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And then you have the ARNP, and schools who are speedrunning people from the street into ARNPs. Oh, you need an RN? We'll have you in our "Accelerated RN" course, getting your RN in parallel with other studies.

In some places, it is possible to go from high school to ARNP within 6 years.

And while supervision requirements for PAs might vary in terms of actual oversight, ARNPs are ostensibly fully fledged independent providers.

And I'll also say that you see the same pre-hospital too. In the PNW, while there are valid criticisms that can be leveled against two of the pre-eminent paramedic programs (Harborview, and Tacoma Community), there are far, far, too many "strip mall schools" in other states that will take you from "zero to hero" in 4 or 5 months (of 6 days a week, 8 hours a day, of just class time), and dump you out on the world with just enough retained knowledge to pass your NREMT and the barest amount of ride time to meet DOT mandated minimums. It's scary, to be blunt. These people go out with no clinical experience and are now expected not just to work as a team on a 911 call, but to lead it.




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