Minimum level of experience for FNP - page 3

by grumpygorillaface

I am a nurse on a tele/med-surg floor. I am interested in becoming a family nurse practitioner eventually, but I was wondering if anyone has a recommendation on the minimum years of experience one should have before trying to... Read More


  1. 0
    Linearthinker:
    Walking is a psycho-motor skill that can't be compared to an intellectual skill. You haven't even been out of school yet..how could you possibly even be able to think the issue through? School is school...it's not the job. I respectfully disagree that the curve flattens in "short order." For someone with no experience, compared with your experience, I would give it a decade! It's a disservice to our profession and to patients, to allow students to become advanced practitioners without even experiencing the basics.
  2. 1
    First of all, it was allegory. Secondly, I've been out of school for 9 months. I just chose not to "work" for money, I do mission work. Thirdly, with regard to the "flattening" curve, I've seen it. I understand and accept that you may not have. In my experience, 5 years in, it has been impossible to distinguish the NP with 1 year prior RN experience from the NP with 10 years. I believe my experience has earned me the right to hold an opinion.

    I respect that you disagree, and I'll thank you not to patronize me.
    ConscientiousFNP likes this.
  3. 1
    Quote from CCRNDiva
    You know what's ironic? The very universities that have these direct entry programs are usually affiliated with medical centers that require or strongly prefer NPs with at least 2 yrs of nursing experience if they don't have NP experience. I've looked at several job descriptions at Vandy Medical Center, Hopkins, etc and they all want NPs with nursing experience. What does it mean when the very medical centers they are affiliated with want a NP with nursing exeperience?
    That's an astute observation. I've never worked with direct-entry ACNP's until I moved to California where these programs are prevalent. The institution we are affiliated with has direct entry NP programs (including one for ACNP's). Sure the entry requirements are rigorous and the ACNP students are required to work preferrably in the ICU after completion of the RN portion of the program (without getting a BSN). However, many of the graduates end up working at the bedside as ICU nurses upon graduation and transition to NP later. This is how my co-workers who are direct entry grads did it. Some (who graduated from east coast programs - Columbia, Yale, Case) got jobs as NP's right away but brought their NP experience to the table when they got hired here. So you're right, some of the very same universities that offer the direct entry option have "direct-entry unfriendly" hiring practices in their affiliated medical centers.
    CCRNDiva likes this.
  4. 0
    What should be understood is that FNPs have credibility and reliability in primary care. Most of the responses to this post are related to NPs that work in hospitals. Perhaps with increased knowledge of the field, the distinctions of the two can be better understood and more accurate judgement made. Primary care is where you find your FNPs, PNPs, and WHNPs and hospitals are where you find your ACNPs. There is a special program for that. That being said, NP programs prepare their students rigorously for whichever track the student is taking. As for FNPs, do we have clinicals in hospitals, well, do you provide PRIMARY CARE in hospitals. No and No. It's just that simple. We are in the office doing WELL patient visits, preventative care and referring to specialties as needed. Once one understands this and understands the difference, they might say "hey, yeah, about that nursing experience....maybe not so helpful there." Furthermore, I worked in outpatient as a nurse because of this whole ridiculous and at times ignorant notion of needing experience and the only thing I got from it is difficulty in switching my mind over from carrying out orders as supportive staff to being the final decision-maker as a Primary Care Provider.
  5. 1
    I don't think that any of us here are slow and unable to understand the difference between a FNP and an ACNP. Your post seems to ignore the fact that many FNPs are working in environments managing sick patients. Most FNPs are not just caring for well, healthy patients. Several are working in hospitals, clinics and the like. Many illnesses are now managed on an outpatient basis as patients are living longer with chronic illnesses.

