I saw this posting yesterday and was not going to respond. During today's practice I was asked by two separate NP students I precept how I knew so much about taking care of people. At first I thought they were just being students.Then the thought crossed my mind about the posting I had read from DMR1. Pondering on it for a few minutes I realized that my experiences as a RN prior to becoming an NP increased my knowledge about procedures and critical thinking...blah,blah,blah. What my experiences really did was to allow me to "experience" hands on the way to APPLY the academic knowledge taught to me in school. Elkpark related that "generalist nursing experience is of limited usefulness". This may be true in psych nursing, but my background is ER/ICU, twenty years worth. My knowledge of diagnostic lab/procedures/treatments/and pharmacology was first introduced while seeing patients in the ER/ICU. As far as my NP training in the same areas while in school... well, let's say that the academic programs were "somewhat lacking" in those areas. I actually corrected one professor who proposed volume replacement of one liter IV in a patient with CHF and very obvious 3+ edema. Her response to my challenge was that the lungs were essentially clear, and a "little" fluid would make the patient comfortable.
In addition, the countless hours of triage, assessment, and interventions I performed helped me to weed out superfluous and time wasting steps taught to me in school by academicians who "talked the talk" but had not practiced on actual patients for many years. No, I am not talking about shortcuts but actual practice techniques that reduce the amount of time required to perform procedures and actions. So, once I started the NP program I knew what was actually needed to take care of the patient as well as being exposed to some new and very different "scope of practice" areas concerning the NP role. Those "different" areas being diagnosis, treatment, and medication. My previous experience had me performing the orders, but in the NP role you give the order as well as take responsibility for the order. It is entirely different when you are the one who has to come up with the diagnosis/treatment/medication... and it better be right. Yes, my experience prior to entering NP school helped me greatly.
Now for the kicker... not only do I practice as an NP, but I also teach Med/Surg and OB as an assistant professor at a Nursing College. What do I tell my students about practice and experience? First, get your RN degree.
Afterwards practice anywhere you want for at least a year, preferably two. That way you get your feet wet, and apply some of that book knowledge just crammed into your head. Plus, you may find out that Advanced Practice is not exactly what you want to do, or that it is exactly what you want to do. Take a little time to expose yourself to what you think you want to do, precept with an NP for a couple of weeks. I actually had a nurse who decided to not continue with school once she saw my workload and what was expected and demanded of me as an NP.
Yes, the Advanced Practice role/responsibility is entirely different than the general RN role. Previous experience in the RN role helps to ease the introduction into Advanced Practice by allowing time to practice and apply the necessary critical thinking and application of nursing knowledge taught in school. As a result I very much recommend that any nurse considering the Advanced Practice role get some actual time and experience practicing the role of nursing prior to moving up the ladder to NP. So go get some experience...