Need Advice on FNP school! - page 4

by amberthenurse

24,484 Views | 48 Comments

hi, i have been a nurse for about 2 years, but with only about 7 months real experience in the hospital. i am wanting to go back to school for fnp, but am a little concerned that i don't have enough experience. my questions are:... Read More


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    I have worked in three different EDs in three different communities (one a very rural, poor area; one in a blue-collar type community; and one in a very well-to-do community just outside of a large city) and the above just isn't true. Even if it was - think about it - the homeless are probably some of the most challenging patients to encounter that would give you the most experience because they can have so many untreated, co-existing problems going on at the same time such as diabetes, cardiac problems, asthma, copd, HTN, psych issues, etc. Even though those are all mostly chronic conditions, having the one patient who has not been treated for any of those diseases for years may present with serious acute problems such as DKA, severe HTN, acute renal failure, etc.

    I have never worked in an ED where I wasn't challenged and didn't have a good mix of acute and chronic problems presenting through the doors.
    missdeevah likes this.
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    Glad to see this thread and replies. I am fresh out of an ADN program after both BA/BS from a past life. I too am wondering how much experience to glean before applying to FNP programs. It seems like there is so much difference of opinion. My instructors have suggested that working part time in med/surg or rural ambulatory with physical assessment should be sufficient while I complete a 2-3 year program. Programs in Spokane (the big city here) are not requiring RN experience for admissions. It sounds like I need to talk to employers to see what type of RN experience they expect of FNP's. Any ideas?
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    Quote from BCgradnurse
    Now that just makes me angry!!! Once again, it perpetuates the notion that we are doctors' handmaidens and their opinion counts so much more than people who acutally know you well and can speak to your abilities. I would think your unit manager's or DON's opinion would be much more valuable. Are there any other programs you could look into?
    Almost every program I looked into wanted letters of recommendations from doctors.
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    Be careful who you listen to. I wasted YEARS of my life in anesthesia. I went to anesthesia school after 9 years in the SICU b/c everyone convinced me to do it (supervisors, nurses, CRNAs). The school even required ICU experience to get in. Being a CRNA has nothing to do with the ICU. What they should require is OR experience. I did not know this about myself until I was in school, but I DESPISE the OR...I absolutely hate everything about it and left the field entirely.

    What I would suggest is working in whatever area you want to practice in as an NP. If it's ACNP, do ER or ICU. For FNP, do a clinic or some other outpatient work. I think getting experience during the school is perfectly fine. I used to think that an NP student should have at least a year or two of RN experience. Now that I have gone through the program, I don't think it matters that much. If you are willing and able to go to an NP program...DO IT!
    As time goes by, things change, situations change with money, marriage, family, the economy, health issues, etc. Go to NP school when you are physically, mentally and financially able to go. Do not put it off simply because you are a new RN.

    The truth is, I have 19 years of RN experience but most of what I learned for the FNP role was not what I did as an RN. In the NP program, I learned new skills, different diseases/ treatments and a different approach to patient care- a focus on health promotion rather than treating diseases. Just my 2 cents!
    Last edit by FNPGrad on Jun 25, '10
    Conqueror+, ChristineN, nurseman78, and 5 others like this.
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    Great thread! I am graduating from a BSN program next May. My school allows direct entry into the FNP program with a minimum 3.0 GPA, although I would like to look at other schools. The schools in my area all require at least one year work experience as an RN. Which programs do not require experience? Thanks!
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    Quote from FNPGrad
    Be careful who you listen to. I wasted YEARS of my life in anesthesia. I went to anesthesia school after 9 years in the SICU b/c everyone convinced me to do it (supervisors, nurses, CRNAs). The school even required ICU experience to get in. Being a CRNA has nothing to do with the ICU. What they should require is OR experience. I did not know this about myself until I was in school, but I DESPISE the OR...I absolutely hate everything about it and left the field entirely.

    What I would suggest is working in whatever area you want to practice in as an NP. If it's ACNP, do ER or ICU. For FNP, do a clinic or some other outpatient work. I think getting experience during the school is perfectly fine. I used to think that an NP student should have at least a year or two of RN experience. Now that I have gone through the program, I don't think it matters that much. If you are willing and able to go to an NP program...DO IT!
    As time goes by, things change, situations change with money, marriage, family, the economy, health issues, etc. Go to NP school when you are physically, mentally and financially able to go. Do not put it off simply because you are a new RN.

