Are you a nurse practitioner without any nursing experience?

Specialties Advanced

Published

Looking to find "that" nurse practitioner that I keep hearing about from other professions but have never come across that became a NP without any nursing experience. I have already been enlightened that there are programs that accept BSN new grads and direct-entry programs that only "strongly encourage" students to work as a RN during school, but are there really students who don't do it? I am very curious.

PAs cannot open their own practices, ever. In states with full practice authority, NPs can open their own practices.

True enough, although the VAST majority of NPs won't open their own practice. There are advantages going the PA route, too.

An NP is at the top of the nursing profession, a PA will always have to work for a doctor. That's why I chose NP.

Top of the nursing profession? Probably not. Clinically, the role of an NP is essentially the same as a PA. But one practices nursing and the other practices medicine? I don't think so. ARNPs, it can be argued, practice medicine.

The profession (and education) of nursing is highly fractured. I can't think of another job that has three academic points of entry (e.g. ADN, BSN, entry-level MSN), with all graduates practicing as registered nurses. Personally, I see the "top of the nursing profession" including roles as nurse scientists (PhDs), educators, managers/leaders and CEOs/CNOs.

The profession (and education) of nursing is highly fractured. I can't think of another job that has three academic points of entry (e.g. ADN, BSN, entry-level MSN), with all graduates practicing as registered nurses. Personally, I see the "top of the nursing profession" including roles as nurse scientists (PhDs), educators, managers/leaders and CEOs/CNOs.

I agree with you and I believe the nursing governing bodies also agree with you. That's why you've probably noticed LPN programs on the decline and LPNs recently being removed from hospitals and kept to long term care facilities (nursing homes). You may have also noticed many hospitals no longer hiring RNs unless they have their BSN and other hospitals offering to pay for their ADN nurses to go back to school and obtain their BSN. They are trying to move entry level RNs all being BSN.

You'll notice that CRNAs have pushed their entry level requirement to doctorate instead of masters. NPs have responded to this and have started transitioning many of their programs to a doctorate instead of masters as well. There isn't a mandate yet that NPs must get their doctorate for entry into practice but I wouldn't be surprised if they follow the path of the CRNAs soon.

I think the nurisng field is trying to clean up it's confusing stratification of education so the public has a clear understanding of our roles, especially for advanced practice. A "nurse" will be a BSN and an advanced practice nurse will be a doctorate for the majority, in my opinion.

I agree with you and I believe the nursing governing bodies also agree with you. That's why you've probably noticed LPN programs on the decline and LPNs recently being removed from hospitals and kept to long term care facilities (nursing homes). You may have also noticed many hospitals no longer hiring RNs unless they have their BSN and other hospitals offering to pay for their ADN nurses to go back to school and obtain their BSN. They are trying to move entry level RNs all being BSN.

Right. That all has to do with the Institute of Medicine's recommendation that 80% of the RN workforce being educated at the BSN level by 2020. My instructors are continually encouraging us to find a RN-BSN completion program upon graduation. Where I live, the hospital systems goes through cycles of mass hiring and mass layoffs of LPN staff. I think they predominantly keep to LTC facilities because of a higher earning potential. The hospital systems further north either require or highly recommend a BSN.

You'll notice that CRNAs have pushed their entry level requirement to doctorate instead of masters. NPs have responded to this and have started transitioning many of their programs to a doctorate instead of masters as well. There isn't a mandate yet that NPs must get their doctorate for entry into practice but I wouldn't be surprised if they follow the path of the CRNAs soon.

Indeed. I understand the pushback of the DNP, especially since there is little research on patient outcomes between MSN-prepared APRNs and DNP-prepared APRNs. But the eventual transition to the DNP as entry-level to advance practice (NP, NS, NM, NA) is inevitable; the AANA is just leading the charge. Might as well embrace the change, though I do wish the extra year would increase the number of clinical hours. It seems silly that a typical PA program will be about a year shorter than DNP NP programs, but with nearly 3-4 times as many clinical hours in the student-provider role.

I think the nurisng field is trying to clean up it's confusing stratification of education so the public has a clear understanding of our roles, especially for advanced practice. A "nurse" will be a BSN and an advanced practice nurse will be a doctorate for the majority, in my opinion.

I hope so. To become an RN, you can go through:

1) an ADN program

2) an LPN to RN ADN completion program

3) an LPN to RN BSN completion program

4) a BSN program

5) an accelerated BSN program

6) an entry-level MSN program

7) do diploma programs still exist?

Sooo many points of entry. The fractured state of graduate nursing programs is even worse:

1) MSN education (RN)

2) MSN leadership (RN)

3) MSN clinical nurse leader (RN)

4) MSN (NP); and within these: FNP, PMHNP, NNP, etc.

5) MSN (CNS); with a bunch of certifications

6) MSN (NM)

7) MSN (CRNA)

8) then you have all the DNP equivalents

So many degrees, so many roles, so many certifications, so many accrediting bodies, so much OVERLAP. Rid the redundancy.

Tacomaboy3, I agree that the extra year should include more clinical hours along with more education that enhances your clinical skill. I know little about CRNP programs but I know my CRNA program has approx 2,600 clinical hours upon graduation. Also, for SRNAs to take boards there is a strict requirement of certain case types and certain skills that have been documented many times successfully.

I used to think all PA programs were tightly structured and regulated until 2 of my friends in a PA program recently told me they set up their own clinical sites and rotation specialties. One of their classmates wanted to live in California so she moved there and set up all her rotations there, she just flys to campus to take a test occasionally. It sounds like PA programs are structuring themeselves more like these hybrid NP programs than I realized.