    Again, it is called advanced practice nursing for a reason and I, for one, find it disappointing when someone has chosen to pursue advanced practice nursing when they have such a negative attitude towards the role of nurses. It's unfortunate that you feel that you did not benefit from your time as a nurse.
    elkpark likes this.
  6. 1
    My viewpoints and comments come from obtaining an education and experience as a nurse as well as that for a nurse practitioner. The offense that I initially spoke of that some nurses take when having this discussion has been made clear as you have chosen to believe one is saying that you are slow and unable to understand the difference. Instead of considering a different viewpoint, you have chosen to take offense. And this action is precisely what fuels the continued dissension between nurses and nurse practitioners. On the other hand, I considered all that was offered through people's opinions and responses to my post. I thought to myself "wow, that is correct. ACNPs are in the hospitals, but most FNPs are in primary care." However, that realization (not offense-taking) did not change my view of what my role is, where I belong, and what experiences will help me to become an efficient health care provider.

    Why don't we try this? Why don't we learn to support and build each other up in ways that strengthen the field of nursing. Let's face it. There isn't a whole lot of comradery that exists among the nursing profession as a whole....historically and present day. In fact, it was an MD that came up with the idea of having nurse practitioners, but he said when he saw all the bickering and fighting among the nurses with regard to this, he viewed nurses as antagonistic and decided instead to create the physician assistant. And guess what? These nurses he was trying to train to become nurse practitioners had been working as nurses all their lives, so what ever could have been the problem?

    How about this? Instead of fighting amongst ourselves on the topic of experience, advocate for what you believe in. If you think that nurse practitioners should have nursing experience first and you feel it is better for our patients, then move this conversation from this post and bring it to you legislatures. Until there is evidence-based practice that can supports your views and opinions, NPs will continue to begin practicing as primary care providers regardless of experience because research, statistics and patient satisfaction surveys have shown that it is highly efficient.

    I am totally open to evidence-based hypotheses and theories that will influence my decision on how and when to practice. Until such a time, I will operate with regard evidence-based practice and research and will continue to practice healthcare with confidence, pride and understanding that I am making a positive impact in the lives of my patients.

    If I am supported by nurses and nursing-experienced NPs, great. If not, that is fine too because strong opinions not backed by evidence do not carry that much weight.
    Last edit by ConscientiousFNP on Aug 14, '11
    FNPdude74 likes this.
  7. 1
    I agree with ConscientiousFNP. Not in every detail, but generally speaking anyway. I have recently applied for a PT FNP position and for payscale purposes, they are counting my 25 years of experience. I'll make more money than the FNP with 10 years advanced practice experience because she was a RN for "only" 8 years before becoming a NP. If I were the other FNP I'd be pi$$ed as he//. They are telling her in effect, that my RN experience is literally more valuable than her NP experience, and everyone posting on this thread knows that is hogwash. I think it's ridiculous, but I'll cash the checks.
    FNPdude74 likes this.
  8. 0
    Quote from ConscientiousFNP
    My viewpoints and comments come from obtaining an education and experience as a nurse as well as that for a nurse practitioner. The offense that I initially spoke of that some nurses take when having this discussion has been made clear as you have chosen to believe one is saying that you are slow and unable to understand the difference. Instead of considering a different viewpoint, you have chosen to take offense. And this action is precisely what fuels the continued dissension between nurses and nurse practitioners. On the other hand, I considered all that was offered through people's opinions and responses to my post. I thought to myself "wow, that is correct. ACNPs are in the hospitals, but most FNPs are in primary care." However, that realization (not offense-taking) did not change my view of what my role is, where I belong, and what experiences will help me to become an efficient health care provider.

    Why don't we try this? Why don't we learn to support and build each other up in ways that strengthen the field of nursing. Let's face it. There isn't a whole lot of comradery that exists among the nursing profession as a whole....historically and present day. In fact, it was an MD that came up with the idea of having nurse practitioners, but he said when he saw all the bickering and fighting among the nurses with regard to this, he viewed nurses as antagonistic and decided instead to create the physician assistant. And guess what? These nurses he was trying to train to become nurse practitioners had been working as nurses all their lives, so what ever could have been the problem?

