complete strangers (who you don't even currently know) is worth that sacrifice.

How is a physician going to treat you poorly if you don't work for them? Its up to you whether you will allow someone to treat you bad without a response from you. I'm a nurse. I don't permit physicians to treat me poorly, and have never personally been treated poorly by a physician. (At the same time, I make it a point to not invite any ire, but I would posit that condescension from someone less able than myself like a CNA would feel much more frustrating to me than from a physician). That latter point is a mantra that goes a long way towards not being treated like a punk.... which I think that a lot of nurses and PA's and NP's might not fully appreciate when they get called out. It means you need to be right, not powerful. I don't work for physicians. If I mess up in my work, I deal with the consequences of that, but even if that's the case, a physician taking in on their own to rebuke me is out of the chain of command (but I have no doubt that their political pull can be make or break if there is a conflict). I don't look at power or position as if it will give me a license to insulate me from being accountable. Being a physician will only amplify the consequences of mistakes and enhance the level of scrutiny... from your peers, as well as staff such as nurses and non medial stakeholders.

Everyone has a boss they answer to... whether its a spouse, a client, a judge granting alimony, circumstances, lawyers, creditors, human resources, the law, other business partners. I mentioned in another post that the military is really the next best thing if you want to demand unrequited respect from others, but even that is an illusion. If respect from those who would otherwise be willing to act condescendingly towards you would drive you to take on significant burdens that would affect those you love, then your victory will be hallow. You are basically hoping to command respect from a holes. You probably already know that a holes respect nobody... not even their equals. They may even be worse towards those that are their betters.

Wise words, I appreciate it.

 

[HelpMeFailedStep1]

Ok... here’s a novel. I’m an amazing typist:

As far as looking back in ten years with a sense of regret if you take the NP or PA path, keep in mind that in ten years you may just be finally settling ito your first couple years as a physician if you choose that direction. To become a physician, you have prereqs to complete, then med school, a residency of variable length, and then fellowship of variable length (if you want to be truly respected in your specialty as a doctor). In bare bones family practice I think you have 8 or nine years of training ahead of you, counting prereqs. If you specialize and do a fellowship, you are looking at quite a bit more. But you will be secure in the knowledge that you walk around both a hospital and a sterile medical office building commanding the respect of other physicians and a smattering of staff, which I guess is so important that you will spend almost 13% of prime family time and healthy years pursuing it at the expense of almost everything else in your life. Not to mention debt you will accrue that will require several years to repay under the best of circumstances. So when would you relax? When does your financial landscape finally show that you don’t have a negative sign in front of the balance? How long from there will your savings account be healthy enough that you can sit back and tell yourself that you don’t have to work long hours to have a nice cushion of cash to rely on?

And if you go to DO school, or don’t do a fellowship, or match to one of the less prestigious residencies in a less sought-out specialty, are you going to feel any less like a rockstar among the folks you want respect from? Not all physicians even look at each other as equals. I’ve seen hospitalist internal medicine docs chaffe at comments and lack of respect shown to them by specialists. And outside the hospital, physicians can be looked up to by the public, but typically it comes down to what kind of luxury items they are flaunting that catches folks’ eyes...the same kind of attention attracted by any other member of society with funds to show. You don’t have to go to medical school to get that. If anything, being a physician these days isn’t as impressive to the Everyman like it used to be, because everyone is entitled, don’t cha’ know. In fact, as a physician, you’ll probably be the one sitting across from countless patients who take the approach that you are the one who should be honored to be in their presence. That will make each of the important life events you sacrificed to get to that point all the more sweet to savor. Missing your child grow up to hang out in the library so that you can have a patient tell you they know more than you swhile they mistake you for their chiropractor will be worth it.

If you are choosing medicine based on a craving for respect from people that you know, or may not even have met yet, then you will certainly get the reward you deserve. My guess is that you’ll be the one telling others to respect you, because it probably won’t come naturally in today’s society.

PA will involve more prereqs than NP school for you. However, the time invested in NP will likely even out given that you’d probably be doing an accelerated bachelors RN and then a 2 year NP program. NPs and PAs can frequently be interchangeable in the workforce, but in half the states and the federal government, NPs are their own masters, so there’s that to think about when deciding between them.

It sounds like you have some drive in you. I have just enough drive in me to not want to be required by my profession to set up an arrangement with a superior authority like a physician for me to practice my craft. That fact was enough form me to decide to forgo becoming a PA in favor of having more control over my own destiny as an NP. In my state, we don’t need any arrangement with a physician to practice, so the choice was easy, but I think I’d still make the same decision even in a state with significant requirements that demanded a physician overlord. In no state or territory do PAs have a better arrangement in that regard than nurses... at best for them there are a few places where there is essentially parity. But as time goes on, nurses will advance independence for NPs to all locations, and one or two states each year do just that, and each year PAs get nothing. It’s not a boast, it’s just the reality of the efficacy of the lobbies. The AMA announced they will work to fight NP independence, but even that isn’t going to yeild fruit. NPs are already independent and doing fine, and that fact will stare the AMA in the face any time they try to argue against it spreading, let alone turning back the clock. And again, don’t take this as a boast, just see it for the reality that it is. The time for the AMA to stop that train was half a century ago.... by now it’s crossed the continent several times. And the time for PAs to have made a move for their own independence was long ago too. Because they have waited so long to even discuss any form of independence means that we’ve come all this way with them doing what they’ve been doing up to now, and there isn’t an appetite for giving them more. I find that unfortunate, but i wasn’t going to try to fight that battle from within. I just moved on and have been glad I did.

