If you don't have to be (insert job) before becoming a PA, why become an RN before NP?

  1. So, I'm just curious, I've seen conflicting views on the RN -> NP route or just straight direct entry MSN NP route.

    I already have a bachelor's degree and worked in healthcare for a few years (to get my patient contact hours and took pre-reqs for an MS in Physician Assistant program).

    However, life circumstances changed that route and I have been debating whether I should go for a direct entry MSN (NP) program instead. There are many factors weighing in that decision, but overall, nursing suits me more.

    Obviously, you get your BSN along the way when you enter these (direct entry MSN) programs, but you don't practice as a BSN, you just go straight through.

    One of the things I've read in other posts is the argument for becoming an RN / BSN first and practicing in that area before becoming an NP (or that it helps your chances for employment in an NP role).

    I'm not in the nursing world, so I guess I don't understand why the same concepts aren't applied as they are in a PA role.

    Most people who go to PA school have the patient contact hours in some form (PT, OT, EMT, Aides etc.), but they aren't judged by that when they graduate to perform their mid-level practice of medicine (because it's not the same role or the same scope).

    So, why do some nurses think you need to be an RN / BSN first in order to be a "good NP?"

    If you're a competent individual and fully immerse yourself in the world of NP, why do you need to be an RN / BSN first when it's not the same thing?

    I'm not so far left field that I don't understand how a role as RN / BSN could be helpful to draw from certain experiences or knowledge, but at the end of the day, they are two separate roles with two separate scopes, so why define someone's ability as an NP based on RN / BSN experiences / duties (or lack thereof)?

    And, is it really going to be hard to find a job after doing a Direct Entry MSN / NP program vs. becoming a BSN then going the NP route?

    Does this make sense? Or, am I just not understanding the dynamics of these roles?

    I'm asking this from a place of trying to understand, not controversy for the record.
    Last edit by nightingale4me on Oct 10
    •  
  2. 16 Comments

  3. by   lhflanurseNP
    The reason you need to be a nurse before being a NP, is the course is shorter than that for PA. As PAs have little to no experience, they have to learn EVERYTHING. The idea behind the NP is that it is an advanced nursing role...builds on what you have already learned. Hope this helps.
  4. by   nightingale4me
    Quote from lhflanurseNP
    The reason you need to be a nurse before being a NP, is the course is shorter than that for PA. As PAs have little to no experience, they have to learn EVERYTHING. The idea behind the NP is that it is an advanced nursing role...builds on what you have already learned. Hope this helps.

    Why do Direct Entry MSN / NP programs exist then if that is case?

    I was always under the impression that Direct Entry MSN / NP was similar to MS in PA.

    Beside medical vs. nursing model, what is the difference (don't both of these programs offer advanced studies for people without experience)?

    Can you elaborate? Thank you!
  5. by   elkpark
    Two different disciplines, two different educational models.
  6. by   BCgradnurse
    I'm a Direct Entry graduate who worked for many years in a non-nursing health care profession before I went back to school. I have not worked bedside as a RN. I graduated 8 years ago and had no trouble finding a job at that time...No one cared about my lack of RN experience; employers were more concerned about my lack of NP experience. I don't think not having bedside RN experience has hindered me at all. I use very little of what I learned in the RN portion of my program.

    If you choose to go this route, select a reputable school with a competitive program. You don't want to go to a school that has low admission standards. Be willing to go over and above the minimum clinical requirements, as the more clinical time you can get, the better. Sadly, also be prepared to hear a lot of negativity from nurses who cannot see how DE grads can be successful NPs. Work hard, do your absolute best, and let your performance speak for itself.
  7. by   AmyHelene
    PAs and NPs are two different entities. If you don't want to be an RN, why be an NP? The concept of an NP grew out of nursing and is very much linked.
    Of course you can go to NP school, never work as an RN, and still function as an NP, but why? It makes no sense. And whether or not you get attitude from RNs or NPs who were RNs before becoming NPs, you should understand where they're coming from.
  8. by   BostonFNP
    Quote from lhflanurseNP
    The reason you need to be a nurse before being a NP, is the course is shorter than that for PA. As PAs have little to no experience, they have to learn EVERYTHING. The idea behind the NP is that it is an advanced nursing role...builds on what you have already learned. Hope this helps.
    DE NP programs and PA programs are both 3 years though often the DE program is 3+.
  9. by   BostonFNP
    Quote from AmyHelene
    Of course you can go to NP school, never work as an RN, and still function as an NP, but why?
    There are lots of reasons why someone might choose NP over PA route and vice versa.
  10. by   ALRN1908
    These programs exist because nursing schools saw it as a solution to the "nursing shortage" to streamline more nurses into the profession and as a way to make more tuition money as most of these programs charge the graduate rate even for the undergraduate classes.
  11. by   DizzyJon
    Quote from nightingale4me
    So, I'm just curious, I've seen conflicting views on the RN -> NP route or just straight direct entry MSN NP route.

