Schools of nursing starting white coat ceremonies...

[787593]

Agreed. This is exactly the kind of thread that will live forever. The goons are going to run all over this and flood it with nonsense.

Edit: looks like I should have read further before posting....They got to this thread quicker than I thought.

Lol

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[username456789]

Ok, do you have any suggestions how nurses can get a better education, how we can try to change the curriculum? I went on an interview just today for a nurse internship. The hiring manager, a clinical nurse specialist, asks "Where do you see yourself in 5 years?" Answer that I googled for last night: "Having got my DNP!" Everyone who is in nursing above me and involved in hiring or education encourages DNP. Can you tell me what is wrong with the NP program (my guess is not enough clinical hours?) and how students like myself can get a better education?

The problem is not just " lack of clinical hours", although that's a big one. The major problem that is essentially unfixable is the enormous gap in foundational scientific knowledge. Yes, even if you get a BSN and take undergrad sciences, the curriculum in the first two years of medical school - much maligned as it may be on here - is something that has absolutely no analog within nursing.

Becoming a nurse practitioner, or indeed a DNP, is like trying to build a high rise apartment on a swamp with no foundation. You can keep trying to build it higher and higher, but it's a fools errand.

Practicing nursing is not practicing medicine. Except that the nursing administration in lobby is trying to practice medicine under the guise of practice in nursing. There are probably ways to improve nursing education in general. Trying to pretend that its goals are the same as medical education is not one of them.

 

[Mad Jack]

Ok, do you have any suggestions how nurses can get a better education, how we can try to change the curriculum? I went on an interview just today for a nurse internship. The hiring manager, a clinical nurse specialist, asks "Where do you see yourself in 5 years?" Answer that I googled for last night: "Having got my DNP!" Everyone who is in nursing above me and involved in hiring or education encourages DNP. Can you tell me what is wrong with the NP program (my guess is not enough clinical hours?) and how students like myself can get a better education?

Well, aside from the fact that you get 20x less training (literally) than a board certified physician and most of the classes are fluff, nothing is wrong.

It's easy to get a better education though. There's this place called medical school.

 

[Crayola227]

Go to medical school.

 

[thenursingstudent]

Well, I might be annoying to some by continuing this but I'll remind you that you don't need to read it.

I'm confused by the responses to my question about how NP schools can be better. I ask physicians and med students because you have very clear ideas, expressed on these forums, about what bad NP's are, coming from personal experiences. Nurses don't seem to think there is any problem with their nursing graduate education, besides maybe lacking clinical hours, and even that isn't a consistent element among nurses. One nurse told me that her clinical hours for an MNP was "the same as a full time job, so plenty."

On these forums, it's made clear that nurses aren't doctors and shouldn't try to be. But then when I asked how can NP schools be better, the replies above suggest to follow the path of med school, or even "go to medical school." Nurses don't want to be doctors, wait let me rephrase that, nurses shouldn't want to be doctors or they should go to med school yes. I want to stick within my scope of nursing, or I certainly would plan on applying to medical school.

I agree that we need a stronger and more of a science background though. This is where I feel like nursing needs a kick in the butt toward professionalism, because my classmates aren't into science and don't think it's any importance to nursing, and I think neither do some of my nursing teachers (every other word is "evidence based practice" without really any understanding or meaning behind it). If the nursing community became more professional, I don't think we'd attract the kinds of students who make up a lot of it. I know I sound like a pretentious snob but I'm talking about watching my classmate play a game on his laptop during lecture and ask "why did we even need a chemistry class for nursing." Anyway, thank you for the discussion. Ugh makes me want to try to go to MD school.

 

[syma]

On these forums, it's made clear that nurses aren't doctors and shouldn't try to be. But then when I asked how can NP schools be better, the replies above suggest to follow the path of med school, or even "go to medical school." Nurses don't want to be doctors, wait let me rephrase that, nurses shouldn't want to be doctors or they should go to med school yes. I want to stick within my scope of nursing, or I certainly would plan on applying to medical school.
.

The desire for independent practice and change in scope of practice says otherwise.

 

[Lexdiamondz]

Well, I might be annoying to some by continuing this but I'll remind you that you don't need to read it.

I'm confused by the responses to my question about how NP schools can be better. I ask physicians and med students because you have very clear ideas, expressed on these forums, about what bad NP's are, coming from personal experiences. Nurses don't seem to think there is any problem with their nursing graduate education, besides maybe lacking clinical hours, and even that isn't a consistent element among nurses. One nurse told me that her clinical hours for an MNP was "the same as a full time job, so plenty."

