Need Advice on FNP school!

Specialties NP

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Specializes in ICU-Step Down, Cardiac/CHF, Telemetry, L&D.

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!

elipscombs

16 Posts

I think the opinions will vary, but I believe a lot of it comes down to you.

FNPGrad

61 Posts

Specializes in ICU, Trauma, Anesthesia, Education, etc..

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. :cheers:

Now...for the BAD news. :flmngmd: 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! :oornt:I just love this site and get very passionate and excited chatting with all of the incredible nurses I've met here!!

:lvan:

lesrn2005

186 Posts

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?!

Specializes in Family Practice, ICU.
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!:twocents:

Thanks for sharing this. This is EXACTLY what I feel about other people's feelings on new RN grads going right into NP school. They're totally different roles. An MD or a PA doesn't have to spend x number of years as a medical assistant to go to med school. I am going to try to shoot to go to school as soon as possible, although I'll probably take a year or two and work to pay off some debt.

Specializes in Family Practice, ICU.
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.

Exactly. While being an RN is good exposure to treatments and meds and all, that is completely different from knowing when and why to actually order them.

RCP21

9 Posts

Hey Amber,

I will be starting my last year of FNP school next semester. I started in health care in 1990 as a Resp. Therapist. I graduated from BSN school in 2003. There is no way I would have been ready for FNP school without my Resp. Therapy background! As for post-graduation orientation for NP's, there ain't none. You'll be oriented to the charting method (paper or electronic), shown where the bathroom is, and that is about it. Basically you will feel like you've been (and you'll hear this a thousand times, by the way) "thrown to the sharks", because you will be thrown to the sharks. Hopefully your care providing colleagues will be willing and able to help you in the areas in which your are least self-confident.

That being said, Ive heard of new BSN grads going right into MSN-NP preparation. They must be really bright or in a very easy program. I'm not saying that it can't be done. I am saying that in my humble opinion it shouldn't be done, there is a vast amount of "stuff" that must become second nature to the Nurse prior to entering training for "Advanced Practice Nursing". Learn as much as you can in the Hospital, ask a bunch of questions, learn to read ECG's, X-rays, MRI's, CT's etc. well. Learn why the care providers order a certain therapy, versus ordering something else. Don't be afraid to be wrong!! You will learn a great deal be asking follow-up questions that require redirection by the provider giving the answer. It will mold your methods of critical thinking, problem solving, and logic.

Most of all, enjoy Nursing! Enjoy the fact that you are the only one around treating the patient, not the patient's disorder or disease process!!

Hello,

I'm definitely inspired by you! Do you think the selection committee for an accelerated program will look favorably at my 9 years of experience as respiratory therapist? I graduated with an undergrad degree in Health and Exercise Science in 2000. My Gpa was on only 2.6 per I was a collegiate athlete which required me to miss alot of class. I subsequently got an AS degree in respiratory therapy in 2002. I finished with a 3.4 GPA. Relistically, do you think I have a chance of getting accepted into an accelerated program with all of the stiff competition?

Specializes in Emergency, Cardiac, PAT/SPU, Urgent Care.
Thanks for sharing this. This is EXACTLY what I feel about other people's feelings on new RN grads going right into NP school. They're totally different roles. An MD or a PA doesn't have to spend x number of years as a medical assistant to go to med school. I am going to try to shoot to go to school as soon as possible, although I'll probably take a year or two and work to pay off some debt.

No, but PA students (and especially MD students ) get a LOT more clinical time than is required to graduate from an NP program. An NP program actually builds off of the foundation of knowledge that you gain while working as an RN. Like I've mentioned on here in the past - yes, you can learn the "typical" presentations of all the different types of common diseases, conditions, etc. from a text book - but it is the atypical presentations you need to worry about and don't want to miss, and these you typically (hopefully) learn while spending a few years as an RN prior to entering an NP program.

Specializes in Emergency, Cardiac, PAT/SPU, Urgent Care.

Reading some of these posts regading nursing being "robotic and task-oriented" somewhat shocks me, maybe because most of my RN background was in the ER. Completely different world than med/surg - you have to have excellent assessment skills and be very good at getting the patient's HPI because as the triage RN, you need to determine (quickly) who needs to be seen right away, who can wait, and what things you need to get started (labs, x-rays, certain treatments, etc.) before a doc even lays eyes on the patient. Yes, there are standing orders for common presentations, but you almost need to be able to somewhat "diagnose" the condition in order to get the things rolling in the right direction. As an ER RN, you will see many different typical/atypical presentations for all different kinds of conditions. It will only make you a better NP in the end. Just my 2 cents.

Specializes in Family Practice, ICU.

I think, regardless, you learn to be a capable provider. The greater experience will help, but if you know that you would like working as an NP, I say don't postpone it too long. Especially with the pending move to a doctoral degree requirement. Get 'er done!

Specializes in Emergency, Cardiac, PAT/SPU, Urgent Care.
I think, regardless, you learn to be a capable provider. !

I truly hope this is the case, I really do. The more popular the NP role becomes, the more we are viewed under a microscope, especially since other healthcare providers seem to be very skeptical of our current training and experience.

All I know is that my clinical experiences as an RN have come in very handy on several occasions to recognize abnormalities or odd presentations that weren't outlined in a text book. Sure, you don't have to wait years and years to go back to school - but I do feel that a good solid year or two of full-time ER or urgent care experience would be very helpful to anyone wanting to become specifically a FNP.

Best wishes to all - just sharing my view on it as a currently practicing NP.

globalRN

446 Posts

having clinical experience dealing with patients with the potential to 'crash and burn'

is always good to have. helps to develop that 6th sense which is really the inner voice of experience. Clinical RN experience also gives u the knowlege of what u would expect

to be the medical orders for a given patient-so u can tell what are good orders and what are downright dangerous

If you have little clinical experience in assessing patients, it will come back to bite u on the butt as a NP. that is my experience when I see NPs who have a lot of quality RN experience vs NPs with very little clinical RN experience.

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