Cross-posted with my nursing blog Caffeine and Xanax. A lot of blather about NP programs and what I’m going to do about school ahead.
My problem with my chosen field
I like being a nurse. I’m not crazy about it but it’s ok. I like critical care, just not the hours. I’d prefer to be making more money, because duh, who wouldn’t? Thus, I’m in school to be a nurse practitioner. Nurse practitioners are mid-level providers, and in some states have independent prescription-writing authority, but not in my state. There is a huge debate between the nursing world and the “doctor” or physician world as to what the purpose and value of nurse practitioners really are. My personal dilemma is that I’m a nurse, and yet I side with the doctors for the most part when it comes to the abilities of the nurse practitioner.
Obviously, some doctors are great, some are terrible. Same with nurse practitioners. And yet… so many nurse practitioners think that they should be able to diagnose, order testing, and write prescriptions on the same level of physicians and even believe they deserve equal pay. I work with medical residents and can tell you, they are brilliant. They have undergraduate degrees in chemistry or biology, four years of intense and rigorous study of pathophysiology, and go on to devote three to four years of their life after that to residency, where they eat, breathe, and sleep medicine. Undergraduate nursing programs barely prepare you for the field of nursing, let alone medicine, with one semester of rudimentary pathophysiology, and a lot of BS courses about nursing “theory”. Really, you learn from externships, a few clinicals that are one day per week for 5-7 hours, and then on the job wherever you are hired. After that, you can get some work experience and go on for an additional two years to prepare you for “advanced practice”, and this consists of one more semester of pathophysiology, pharmacology, health assessment, 500-700 hours of clinical experience (compared to over 12,000 hours of residency by doctors), and a ton of BS nursing theory classes, which are like brain-washing “nursing is holistic and wonderful” seminars.
Now, in spite of this, there are many truly knowledgeable and talented nurse practitioners out there doing great work, but were they prepared for medicine as physicians are? No fucking way. Do a lot of them have better people skills? Yes. I don’t know why, but the majority of docs are lacking in this area. But as far as diagnosing capabilities and knowledge of medicine? Not even close. A lot of NPs can gain this over the years by working with talented practitioners of all sorts, but out of the gate NPs are way, way, way behind new physicians. I hate that nursing school tries to tell me otherwise, as do some nurse practitioners. Having a doctorate in nursing is not even close to being the same as being a doctor of medicine (MD), and it’s appalling to me that some NPs insist on being called “Dr.”.
My problem with my current NP program
I chose this particular University because of the following reasons, and in this order: 1) They only required a stats class within the past 10 years instead of past 5 (mine was 6 years prior), 2) I went to this University for undergrad and felt familiar with its instructors and campus, 3) It was closer or as close as other programs, 4) I was very confident I would be accepted right away as it was a new NP program and I had contacts with professors from undergrad years.
I chose the adult-gerontology primary NP program because, um, that’s the only one this school offered, and I also thought it would suffice for my career goal of being a primary NP for the elderly. It may suffice, but as I’ve gone along in the program I’ve been unhappy that it is very difficult to find preceptors and also they offer no specialization in geriatrics or palliative care, my two main interests.
My other huge, maybe largest, gripe is that this program is so unorganized. This is perhaps due to the fact that I’m in only the second cohort of the NP program, so the program coordinators are sort of upgrading things as they go, but even so, I feel like they do not communicate expectations or requirements to us clearly. One professor took the time to tell us what we needed to do for clinical sites and such, but the program coordinators themselves never went over it with us. You always feel like you’re “lucky” to find out a bit of crucial information as to what you’re supposed to be doing. It’s crazy. No one in the program is happy, no one thinks anyone running it has a clue what’s going on. Plus, the University is not affiliated with area hospitals, which means finding a preceptor comes down to personal connections. It SUCKS.
Why I’m changing my career goals (somewhat)
I was so intrigued to find out that another University within the same driving distance as my current program (which is held offsite, an extra 25 miles in the opposite direction of the main campus) has an NP program that specializes in Palliative Care/Hospice and is also an Acute NP program. Acute meaning I could deal with chronic and acute illnesses (such as I’m used to) as opposed to outpatient, “I have a cold”, boring stuff. I can transfer 6 credit hours total to that school if accepted. So 2 of my 3 classes could transfer, not a total wash. I’ve decided to apply to their program, which is well-established and, I pray, more organized.
The University I currently work for, one of the best in the nation for medicine, also has an Acute NP program, and even though it doesn’t offer the additional “Hospice/Palliative Care” title, it would allow me to have preceptors in the actual areas I am interested in learning, rather than just taking whatever bone is thrown my way like I’m being forced to do now. These are top-notch, #1 nationwide, specialty areas, clinics, and treatment centers. Not to mention that if I got my foot in the door in this system I would keep my seniority and awesome benefits and retirement plan, plus remain in a strong union.