On these forums, it's made clear that nurses aren't doctors and shouldn't try to be. But then when I asked how can NP schools be better, the replies above suggest to follow the path of med school, or even "go to medical school." Nurses don't want to be doctors, wait let me rephrase that, nurses shouldn't want to be doctors or they should go to med school yes. I want to stick within my scope of nursing, or I certainly would plan on applying to medical school.

I agree that we need a stronger and more of a science background though. This is where I feel like nursing needs a kick in the butt toward professionalism, because my classmates aren't into science and don't think it's any importance to nursing, and I think neither do some of my nursing teachers (every other word is "evidence based practice" without really any understanding or meaning behind it). If the nursing community became more professional, I don't think we'd attract the kinds of students who make up a lot of it. I know I sound like a pretentious snob but I'm talking about watching my classmate play a game on his laptop during lecture and ask "why did we even need a chemistry class for nursing." Anyway, thank you for the discussion. Ugh makes me want to try to go to MD school.

This isn't exactly true. Many, many NPs have stated, both in person and online, that the didactics and clinical training involved in many master's and DNP programs are lacking, and the "clinical hours" reported can range anywhere from writing notes and taking histories to simply shadowing.

The problem with how to make NP programs better is that they work with a student pool that generally has much less of a science background than medical schools (or PA, Dental and DPM schools) and who overall tend to be weaker students. As it stands the current model for NP training makes schools the most money so they're going to be very loathe to change it for the sake of making better practitioners - if they were to make the training more useful and more rigorous overall they would 1) have to accept fewer students and 2) have to justify to those students the utility of an NP degree vs. training as a PA, MD or DO.

 

[Stagg737]

I think there've been a few good responses here already, but I'll try and address individual questions you have.

Ok, do you have any suggestions how nurses can get a better education, how we can try to change the curriculum? I went on an interview just today for a nurse internship. The hiring manager, a clinical nurse specialist, asks "Where do you see yourself in 5 years?" Answer that I googled for last night: "Having got my DNP!" Everyone who is in nursing above me and involved in hiring or education encourages DNP. Can you tell me what is wrong with the NP program (my guess is not enough clinical hours?) and how students like myself can get a better education?

If you're asking how to get an education that will make you more apt to practice independently, I agree with previous responses that you would need to go to medical school or at the very least PA school (it honestly blows my mind that DNPs have been given the right to practice independently before PAs, but that may be because many PAs chose that route over med school because they didn't want the liability/responsibility of a physician).

If you're asking how can you get a better education to improve your nursing skills, I think there are two routes.

1) More clinical experience seeing a wider variety of cases. Imo, once you've got foundational knowledge, nothing is a better teacher than experience. I've seen claims that DNPs are qualified to practice independently because they've got an extra 750 hours of clinical training. To give you some perspective, many med students put in more hours than that on their two month surgery or IM rotations. Imo an extra 2 months is not nearly enough time to gain the knowledge needed to practice independently.

2) Continuing medical education/grad programs which emphasize how to identify and differentiate between common conditions with relatively similar presentations and how to identify the zebras. Example: On my peds rotation we worked with an NP that would run a rapid strep test on any kid with a sore throat. This is not only a waste of her time, it's a waste of money and doesn't give you any useful information in many cases (since you should know it's not strep). So learning how to differentiate between strep vs. irritation from postnasal drip vs. URI vs. sinus infection (causing postnasal drip leading to a sore throat). Knowing how to create a valid differential diagnosis is essential and something which many nurses I've worked with aren't very good at.

Well, I might be annoying to some by continuing this but I'll remind you that you don't need to read it.

I'm confused by the responses to my question about how NP schools can be better. I ask physicians and med students because you have very clear ideas, expressed on these forums, about what bad NP's are, coming from personal experiences. Nurses don't seem to think there is any problem with their nursing graduate education, besides maybe lacking clinical hours, and even that isn't a consistent element among nurses. One nurse told me that her clinical hours for an MNP was "the same as a full time job, so plenty."

On these forums, it's made clear that nurses aren't doctors and shouldn't try to be. But then when I asked how can NP schools be better, the replies above suggest to follow the path of med school, or even "go to medical school." Nurses don't want to be doctors, wait let me rephrase that, nurses shouldn't want to be doctors or they should go to med school yes. I want to stick within my scope of nursing, or I certainly would plan on applying to medical school.

I agree that we need a stronger and more of a science background though. This is where I feel like nursing needs a kick in the butt toward professionalism, because my classmates aren't into science and don't think it's any importance to nursing, and I think neither do some of my nursing teachers (every other word is "evidence based practice" without really any understanding or meaning behind it). If the nursing community became more professional, I don't think we'd attract the kinds of students who make up a lot of it. I know I sound like a pretentious snob but I'm talking about watching my classmate play a game on his laptop during lecture and ask "why did we even need a chemistry class for nursing." Anyway, thank you for the discussion. Ugh makes me want to try to go to MD school.

