I said your difficult courses aren't useful. Nursing theory is, objectively, garbage, and I've seen the "research" that comes out of many of these programs, and it is laughable. NPs aren't useless, they are just undereducated for what they claim to be capable of doing safely.
I mean, we've got plenty of anecdotes but no one is willing to fund a study which pairs patients in equal number to NPs and physicians. One such study that is frequently cited as "proving" equivalence was done between NPs that had twice as much time per patient and were provided with disease-specific training versus physicians that had half as much time per patient and no special training beforehand, and only compared patients with the disease in question rather than general outcomes. Give me a study between NPs and physicians that have a panel of 2000 patients each of equal acuity and I guarantee the doctors will come out on top. Such a study has never been fine because nurses know that it will not be in their favor, and physicians can't force them to be on board for such an experiment.
You don't know what you're unprepared for or the mistakes you are making because you lack the knowledge to realize you are making mistakes and where the borders of your knowledge truly lie.
They did not have equal patient time, acuity, or patient panel size, and those NPs were free to consult with the physicians in the office regarding any complex cases. I want an apples to apples study, equal time, equal patients, zero physician backup, and equal hours worked.
Expecting one man to fund a large multucenter study is literally the most ridiculous thing I've read on SDN in weeks.
There was no control for time or physician support.
I'm going to be off in PP land, far away from primary care general medicine if I play my cards right. Won't be in a position to be taken seriously in regard to research proposals.
PP???
Most have seen nursing curriculum, see @dr zaius post, as well as anyone who has done RN/NP-->MD/DO will explain the severe distance between the two. 8th graders also take A&P it doesn't mean it's the same content.
You mean politicians (who know nothing about medicine and want to cut costs) and nurse orgs and lobbyists that put out these pathetic studies? There's a reason only politicians and laypeople are impressed by those equivalency studies while literally no researchers are. Can you point to a study showing that CNAs can't give equal competency compared to RNs?
Private practice.
Do you have any proof that they can't give equal competency compared to a RN? There are no studies for this. Some CNAs are involved with and have seen a vast range of pathology, are eager to learn on the job with some even having additional training and education, and if trained correctly can do anything an RN can. There is even a new CNARN degree program where CNAs can get the equivalent training similar to a BSN in 4 months if they've put in their time and gotten the right experience.
We look at NP education about the same as NPs look at LPNs. The minimum total hours an NP needs throughout their entirety of training is 1,100 at the BSN level and 650 at the advanced level, with roughly 100 credits in total (per my local university, which is 51 credits for the bachelor's degree and 47 for the NP), compared with the 18,000 clinical hours a physician completes, in addition to an absurd amount of credits (Baylor estimates their MD program to be at about 339.5 credit hours, to give you an idea) at the advanced level. PAs have 2,000-3,000 clinical hours at the advanced level, plus around 173 credits of study at the advanced level. That's a quality and quantity difference no amount of practicing at the basic bedside level can bridge, in my opinion, and it's why I generally prefer physician assistants to nurse practitioners, except in certain cases (CRNAs, neonatal NPs, psych NPs) where the training goes above and beyond the minimum standards present in the general FNP degree, and even then only when I am familiar with graduates from that program and the way in which they educate (Columbia and Yale, for instance, have both excellent NP programs that train their students in decent hospitals; Yale grads, in particular, are fantastic). There are a great number of NP programs I would refuse to hire a graduate from due to their lackluster standards in clinical and didactic education, but there are zero PA programs I have encountered that would outright disqualify a candidate due to the general poor standards of their programs and ignorance of their graduates.
There are NPs out there practicing without any degree, as one used to be able to get certificate RN, the NP degree was a certificate of added qualifications on top of that, and thus there are NPs out there that were grandfathered in with NO degree whatsoever (I dug up a couple of these in the last thread about this topic, which were largely old NPs that graduated from hospital-sponsored RN certificate programs and then later moved into the earliest NP certificate programs).
Most states have grandfathering clauses that protect the practice rights of practitioners as credentialing for new practitioners changes. Licensure is granted by states, not by the central nursing bodies, so states are free to create such clauses and generally do to protect their workers. This is particularly important in the case of NPs, as the first Master's level NP program didn't exist until the 1980s, and, shockingly, some people were adults that already had established careers in the 1980s! These people were grandfathered in when the Master's programs were created, and that has continued to this current day. Per the ACPCNP: Grandfathering in Regulation The intent of the Consensus Model is that CNPs who are recognized by the state when the new regulatory framework is implemented in that state will remain eligible to practice even though they may not meet all elements of the new framework. Nevertheless, the availability of a grandfathering clause to a licensee may be conferred only by the state in which the CNP wishes to practice.
Who are you fighting against? What are you trying to achieve? You state that you are fighting for RNs, but all I see is you airing out your personal credentials and half-baked knowledge that might as well have been gleamed from sleeping at night with First Aid under your pillow. Healthcare isn't intended to be mutually destructive amongst all care level providers, it is supposed to create a constructive environment in which the patients can be cared for amidst the chaos of hospital politics. Go ahead and be a trail blazer. Tell me where you end up when you reach the end of the road.
Probably about as many as there are certificate PAs with no Bachelor's degree and no prior health care experience, which is to say, less than you could probably count on two hands if even that.
Actually, I stand corrected. 2.3% of NPs do not have a graduate per the AANP. Since there was never a BSNP and things jumped straight from certificate to Master's, those are all certificate holders, who may or may not have a bachelor's degree.