    I already have a bachelor's degree and worked in healthcare for a few years (to get my patient contact hours and took pre-reqs for an MS in Physician Assistant program).

    However, life circumstances changed that route and I have been debating whether I should go for a direct entry MSN (NP) program instead. There are many factors weighing in that decision, but overall, nursing suits me more.

    Obviously, you get your BSN along the way when you enter these (direct entry MSN) programs, but you don't practice as a BSN, you just go straight through.

    One of the things I've read in other posts is the argument for becoming an RN / BSN first and practicing in that area before becoming an NP (or that it helps your chances for employment in an NP role).

    I'm not in the nursing world, so I guess I don't understand why the same concepts aren't applied as they are in a PA role.

    Most people who go to PA school have the patient contact hours in some form (PT, OT, EMT, Aides etc.), but they aren't judged by that when they graduate to perform their mid-level practice of medicine (because it's not the same role or the same scope).

    So, why do some nurses think you need to be an RN / BSN first in order to be a "good NP?"

    If you're a competent individual and fully immerse yourself in the world of NP, why do you need to be an RN / BSN first when it's not the same thing?

    I'm not so far left field that I don't understand how a role as RN / BSN could be helpful to draw from certain experiences or knowledge, but at the end of the day, they are two separate roles with two separate scopes, so why define someone's ability as an NP based on RN / BSN experiences / duties (or lack thereof)?

    And, is it really going to be hard to find a job after doing a Direct Entry MSN / NP program vs. becoming a BSN then going the NP route?

    Does this make sense? Or, am I just not understanding the dynamics of these roles?

    I'm asking this from a place of trying to understand, not controversy for the record.
    "perform their mid-level practice of medicine"...ugh ouch.
  12. by   ghillbert
    Quote from nightingale4me
    they graduate to perform their mid-level practice of medicine
    I don't know if that was meant as a dig, but you won't get a very good reception by describing our practice and profession as "mid level practice of medicine".

    It's a pretty simple concept - nurse practitioner is an ADVANCED PRACTICE NURSE. You can't be advanced with out being basic. The point is that the medical knowledge gained in NP school builds on to the RN education and experience. How much it affects NP outcomes, you can decide for yourself, but obviously it's clear where that comes from.

    If you want to be a PA, go do PA. I probably would if I had to choose again, just for the ease of moving around different specialties (get a new job, get on the job training) versus having to go back to school for everything as an NP.
  13. by   staphylococci
    I'm currently working with several experienced NPs who were direct-entry graduates. Seeing how well they perform as providers has definitely changed my opinion on the necessity of RN experience before starting NP school. All of them have previous degrees in Biology or Biochemistry and are very knowledgeable about primary care. Heck, I regularly consult them on many of my own patients (I am a new grad NP)! My time as a critical care nurse informs some of my practice as an NP, but not much of it pertains to what I do in primary care. I feel like a novice again because the roles are that much different from each other.
  14. by   aprnKate
    From my understanding, PA's have their license but they always have to have a supervising physician. NPs have their own license as well but do not necessarily have to be under a physician to practice depending on what state they practice. In TX both NP and PAs have to have a delegating physician to prescribe controlled substances and as well as their own DEA numbers and cannot own their own clinic practice (although there are loop holes around this)

    NPs in AZ don't have to have a delegating physician to prescribe controlled substances. NPs in NM can own their own practice and not have to be under a physician from what I understand. I'm not sure if PAs are allowed in other states to own their own practice without being under a physician


    This is something you should delve into when you are trying to decide which route to go.

close