Wednesday, April 22, 2009

NP issues....

Okay, so apparently some on here think that I have taken an "anti-NP" stance.

As usual, people have things backwards, upside down, and all over the place. I am far from being "anti NP". I actually advocate for BOTH PA's and NP's when I can, and am an outspoken proponent for both. The problem is, that NP's as whole hear the SLIGHTEST criticism, and they immediately attack. Which is too bad.

I have posted here in the past about the educational differences, and the differences in licensure and certification.

One commenter remarked that "phyasst, most of the PA programs are at Community Colleges not medical schools. I also agree with the last commentor that PA initial education is very basic and comparable to two year RN ADN programs, Respiratory Therapist and ect."

I don't know what to say to such ignorance. Of the 142 PA programs in existence that are accredited by ARC-PA, ONLY 3 are community colleges. These are remnants of the older days in the early seventies when PA programs WERE at community colleges. BTW, one of them actually grants a Master's degree now.

Please look here

I don't know if it's a reading comprehension thing, or just plain ignorance, but I AM FIGHTING FOR BOTH PROFESSIONS.......

Do I have concerns about NP education, and specifically the DNP degree and it's potentially negative effect on the supply of primary care providers in rural and underserved areas? Yes, I do. And BTW, so do MANY of the NP's I know and work with.

Do I have concerns about the PA education, and specifically the students that I have been seeing lately that are younger and younger with less and less real prior HCE? Yes, I do, which is why I am advocating mandatory residencies for PA's.

Do I have serious concerns about EITHER profession having programs betcha, and as of right now, I am not aware of a single PA program online, but if there was, I would decry it as loudly as I decry the NP ones.

Do I have concerns about the combined RN/NP programs where the student NEVER actually works as an RN prior to becoming an NP? Yep, and so do most RN's that I know and work with.

BTW, the PA profession has a "clinical doctorate" program too. The Baylor/Army EM residency program awards a DSc degree, and with 5600 clinical hours, and close to 700 didactic hours over a period of 18 months, I would most assuredly call it a "clinical" doctorate. Guess what, I would be JUST as opposed to graduates from the program using the title doctor in the clinical setting.

I am pro PA, I am also pro NP, NP's have been valuable colleagues, co-workers, and have filled a very valuable niche in the healthcare market by delivering low cost, high value care, especially in primary care settings.

Does this mean that I cannot question either profession? If so, then you have truly drank the kool-aid.

At the end of the day, after advocating for PA's and NP's, there is one group that I must advocate for, even at the expense of the above two....

The patient.

As Charles Mayo said. "That which is in the best interest of the patient, is the only interest to be considered".


Anonymous said...

I'm an NP, and share your concerns. No need to detail which ones, every one of them are true to my way of thinking. I want to work with physicians, not do my own thing. The DNP curriculums are alarming. When NPs are required to have a thorough grounding in the basic sciences, I'll be happier. I regard this training as step one in a basic understanding of the human body. If a potential NP is intimidated by college level chemistry, biology then s/he has no business as a midlevel. Nursing instructors simply are not qualified to teach pharmacology...they frequently don't understand chemistry well enough. There are absolutely stellar NPs but I think we are, and have been, on a very dangerous track.
In terms of political agendas, I am saddened by the tone of many prominent nursing leaders. We need the input of physicians, instead of encouraging adversarial relationships with medicine. I might add that the tone of advanced practice nurses needs to be tempered in that we are influencing the public's perceptions of healthcare in general, which are less than rosy right now. I love what I do, but I see the makings of a perfect storm brewing.

Anonymous said...

phyasst, You got to do better than this. This is contrived and obviously not a NP. "When NPs are required to have a thorough grounding in basic sciences, I'll be happier" was written by a detractor not a ARNP. Why would the DNP curriculums be alarming? Why are Nursing instructors "simply are not qualified to tearch pharmacology"? Why are NPs on a "very dangerous track"? An why is this person saddened? These questions will keep many NP Blog impostors up all night in the coming weeks ahead.

Anonymous said...

