Becoming an NP with little to no nursing experience??

NYNewGrad · Dec 8, 2006

Hello to all!!! I have worked as a parmamedic for 20 years,

It's not like you have no experience - If you're a good medic with strong assessment skills and diverse healthcare exposure I think you'll be okay. Maybe not first pick over a NP with 20 years RN experience, but probably on a fair playing field with NPs that have 3-5 years RN experience.

nurseangel47 · Dec 8, 2006

Hi, Blurr156! Blllluuuuthhhhgggghhhh (supposed to be a "raspberry", blown from mouth in taunting way!) don't know how to spell a sound! hehe

to those committee members/et al who think that you " ' haven't paid your dues' " ! ?! How dare they say that a NP student/new grad hasn't paid their dues as a practicing nurse before entering the NP role? What about the experiences gleaned from school? I'm sure that the clinical instructors put them through rigorous training experience on the floors as staff grunt work helpers just like we were trained as nurses in nursing school.. AND I think that the 20 yrs you've held your own in the field as a paramedic is just as good if not better seeing as how it's got it's own stressors and you just have to go with what you've got on the run so to speak and stabilize them before you run 'em in, that this should count as much as nursing in a hospital or other facility...? Am I wrong here? Maybe it's just the way I look at the general picture of things and from the years of experiences I've accrued. Never been a paramedic. Don't think I'd like that kind of danger and adventure every day at work. Regular staff nursing is jangling enough for me, thanks! Hats off to you for being a paramedic...have always admired you guys! First on the scene, scene maybe not safe to be at, perhaps not secured by police/security...guns/knives, the walking wounded, crowds of onlookers...yikes! Not for me.

I digress. Sorry. I totally disagree with that corporate committee's decision. But then, when do the stuffed suits ever make decisions that remotely realistically relate to those of us in the trenches???!!!

Sorry. Just have had it up to my eyeballs in corporate decision making!

Good luck to you in pursuit of perhaps sliding in under this wrong rule!

Trauma Columnist · Dec 8, 2006

Hi nurseangel - appreciate your opinion. However, it is sometimes difficult to obtain an NP position with NO RN experience. I will be honest that in my market - I only got interviews because of my 12 years of RN experience (10 in a level one ER and 2 years in a large ICU).

And...when you think about it - did you learn much more than the basics of assessment in nursing school? I didn't. I honed my skills by working in nursing. That lends credence to an advanced practice nurse. Otherwise, you have a new grad with a master's degree, but still a new grad.

sunnyjohn · Dec 8, 2006

I will start a direct-entry MN/MSN program in May 2007.

Even though I am certain my program will teach me all I need to know, I fully expect to spend time at the bedside AFTER graduation perfecting my clinical skills. I would be nervous if I was just out there with no net.

I think direct-entry programs are great. They allow people with varied experience into the nursing profession. Those of us in these programs are probably a less, well, 'jaded' MSN than the nurse that has had to put up with it for more years.

STILL, we have MUCH to learn from those who have been in the trenches. experience is the best teacher.

IMO the best direct-entry programs are those that encourage us MN/MSN/NP/APN/CNS/CNL/CRNA wannbe's to learn at the bedside, soak up the wisdom of experienced nurses and TAKE OUR TIME.

Dreamer-RN · Dec 8, 2006

mvanz9999,

I am a fellow IT career changer as well. I have been accepted into an accelerated BSN/MSN program (Nurse Practitioner). It will take a total of three years to complete (two years for BSN and one year MSN full-time).

Knowing that I lack nursing experience, I certainly want to gain as much experience as I can while in school. The school I will attend is affiliated with a hospital. I saw the hospital offers nurse externship opportunities for student nurses. I intend to take advantage of this opportunity while pursuing my BSN (students work no more than 32 hours a month). Due to I have the summers off (BSN portion), I am hoping I can do the externship full-time during the summer.

While pursuing the MSN, my plans are to work as a nurse either part-time or full-time.

My suggestion is to look into ways to gain experience while you are pursuing your degrees. This way you can have some experience once you complete your MSN, instead of none.

Blurr156 · Dec 9, 2006

Wow!! Great dialogue going on here. Thanks to all for the comments. A special thank you to nurseangel47 for your positive comments about the paramedic field. Although we do have our interesting moments in the field, it's not always "Rescue 911", believe me. You would be amazed at the minimal things that people will call 911. Anyway, I give a hearty kudos to all those in the healthcare field. Between cost containment and staffing issues, it has been a challenge which affects all of us. On a bit of a down note though, I just found out that I won't be eligible to apply to the program I wanted. It turns out that although you can still have a couple of outstanding prereqs. when you apply, you must have already taken the GRE and I haven't done that. I only came across this program last week. Ah well, more plans to work on. Thanks again to all. Best to all on your educational and career goals. And of course, happy holidays!!!

mvanz9999, RN · Dec 10, 2006

mvanz9999,
I am a fellow IT career changer as well. I have been accepted into an accelerated BSN/MSN program (Nurse Practitioner). It will take a total of three years to complete (two years for BSN and one year MSN full-time).
Knowing that I lack nursing experience, I certainly want to gain as much experience as I can while in school. The school I will attend is affiliated with a hospital. I saw the hospital offers nurse externship opportunities for student nurses. I intend to take advantage of this opportunity while pursuing my BSN (students work no more than 32 hours a month). Due to I have the summers off (BSN portion), I am hoping I can do the externship full-time during the summer.
While pursuing the MSN, my plans are to work as a nurse either part-time or full-time.
My suggestion is to look into ways to gain experience while you are pursuing your degrees. This way you can have some experience once you complete your MSN, instead of none.

