[mvanz9999]

Originally Posted by BrandyNP

Did the recruiters want the NP to have experience as a RN or NP? My experience in the RN role and NP role are not interchangeable. My scope of practice is completely different (with far more liability) as a NP.

Are the hospitals in Chicago only hiring Acute Care/Trauma NP's to practice in the hospital setting? Do they have outpatient clinics for FNP's to work?

In Chicago, there really isn't much of a difference between NPs and CNS. The recruiter told me that I would need "clinical" experience. Of any type. RN, NP, CNS, whatever. Their concern was with clinical exposure in any degree.

Hospitals mostly hire NPs to practice within the hospital, although the majority of the hospitals do have outpatient clinics which remain part of the hospital. I have reviewed some bios of working NPs at the hospital and there doesn't seem to be any reason for certain practitioners to work certain places.

For example, in the cardiology dept. of Northwestern, there are 4 Critical Care Nurse Practitioners, and a Critical Clinical Nurse Specialist listed as Cardiac Advanced Practice Nurses, 2 NPs listed as Vascular APNs, and more NPs and CNSs listed as Cardiology Advanced Practice Nurses.

So, I don't see any reason why NPs and CNSs are bound to either practice setting.

[neuronightnurse]

My first post ever to any internet message board, so please forgive any unintentional breach of etiquette!

Wonderful discussion! Many important points brought out for anyone considering pursuing an advanced nursing degree. (Also, despite the deviation from the original thread, thank you, Uberman5000 for the excellent reply re: increased liability as an NP. It should be required reading for that certain portion of the nursing population terrified to make the slightest intervention without fear of losing their home. You are forgiven the "phallacy.")

It seems obvious to me that any years of experienced gained in any medical setting would be an advantage when graduating from an NP program. Despite this, there is an increasing number of direct-entry programs and it is now possible to graduate as an NP without any RN experience. Most people seem to agree that the "ideal" would be an NP with extensive experience in their specialty. However, most of you have been nurses long enough to know that the "ideal" is a fantasy. "Ideally" we would have at least 45 uninterrupted minutes to discharge a patient, much longer to admit them, there would always be a reassessment 1 hour after every pain med administration, patients would always be turned every 2 hours...you get the picture. Yet, despite the lack of ideal patient care, most patients leave the hospital with their acute conditions approriately addressed. The question then becomes can newly minted NP's be effective even if they lack the "ideal" amount of experience?


Let's turn our attention to newly minted residents. Ask any RN at a teaching hospital. July is not a good time to be a patient. Particularly on the night shift. These new residents are intelligent, terrified, overwhelmed people. Sometimes, their response to a 2am call is "What do you guys usually do on your floor?" But, pretty soon, just like most people who are capable of graduate-level education, they find their way through and learn to practice medicine in a safe, effective manner.

My guess is that Master's prepared nurses, regardless of their tenure, will most likely do the same.

[Clarence Nightingale]

Originally Posted by neuronightnurse

Let's turn our attention to newly minted residents. Ask any RN at a teaching hospital. July is not a good time to be a patient. Particularly on the night shift. These new residents are intelligent, terrified, overwhelmed people. Sometimes, their response to a 2am call is "What do you guys usually do on your floor?" But, pretty soon, just like most people who are capable of graduate-level education, they find their way through and learn to practice medicine in a safe, effective manner.

My guess is that Master's prepared nurses, regardless of their tenure, will most likely do the same.

Thank you neuronightnurse for bringing up a point I wanted to share. We're talking about NP's coming out with no experience, but look at resident physicians and even new grad PA's. All of them come out of their training with a similar lack of experience. I am in the middle of my MSN at a University with a teaching hospital, and I can say that we spend 2 years after our Bachelor's degree with very little social life. We study just as much as med students and we end up spending 1000's of clinical hours in the hospitals/clinics, just like med students. And there are many people in my program who have the grades and motivation to have attended medical school, yet chose NP because they prefer the nursing model over the medical model. The source of criticism I have seen that we almost always run into is not from physicians, not from anyone but other RN's. Most notably it seems to come from ADN prepared RN's. I wish they'd stop acting like we are just someone that walked in off the street with no education or life experience and started this program. Most of us will finish with 6+ years of schooling. As for jobs when you get out, I have several friends that have finished the program with no RN experience that have gotten NP positions in a fairly saturated market here. Sometimes it's who you know. They've proven themselves during the clinical rotations to the NP that supervised them, or at the hospital where they did some of their 2nd year rotations.

[traumaRUs]

Hi and welcome neuronightnurse - very insightful post. Thanks for this viewpoint.

Hi and welcome Clarence - I wish you the best. However, I do feel that your generalization: "Most notably it seems to come from ADN prepared RN's. I wish they'd stop acting like we are just someone that walked in off the street with no education or life experience and started this program. Most of us will finish with 6+ years of schooling. "

I personally am an LPN/ADN/BSN/MSN, post-MSN APN so I feel qualified to answer this. I would have done an ADN to MSN program if one had been available where I live but it wasn't. However, I think my experience as an RN was invaluable in making me an excellent APN. Yes, I've had the requisite multi-year education as you have and yes, I went into nursing in my 30's so had plenty of life experience also. However, by having 12 years of nursing experience to bring to the table as an APN, I KNOW that my assessment skills are top notch and I do feel comfortable with the autonomy that I am expected to assume.

Good luck...what type of APN program are you doing?

[Clarence Nightingale]

I did not mean to sound as if I was downing ADN programs. It's just been that the majority of nurses who have had derogatory things to say about our Bridge-MSN program were ADN prepared nurses. That's all I was trying to share. I'm doing an Adult Nurse Practitioner program with a specialty in Cardiovascular Disease. I can certainly understand how nursing experience will help people's assessment skills. I know that more experience is better but I just wanted to say that just because we're going through a program without having been nurses before, doesn't mean we're going to flop as NP's. And that has been what we've heard alot in clinicals. We (and I especially) are putting out hearts and souls into the program and working very hard to be good at what we want to specialize in. I don't now anyone that has lasted in the program thus far that hasn't been super motivated and a very hard worker.

Thank you for your warm welcome Trauma. A little background about me, I was an Army medic for 5 years (got to see some fantastic trauma injuries I won't likely see here in regular practice any time soon) and then worked at a Burn Center in college. I've worked the last couple of years part-time (in addition to my full-time teaching job) in the level-1 Trauma Center Emergency Department here.

[traumaRUs]

Got it thanks Clarence and thanks for your military service...I'm a very proud USN vet myself.

May I ask where you are located (general area)? I live in downstate IL (read - rural) and when I graduated in May, it is a tough market.

[Clarence Nightingale]

I live in Middle Tennessee. Nashville to be exact.

[traumaRUs]

Thanks - I didn't realize that was a saturated market.

[Clarence Nightingale]

There are several programs in the area that put out MSN advanced practice nurses. It's tough getting a job here when you graduate. The other problem is there is Vanderbilt's Med School so they have a million residents to do the jobs that NP's could do. And the residents cost them less.

[BrandyNP]

Originally Posted by Clarence Nightingale

I live in Middle Tennessee. Nashville to be exact.

I was wondering if you are going through the Vanderbilt program. I graduated from that program in 2005 (Adult/Geriatric). I sent you a private message.

Good luck in your endeavors!