[NPInfo] Don't mix apples with oranges... Clinical Education of NPsvs. MDs etc

[Lisa Meyer]

Nancy,
I truely mean no disrespect by my response.  Please correct me if I'm off on 
any of the following points.  I celebrate being an NP every day!  I don't 
compare my education to that of a physician and feel that it is "lesser".  I 
compare the education I received to the care I am expected to give every day 
and I see a HUGE problem with the adequacy of our education.  When I was a 
new NP, I thought of Benner, and decided it might be okay.  I've been an NP 
now for 6 years and have precepted NP students.  I increasingly think it's 
NOT okay.


Are there ANY states that do not require certification or completion of a 
board exam for PA's?  Shouldn't ALL states require certification?  It is my 
opinion that the board exam I took (ANCC) was far too easy.  I think I 
finished it in about an hour.  Is it okay for a board-certified, liscensed 
professional to still require 3 years of on the job training to be 
competent?  When these professionals can literally kill someone with a 
mistake?  Skill acquisition does also apply to physcians, but physicians get 
much more skill education and supervised learning of their skills in medical 
school and residency.  And while it may be an expectation of most NP 
programs that their students "manage" patients, this is carried out and 
interpretted in a lot of different ways.  There is so little standardization 
between programs!  And finally, yes RN experience "counts", but again this 
varies tremendously depending on the area of practice and length of time a 
person is a nurse.  You can put a requirement on number of years in 
practice, but is someone who worked 2 years, full-time as an ICU RN 
equivalent in knowledge or skill to someone who worked 2 years part-time as 
an RN in a dermatologists office?

Curriculum needs to be made more clinically rigorous, a residency needs to 
be made mandatory, and programs need to be standardized.

Lisa

----- Original Message ----- 
From: <Nbalkon at aol.com>
To: <npinfo at nurse.net>
Sent: Sunday, December 02, 2007 8:45 PM
Subject: [NPInfo] Don't mix apples with oranges... Clinical Education of 
NPsvs. MDs etc


>A thought....
>
> Often we as NPs devalue NP education and  clinical competence feeling that
> it's "lesser than" that of our physician  colleagues.
>
> PLEASE take into account that...
>
> 1. ALL states [except five] require national  certification for NP 
> practice.
>
> 2. National certification requires graduation from MS  program.
>
> 3. National certification tests knowledge requisite for  entry into 
> practice.
>
> 4. Yes!  Book smart doesn't necessarily mean adept  with clinical 
> skills...
> but... PLEASE think about Benner... novice to expert.  Trajectory to 
> expert
> requires passage from novice.. to.. advanced beginner...  to... 
> competent...
> to... proficient... to expert.   Competence takes  up to THREE YEARS in 
> role!
>
> 5. Skill acquisition applies to our physician  colleagues also.
>
> 6. It is an expectation that NPs "manage" patients  during their 
> educational
> program.
>
> 7. NPs are RN's first. Often we forget the influence of  RN education and 
> RN
> clinical practice on the development of an NP.
>
> 8. CELEBRATE all that NPs do!  The level of care  they provide.
>
> Nancy Balkon, PhD, ANP-C, APRN-CS, NPP
> Southern New York State Representative --  AANP
> Clinical Associate Professor, Stony Brook School of  Nursing
>
>
>
>
>
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