That is basically what I'm planning on doing. Trauma gave me some good advice. The program I'm looking at starts with getting MSN in nursing - 15 months. After you pass the NCLEX, you become RN. The second portion is the post master certificate (ie, NP, CNS) during which they encourage you to work as an RN. So I'll have that year or two of RN experience, then I'll work full time as an RN while pursing an NP-type job.

sunnyjohn · Dec 10, 2006

That is basically what I'm planning on doing. Trauma gave me some good advice. The program I'm looking at starts with getting MSN in nursing - 15 months. After you pass the NCLEX, you become RN. The second portion is the post master certificate (ie, NP, CNS) during which they encourage you to work as an RN. So I'll have that year or two of RN experience, then I'll work full time as an RN while pursing an NP-type job.

Ahh, sounds like the direct-entry program at DePaul. That program is new, but it already has a good rep!

mvanz9999, RN · Dec 11, 2006

Ahh, sounds like the direct-entry program at DePaul. That program is new, but it already has a good rep!

Actually no. That program is around $60,000, which I am unwilling to pay.

It's the one at UIC. I think the cost is much more acceptable. DePaul is just TOO expensive. In addition, from what I've been told, DePaul does not have the best reputation for clinical nursing. That is more for administrators and researchers. Am I wrong?

Uberman5000 · Dec 12, 2006

Hello to all!!! I have worked as a parmamedic for 20 years, have a B.A. in Economics, and I wanted to advance my career in healthcare. I was originally looking to pursue the PA route, but for certain practical reasons (including my union not helping to pay for it) I have been looking at other options, nursing/NP. I was very excited to learn of a school near me that has a combined BSN/NP program for people with non-nursing bachelor degrees. I was about to start looking deeper into this program when a good friend of mine who is a member of an interview committee at a nearby hospital told me that I shouldn't do the program because I would have trouble getting a job. The reason stated was because I wouldn't have been seen as having "paid my dues" as a nurse first. Is this true? I could understand why someone might feel that way about someone who went through this type of program never having worked in healthcare before. However, I like to think that to a certain degree I've paid my dues (I know it isn't nursing, but from a time in healthcare perspective). My friend did say that I might be considered an exception to that rule. The program is at a VERY well known school and I was told by my friend even then it wouldn't matter. I was wondering what people here thought regarding this topic. Thank you for any guidance you can provide.

To some degree it depends on your previous experience..but we all have to start somewhere. Keep in mind NP's generally have a different purview than RN's so you could very well be doing primary care. I dont follow the logic of some on this board...by what they are saying you need to get experience as an RN to work as an NP, so by that line or reasoning you would have to work at a hospital say in a med surg unit, insert catheters, enemas, etc.....before you could enter a completely different setting to practice as an NP(private office doing primary care). The two settings arent exactly related so I dont think one should make a blanket statement that as an NP you have get RN experience, because NP's dont necessarily need to practice like RN's.

Nothing wrong with graduating from school and going to work in a private medical office doing primary care...you will get hired with no experience for that because that is what you went to school for; dont listen to other people tell you that you cant get a job, trust me they are wrong everytime.

jjjoy, LPN · Dec 12, 2006

"...I am certain my program will teach me all I need to know..."

Hopefully, most programs do teach all that a practicing NP needs to know. However, traditionally, NPs have been valued for the experience they bring to the position. The formal training filled in the gaps; it wasn't the foundation.

I know that in regard to RN/BSN programs, many graduates still have a long way to go to be full functioning as practicing nurses. Schools plow through a zillion things you might run across and reinforces safe practice. The clinical experience just gives a taste of what to expect to in the different areas of nursing.

Much of the assessment skills that nurses are valued for are gained through their work experience, not their schooling. You can have memorized every single sign and symptom of this and that but for many until you see it in the flesh in all the variations that people come in it's not very useful in an applied sense where you are making judgements based upon your assessments.

I know I wasn't made aware of the graduation/practice gap by my nursing program. For most of the program, the instructors kept telling us all about the varied possibilities outside of generic bedside nursing. It was only during the last term that they started telling us that we'd be well-advised to do generic bedside nursing to "hone" our skills. And it wasn't til I started working, and found these boards, that I realized how big the gap often was between nursing school and nursing practice.

I can't say how well direct entry programs prepare their students, but I would advise potential students to not just assume that they will be marketable and personally professionally ready to practice immediately upon graduation.

Trauma Columnist · Dec 13, 2006

I would like to address the idea that experience as an RN isn't necessary to be an NP:

1. The role of the advanced practice nurse is just that - advanced beyond the basic level.

2. Assessment skills are not something you can read about in a book, on a computer or get from clinical experience. It is something that is gleaned from the experience of examining many, many patients with multiple and different symptoms and disease processes.

3. Time management is another skill learned well as a staff nurse. You have to be able to weed out the supercilous versus the emergent. Again - not something you can come from another field and just "know." (Nursing is a second career for me also).

4. NPs (and other APNs) will never regret the time spent learning to be a nurse. Even as an APN, you must still be competent enough to do nursing care.

5. NP education isn't about tasks - its about assessment and prioritizing care. Anyone can learn to do a task or order a task. However, if you do not know the task, how can adequately assign it?

At any rate, just my $0.02 worth.

BTW I really like this thread. I know we don't always agree but we can learn so much from opposing viewpoints too.