Becoming an NP with little to no nursing experience?? - Page 10
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Dec 17, '06 by sirIYes, many times I see NPs who have difficulty with the transition from RN to NP. The ones (NPs) who have had greater difficulty are the ones without RN experience (and, no, that is not the ONLY reason they have difficulty). I know you do not want to "hear" this statement (NPs need RN experience), but that's my own personal experience as I serve as NP mentor. Mentor to both DE NPs as well as NPs who have RN experience.Surely you have seen NP's that are unable to process this information as NP's (unable to make the leap so to speak)? Or what about qualitative differences in experience? Is a med surg nurse the same as an ICU nurse?
I rather find that ICU nurses possess a great deal of Med-surg experience. And, of course they (ICU, Med-Surg) are not the same. Former is acute and latter is chronic.
Nursing educators and at least one state BON state that the NP's only qualifications are what they learned as NP's not their previous experience as nurses.
True. Graduation from an APN program and successfull certification is what qualifies you to be recognized as APN. But, you have many RNs who are considering APN and as RNs are restructuring their minds to apply the knowledge gained as RN to their futures as APNs. And, I speak as an Educator as well as an APN.
If you are referring to my comments, no, I do not assume. My observations are from personal experience over many years.There are a number of assumptions here that may or may not be true about how useful nursing experience is as an NP.
This assumes that an NP that is an experienced nurse would be able to see patients faster than an NP that is an inexperienced nurse.
I highly doubt that previous experience has anything to do with the speed with which the NP sees patients.
I've tried to address this statement and really not sure what you are driving at here.But can you assume all nurses have equal exposure to scenarios and situations just because they have experience.
Finally a question to Siri - as someone who is looking at a Hospital job. My understanding is that since hospitals have relatively deep pockets that they have assets to use if an award goes over the amount of insurance they carry (alleviating the need for an NP or PA to pay out of pocket). In private practice it is common for the employer to pay for malpractice. Is th insurance. Is this common in institutional settings.
And, as I have pointed out with a previous question/statement regarding liability issues, this question needs to be addressed in another thread for it is off-topic from the OPs original intent: Becoming an NP with little to no nursing experience?? - AdminDec 17, '06 by sirIQuote from traumaRUsExcellent comment, traumaRUs.Many have asked me over the past few months about my professional background. When they hear I'm a new grad APN they always ask what else I've done. When I tell them that I have 10 years experience in our local level one trauma center and another year in the ICU, they all relax and know they are in experienced hands.
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Dec 17, '06 by core0Quote from siriOK lets look at three scenarios. One is a nurse that has 4 years med-surg experience, one is a nurse that has 4 years ICU experience and one is a nurse that has 4 years of inpatient psych experience. They all have four years of nursing. Are they all equal? Do they all have the same exposure to disease conditions and illness? This is my point here. The assumption seems to be that all nursing experience is equally valuable. I would assert that it is not just the type and quality of experience but the way the nurse processes that experience that matters.Quote:
But can you assume all nurses have equal exposure to scenarios and situations just because they have experience.
I've tried to address this statement and really not sure what you are driving at here.
David Carpenter, PA-C - AdminDec 17, '06 by sirIQuote from core0No, they do not have equal exposure to disease conditions/illnesses. That's impossible and to think this is inaccurate.OK lets look at three scenarios. One is a nurse that has 4 years med-surg experience, one is a nurse that has 4 years ICU experience and one is a nurse that has 4 years of inpatient psych experience. They all have four years of nursing. Are they all equal? Do they all have the same exposure to disease conditions and illness? David Carpenter, PA-C
Again, no assumptions. An accurate statement, however.The assumption seems to be that all nursing experience is equally valuable
YES, all experience has a hand in preparing the RN for the role of APN. All experience opens a door to how disease entities are handled; how the HCP arrives at said dx; why and how dx studies are performed; how to interpret said dx studies and apply to the disease process; how/why/when additional consult/referral is necessary as it applies to said disease process; all seen day in and day out as an RN. This helps shape one's own abilities to process information and apply to one's future as an APN.Last edit by sirI on Dec 17, '06 -
Dec 17, '06 by blueskyQuote from core0OK lets look at three scenarios. One is a nurse that has 4 years med-surg experience, one is a nurse that has 4 years ICU experience and one is a nurse that has 4 years of inpatient psych experience. They all have four years of nursing. Are they all equal? Do they all have the same exposure to disease conditions and illness? This is my point here. The assumption seems to be that all nursing experience is equally valuable. I would assert that it is not just the type and quality of experience but the way the nurse processes that experience that matters.