As you said, a major issue with some DNP schools is the curriculum. From what I've been told, the curriculum at some schools is basically logging clinical hours and doing a research project. I honestly think that in terms of improving education, the research is a complete waste of time and directing that time towards improving clinical foundational knowledge is would go a long way in creating DNPs that could even potentially function independently. I'm not saying nurses can't or shouldn't do research, I just don't think it's a beneficial way for them to increase their educational level significantly.

 

[RogueBanana]

The white coat is overrated. There should be a universal identifier though to separate doctors from the rest of the staff. Any ideas? Doctor beenies?


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Doctor Capes have a nice ring to it. Plus it would protect your back AND you can whirl it around to distract the midlevels while you quietly escape to your coffin to slumber and feed.

 

[hello1234!]

Well, I might be annoying to some by continuing this but I'll remind you that you don't need to read it.

I'm confused by the responses to my question about how NP schools can be better. I ask physicians and med students because you have very clear ideas, expressed on these forums, about what bad NP's are, coming from personal experiences. Nurses don't seem to think there is any problem with their nursing graduate education, besides maybe lacking clinical hours, and even that isn't a consistent element among nurses. One nurse told me that her clinical hours for an MNP was "the same as a full time job, so plenty."

On these forums, it's made clear that nurses aren't doctors and shouldn't try to be. But then when I asked how can NP schools be better, the replies above suggest to follow the path of med school, or even "go to medical school." Nurses don't want to be doctors, wait let me rephrase that, nurses shouldn't want to be doctors or they should go to med school yes. I want to stick within my scope of nursing, or I certainly would plan on applying to medical school.

I agree that we need a stronger and more of a science background though. This is where I feel like nursing needs a kick in the butt toward professionalism, because my classmates aren't into science and don't think it's any importance to nursing, and I think neither do some of my nursing teachers (every other word is "evidence based practice" without really any understanding or meaning behind it). If the nursing community became more professional, I don't think we'd attract the kinds of students who make up a lot of it. I know I sound like a pretentious snob but I'm talking about watching my classmate play a game on his laptop during lecture and ask "why did we even need a chemistry class for nursing." Anyway, thank you for the discussion. Ugh makes me want to try to go to MD school.

It's not a question of just simply making NP schools better, because even if they are better I don't think NP's are practicing medicine. There is no amount of additional training other then medical school that will make them capable of practiticing medicine. Period. They are practicing nursing, which is a field I respect. I know I would not be able to function as a nurse without going to nursing school.

 

[username456789]

It's not a question of just simply making NP schools better, because even if they are better I don't think NP's are practicing medicine. There is no amount of additional training other then medical school that will make them capable of practiticing medicine. Period. They are practicing nursing, which is a field I respect. I know I would not be able to function as a nurse without going to nursing school.

Here is actually where you and I disagree, I think. It may just be in use of language.

Nurses practice nursing.

Nurse practitioners are nurses who are trying to practice medicine, but continue to claim that they are practicing nursing (to skirt that whole having-to-be-overseen-by-the-BOM thing).

Asking "how can we make nurse practioner education better", to me, is a nonstarter - because nurse practioners are already trying to be something they're not. They are trying to practice medicine, but with a nursing education. Nursing and medicine are two very different but complementary vocations.

To the poster asking "how can we make nurse practitioner education better?", my unfortunately blunt answer is: "you can't, and you shouldn't." An alternative answer would be "go to medical school instead."

 

[hello1234!]

Here is actually where you and I disagree, I think. It may just be in use of language.

Nurses practice nursing.

Nurse practitioners are nurses who are trying to practice medicine, but continue to claim that they are practicing nursing (to skirt that whole having-to-be-overseen-by-the-BOM thing).

Asking "how can we make nurse practioner education better", to me, is a nonstarter - because nurse practioners are already trying to be something they're not. They are trying to practice medicine, but with a nursing education. Nursing and medicine are two very different but complementary vocations.

To the poster asking "how can we make nurse practitioner education better?", my unfortunately blunt answer is: "you can't, and you shouldn't." An alternative answer would be "go to medical school instead."

Maybe I didn't make myself clear, but I agree with everything you just said.

 

[username456789]

Maybe I didn't make myself clear, but I agree with everything you just said.

I figured you did, I think the confusion was just in the word choice we both used.

 

[Mad Jack]

Well, I might be annoying to some by continuing this but I'll remind you that you don't need to read it.

I'm confused by the responses to my question about how NP schools can be better. I ask physicians and med students because you have very clear ideas, expressed on these forums, about what bad NP's are, coming from personal experiences. Nurses don't seem to think there is any problem with their nursing graduate education, besides maybe lacking clinical hours, and even that isn't a consistent element among nurses. One nurse told me that her clinical hours for an MNP was "the same as a full time job, so plenty."

