Nurse practitioner training has changed

[Anonymous]

I'm a doctor and this is something really disconcerting that I've witnessed both as a doctor and as a patient. There is not nearly enough attention given to this, and it will be the last nail in the coffin of American healthcare. Sorry about the paywall. https://www.bloomberg.com/news/features/2024-07-24/is-the-nurse-practitioner-job-boom-putting-us-health-care-at-risk

"Early waves of NP students were often experienced registered nurses seeking to increase their skills and responsibilities. But as demand spiked, more schools began offering “direct entry” programs that accepted students with a bachelor’s degree in unrelated fields. Today the fastest among them can prepare students for NP licensure exams in three years of education that encompasses a bachelor’s in nursing, registered nursing licensing (all NPs have to become RNs, even if they haven’t yet worked in the field) and a master’s in nursing. In 27 states, licensed graduates are allowed to treat patients and prescribe drugs with no physician oversight, even if they have no prior nursing experience...
...Students must obtain 500 clinical hours to graduate. That’s less than 5% of the amount required of medical doctors before they can practice medicine."

[Anonymous]

Yikes.

I was looking at nursing programs recently and thought the same as you. I was in disbelief.

[Anonymous]

RN here, it would help if they did bedside 2 years as the ones I worked alongside did just 10 years ago. But I do not blame those they choose direct entry—bedside is brutal though you learn so much.

[Anonymous]

Agree. My dermatologist recently retired. I received a letter saying the person taking over his practice was “Board certified in dermatology”. I went and had two moles removed. The new “doctor”, who was very nice, turned out to be a nurse practitioner, certified by a nursing board. I was shocked. In reviews people referred to her as “doctor” and the practice had the name “dermatology” in it. I think NPs can be very helpful, but in specialties, she doesn’t have close to the training of a physician dermatologist. Pretty scary.

[Anonymous]

I’m a nurse. I think there’s a few issues. One is that many nurses are skipping the RN experience and going straight into NP school. The other is that there is no consistency on the quality of programs. So many NP diploma mills have popped up that seem to take anyone with a pulse and a BSN. Some of my colleagues in NP school have no common sense even in bedside nursing. I wouldn’t trust them as a patient. And it’s a shame bc there are great NPs out there.

[Anonymous]

This is why I will see an NP for minor issues like strep, UTI, common cold, but not for anything else.

[Anonymous]

I don’t understand how the qualifications can be less than for an RN?

[Anonymous]

Anonymous wrote:Agree. My dermatologist recently retired. I received a letter saying the person taking over his practice was “Board certified in dermatology”. I went and had two moles removed. The new “doctor”, who was very nice, turned out to be a nurse practitioner, certified by a nursing board. I was shocked. In reviews people referred to her as “doctor” and the practice had the name “dermatology” in it. I think NPs can be very helpful, but in specialties, she doesn’t have close to the training of a physician dermatologist. Pretty scary.

Yup. I'm a psychiatrist and there are so many psychiatric NPs out there who have "Psychiatry" all over their websites. And if they have a doctorate in nursing, they call themselves "Dr" as well. I have had many patients who said they were tricked by this.

[Anonymous]

Anonymous wrote:I don’t understand how the qualifications can be less than for an RN?

There are problems with NP programs, but no one is saying that NP’s have fewer qualifications than RN’s.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I don’t understand how the qualifications can be less than for an RN?

There are problems with NP programs, but no one is saying that NP’s have fewer qualifications than RN’s.

Don’t most RN programs have real in-person training? Per the article these NP schools are all online and don’t provide their own clinical training.

[Anonymous]

I am a nurse working in academia. My students seem to feel immense pressure to get a masters or NP. As though a BSN isn’t enough to be successful as a nurse. I tell them all they need to work first. Doesn’t even have to be bedside but to actually work as a nurse in some capacity for a few years before doing their graduate level degrees. However they all want to advance their professional selves and they think more education / qualification is how to do it.

[Anonymous]

With the dearth of primary care MDs, this is a way to get more primary care providers out there. Might not be ideal, but it's filling a gap where care is really needed.

[Anonymous]

I am an emergency physician and it is astounding how many NP's send patients for non-emergencies and vice versa, failure to recognize one. One of our most recent cases involved a patient whose EKG clearly showed a heart attack the day prior, but was told it looked okay. The majority of our new grad nurses in the ED are all planning on applying for online degrees and have about 4 months of clinical training under their belt. Pretty frightening.

[Anonymous]

Anonymous wrote:I am an emergency physician and it is astounding how many NP's send patients for non-emergencies and vice versa, failure to recognize one. One of our most recent cases involved a patient whose EKG clearly showed a heart attack the day prior, but was told it looked okay. The majority of our new grad nurses in the ED are all planning on applying for online degrees and have about 4 months of clinical training under their belt. Pretty frightening.

This is exactly why I will never to go one. I have had experiences with them recently with my parents and they just don't have enough education, training and experience to actually be effective for anything more than minor issues. To try to pass them off on the rest of us rather than giving access to actual MDs is a disservice to all of us. Healthcare is broken and more NPs is not the answer.

[Anonymous]

My DS is a physician so I know how long his training was. I would never see a NP or PA unless it was something minor. Beware of front office staff offering an earlier appointment to an NP/PA. This happened to me at a new practice. I asked for Dr X, she had recently opted to go part time, so the staff member offered me another person. Why isn’t my co-pay cheaper if I am not seeing a physician?