David Carpenter, PA-C
Complete red herring. 99.9 % of nurses who pursue NP degrees pursue it in their own specialty. - Dec 17, '06 by core0Quote from blueskyDo you actually have any figures on this. The quote on the Psych nurse was from experience with an NP in an FNP program. I have seen plently of ICU nurses in FNP programs also. What is "their specialty" from a nursing perspective? What "specialty" does Med-surg go into?Complete red herring. 99.9 % of nurses who pursue NP degrees pursue it in their own specialty.
David Carpenter, PA-C - Dec 17, '06 by core0I've been thinking about this a little more and some of the responses. I think that in answering the original poster, some divisions have been exposed. When looking at this I think that I have heard a lot of anectdotal experience but no true studies that show a difference.
In examining this lets make a couple of (what I consider reasonable) assumptions:
1. There are no studies that show that direct entry nurse practitioners are worse as clinicians than NP's with nursing experience.
2. There are no studies that show that direct entry NP's have any other measureable diffences than NP's with nursing experience (patients seen, higher malpractice etc).
Now, I think that one of the main items that everyone seems to be dancing around is that to admit that there is no difference between direct entry and other NP's is to denigrate nursing experience as part of being an NP. If in fact there is no difference between direct entry and others then the logical follow on question is, is nursing school necessary for entry as an NP? While viscerally this takes one away from the origins of the profession, I would maintain that this is an outgrowth of the direct entry programs themselves and to a lesser extent the rise of direct entry BSN programs.
At some point a decision was made not to include nursing experience as one of the requirements for NP. If you look at the CRNA requirements there is a requirement for one year of acute care nursing experience prior to CRNA school. This is a clear example that this specific type of nursing is considered valuable for CRNA's. On the other hand the lack of such a requirement for NP's either indicates a tactit acknowledgement that this is not valuable or (more likely) an acknowledgement of the difficulty quantifying the value of previous experience. In addition NONPF seems to tactically acknowledge this.
With at least 24 direct entry programs this is a problem that nursing will have to address. There are relatively simple studies that probably could be done (for example compare certification rates for experienced vs. direct entry NP's). There is a growing body of research on the value of bedside nursing including at least one study that shows a link between nursing education level and death rate in hospitals. I have seen little or no outcomes research from NP's particulary in the various educational environments that have cropped up.
Just my thoughts from a non-nurse.
David Carpenter, PA-C - Admin
Dec 17, '06 by traumaRUsI think that the experience one gets from being an RN, provides you a pathway to what type of NP you want to be. If for example, you work in an ER and decide you really like caring for kids, you migh want to get Peds ICU experience before committing to a PNP program. Likewise, if you think that L&D might be what you want to do, working in a busy L&D unit might prove beneficial.
This is not to say that all works out like we think it should. Most of my RN experience is in the ER. I really, really wanted to stay in the ER, but there were no positions so...I went with what was available. Nephrology had never even entered my head. However, my assessment skills and ability to handle emergencies very independently has helped tremendously. The staff know that even if I can't handle a dialysis machine issue, I can take care of the patient and know what I'm doing is the right thing in the right order. If I had no experience as an RN, I truly would be scared.tokidoki7 likes this. -
Dec 17, '06 by PANurseRN1Also bear in mind that you will be held to the standard of care of an advanced nurse practitioner. A med-mal atty. or a BON isn't going to care if you went straight through a direct-entry program and didn't get experience first...they are going to hold you accountable for the level of knowledge and skill and advanced nurse practitioner should have.
Which did you learn how to do first, walk or run? -