On these forums, it's made clear that nurses aren't doctors and shouldn't try to be. But then when I asked how can NP schools be better, the replies above suggest to follow the path of med school, or even "go to medical school." Nurses don't want to be doctors, wait let me rephrase that, nurses shouldn't want to be doctors or they should go to med school yes. I want to stick within my scope of nursing, or I certainly would plan on applying to medical school.

I agree that we need a stronger and more of a science background though. This is where I feel like nursing needs a kick in the butt toward professionalism, because my classmates aren't into science and don't think it's any importance to nursing, and I think neither do some of my nursing teachers (every other word is "evidence based practice" without really any understanding or meaning behind it). If the nursing community became more professional, I don't think we'd attract the kinds of students who make up a lot of it. I know I sound like a pretentious snob but I'm talking about watching my classmate play a game on his laptop during lecture and ask "why did we even need a chemistry class for nursing." Anyway, thank you for the discussion. Ugh makes me want to try to go to MD school.

If you wanted to imorove nursing education, you'd have to remove the fluff (nursing theory) and implement a serious revamp of preclinical education that included courses similar to what physician assistants take- basically a one-year abbreviated medical school preclinical education, lacking in depth and breadth but serviceable. Integrating a true clinical year (with 2000+ hours rather than the 700 or so most have now) concentrated in one area of practice would also help.

 

[Mad Jack]

I think there've been a few good responses here already, but I'll try and address individual questions you have.



If you're asking how to get an education that will make you more apt to practice independently, I agree with previous responses that you would need to go to medical school or at the very least PA school (it honestly blows my mind that DNPs have been given the right to practice independently before PAs, but that may be because many PAs chose that route over med school because they didn't want the liability/responsibility of a physician).

If you're asking how can you get a better education to improve your nursing skills, I think there are two routes.

1) More clinical experience seeing a wider variety of cases. Imo, once you've got foundational knowledge, nothing is a better teacher than experience. I've seen claims that DNPs are qualified to practice independently because they've got an extra 750 hours of clinical training. To give you some perspective, many med students put in more hours than that on their two month surgery or IM rotations. Imo an extra 2 months is not nearly enough time to gain the knowledge needed to practice independently.

2) Continuing medical education/grad programs which emphasize how to identify and differentiate between common conditions with relatively similar presentations and how to identify the zebras. Example: On my peds rotation we worked with an NP that would run a rapid strep test on any kid with a sore throat. This is not only a waste of her time, it's a waste of money and doesn't give you any useful information in many cases (since you should know it's not strep). So learning how to differentiate between strep vs. irritation from postnasal drip vs. URI vs. sinus infection (causing postnasal drip leading to a sore throat). Knowing how to create a valid differential diagnosis is essential and something which many nurses I've worked with aren't very good at.



As you said, a major issue with some DNP schools is the curriculum. From what I've been told, the curriculum at some schools is basically logging clinical hours and doing a research project. I honestly think that in terms of improving education, the research is a complete waste of time and directing that time towards improving clinical foundational knowledge is would go a long way in creating DNPs that could even potentially function independently. I'm not saying nurses can't or shouldn't do research, I just don't think it's a beneficial way for them to increase their educational level significantly.

That they do research with such a poor understanding of physiology, medicine, and the basic sciences astounds me. It's usually fluff research, like patient satisfaction and such.

 

[Psai]

That they do research with such a poor understanding of physiology, medicine, and the basic sciences astounds me. It's usually fluff research, like patient satisfaction and such.

Nurses are just as good as doctors, here is my nonrandomized retrospective 6 month chart review that measures paperwork completion. This is a definitive work that justifies my existence.

 

[Crayola227]

Nurses are just as good as doctors, here is my nonrandomized retrospective 6 month chart review that measures paperwork completion. This is a definitive work that justifies my existence.

 

[Luka75]

Nurses are just as good as doctors, here is my nonrandomized retrospective 6 month chart review that measures paperwork completion. This is a definitive work that justifies my existence.

Before I picked up on the sarcasm, I was about to ask what happened to this:

You can put a dress on a pig but in the end it's still a pig

 

[W19]

If you wanted to imorove nursing education, you'd have to remove the fluff (nursing theory) and implement a serious revamp of preclinical education that included courses similar to what physician assistants take- basically a one-year abbreviated medical school preclinical education, lacking in depth and breadth but serviceable. Integrating a true clinical year (with 2000+ hours rather than the 700 or so most have now) concentrated in one area of practice would also help.

I already clocked in ~1000 clerkship in which I do H&P and progress notes etc... and most physicians still think that I am an idiot. Power to these nurses who are able to function as 'providers' with only 700 hours. Nurses must be very smart!