BSN to NP: to wait or not wait - page 2

by Walker.Abb

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I'm working on finishing my BSN with hopes of beginning the Nurse Practitioner program within a year of graduating. My question is for current practicing NPs: do you think there should be a minimum of years worked as an RN before... Read More


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    I think 1-2 years of experience is sufficient. There are so many basic things in nursing that are helpful when you get to NP school. Just knowing about all the drugs, various treatments, how to triage certain conditions are things that you become more familiar with when working as an RN. And if you want to specialize as an NP, say in cardiology or oncology, it really helps to have that work experience. Employers look for that too.
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    I agree work experience helps. But why don't you start school and work at the same time? At least you can get some classes out of the way like nursing research and theory, roles course, health policy, etc. I did that and after a year, I stopped working due to heavy load of clinicals and didactics. Working certainly helps you get more exposed to the work environment, but acute care nursing is not like primary care nursing. It is different in the way of thinking and approaching things. You're not going to be in a primary care setting with "everything within reach" as in a hospital. Most clinics do not or will not carry CRRT machines, PFT machines, etc due to logistics and cost issues. Some things helped me though such as inserting IVs for hydration and giving IV NSAIDs for acute pain in migraine. I'd say nursing experience I'll help you in skills and prioritizing, but there are many nurses I've talked to that told me they feel incompetent during their FNP clinical even though they had over 10-20yrs of experience. I cant say that for all nurses though. I respect nurses with that much RN experience. As an RN, I did not interpret tests to make diagnoses, read X-ray films for things such as bronchograms on a possible lung consolidation in the radiologic zone of BS. I have never sutured lacerations, performed orthopedic joint injections with corticosteroids in shoulders/spine/knee/etc, perform womens health pelvic exams, deliver babies, intubated a patient, make casts, etc....until I got into the fnp program. You do different things and the practice is different. I feel like I know more quicker going through this program than working 1 year, but that's just me because I'm a geek who doesn't mind sitting in front of books all day and reading online journals on medscape, MD consult, pubmed, and listening to medical podcasts. I'm also a tech geek who is heavily involved with using my iPad and iphone for quick knowledge. This is all just me. Sorry if I offended anyone who has extensive RN experience. This is something I wanted to do with my life and chose this path to become a FNP and its not for everyone. however, I must agree that most hospitals choose NPs with at least 1-5 years of RN experience. Especially if you want to become a hospitalist, work in ER/intensivsts, most places require the experience as an RN and that's understandable. I'm tired now but ill say more later.
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    I'm in the Alternate Entry program at UT and am a psych NP student. Been an RN for a little over a year and a half. After I did the intensive RN part of my program, instead of immediately taking the first of two NP years full time, I only took adv patho and adv pharm the first year while I worked full time in ICU for a year and a couple months. Now been in ER for 6 months.

    Totally worth it. Just 3 months of ICU helped me coast in adv. patho when some of my classmates struggled. I have a much better grasp of acute care conditions, psychosocial conditions, the gaps in US healthcare, effects of local and regional healthcare policy than my classmates that haven't worked. Cuz when you're an RN, you're out in the Real World... and nursing school is definitely NOT the Real World.

    I would like to temper this by saying that being an RN and NP are very different roles. I think some people put more emphasis on the RN role than is necessary (I've known RNs that have been RNs for 20 years and wouldn't let them prescribe anything for my goldfish even if they went back to school.). There is a lot to learn in NP school that you aren't taught as an RN. Advanced practice is not all intuitive, and you won't learn to prescribe and diagnose by osmosis. It all depends on what kind of work experience you get, how intelligent you are, and how much effort you put into getting the most out of work and school.

    I would say to anyone thinking of becoming an RN, new BSN or thinking of a direct-entry program... work for a year. Work in a high-acuity environment with good educational support for new nurses. Take a year to have fun, earn your stripes and make the new nurse mistakes, and most importantly, study study study.
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    I'm in a BSN/RN program (second degree and career for me). My plan, at the moment, is to immediately begin a master's program for nurse practitioner immediately. I'll work and do the school thing part-time. The university I'd take my courses through require 1800 patient contact hours for the clinical portion of their NP programs so I'd have to wait a while to take that. That's fine and would only benefit me. However, while I've still got school fresh on the mind I'll go ahead and knock out research methods, theory, the administrative-type courses, community health, advanced patho, advanced pharm., etc. Once I've got the hours down I can do the advanced health assessment course and choose an area of specialization be it psych, family, or admin.
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    I graduated with my BSN in August 2010 and fully intended to work for several years before pursuing grad school. Well lo and behold, it's 6 months after graduation and I still haven't found work. I could let myself languish for however long it takes to find work, but in the meanwhile time is slipping away. So I'm applying to grad schools now. I agree it's ideal to have nursing experience and it will not be easy to apply for NP jobs with no floor nursing experience. At worst I'll work while in school or do a few years floor nursing with an NP degree. Hey maybe that way i'll at least get hired.
  6. 0
    All good ideas - thanks for all the input! I do worry too about not being able to find a job after graduation and I have found that is really influencing many people's choices about entering grad school sooner than later after grad from BSN programs. I'm interested - do most NP students work while pursuing their degree? The NP course-load seems awfully heavy.
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    I work full time and go to school full time and still manage to keep a 3.56 so yes you can do it if you plan and study your butt off I have two kids and a hubby my children participate in sports in the summer and I still plan to make it to every game even if I have to take my flash cards with me. If you really want it you can do it
  8. 0
    I think 2 years should be the absolute minimum requirement for NP school. It is such a great foundation and absolutely helps when you get to school. You will gain that insight into subtle patient changes and words they say. That just takes time. You will be a better NP for it, and at that time, you could go ahead and go for the DNP I went back to school after approx 11-12 years of RN experience. It was priceless! There is also a high level of leadership expected in this role. You are on the right track! Doors will open where and when they are supposed to. Many people are rushing back to school, but as many of the people have said, at least 1-2 years of experience will put you many lengths ahead of those who haven't had that experience. There are just some things you learn by doing. Best of wishes!!!
  9. 1
    I got into a MSN FNP program at UIC - we had group interviews and while I will have had 2 years of experience prior to beginning my program, and 4 prior to beginning clinicals (im doing the program part time), there were others in the group that qualified (over hundreds of other applicants) to be there, and they were still finishing their BSN and will have then gone straight into their MSN after their summer break/graduation.

    While I have learned a lot of actual SKILL as a nurse having had my two years experience, that will come and those specific "skills" may not even be necessary for you working in a primary care setting (if that) as an NP. The biggest SKILL I've improved upon is CONFIDENCE and CRITICAL THINKING, as well as reading through H&P's - being proactive on what will be ordered by the doctors in terms of diagnostic tests/procedures. You may even do better just because you are used to being in school, you have everything you learned fresh in mind, while I have not been in school for 2 years, others longer than that and have forgotten a lot of things that I don't readily use on a day to day basis at work.

    Starting IV's and putting in foleys and yada yada prob won't be pertinent as an NP. So I honestly think it is not a big deal. There are pros and cons to both, and you may have to work harder, and perhaps even when your out as a novice NP compared to someone who had been exposed to RN experience, but you can still do it, it is not impossible, just be willing to work as hard as you can!

    Of course having had RN experience will probably help to make you a better NP, but that doesn't mean not having any RN experience means you will make a bad NP, you could still be a stellar NP.


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