HOWEVER.... for the most part, if you are the typical worker who wants to punch in and out every day for work, and want a secure and rewarding job that is generally very busy, with a degree of security and some potential for spontaneity, “midleveling” might suit you. If you wanted folks to salute you, the military would have given you that for a lot less time and a lot more return on your investment. If you try to get respect by doing medical school, keep in mind that it will come at the cost of your fantastic earning potential divided by the hours of study and training you will need to put into that quest, which probably will amount to being paid less than minimum wage for your trouble.

I don’t know what you do all day currently for work, but in my case, my work life ultimately morphs into being the thing I do in between the time that I’m able to do the things that I really enjoy doing. I work to live. My work enables me to help others to live as well (not to mention effects on the lives of my patients and their families). But what I crave most from my work is independence from administrative agents who complicate my workflow.... bosses. I mostly am referring to managers and being managed... I’m quite fine with natural limitations that exist in my work.

My desire for respect in my role basically boils down to simply being treated professionally. Respect is earned. If I don’t have that, I do what I can to obtain it, as long as what it.

Ive seen people like yourself suggest a 2 year NP program, is that for a Masters?

Because where I live a DNP is standard, and as far as ive researched a DNP can only be completed in 3 years minimum with most taking 4 years at a brick and mortar school

 

[pamac]

Ive seen people like yourself suggest a 2 year NP program, is that for a Masters?

Because where I live a DNP is standard, and as far as ive researched a DNP can only be completed in 3 years minimum with most taking 4 years at a brick and mortar school

Indeed, I find you to be declarative, but I think I can rework your statement into the question that I think you'd like me to answer:

Q: Do you suggest a masters over a DNP, and where would an NP with a masters fit into a world where I feel like DNP's are becoming the new normal?

A: If you want to be done in 2 years, then go for the masters degree. If you want to be done in 3 or more, go for the DNP. From my perspective, I don't see DNP's being hunted down and hired over masters degree folks at this time, but maybe it will change. However, I would rather pursue a masters, and use the time I would put into a DNP to instead go towards getting another certificate in another specialty so that I would be more well rounded as a provider. That would give me more options. Since I'm working on finishing up my psyche NP, I should already have good outlook for jobs, regardless of whether I have a masters or a DNP. A DNP for me would just be a feather in my cap, and not a threshold for entry into the profession, or to open doors for employment. If there is a school near you that is churning out DNP's, that might account for their prevalence.

 

[HelpMeFailedStep1]

Indeed, I find you to be declarative, but I think I can rework your statement into the question that I think you'd like me to answer:

Q: Do you suggest a masters over a DNP, and where would an NP with a masters fit into a world where I feel like DNP's are becoming the new normal?

A: If you want to be done in 2 years, then go for the masters degree. If you want to be done in 3 or more, go for the DNP. From my perspective, I don't see DNP's being hunted down and hired over masters degree folks at this time, but maybe it will change. However, I would rather pursue a masters, and use the time I would put into a DNP to instead go towards getting another certificate in another specialty so that I would be more well rounded as a provider. That would give me more options. Since I'm working on finishing up my psyche NP, I should already have good outlook for jobs, regardless of whether I have a masters or a DNP. A DNP for me would just be a feather in my cap, and not a threshold for entry into the profession, or to open doors for employment. If there is a school near you that is churning out DNP's, that might account for their prevalence.

I know that masters vs DNP is 2 vs 3-4 years

What i was referring to is actual nursing school itself...is it either 1-1.5 years or 4 years? Or are there some 2 year programs for a second bachelors program?

Trying to finish and become a DNP (the standard as far as i know in my area - i know DNP that are having trouble getting their dream job in the clinics im sure an NP compared 1:1 with little experience they would choose DNP)

I also am interested in DNP in case I want to doing nursing education / non clinical corporate work which from my understanding requires a DNP

If I decide to go to nursing school it will most likely be at an accelerated program, I am just worried about the gigantic attrition rates for these accelerated programs (40-50% AND HIGHER??) and if that's just due to poor scheduling and planning by the university. Some institutions will work to create a schedule for their students others will create whatever they feel like and if it negatively affects the students oh well. That's why ive read that some accelerated programs do not mix clinicals with didactics so you arent going to class in the morning, working in your clinical hours in the evening, then studying at night rinse and repeat

 

[762513]

I know that masters vs DNP is 2 vs 3-4 years

What i was referring to is actual nursing school itself...is it either 1-1.5 years or 4 years? Or are there some 2 year programs for a second bachelors program?

Trying to finish and become a DNP (the standard as far as i know in my area - i know DNP that are having trouble getting their dream job in the clinics im sure an NP compared 1:1 with little experience they would choose DNP)

I also am interested in DNP in case I want to doing nursing education / non clinical corporate work which from my understanding requires a DNP

If I decide to go to nursing school it will most likely be at an accelerated program, I am just worried about the gigantic attrition rates for these accelerated programs (40-50% AND HIGHER??) and if that's just due to poor scheduling and planning by the university. Some institutions will work to create a schedule for their students others will create whatever they feel like and if it negatively affects the students oh well. That's why ive read that some accelerated programs do not mix clinicals with didactics so you arent going to class in the morning, working in your clinical hours in the evening, then studying at night rinse and repeat

I went to an accelerated RN program. We started 60 students and graduated 7 on time. There are two reasons for that kind of attrition: the quality of the student and the rigor of the program. Direct entry accelerated programs tend to attract students who want a quick degree yet do not realize what that entails. Accelerated RN programs are very challenging. We used ATI exams for every class and if you fail the ATI, regardless of your overall grade, you fail the course.

I’m about to graduate in May with my DNP. I went that route because I want to teach eventually and my tuition was free through the military at a well respected local state school. If you want to teach just go DNP from the start and get it done with.

 

[pamac]

Only 7 graduated on time? Those are expensive programs. All the folks near me that go to the nearby program are serious about not falling out. Thats too much money to fall by the wayside part way through.