    How about this? Instead of fighting amongst ourselves on the topic of experience, advocate for what you believe in. If you think that nurse practitioners should have nursing experience first and you feel it is better for our patients, then move this conversation from this post and bring it to you legislatures. Until there is evidence-based practice that can supports your views and opinions, NPs will continue to begin practicing as primary care providers regardless of experience because research, statistics and patient satisfaction surveys have shown that it is highly efficient.

    I am totally open to evidence-based hypotheses and theories that will influence my decision on how and when to practice. Until such a time, I will operate with regard evidence-based practice and research and will continue to practice healthcare with confidence, pride and understanding that I am making a positive impact in the lives of my patients.

    If I am supported by nurses and nursing-experienced NPs, great. If not, that is fine too because strong opinions not backed by evidence do not carry that much weight.

    First, for clarification, I did not take offense to your post. I chose to disagree with you, but no personal offense was taken. Second, your argument continues to be based upon the premise that all FNPs practice in primary care offices, managing well patients and health promotion. My point was and is that many FNPs practice in EDs, clinics, outpatient care services while managing patients with episodic and chronic illnesses. That is a fact, not a strong opinion. Employers tend to prefer NPs with nursing experience; that is a well established fact, not an opinion. Third, I don't believe that I ever questioned your role in primary care. I chose to disagree with your belief that requiring nursing experience to enter a FNP program was a "ridiculous notion". Not once did I question your practice as a FNP while I explained my position. I stated that it is disappointing to me when an advanced practice nurse has a negative view of the role of nurses.

    The OP asked for opinions and we happen to have opposing views. Does that mean that I don't support you in your role as a NP? No, and I'm sorry if that is how you perceived my post. We are not fighting, but instead disagreeing. I do not have to agree with your stance and you have no obligation to agree with mine.
    Last edit by CCRNDiva on Aug 15, '11
  9. 0
    Quote from ConscientiousFNP
    In fact, it was an MD that came up with the idea of having nurse practitioners, but he said when he saw all the bickering and fighting among the nurses with regard to this, he viewed nurses as antagonistic and decided instead to create the physician assistant.
    Do you have some documentation of Dr. Silver saying this? I'm v. skeptical.
  10. 2
    Nobody's really taking offense here. Allnurses is all about making your opinions heard and if you happen to read a post and disagree, that is OK. Nobody's trying to break any camaraderie either. No poster ever stated in this forum that it is a waste of time to attend a direct entry program for NP's and only experienced nurses should pursue the NP role. The fact is direct entry programs for NP's have been around for a while and will not go away. With that said, I just wish we nurses as a whole, admit the fact that we can no longer own the claim that we NP's are "better" because we were nurses at the bedside first. That statement does not apply to every single one of us anymore since we have been allowing individuals who never worked as nurses to fast track into a career as NP's. Unfortunately, we also could not claim that we are following the PA model of education when we defend the direct entry option because our clinical hours are significantly lesser and our programs vary in content considerably.

    I should apologize to the OP for getting sidetracked with the direct entry issue when the intent of the original post is to ask what the minimum level of RN experience is for an FNP. My response would be that experience can only help and it is really up to the individual to self assess what is enough. For me, the point of having the "bedside" experience is to allow self realization of where one's interests lie. NP's are advanced practice providers who are "specialized" into a field of healthcare such as caring for families, the acutely ill, women, children, neonates, and the promotion of mental health while still rooted in the profession of nursing. You get locked-in to a specialty as NP. It would only benefit one to have some experience in the field you want to get locked-in to and hopefully a desire for advancement in that field.

    I also know that we have invoked the word "evidence" in these posts and have questioned that there is no research that proves that experience as a bedside nurse create better NP's and that inversely, direct entry grads who enter the NP workforce are unsafe. But is it even possible to come up with sound research that can challenge these hypotheses? That's impossible to prove because human variables are just too difficult to control.
    Let your own self be the judge of that while armed with the knowldege of what is true about NP training and the job market you will have to face, seek the advice of individual NP's, and follow what you feel will work for your future.
    FNPdude74 and CCRNDiva like this.


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