Now I get why experience means everything yet nothing

Specialties NP

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Now I finally get why nursing experience can prove invaluable in NP school, yet actually means nothing. It appears that nursing experience gives a valuable base from which to relate but does absolutely nothing for helping one think through a disease process as a provider. I may be simply stating the obvious, but I am amazed at how different the two roles are. I am be no means an old pro, but some conditions I can take care of in my sleep - as a nurse. As a potential provider though, even a simple cold is not so simple. It is amazing how a myriad of disease processes and conditions can present with mostly the same symptoms, only differentiated by some seemingly obscure item in their history. I can see how some are making a mistake in pursuing a NP degree though. Listening to them, what they really want is to further their bedside nursing career. A degree as a NP CHANGES your career, not furthers it. The confusion manifests itself in the struggle to move away from the bedside nursing thinking process, to that of a provider. We all have that struggle, but some seem to not realize that their struggle is not with the material, but the role itself. All that being said, I love NP school. I can see one why, generally, a couple of year's experience nursing is good but also why decades of experience is not necessary. It truly does come down to the individual.

Actually yes. There is NO state that allows PAs to practice independently. Many states allow NPs to practice independently.

I'm not saying one is better than the other but that is just the way the laws are.

"Many states?" How many exactly? Correct me if I'm wrong but the last account I read put it at less than ten states, as "independent pratice" and "scope of practice" have very different implications.

Btw, PA's can and do, own their own practices under the "supervision" (cough cough), of an MD...fuzzy lines drawn in the ever- shifting sands of legal interpretation. :)

And I agree, one is not "better" than the other.

Lots of ignorance flying around.......lots of jealousy.....

Someone please tell me whhat slinging zpack at walgreens has to do with bedside nursing?

Let me tell you. Diddly squat.

I had a lengthy conversation with the dean of the FNP program at Columbia University. Her opinion is that every day working at the bedside is time and money lost......

Just sayin

Handing out meds at Walgreens means a lot more of you've followed patients daily at the bedside and observed their daily response. The dean's opinion means little as she probably never worked on the floor prior to becoming a NP. Now, if she wants to go head to head with a nurse who had 37 years of experience prior to becoming an NP, I'll be waiting.:smokin:

Handing out meds at Walgreens means a lot more of you've followed patients daily at the bedside and observed their daily response. The dean's opinion means little as she probably never worked on the floor prior to becoming a NP. Now, if she wants to go head to head with a nurse who had 37 years of experience prior to becoming an NP, I'll be waiting.:smokin:

I very clearly posted the contact information for the school. Feel free to give her a call. She can hold her own, I assure you.....

Specializes in Pediatric Pulmonology and Allergy.
I very clearly posted the contact information for the school. Feel free to give her a call. She can hold her own, I assure you.....
What the job market tells you matters a lot more than what a school recruiter will tell you. Of course they want to boost their enrollment and student population as much as they can. More prestige and $$$ flows to them. But are they really serving their student body well by telling them they don't need nursing experience to become an NP, when 90% of NP job listings specify that they're looking for minimum 3-5 years of nursing experience?
Specializes in ..

I actually think that many of the views here are not that far apart. First of all, I personally think that SOME bedside experience is important and necessary, but due to the difference in the RN vs NP roles, bedside experience is not CRITICAL. This is a new viewpoint for me. Remember, only a fool never changes. Some people, depending upon how they learn, their level of confidence, and how their undergrad nursing program taught, need more or less bedside experience…… depending upon the person. Yes, I think direct entry NP grads are at a disadvantage, but we’d better get used to the idea. One thing we all seem to keep forgetting is that years ago, many years of bedside nursing were required to reach the level of knowledge necessary to step into the NP role. Now, many things that could only be learned by experience are taught in undergrad BSN programs….the knowledge base has grown, so the timeline to reach “expert” status has shortened. This does not mean that newer NP’s are smarter than previous ones or that newer NP’s lack “respect” for the hard work of the past, but that newer NP’s simply have the benefit of this larger knowledge base. The other thing forgotten here is that time and experience mean nothing if the person involved makes no use of it. How many RN’S do you know who only do the minimum required by law to keep a license, thus making them near incompetent or just downright dangerous? On the other hand, there are CNA’s and LPN’s who constantly read, listen, question and research and have grown tremendously in their knowledge base but will never be able to be NP’s. Which do you think is better: A fresh BSN RN who spends one to three years asking questions, researching and absorbing knowledge OR twenty years of someone who just punches a clock, follows the orders on the chart and occasionally picks up a few gems here and there? I have my own ideas as to why nurses (and thus NP’s) in-fight and backbite more than PA’s or MD’s, but I’ll save that for another thread.

