Do you have to be a Nurse before a NP?

  1. Hi,

    I am currently in a Master's Entry Level Program in Nursing. I have a BS in another field and in June I will have my RN. I will start working on my Master's in Nursing starting in the Fall.

    I am wondering-do you have to be a floor nurse before you can be a NP? I only ask b/c I have started looking into new grad training programs as floor nurses but most of my fellow classmates are not doing this. They want clinic work, dislike the role of the bedside nurse, and don't think it is necessary to be a floor nurse before becoming a NP. They feel that all the procedures we are learning (dealing with IVs, putting in NG tubes, suctioning, etc) won't help them as NPs.

    I just want to do what is best for my career and wonder if a staff nurse in a clinic is better work experience than a floor nurse for those wanting to be Adult NPs.

    Any input is greatly appreciated
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  2. 23 Comments

  3. by   WashYaHands
    I don't think you HAVE to be a floor nurse before becoming an NP, but I do think that the experience in floor nursing would provide you with more learning opportunities in the long run. Patients who are hospitalized are more ill than those that may visit a clinic so you'd be exposed to the "worst case scenario" of a disease process. Since you'd be caring for patients 8-12 hours at a time, you'll also be able to get to know the patients and learn how illness effects people on a human level as well. That's not to say that clinic nurses don't do this, but I think in your situation you'd see the impact sooner. And, you'd be exposed to more treatments and procedures that, in the future, you may be subjecting your patients to. If as an NP you're ever employed at a hospital, you'll have that experience to help you as well as be able to relate to the floor nurses on a more personal level.
  4. by   susanmary
    You will gain valuable experience, assessment skills, critical-thinking skills, etc. working in acute care. I would definitely go this route as your ultimate goal is to be an adult nurse practitioner. You might even consider a step-down or icu position -- let your fellow students do the clinic route -- do what is best for you. This is your career -- you decide. You can always change. I'd go for a teaching hospital & go from there. Best of luck to you.
  5. by   sjoe
    "They want clinic work, dislike the role of the bedside nurse,"

    Well, they have their own good reasons for disliking it. Being a floor nurse IS good overall experience and it certainly gives you a real appreciation for what these nurses do, as well as a good idea of what happens with any of your future patients you transfer to a floor.

    On the other hand, working on the floor leads many people to lose respect for nursing, for doctors, for our present state of healthcare in general.

    So, maybe you could shadow a floor nurse for a while, to see whether you are willing to put up with that environment in return for the experience (and the $$).

    You might also look carefully into job opportunities for new NPs before you invest the time and money to become one. In many places, there are very few jobs.


    Good luck.
  6. by   Granted Fal
    how did you get out of your AssocRN without any floor experience ?
  7. by   spineCNOR
    "They feel that all the procedures we are learning (dealing with IVs, putting in NG tubes, suctioning, etc) won't help them as NPs."

    Just a thought-- I would expect that other nurses the NP is working with, even in a clinic setting, would look to the NP as a resource person for questions or assistance with procedures.

    As an above poster suggested, working in an ICU might be a good idea- you would learn a good deal about pathophysiology and disease processes in this setting, probably more quickly than you would learn from your textbooks.
  8. by   Enright
    I've always found this question frightening, and I am hearing it more and more. (I believe it was asked sincerely, tho, so no flames). It is as if there is a mindset amongst the direct-to-NP crowd that registered nursing is beneath them.

    I find it bizarre that someone would want an advanced degree in this profession but have no interest in learning the rudimentary skills.

    I can tell you that there is a glut of NPs in many parts of the country and many of my NP friends have gone back to hospital staff nurse positions to make a decent wage. If they had never had that experience I wonder what they would do.....

    In my role as a consultant , I no longer do anything remotely like my former hospital role. But I use that clinical experience every day. And I think an NP would be much poorer for not having it.
  9. by   Anaclaire
    The best NPs I've worked with had 3 to 5 years experience "in the trenches" before continuing their education to become NPs. They were much more aware of the reality of patient situations and how their orders and input would assist the patient and staff to do the best job possible. They also had excellent technical skills and could come to the rescue when a difficult procedure needed to be done. They seemed to be calmer and more in control during crisis situations also. Needless to say, they instilled confidence in their co-workers and were much more respected by the staff. I know it doesn't seem fair, but in general, people expect an "advanced practice nurse" to be more knowledgable, more 'together', and more of a role model who earns respect of their peers.

    Also, I've heard many of the NPs complain that they don't receive the pay or respect they deserve for the work they do, and I know a couple who have quit being NPs because of it. They tend to have to work off shifts and pull long hours... our physicians tend to use them as their "fill-ins" and from my point of view, they were often "used". We loved our NPs and supported them in every way we could.

    Just sharing my experience...

    Wishing you only the best in your nursing career!!!

    Warmly,
    Anaclaire
  10. by   SmilingBluEyes
    Good GRIEF ALMIGHTY why the HECK would you NOT want to have this VALUABLE experience? I sure would not want to see an NP who did NOT have it!! ARE there any who don't? I know of NONE myself.....Sorry but this is Terribly naive thinking, but then you can disagree, I suppose. But maybe it's ME who is naive....i dunno.......

    *scratches her head in total, abject confusion* I am sorry if this is seen as flaming...not meant that way but I cannot believe anyone would really choose to go this route. Really.
    Last edit by SmilingBluEyes on Feb 4, '03
  11. by   maureeno
    The 'advanced practice' nursing programs were first started so experienced nurses could expand their practice to include routine diagnosis and med prescription. The programs now attract people who ought rather be in a physicians assistant program. This is a sore spot with me. In the status race to get nurses into 'suits' and away from the bedside, nursing schools themselves devalue nursing. As another thread so frequently points out, the 'nursing shortage' is not a shortage of numbers but of willing workers.
    I appreciate you are asking the question and also believe you will make a calmer, smarter NP if you take a spin with us at the bedside. It is dirty, important work.
    Not an experience to be missed.
  12. by   Nurse Ratched
    Fascinating question - like others, I can't imagine one NOT being a nurse first. It just seems intuitive. However, we have to ask, is a nurse practitioner more like a nurse or more like a doctor? (Not joking, not flaming, just asking a genuine question...) They have prescriptive authority, diagnose, etc., and no one ever assumes that a doctor ought to be a nurse first - maybe they should be, but that's another thread .

    Just throwing that out to chew on...
  13. by   sjoe
    Postscript: If it is someone's goal to be a NP without doing nursing first, why not skip nursing altogether and just go for a PA?
  14. by   Nurse Ratched
    Originally posted by sjoe
    Postscript: If it is someone's goal to be a NP without doing nursing first, why not skip nursing altogether and just go for a PA?
    Interesting point, sjoe. I was under the impression previously that PA's were "higher on the food chain," if you will, than NP's. In my state, PA's have to have all scripts cosigned, but NP's only have to have those for narcs co-signed.

    Edited to add: so I guess, the difference is whether one is willing to be a "practitioner" or an "assistant" - almost seems to imply in the titles that there is a greater degree of autonomy in one. I personally wouldn't want the greater autonomy without the experience.
    Last edit by Nurse Ratched on Feb 4, '03

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