    The truth is, I have 19 years of RN experience but most of what I learned for the FNP role was not what I did as an RN. In the NP program, I learned new skills, different diseases/ treatments and a different approach to patient care- a focus on health promotion rather than treating diseases. Just my 2 cents!
    Dear FNPGrad: You have very good advice so I'm asking for your input here. I am interested in doing NP for Hospice, I currently work as a Hospice RN inpatient unit. Have done many years of field nursing for Hospice also. I especially like the psyche part of Hospice nursing with pts. and families. I will be graduating this Dec. 2010 with BSN and was thinking about doing NP school. So following your advice on previous post, it seems I'm in the right work area currently. Any other suggestions?
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    I am going to tell you my personal experience, this may not apply to anyone else on this site. You will find a lot of people that tell you to wait 2 or 3 years before applying to FNP school. I will honestly say that my four years of performing "tasks" and pretty much being a robot did not prepare me for FNP school. I think that I have forgotten a lot of the things that I learned in nursing school about various diseases and conditions because I don't have to use it much. I find that the floor is very task oriented and repetative. You spend most of the day following orders and having someone else to think for you as opposed to NP where you are able to think for yourself and make your own decisions. I really wish I would have started FNP school right after school that way everything that I learned would have still been fresh in my mind. My advice would be, if you think you can survive NP school without the years of experience than go for it. Working on a Med/Surg floor is great for learning how to hold your bladder for 12 hours, not eat, do paperwork, and in SOME settings play the doctor's flunky. As for orientation after school, that depends on the state that you work in. I am planning on working in MS which requires 720 hours of orientation. Just do what is best for you and NOT what someone else thinks is best for you!
    nurseman78, gerry79, and lesrn2005 like this.
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    I think the opinions will vary, but I believe a lot of it comes down to you.
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    Hi lesrn
    So sorry for the late reply! I'm sure you're really going to think I'm crazy but I started doing homecare in 1993-94 when I was a much younger RN and wanted to supplement my income - in addition to the 3 -12's I was doing in the ICU (Ahhh..to be that young again and have all that energy) Anyway...I started in '94 and never stopped. I absolutely, positively LOVE home care and still do per diem when I can. There is nothing like caring for a patient in their own environment and being able to help a patient stay in their own home.:redpinkhe

    Believe it or not, my home care skills were the most useful skills I brought to the primary care setting. I was surprised to learn that even though the MDs are ordering home care and signing orders, they have very little knowledge of who qualifies for what services, Medicare vs Medicaid guidelines, home medical equipment coverage, available community services, etc. You already posses a ton of knowledge from your hospice homecare experience that will transfer well into NP practice. In addition to what I listed above, you are experienced and well-versed at teaching home safety, fall prevention, safe and appropriate medication use, skin care/dressing changes... lots of important stuff. In addition, you have excellent communication skills, the ability to quickly and effectively develop rapport with family members/caregivers, experience collaborating and coordinating with multi-disciplinary team members, strong assessment skills, experience with ICD-9 coding and billing - these are all immensely helpful in primary care. The Hospice end of it gives you additional knowledge in end of life care, advance directives, pain management/palliative care and dealing with grieving. You are in a prime position to nicely transition into the NP role.

    Now...for the BAD news. NPs are NOT allowed to certify a patient for homecare, sign or give ANY orders for meds or treatments - nothing. There is current legislation that is working to change this. I STRONGLY encourage you to get involved and do a Google search for "H.R. 4993, the Home Health Care Planning Improvement Act" It is easier than you think to write to your state legislators and I have gotten very positive results from a relatively small investment of time and effort. Just in case this post gets edited or deleted - So sorry to the moderators if I am posting something that's not allowed :smackingf - I am going to send you a private message

    Sorry for AGAIN hijacking this post! I just love this site and get very passionate and excited chatting with all of the incredible nurses I've met here!!
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    Hi FNP: The NP's I worked with in "the field" did/do write orders for meds and wound care but it is done under the Doc. I have had one NP that ordered Hospice for her Home care patients also. Hmmm?!


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