Super torn between pre-med and NP - advice?

[Matthew9Thirtyfive]

I can buy that. You take NP's one at a time based on their background and experience. Calling all NP's "trash" as has been often done on this website is foolish.

I usually see it as calling NP education and the NP lobby as trash. Which they mostly are. Individual NPs can be good or bad. My experience has been mostly bad or mediocre with the occasional good one.

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[Lucid_Dream]

I can buy that. You take NP's one at a time based on their background and experience. Calling all NP's "trash" as has been often done on this website is foolish.

I’ve heard the NP exam is easier than the NCLEX (my friend complained that he wasted so much time studying for it when it turned out he didn’t need to), and I’ve never heard of anyone being rejected from NP school. However, out of 8 people I know who recently applied to CRNA, only one got in,

 

[762513]

I usually see it as calling NP education and the NP lobby as trash. Which they mostly are. Individual NPs can be good or bad. My experience has been mostly bad or mediocre with the occasional good one.

NP education needs to be standardized, but there are as many quality NP programs as there are poor ones. The NP lobby is outstanding for their stated goals, even people who hate NP's agree on that.

I’ve heard the NP exam is easier than the NCLEX (my friend complained that he wasted so much time studying for it when it turned out he didn’t need to), and I’ve never heard of anyone being rejected from NP school. However, out of 8 people I know who recently applied to CRNA, only one got in,

The NP exam is not easier than the NCLEX. The difference is you can't hit the Qbank to prepare for the NP exam. You have to know the content.

 

[Lucid_Dream]

NP education needs to be standardized, but there are as many quality NP programs as there are poor ones. The NP lobby is outstanding for their stated goals, even people who hate NP's agree on that.

The NP exam is not easier than the NCLEX. The difference is you can't hit the Qbank to prepare for the NP exam. You have to know the content.

Their goals seem to be pumping out as many NPs as possible regardless of the consequences.

 

[762513]

Their goals seem to be pumping out as many NPs as possible regardless of the consequences.

The stated goals of the NP lobby is to allow every NP full independent practice (I'm not supporting that position I'm just telling you what the goals are) and have been extremely successful in that goal.

 

[Matthew9Thirtyfive]

NP education needs to be standardized, but there are as many quality NP programs as there are poor ones. The NP lobby is outstanding for their stated goals, even people who hate NP's agree on that.

1. I know a number of NPs who graduated from supposedly quality programs who felt their education woefully underprepared them to practice. I’ve yet to meet a PA who has felt that way.

2. I’m referring to shoving independent practice of providers with inferior training upon the public under the guise of a physician shortage. Just because they’ve been successful at it doesn’t make it good.

The NP exam is not easier than the NCLEX. The difference is you can't hit the Qbank to prepare for the NP exam. You have to know the content.

I took a practice fnp exam, and it was disturbingly easy. Very protocol driven and a lot of nursing fluff questions.

 

[Lucid_Dream]

The stated goals of the NP lobby is to allow every NP full independent practice (I'm not supporting that position I'm just telling you what the goals are) and have been extremely successful in that goal.

I’m highly supportive of there being a nurse specialization above RN, but the education needs a serious reworking. My whole RN to BSN has been an English course. Nothing on nursing whatsoever. It’s all on writing papers and APA format, along with furthering the nursing profession and how to lobby.

According to my FNP friend, NP had more applicable knowledge but still a lot of stupid nursing theory fluff. He estimated out of a 3 year program, a year and a half was useful.

 

[Matthew9Thirtyfive]

I’m highly supportive of there being a nurse specialization above RN, but the education needs a serious reworking. My whole RN to BSN has been an English course. Nothing on nursing whatsoever. It’s all on writing papers and APA format, along with furthering the nursing profession and how to lobby.

According to my FNP friend, NP had more applicable knowledge but still a lot of stupid nursing theory fluff. He estimated out of a 3 year program, a year and a half was useful.

