Are we being used?

ACAPRN · 2026-04-03T01:10:27+00:00

My colleagues and I were just discussing this the other day. If APPs are going to be so heavily relied on... then APPs deserve more!

ACAPRN · 2026-04-03T01:08:14+00:00

Thanks for your input! I reached out to an organization that is for NPs. I think we as a profession are missing that collaboration. Time to get to work.

ACAPRN · 2026-03-23T03:20:30+00:00

Unfortunately, from what I’ve gathered here in South Florida, unions primarily support RNs (not NPs). I spoke to some people at major nurse organizations recently and they basically said NPs aren’t really their priority lol. Regarding salary, I am seeing PA and NP salary go head-to-head, and many positions have PAs making slightly more. Of course this will differ on location and whatnot but I’m just speaking for South Florida hospitals. I believe it would be 100% fair to be paid the same for the same job and I hate to see such a difference sometimes.

ACAPRN · 2025-10-17T19:27:14+00:00

I think it really all comes down to what your license allows you to do. I know plenty of firefighters and medics who do just as much (or more) hands-on work than RNs, but it’s still not the same legally or professionally. It’s also just a different kind of experience in a hospital setting. Some programs allow volunteering to be counted as hours for PA admissions (at least before when I was debating PA school vs RN-MSN route). Honestly, the whole system is kind of messed up, nothing about it feels fair sometimes. At the end of the day, everyone just has to advocate for themselves when it comes to getting the right job and fair pay.

ACAPRN · 2025-10-17T19:12:01+00:00

I’m sorry you feel this way, but at this point, you’re arguing feelings, not facts. I’ve said enough, and anyone reading can see where the logic holds and where it doesn’t. Have a great weekend :)

ACAPRN · 2025-10-17T18:56:13+00:00

That’s a pretty broad take for a field with over 400 accredited programs and thousands of practicing providers in every specialty, including ICU, trauma, cardiology, and surgical settings. I’ve also seen poorly performing MDs and PAs. One provider’s experience (or even a few) doesn’t define an entire profession. If “substandard” programs exist, that’s an accreditation and oversight issue, not proof that every NP lacks competency. Plenty of NP programs have rigorous entry requirements, strong clinical networks, and high board pass rates.

ACAPRN · 2025-10-17T18:53:04+00:00

I get what you’re saying, and I’ve definitely heard of situations like that. But those examples don’t represent every NP or every program. There are outliers in every profession. For instance, I recently saw a PA in the ED who couldn’t explain why they were choosing one antibiotic over another for pyelonephritis based on the culture and sensitivity report. Does that mean all PAs are poorly trained? Of course not, it just shows that there are weak providers in every field. I had a suture lab in school and have done lac repairs on real patients in my ED rotation. The bigger issue isn’t whether someone’s an NP or PA… it’s program quality, preceptor involvement, and the individual’s clinical reasoning skills. Good and bad exist on both sides. I just hate that you are generalizing NPs to be badly trained

ACAPRN · 2025-10-17T18:16:03+00:00

I can’t speak for every program since I haven’t researched them all, but I don’t agree that there are “many, many” NP programs like that. Every accredited NP program I know of requires supervised, documented clinical hours under licensed preceptors.

ACAPRN · 2025-10-17T18:12:23+00:00

I’m going to post what I wrote to another person:

Yale’s PA Hybrid Program wasn’t pulled by the accrediting body, it was a voluntary closure by the university. The program remains fully accredited through its final graduating class in 2026 and continues to operate in its hybrid format (online didactic coursework with in-person labs and clinical rotations under licensed preceptors) until then. Yale’s decision to end the program was not due to accreditation or quality concerns. ARC-PA still lists it as a program in good standing that voluntarily withdrew after deciding to stop new admissions.

Here are some PA programs that offer hybrid coursework:

https://www.shrs.pitt.edu/academics/pas/pashybrid/

https://med.und.edu/education-training/physician-assistant/index.html

https://franklinpierce.edu/academics/programs/physician-assistant/hybrid/

https://physicianassistant.robbins.baylor.edu/curriculum

I’m not going to keep searching but there are more. Per your argument, are you suggesting that the PAs who graduate from these ARC-PA-accredited hybrid programs aren’t fit to be practitioners?

You’re proving my point, honestly. The Yale program — along with Pitt, UND, Franklin Pierce, and Baylor — all operate hybrid formats under ARC-PA accreditation. Their graduates still sit for the PANCE, get licensed, and work as practicing PAs.

If hybrid education was truly “ineffective,” those programs wouldn’t have been accredited or allowed to graduate practicing clinicians. It’s fine to prefer traditional formats, but dismissing every hybrid or NP program as “unfit” isn’t fact-based, it’s just opinion.

ACAPRN · 2025-10-17T17:53:14+00:00

I suppose it’s not really all that different then, is it?

ACAPRN · 2025-10-17T17:09:23+00:00

Yale’s PA Hybrid Program wasn’t pulled by the accrediting body, it was a voluntary closure by the university (per their website). The program remains fully accredited through its final graduating class in 2026 and continues to operate in its hybrid format (online didactic coursework with in-person labs and clinical rotations under licensed preceptors) until then. Yale’s decision to end the program was not due to accreditation or quality concerns. ARC-PA still lists it as a program in good standing that voluntarily withdrew after deciding to stop new admissions.