Perfect Storm!! I loved that movie!
Thanks for your blog.
PA2010 student

Anonymous said...

anon 1:16 AM comments should be required reading by all NP students, practitioner, educators. It shows the animosity that *others have toward us and the lengths they will go to spread gossip and misinformation. It is very apparent that this posting is wriiten by one of our detractors NOT a NP.

Anonymous said...

Do you have netflix? I like movies.
Thank you for your blog.
PA2010 student

physasst said...

I have no idea who anon 1:16 is. I have never, nor will I ever post anonymously to my own blog.

Believe me, if I have something to say, I will say it under my own identity.

physasst said...

The DNP btw, is turning out to be a good thing for us.

I've had at least 7 nurses now over the past 4 months come to me asking about PA school. WHY? Cause none of them, not a single one wants to deal with this, how did one phrase it, oh yeah, "DNP crap"
I have given them all information on the two universities with PA programs in the area, both Master's level. At least 2 sound like they are seriously going to go to PA school.

Just an anecdotal observation from my little corner of the medical world.

Anonymous said...

Thats great because the DNP student we want must be highly motivated, capable and willing to take on the responsibility that comes with it. People seek there own levels of comfort in life. Just a thought.

physasst said...

I agree, and PA school is no picnic either.

Look, I'm not 100% opposed to the DNP, I'm just worried that you guys are hastily throwing together something that likely won't improve patient care, and could hamper access to care.

If you can show that it has no effect on provider supply trends in urban, and rural underserved areas, I will advocate FOR the DNP. Until that point, I am concerned, as are other policy wonks.

Haeriphos said...

I believe North Dakota's PA program is partially online. It also requires you to have your RN and three years experience. They have a pilot program running right now where they'll take other healthcare professionals (medics, RT, etc) also. It looks like you spend 4 weeks at UND, then some time with your preceptor in your home town, do some online work, back to UND, etc..

Anonymous said...

I am the original commentator and, oh yes, I most assuredly am an NP and have been one for some time. I stand by what I have said and am actually considering PA school for personal and professional reasons.
I am alarmed and saddened by the turn my profession has taken and I have many more years to work. I might just enjoy them better as an PA.
Yes, there are NPs who then go on to PA school. No, I don't wish to be a physician.
I wish everyone all the best in their endeavors.
ps.. comment of the month is phenomenal. kudos to the poster.

Anonymous said...

physasst is a brief email communication a possibility? I'm the NP anon 1:16 commentor, tx

Anonymous said...

phyasst,I didn't believe there were any ONLINE NP programs but now that anon 1:16 has idntified him/herself...I'm a believer. She/he is not typical of NP education but there are exception to ever rule. As in nature, androgeny. Right, anon 1:16?

Anonymous said...

Haeriphos, points out that the North Dakota PA program is partially online and takes EMT as students. They receive very little hospital experience and are placed with a preceptor while completing there studies online.PA prgrams consist of diploma,ceritificates,AS degrees,BS degrees and MHS degrees. There students come from diverse educational and work backgrounds.

Anonymous said...

Its interesting that the North Dakota currently takes ONLY RNs. I think it makes the NP point that they have the education and experience to start immediately.
I work closely with newly graduate NP and PA. I think both are terrific but NPs, due to their past nursing experience and education "fit in" faster and are more at ease in the clinical setting than the PA.

Anonymous said...

A.T.Stills University has a online PA program and Drexel has an entry level online PA program also.

Randall Sexton said...

"Do I have serious concerns about EITHER profession having programs betcha, and as of right now, I am not aware of a single PA program online, but if there was, I would decry it as loudly as I decry the NP ones."

It bothers me to see smart people decry progress in educational delivery. Perhaps if you were to consult with someone who knows "education" they would be able to change your mind. You're certainly welcome to an opinion, but it needs to be an informed one. There are lot's of studies on distance education out there for your review. Sure there are some subjects that need active "live" student participation, but the majority can certainly be done online.

Anonymous said...

Its not what you call yourself as much as what you do, and how you do it. There is increasing acceptance by patients of both NPs and PAs as care providers, in part because they are more accessible than doctors. As example, online web sites for email communications between patients and their health care providers, such as, include both NPs and PAs. The important thing is that patients can depend on them.