When the profession at large is more concerned with how many initials they can put after their name and getting to call themselves doctor without actually going to medical school than they are about ensuring advanced practice nurses are well trained and will take good care of patients, that’s what happens.

And my wife is a nurse. Got nothing against them. Just their organizations and the militant ones who care more about their egos than their patients.

 

[762513]

1. I know a number of NPs who graduated from supposedly quality programs who felt their education woefully underprepared them to practice. I’ve yet to meet a PA who has felt that way.

2. I’m referring to shoving independent practice of providers with inferior training under the guise of a physician shortage. Just because they’ve been successful at it doesn’t make it good.



I took a practice fnp exam, and it was disturbingly easy. Very protocol driven and a lot of nursing fluff questions.

You can disagree with an organizations goals but acknowledge they are extremely successful as an organization. There's no PA or NP school that really prepares people well enough for practice. PA's might think that they are prepared because many of them often haven't seen enough of healthcare to know how unsafe a new midlevel really is. The actual NP exam yes has research and fluff questions, but the issue is there's no way to prepare for the range of questions. For example, the FNP exam covers such a wide variety of patient's that it's very difficult to prepare for.

 

[Stagg737]

Mental health is a flooded NP area? Not even close, at least in my area. Psych NP's are in high demand and make some of the best cash in the field.

It's also an area where NPs are the most poorly trained to practice independently. On some of my outpt rotations literally half of the new patients were transfers from NP clinics where they were so poorly managed they weren't even on the right class of medications. Some of the treatment plans I've seen are legitimately horrifying and the NPs were lucky their patients didn't kill themselves. NPs have a place in the system, but not the independent route that's being pushed by so many different groups.

 

[Lucid_Dream]

You can disagree with an organizations goals but acknowledge they are extremely successful as an organization. There's no PA or NP school that really prepares people well enough for practice. PA's might think that they are prepared because many of them often haven't seen enough of healthcare to know how unsafe a new midlevel really is. The actual NP exam yes has research and fluff questions, but the issue is there's no way to prepare for the range of questions. For example, the FNP exam covers such a wide variety of patient's that it's very difficult to prepare for.

Being successful as an organization matters little to me. One can say "you can disagree with cancer but you have to admit, those cells are really successful at spreading!"


The biggest alarm for me was during my Diploma program, RN to BSN, and beyond, a big part of nursing is the "fight the patricarchy!" "We're important too!" etc. So many chapters in my fundamentals book were on "Don't be intimidated by doctors." "Doctors aren't our bosses" etc.

If the nursing profession and leadership focused on making themselves better, instead of professionalizing gossiping and whining, the profession would go far. I honestly do feel like nursing will greatly advance when some of the old nurses from way back when exit the profession.

 

[Matthew9Thirtyfive]

You can disagree with an organizations goals but acknowledge they are extremely successful as an organization. There's no PA or NP school that really prepares people well enough for practice. PA's might think that they are prepared because many of them often haven't seen enough of healthcare to know how unsafe a new midlevel really is. The actual NP exam yes has research and fluff questions, but the issue is there's no way to prepare for the range of questions. For example, the FNP exam covers such a wide variety of patient's that it's very difficult to prepare for.

1. I said they were successful. I just added that success doesn’t automatically make it good or the appropriate course.

2. PAs I have worked with and know personally felt prepared because they are working under supervision, so even in practices where they have autonomy, they have a safety net. NPs are graduating and going into independent practices with 1/10th the training of a physician. That is terrifying.

3. I haven’t been to NP school and managed to do pretty well on that practice exam. But I’ve never taken the real deal, which could be more difficult. It was very formulaic and simplistic. At least we agree that midlevels are scary when they don’t know what they don’t know.

 

[762513]

Being successful as an organization matters little to me. One can say "you can disagree with cancer but you have to admit, those cells are really successful at spreading!"


The biggest alarm for me was during my Diploma program, RN to BSN, and beyond, a big part of nursing is the "fight the patricarchy!" "We're important too!" etc. So many chapters in my fundamentals book were on "Don't be intimidated by doctors." "Doctors aren't our bosses" etc.