Again, I think much angst comes from people making the wrong choices to further their careers. The other issue is that those of us here who “have put in the work” can’t get upset at those who benefit from that larger knowledge base and those of us who gain that benefit can not forget to be respectful and thankful of those whose work in trenches made our path shorter.

Specializes in ..

mindlor,

While I appreciate your enthusiasm for your viewpoint, I would highly recommend cooling your jets a little. No institution of higher learning is capable of preparing anyone for everything and there certainly are many-a-fool walking around with some serious sheepskins hanging on the wall. Be careful not to put too much weight on the formal education as lots of this stuff is still intuition, "critical thinking" and just plain old "I've seen this before." Thank your professors but bow to your elders.

Just my two cents.

First and foremost, a million THANK YOU's to the OP for being brave enough to dare defend DE-NPs on this site. There is so much hate & misunderstanding when this topic comes up on AN that I think most of us DE-NPs try to fly under the radar here.

I'm currently deciding between PA vs ANP route. I've been an RN for 19 years.

It just torques me off that I spent all these years in the trenches... and for what? :)

Guttercat, I think your response is a good example of how DE-NPs are misunderstood by nursing as a whole. Defending DE-NPs as safe and intelligent practitioners is not meant to suggest that RN experience is worthless or that it doesn't contribute to you becoming an excellent NP. One type of NP does not have to be better than another.

When I meet a 'traditional' NP who worked bedside before moving on - I assume that his/her bedside experience influences their NP practice. But most on AN seem to assume that a DE-NP has zero applicable experience that might help similarly in their professional development. There is more than one way to skin a cat ... there is more than one way to learn critical thinking and humanistic interaction than by bedside RN experience. The success of DE-NPs supports that (to whoever said DE-NPs have trouble with employment ... anecdotally I have seen the opposite - where are you and what kind of research is supporting that?)

Handing out meds at Walgreens means a lot more of you've followed patients daily at the bedside and observed their daily response. The dean's opinion means little as she probably never worked on the floor prior to becoming a NP. Now, if she wants to go head to head with a nurse who had 37 years of experience prior to becoming an NP, I'll be waiting.:smokin:

With all due respect, you have no idea what kind of meaning I as a DE-NP derive from "handing out meds at walgreens" without having followed patients as a bedside RN. See my above paragraph ... I believe you when you say that your RN experience helped your NP development - but it's a bit egotistical to think that ONLY that type of experience gives rise to a good NP. We recently took opposite sides in the online education debate - I'll try to let go of my personal bias against online education if you can conceive of a safe NP without bedside RN experience. At the end of the day I think both of our opinions arise out of general ignorance and not malicious intent.

I would love to see a change in the general attitude surrounding DE-NPs on AN.

Specializes in FNP/FPMHNP-BC.

bsnanat2. I totally agree with u. U hit the nail on the head.

Specializes in nursing education.
I actually think that many of the views here are not that far apart. First of all, I personally think that SOME bedside experience is important and necessary, but due to the difference in the RN vs NP roles, bedside experience is not CRITICAL. This is a new viewpoint for me. Remember, only a fool never changes. Some people, depending upon how they learn, their level of confidence, and how their undergrad nursing program taught, need more or less bedside experience…… depending upon the person. Yes, I think direct entry NP grads are at a disadvantage, but we’d better get used to the idea. One thing we all seem to keep forgetting is that years ago, many years of bedside nursing were required to reach the level of knowledge necessary to step into the NP role. Now, many things that could only be learned by experience are taught in undergrad BSN programs….the knowledge base has grown, so the timeline to reach “expert” status has shortened. This does not mean that newer NP’s are smarter than previous ones or that newer NP’s lack “respect” for the hard work of the past, but that newer NP’s simply have the benefit of this larger knowledge base. The other thing forgotten here is that time and experience mean nothing if the person involved makes no use of it. How many RN’S do you know who only do the minimum required by law to keep a license, thus making them near incompetent or just downright dangerous? On the other hand, there are CNA’s and LPN’s who constantly read, listen, question and research and have grown tremendously in their knowledge base but will never be able to be NP’s. Which do you think is better: A fresh BSN RN who spends one to three years asking questions, researching and absorbing knowledge OR twenty years of someone who just punches a clock, follows the orders on the chart and occasionally picks up a few gems here and there? I have my own ideas as to why nurses (and thus NP’s) in-fight and backbite more than PA’s or MD’s, but I’ll save that for another thread.

