Monday, May 11, 2015

my problem with the NP program and why I'm quitting (not really)

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 barelyprepare 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.
Now what?
So after all of that frank (and somewhat scathing) diatribe of NP positions and my current program, what have I decided to do about it?
I’ve been thinking hard all day. I am going to apply to both programs I discussed in PART 1, but that then begs the question: what do I do with the program I’m currently in? Do I stay in it until a for sure acceptance into the programs I really want? I can’t help but think this is a giant waste of money and time, since only 6 maximum credits would transfer (I’ve completed 9 total). Why waste energy, and more importantly, time away from my daughter if the credits don’t even transfer?
I hate being a quitter, but knowing deep down that this program isn’t for me, and isn’t bringing out the best of my abilities or talents, means that I need to leave it and pursue something better. I will probably not be able to start my new programs of choice until next fall, assuming I am accepted at all. But I am actually very optimistic, I believe I will get accepted to at least one of them, and in the meantime I won’t be wasting time away from my daughter. I know that the right career path is out there, and I feel like this last year has really revealed to me what I don’t want in a program and where my true interest lies.
Still, it sucks to officially “withdraw” from a graduate program, especially because I was so proud of being accepted. I have a 4.0 in all of my classes (because they were stupidly, moronically easy and worried me that they weren’t preparing me at all) and I really did love being at my undergrad alma mater. Staying is definitely not right for me, but leaving doesn’t feel good either.
In the end, though, if I’m going to do this, I’m going to do it all the way. Staying in this program would be easiest, but it would not take me where I want to be and it would not adequately prepare me or open doors for me in my desired field. If I lose a year, well, these are two year programs. It’ll be ok. I gain a lot of time with my daughter while she’s little, and am still on track to finish around the time she enters kindergarten. Nothing lost, but possibly everything gained.

Friday, January 23, 2015

what I'm learning from g̶r̶a̶d̶ ̶s̶c̶h̶o̶o̶l̶ YouTube

So yeah, as it turns out, my grad school program right now isn't so much "teaching" me anything as it is facilitating subjects and content matter for me to teach myself, and then get tested on (or assessed via paper writing). So the main way I "learn" in a "classroom" setting is via youtube presentations that I listen to on my phone with bluetooth while I drive to and from work or school. These are lectures presented by nursing or medical faculty for, I assume, their own college courses. Why don't the faculty at my program lecture? I have no idea. One of them creates powerpoints which she emails to us (fine, better than being read to!), and the other does a messy, sloppy facilitated discussion of the assigned reading materials in theory class, which I then have to clarify to myself by listening to a YouTube presentation by another institution's faculty member.

I guess this is part of the times, right? Finding resources. And I'm lucky there are so many free, graduate level presentations out there to just stream. I just, I don't know... why are these other grad students getting actual lectures, with explanations and examples and ideas, and my professors are just sort of... assigning things and hoping we get it on our own? I'm paying the same amount of money!

Fortunately, I'm good at finding the material myself and seeking out the information I need to understand. I guess that's what being a grad student is about, at least for me, in this particular program. Still, it would be nice if someone would teach me something, once in a while.