If the nursing profession and leadership focused on making themselves better, instead of professionalizing gossiping and whining, the profession would go far. I honestly do feel like nursing will greatly advance when some of the old nurses from way back when exit the profession.

Sure, but you can’t call cancer ineffective or inefficient

 

[Lucid_Dream]

I think there is hope for midlevels. I mean the idea is very new. Just needs to condense knowledge more. There is way too much fluff in an already super short program.

 

[Matthew9Thirtyfive]

Sure, but you can’t call cancer ineffective or inefficient

You seem to be missing the point. I’m not sure if it’s intentional or not.

 

[Lucid_Dream]

Sure, but you can’t call cancer ineffective or inefficient

Right. Its worse than ineffective. Its effectively bad. It negligently kills people...

 

[Matthew9Thirtyfive]

I think there is hope for midlevels. I mean the idea is very new. Just needs to condense knowledge more. There is way too much fluff in an already super short program.

I mean, very new compared to medicine in general. PAs have been around for 51 years.

 

[762513]

1. I said they were successful. I just added that success doesn’t automatically make it good or the appropriate course.

2. PAs I have worked with and know personally felt prepared because they are working under supervision, so even in practices where they have autonomy, they have a safety net. NPs are graduating and going into independent practices with 1/10th the training of a physician. That is terrifying.

3. I haven’t been to NP school and managed to do pretty well on that practice exam. But I’ve never taken the real deal, which could be more difficult. It was very formulaic and simplistic. At least we agree that midlevels are scary when they don’t know what they don’t know.

Oh for sure. A new midlevel is terrifying, and I am one, and I can own that. PA’s really aren’t that much safer; no one who goes to school for 2 years including clinical training really could be. If they are “confident” as a new PA then in my opinion, they are fools.

 

[Matthew9Thirtyfive]

Right. Its worse than ineffective. Its effectively bad. It negligently kills people...

Hey you could use that to refer to cancer and the np push for independence. What a coincidence.

 

[Lucid_Dream]

Hey you could use that to refer to cancer and the np push for independence. What a coincidence.

 

[Lucid_Dream]

I mean, very new compared to medicine in general. PAs have been around for 51 years.

And NPs much less than that I would think.

 

[Matthew9Thirtyfive]

Oh for sure. A new midlevel is terrifying, and I am one, and I can own that. PA’s really aren’t that much safer; no one who goes to school for 2 years including clinical training really could be. If they are “confident” then in my opinion, they are fools.

We agree there. I support PAs more because their education is standardized more, is based on a medical model, and their profession requires at least some collaboration with a physician. Used effectively, midlevels can help physicians see a lot more of the bread and butter stuff and get to a lot more patients. But that doesn’t require independence. And the argument for it goes out the window even faster when you see that the vast majority of NPs practicing independently flock right to the saturated cities.

 

[762513]

You seem to be missing the point. I’m not sure if it’s intentional or not.

Nah, just arguing semantics at this point. I understand your position fully.

 

[Lucid_Dream]

NP programs either need to get up on their hard sciences, or fit a different niche than physician lite. Since PA already fills that role, why not fit another unmet niche? Like midwives do.

 

[Matthew9Thirtyfive]

And NPs much less than that I would think.

Apparently since 1965.

 

[762513]

We agree there. I support PAs more because their education is standardized more, is based on a medical model, and their profession requires at least some collaboration with a physician. Used effectively, midlevels can help physicians see a lot more of the bread and butter stuff and get to a lot more patients. But that doesn’t require independence. And the argument for it goes out the window even faster when you see that the vast majority of NPs practicing independently flock right to the saturated cities.