Again, I think much angst comes from people making the wrong choices to further their careers. The other issue is that those of us here who “have put in the work” can’t get upset at those who benefit from that larger knowledge base and those of us who gain that benefit can not forget to be respectful and thankful of those whose work in trenches made our path shorter.

The above, like x1000. Thanks for articulating this. Direct entry will work for some people. It would not have worked for me. I have learned something in every area of nursing that I've carried with me. All my bedside and direct patient care experiences are enhancing my MSN education in ways I could not have anticipated when I was in undergrad in the early 90's. It will enhance my APN practice too. Practice knowledge IS nursing knowledge, along with theory and research.

Specializes in Psychiatric Nursing.

Great OP. Great perspective. Thanks for posting. I went back to staff nursing (travel-psych) after a few years of advanced practice. I was relieved to not have to worry about diagnosis and meds though I would think about them. Now I am back to being a provider 15 min visits, etc. The staff nurse foundation for me is invaluable. I have no problem with direct entry or with pa programs. We all take care of patients.

mindlor,

While I appreciate your enthusiasm for your viewpoint, I would highly recommend cooling your jets a little. No institution of higher learning is capable of preparing anyone for everything and there certainly are many-a-fool walking around with some serious sheepskins hanging on the wall. Be careful not to put too much weight on the formal education as lots of this stuff is still intuition, "critical thinking" and just plain old "I've seen this before." Thank your professors but bow to your elders.

Just my two cents.

First I am a soon to be new RN at 48 years old. So I think age has little to do with this equation. And yes I get passionate about this topic, expecially when folks who obviously have done no research on their own start popping off......

Anyway, you have summed it up nicely. Thank you.

Specializes in Anesthesia, Pain, Emergency Medicine.

NP, according to the American College of Nurse Practioners, Pearson report. 27 states allow totally independent practice.

I know that there are PA owned practices. I have a good friend that has one in Montana. But the fact remains, you still MUST have a collaborative physician and their involvement varies according to state law.

I support PA independent practice. I also support their name change. I think it is just the physicians wanting control and money from the PAs. This is the same reason they fight tooth and nail against NP/CRNAs.

But the fact remains that NPs are making great strides every year. This past year have 3 more states become independent. With the current climate in health care, more will follow.

I thin NPs and PAs should band together to fight for legislative changes.

The 2012 Pearson Report: A National Overview of Nurse

Practitioner Legislation and Health Care Issues ©

By

Linda Pearson DNSc MSN APRN,BC FAANP

For the past 24 years I have annually written a Report summarizing national nurse practitioner (NP) legislation - a Report that has wide dissemination, discussion, and utilization promoting NP legislation. Readers appreciate the concise information format including the state-by-state review of pertinent legislation, rules and regulations that impact NPs, and the government, policy and reimbursement information. For the cost of four to five gourmet coffees, anyone on the web can access the complete summary status of NP legislation, available at http://www.webnponline.com .

HIGHLIGHTS OF '2012 PEARSON REPORT' COMPILED DATA

Within the following “bulleted highlights” are some interesting compilations from the 2012 Pearson Report:

  • The number of NPs within our nation is now more than 180,000 (see 2012 Summary Table). This number of NPs is incredibly good news for the citizens of our country since nurse practitioners are powerfully important health care providers who are helping our nation to improve healthcare outcomes and lower healthcare costs.
  • There is NO requirement for any physician involvement in NP Diagnosing and Treating in TWENTY SEVEN STATES (See MAP – DX/TX – an “Overview of Diagnosing and Treating Aspects of Nurse Practitioner Practice”). This number has INCREASED by three states from last year’s Report!!!!!!

"Many states?" How many exactly? Correct me if I'm wrong but the last account I read put it at less than ten states, as "independent pratice" and "scope of practice" have very different implications.

Btw, PA's can and do, own their own practices under the "supervision" (cough cough), of an MD...fuzzy lines drawn in the ever- shifting sands of legal interpretation. :)

And I agree, one is not "better" than the other.

Link: http://www.pearsonreport.com/

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