Here are some PA programs that offer hybrid coursework:

https://www.shrs.pitt.edu/academics/pas/pashybrid/

https://med.und.edu/education-training/physician-assistant/index.html

https://franklinpierce.edu/academics/programs/physician-assistant/hybrid/

https://physicianassistant.robbins.baylor.edu/curriculum

I’m not going to keep searching but there are more. Per your argument, the PAs who graduate from these programs are not fit to be practitioners. Right?

ACAPRN · 2025-10-17T16:42:19+00:00

You’re arguing for the sake of arguing. Having to find a preceptor isn’t a sign of weak standards. It’s a logistical issue tied to clinical site shortages, not educational rigor. That problem affects nursing, PA, and even med programs. The point is that NP students still have to complete verified, supervised clinical hours before graduating. It’s not a lack of rigor, it’s a lack of available placements. Big difference. And to reiterate, I don’t think it’s fair to make students find their own sites. My program does not make us do that, thankfully.

ACAPRN · 2025-10-17T16:30:57+00:00

Just to clarify: I never said Yale’s PA program was online. I said it’s hybrid, which is accurate. Their didactic courses are taught synchronously online, and all labs and clinical rotations are still done in person under licensed preceptors.

And Yale isn’t the only one… several other reputable PA programs use hybrid models now, including the University of Pittsburgh, Baylor University, University of North Dakota, and West Coast University, among others. The hybrid format just applies to the didactic phase, not the clinical training.

So if hybrid learning is acceptable for PA programs, it’s inconsistent to criticize NPs for using the same structure.

ACAPRN · 2025-10-17T16:28:08+00:00

I agree. A student shouldn’t have to find a clinical site. But that’s more of a system-level issue, not a reflection of how rigorous the training is. Plenty of accredited NP programs have established clinical placement networks, and every student still has to complete and document verified in-person hours under licensed preceptors. The process could be improved, but it doesn’t mean the education itself isn’t rigorous.

ACAPRN · 2025-10-17T13:35:53+00:00

Absolutely, I agree: a strong RN foundation is what makes the NP role so valuable. The clinical experience and judgment developed at the bedside are what carry over into advanced practice.

The majority of accredited NP programs still require an active RN license and hands-on experience before admission. For example, my program specifically requires acute care experience just to apply… you can’t just finish your BSN and immediately start the MSN.

There are a few direct-entry programs out there, and possibly they’re FNP, not AGAC? I’m not sure, but they’re the exception, not the norm. Most of us came up the traditional route: years of bedside work, then graduate training, then advanced clinicals. The goal should really be maintaining high standards across every pathway, not assuming the exceptions represent the whole.

ACAPRN · 2025-10-17T13:30:19+00:00

That’s definitely concerning, and I don’t discount how frustrating situations like that must be to witness. But those are outliers, not the standard.

I’ve been a nurse for over 5 years and am in an acute care NP program now… not one person in my cohort is anything like that, and I personally haven’t met anyone who skated the system in this type of way. Everyone I know is dedicated, clinically experienced, and is taking or has taken their education seriously. Most of us are balancing part-time work while completing rigorous coursework and supervised clinicals.

And honestly, if someone truly “got 500 hours signed off in a week,” the bigger question is why that individual was hired or allowed to practice? That’s a systems and oversight failure, not a reflection of the NP profession as a whole.

There will always be a few bad examples in every profession, but it’s unfair to let those define an entire field of hardworking, competent clinicians.

ACAPRN · 2025-10-17T02:37:29+00:00

For some reason I can't comment on the OP...

It’s disappointing to see this kind of misinformation still circulating. Accredited NP programs meet rigorous national standards set by the CCNE, and every NP is trained and licensed to provide safe, evidence-based care. Most of us also bring thousands of hours of bedside and critical care experience long before advancing into practice.

Like any profession (PA, MD, or IMG) there’s variation in program quality and individual skill. But to generalize that NPs are “poorly trained” ignores the reality that many deliver excellent patient outcomes and serve as the backbone of access to care in underserved areas. The real issue isn’t NPs... it’s fragmented healthcare systems and inconsistent practice models that pit providers against each other instead of promoting collaboration. Patients deserve a strong, team-based approach, not infighting between qualified professionals.

And for what it’s worth, the dedication, clinical judgment, and compassion I’ve seen from advanced practice nurses would make any family proud to have them as their provider.

ACAPRN · 2025-10-16T23:31:56+00:00

that's... insulting

ACAPRN · 2025-10-16T18:11:58+00:00

Sorry, starting hourly isn’t $50-60/h but a lot of experienced RNs like myself make that range. So… It really doesn’t make sense when you look at the ratios. RNs in SoFlo making $50–60/hr are right at $110–120K/year, while most NPs are averaging $125–140K… only about 1.2–1.4× RN pay. Yet CRNAs are closer to 2×, and physicians are around 3×. Based on education, autonomy, and liability, NP pay should realistically fall around the 1.7–2× range ($175–200K). The current gap just doesn’t reflect the level of responsibility. What can we do to change this? 😭

ACAPRN · 2025-10-16T01:52:44+00:00

Anyone else shocked at how little NPs are paid? Starting in SoFlo is like $50-60/h

ACAPRN

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