That's odd she had to set up all her own clinical rotations. I think those kind of programs are rare. When I was considering PA programs, I never came across any. Though, there are some programs in which the school sets up nearly all the clinical rotations (family medicine, general surgery, emergency medicine, etc.), but the student sets up an elective rotation of their choosing (trauma, neonatal, whatever floats your boat). UW's MEDEX NW comes into mind.

I'm happy to hear your program requires a certain number and types of cases and that many clinical hours. I think the job and role of a CRNA is right up my alley. Applying to CRNA programs on the west coast is in my five-year plan.

I agree with you and I believe the nursing governing bodies also agree with you. That's why you've probably noticed LPN programs on the decline and LPNs recently being removed from hospitals and kept to long term care facilities (nursing homes). You may have also noticed many hospitals no longer hiring RNs unless they have their BSN and other hospitals offering to pay for their ADN nurses to go back to school and obtain their BSN. They are trying to move entry level RNs all being BSN.

You'll notice that CRNAs have pushed their entry level requirement to doctorate instead of masters. NPs have responded to this and have started transitioning many of their programs to a doctorate instead of masters as well. There isn't a mandate yet that NPs must get their doctorate for entry into practice but I wouldn't be surprised if they follow the path of the CRNAs soon.

I think the nurisng field is trying to clean up it's confusing stratification of education so the public has a clear understanding of our roles, especially for advanced practice. A "nurse" will be a BSN and an advanced practice nurse will be a doctorate for the majority, in my opinion.

The current DNP programs do not provide clinical education, so I don't see the point. The MSN prepared NPs are doing fine, as evidenced by their outcomes vs MDs. Unless the DNP NPs can demonstrate better outcomes, this is just needlessly adding time and expense to the profession.

I do agree we should make our nursing credential more understandable and streamlined. I would prefer to just see an "NP" and NPs can just add some explanation of specialty, like MDs do. PAs are just "PA"

Given how much LTC pays, there will still be a need for LPNs in some settings. You can't demand a BSN for low paying jobs.

Personally, I think nursing's flexibility is part of it's appeal. There are way more RNs than MDs and we need to ensure that we do not overly restrict entry into nursing practice.

But the eventual transition to the DNP as entry-level to advance practice (NP, NS, NM, NA) is inevitable; the AANA is just leading the charge. Might as well embrace the change

I doubt the NP profession will require a doctorate degree anytime soon. The schools make too much money on all the current students flocking to MSN programs. Plus, as another poster mentioned, master's prepared NP's function quite well as it is.

I am personally not a fan of doctorate degrees in nursing. It requires an extra year of school and rarely pays any better, with no added clinical benefit.

Specializes in Nephrology, Cardiology, ER, ICU.
I doubt the NP profession will require a doctorate degree anytime soon. The schools make too much money on all the current students flocking to MSN programs. Plus, as another poster mentioned, master's prepared NP's function quite well as it is.

I am personally not a fan of doctorate degrees in nursing. It requires an extra year of school and rarely pays any better, with no added clinical benefit.

This!!!! Totally agree. A few years ago I decided to get a DNP - uh what a mistake. Lots of money, more clinical time that was of no use and oh did I say lots of money??? And....no pay raise!

Nope, not for this girl - dropped it after first semester.

Specializes in Adult Internal Medicine.
I doubt the NP profession will require a doctorate degree anytime soon. The schools make too much money on all the current students flocking to MSN programs. Plus, as another poster mentioned, master's prepared NP's function quite well as it is.

I am personally not a fan of doctorate degrees in nursing. It requires an extra year of school and rarely pays any better, with no added clinical benefit.

I did my doctorate because it was free and I wanted to have a terminal degree for the future. I will say I did learn some things and I hope that will translate into my practice over the rest of my career. I wouldn't pay for it though, there shouldn't be a need to pay for it: programs need preceptors and preceptors may have use for academic credits to bridge MSN to DNP/PhD, it's a good deal for both (well less good than cash $$).

Many quality programs now that are transitioning from MSN to DNP are only adding a few extra credits and not even adding any additional time to the program.

I doubt the NP profession will require a doctorate degree anytime soon. The schools make too much money on all the current students flocking to MSN programs. Plus, as another poster mentioned, master's prepared NP's function quite well as it is.

I am personally not a fan of doctorate degrees in nursing. It requires an extra year of school and rarely pays any better, with no added clinical benefit.

I hope you're right. Unfortunately many of the big name nursing schools in my state have already made the transition from MSN to DNP; it may be slow, but I still see the nationwide transition coming.

DNP as entry-level for nurse practitioners... The stupid thing about this is that there are non-NP DNP programs out there: health systems leader, education, community health. The DNP is relatively new but already fractured.

I hope you're right. Unfortunately many of the big name nursing schools in my state have already made the transition from MSN to DNP; it may be slow, but I still see the nationwide transition coming.

DNP as entry-level for nurse practitioners... The stupid thing about this is that there are non-NP DNP programs out there: health systems leader, education, community health. The DNP is relatively new but already fractured.

The DNP is no more "fractured" than the MSN is. For many years there have been a wide variety of concentrations available at the MSN level, and no one thinks there is anything odd or problematic about that; why would that be different for the DNP? As far as I'm aware, the DNP was never intended to be exclusively for nurse practitioners; it was intended to be a practice doctorate in nursing, as compared to the PhD.

The DNP is no more "fractured" than the MSN is. For many years there have been a wide variety of concentrations available at the MSN level, and no one thinks there is anything odd or problematic about that; why would that be different for the DNP? As far as I'm aware, the DNP was never intended to be exclusively for nurse practitioners; it was intended to be a practice doctorate in nursing, as compared to the PhD.

Indeed. But I think MANY people think the MSN, with its dozens of specialties and certifications and tracks, is odd/problematic.

+ Add a Comment