Yeah I understand that viewpoint and agree with it to a point, with the caveat that you evaluate midlevels one at a time based on their background and skill set. I will say that feeling confident isn’t a measure of competence. The more experience I get in some ways the less confident I feel. As I’ve seen amazing physicians completely miss huge things, the less confident I feel about my abilities as a result. It’s an interesting curve. Any new midlevel, PA or NP, who feels confident fresh out of school is a fool.

 

[Matthew9Thirtyfive]

Yeah I understand that viewpoint and agree with it to a point, with the caveat that you evaluate midlevels one at a time based on their background and skill set. I will say that feeling confident isn’t a measure of competence. The more experience I get in some ways the less confident I feel. As I’ve seen amazing physicians completely miss huge things, the less confident I feel about my abilities as a result. It’s an interesting curve. Any new midlevel, PA or NP, who feels confident fresh out of school is a fool.

Agree with all of this.

 

[PeleHonuaMea]

a quick google shows floor RN pulling about 66k, NP pulling 100k fwiw

if only we had a bigger sample than n=2.

Nursing pay varies and is completely dependent on:
- state/region (west>midwest)
- where you work (NF<hospital)
- years of service and experience
- job description and specialty
- who or which organization you work for.
- union vs non-union

Since it looks like you're most familiar with acute care nurses, to give you some numbers:
a RN in NCal hospital can make $75/hr.
For the exact same position, they can make approximately:
$67/hr if they were in SCal,
$62/hr if in Hawaii,
$48/hr if in Oregon, and
$33/hr if in Indiana.

That's just their base pay, not counting any overtime, differential, holiday pay etc. When I was a floor nurse many years ago, we would get guaranteed double time pay for picking up Friday NOC or weekend shifts. It was an easy way to make extra money.

Some union contracts pay more than others, some non union hospitals pay more than others. The organizations with the stronger unions generally pay their nurses the highest in the country.

Some NPs pick up shifts on the floor for the extra cash. A NPs regular work is considered salary/exempt so they're unable to pick up extra shifts or overtime due to their job classification. So they sometimes pick up floor shifts for the extra money.

And depending on the state and organization, some NPs make just a tad bit more than the floor RNs. The NPs in some organizations are included in their local nursing union contract and their pay difference can be somewhat insignificant.

Other NPs are not restricted by a union contract and are paid much more than floor RNs. Again, it all depends.

Hope that helps clear it up a little bit.

 

[ThetisAntithesis]

I am NP, don't go NP.
PAs are better trained.

 

[CyrusHabs7695]

If you are not sure if you want to be a physician, then I recommend going the other route. Its simply way too much work/stress in med school to be there if you aren't 100% committed to being a physician. Theres no way id still be able to continue through this if it wasn't the only thing I wanted to do, and im only like 3 months in.

 

[eaglebaseball4]

A few of my thoughts... My sister is primary care NP, she loves her job and has plenty of time for family. She works 7:30-4:00 every day, and when she leaves work she has 0 responsibility. I think it is a great choice if you’re concerned about family, the med school loans, etc. Also, this may just be a personal observation but in my area the kids of physicians mostly become NPs not doctors... to me this says that doctors know something about the future of healthcare and advise their kids that way.. Me completely speculating though.

 

[ThetisAntithesis]

she has 0 responsibility.

Zero?!! How?!

 

[eaglebaseball4]

Zero?!! How?!

I have no clue! I know she takes home the “on-call phone” 3 nights a month, but really what is 3 days out of 30? She does work for a larger practice though, and it could be that the on-call work is just spread across more bodies.

 

[Lucid_Dream]

Nursing pay varies and is completely dependent on:
- state/region (west>midwest)
- where you work (NF<hospital)
- years of service and experience
- job description and specialty
- who or which organization you work for.
- union vs non-union

Since it looks like you're most familiar with acute care nurses, to give you some numbers:
a RN in NCal hospital can make $75/hr.
For the exact same position, they can make approximately:
$67/hr if they were in SCal,
$62/hr if in Hawaii,
$48/hr if in Oregon, and
$33/hr if in Indiana.

That's just their base pay, not counting any overtime, differential, holiday pay etc. When I was a floor nurse many years ago, we would get guaranteed double time pay for picking up a Friday NOC or weekend shifts. It was an easy way to make extra money.

Some union contracts pay more than others, some non union hospitals pay more than others. The organizations with the stronger unions generally pay their nurses the highest in the country.

Some NPs pick up shifts on the floor for the extra cash. A NPs regular work is considered salary/exempt so they're unable to pick up extra shifts or overtime due to their job classification. So they sometimes pick up floor shifts for the extra money.

And depending on the state and organization, some NPs make just a tad bit more than the floor RNs. The NPs in some organizations are included in their local nursing union contract and their pay difference can be somewhat insignificant.

Other NPs are not restricted by a union contract and are paid much more than floor RNs. Again, it all depends.

Hope that helps clear it up a little bit.

We’re not unionized in Louisiana and with base, diffs, overtime and incentive pay I’ve made 85$ an hour, and often make 65 an hour

 

[Lucid_Dream]

A few of my thoughts... My sister is primary care NP, she loves her job and has plenty of time for family. She works 7:30-4:00 every day, and when she leaves work she has 0 responsibility. I think it is a great choice if you’re concerned about family, the med school loans, etc. Also, this may just be a personal observation but in my area the kids of physicians mostly become NPs not doctors... to me this says that doctors know something about the future of healthcare and advise their kids that way.. Me completely speculating though.

I have an opposing speculation. NP school is ridiculously easy to get into, and only requires less than a 3.0 gpa depending on where you go, and some schools don’t even require a nursing background. There’s no requirement for time as an RN, and much of it is nursing fluff, theory etc.

I can not recommend NP because pretty much every ICU nurse wants to be either an NP or a CRNA, so they don’t have to work bedside their entire life, (most icu nurses I’ve see are very young. 25-40 years old). With a high demand for the school, and no real barriers to entry, supply is vastly greater than the demand and climbing. MD/DO has much more weedout in many ways.

 

[Angus Avagadro]

Supervision is the key. People should have advanced privileges granted by education, and not legislation. I am not in favor of physician extenders functioning independently. If you want to be a doctor, go to med school. Physician supervision is needed. Psych NPs in my area have a phone number written down to call if they they get in trouble. This is their level of supervision. Its ridiculous. There is tremendous financial pressure to grant extenders independent practice rights. These should be granted by education level and not by the stroke of a legislators pen. I have respect for the jobs these physician extenders do, but when did they become "Providers"? I respect Crnas, but what does the surgeon supervised Crna
do when they cant intubate or ventilate an obese patient for a tubal ligation? Ask the gynecologist to trach her? Very much of medical care is routine and uncomplicated and an extender might handle it well. It is unfair to the patient and the extender not to supervise them, on site, so the physician can be present to evaluate the patient if needed.

 

[Lucid_Dream]

Unrelated note- Seeing a LOT more DOs lately. Had never met one 6 months ago, and now I’ve met over a dozen either attending or residents. Had a DO resident respond to a code this morning.

Rock on.

 

[precisiongraphic]

We’re not unionized in Louisiana and with base, diffs, overtime and incentive pay I’ve made 85$ an hour, and often make 65 an hour

Supply and demand, baby! I've heard that Louisiana has a nursing shortage. I'd wager that your base pay is not $75/hour as it is in California. The Louisiana "overtime" or the "we're so short on staff pay" is $75.

 

[Lucid_Dream]

Supply and demand, baby! I've heard that Louisiana has a nursing shortage. I'd wager that your base pay is not $75/hour as it is in California. The Louisiana "overtime" or the "we're so short on staff pay" is $75.

Yeah my base is 26, 5.50 for nights, and 5.25 for weekends. But cost of living is extremely low here.

Base pay cap is somewhere around 36, and the high pay comes from incentive which is 10,20,or 30 extra per hour. Every single shift you pick up you’ll get at least 10 an hour extra plus your overtime.