RN experience helpful and essential to be a NP

[apostolic4eva]

I'm hearing mixed opinions on this topic. Some swear "yes" and some say experience as an RN will not help. The claim is RN and NP is completely different. Would love to hear from the practicing NPs. I just want to make sure I follow the appropriate advice. Thank you!

[MBrickle]

I think another angle to add to this discussion is the fact that in many nursing markets, there isn't much of an opportunity to get critical care experience.

From day 1, I wanted to work in primary care. I was able to get a job in pedi home health which has both allowed me to gain some critical care experience (vent/trach/o2, etc) as well given me primary care experience via the multitude of appointments, doctors visits, etc that a child with complex needs requires. Additionally, I have also spent time communicating with physicians regarding my patients orders, etc.

I do feel this experience will be helpful. I feel the any RN experience can only help when pursing an NP.

Additionally, in the Boston area, nursing jobs are scarce and getting an ICU job would take years as many hospitals seem to only hire nurses with experience and even then, prefer in-house applicants. Getting a med/surg job is only slightly less difficult. I just got my BSN 3 yrs into my career and it would take another 3-6 years to work my way up to ICU in this job market, short of a miracle. Doesn't seem worthwhile to do so when primary care is my ultimate aim.

While I do find RN experience to be helpful, in many job markets it is difficult. Since EBP has shown that DE programs generate high-functioning NPs regardless of lack of nursing experience, I don't think matters much. Ultimately, you reap what you sew, and those who put in the time and effort to stay on top of their practice will be better for it, regardless of background.

[ghillbert, MSN, NP]

Absolutely, no question. Just the practicalities of med administration, and care coordination alone save a ton of time, let alone the health background.

[zenman]

I think as I said above. Helps with pe but the mess used in clinic are totally different than icu. Minus putting the patients home meds down their peg tube. Diagnosing which is one of the biggest parts of our job is totally not used as an rn

You're not the one diagnosing as an RN but you should pick up a boatload of experience connecting a diagnosis with the patient's presentation, and the more years you have doing that the better. So if I saw a patient in the ER with foam coming out of his mouth and he was diagnosed with CHF and I see the same years later as an NP, I'll bet I'll come pretty close to the correct diagnosis, barring any mad dog hanging on to the patient's leg.

[BostonFNP, APRN]

Let's hope any NP regardless of experience could make that diagnosis!

[Riburn3, BSN, MSN, APRN, NP]

I think as I said above. Helps with pe but the mess used in clinic are totally different than icu. Minus putting the patients home meds down their peg tube. Diagnosing which is one of the biggest parts of our job is totally not used as an rn

This is absolutely not true. If you're working in critical care and are oblivious to a diagnosis in an emergent situation you're doing it wrong. When you call a surgeon or intensivist at 3 in the morning, you better have a clear picture of what's going on and what you want for your patient. While technically you aren't diagnosing your patient, any ICU or ER nurse with half a brain knows how to lay down a few differentials and know how to treat their patient.

I ask again where you draw your knowledge from because it seems many of your posts have a heavy opinion that lacks the experience/knowledge to back it up.

[BostonFNP, APRN]

I ask again where you draw your knowledge from because it seems many of your posts have a heavy opinion that lacks the experience/knowledge to back it up.

Out of curiosity, does your experience/knowledge as a student give you more credibility than the poster you are accusing, who by prior posts is a practicing Hospitalist NP.

As I said initially, this is a hot topic and it seems like every nurse from LPN to NP has a passionate opinion on it; not all have the perspective of what it means when actually put in practice.

[Riburn3, BSN, MSN, APRN, NP]

Absolutely it does, from at least my standpoint. I am currently in the role transition from RN to NP so I acutely know exactly what it feels like to be making the role change, and what type of skills as an RN have been of most benefit while I am working as a Student NP. Additionally, I am a CCRN, CSC, CMC CVICU nurse, and if you know anything about those tests, much of the exams are about evaluating a set of symptoms and figuring out what's wrong. Working in critical care, you have know to rapidly interpret data and know what to do. Additionally, being an open heart recovery team nurse affords me a level of autonomy many nurses will never experience. Those skills directly translate into a clinical setting, or at least they do for me. Any critical care nurse worth their salt knows what's wrong with their patient and diagnosis them before they give the doc a ring.

Everyone here is full of anecdotes, just as I am. While I find my critical care experience useful, other nurses might not. However, within my program, the nurses with the least amount of experience are struggling the most. While that might not make a difference long term, it does at least now. I am a big proponent of the quality of RN experience before starting your work as an APRN. There's a reason why CRNA programs want a very specific type of experience, and there's a reason why many NP programs like their nurses having a minimum amount of RN experience.

[BostonFNP, APRN]

Absolutely it does, from at least my standpoint. I am currently in the role transition from RN to NP so I acutely know exactly what it feels like to be making the role change, and what type of skills as an RN have been of most benefit while I am working as a Student NP.

Everyone here is full of anecdotes, just as I am. While I find my critical care experience useful, other nurses might not.

You haven't started your transition yet, that happens during your first year(s) of practice in the APN role. (Unless I am mistaken and you have already graduated and started work as an NP.) I am not sure how you meant the statement "working as a student NP" but remember that your are "learning" (not working) as a student NP; don't short change yourself that time to learn. I do realize you may have meant you are making the best of working as an RN while you are a student NP which is fantastic and you can obviously disregard the previous.

Everyone has anecdotes. The research is divided on the topic and the literature seems to suggest two things: that, objectively, there is little difference in novice NP practice between those with and those without RN experience however those with prior RN experience tend to think it quite valuable. Personally, I value my RN experience but I am also humble enough to know that several of my colleagues without any are as competent as I am.

[Riburn3, BSN, MSN, APRN, NP]

You're very right. I almost feel like the difference is similar to how an LVN that gets their RN has an advantage over new RN's in school and immediately following graduation. At first it's a large leg up, but over time the quality playing field evens out. I would imagine that long term, previous experience as an RN is of little value when you are an NP. Most of these topics address if previous experience helps, and at least in NP school, I feel it certainly does, but long term, it will be of little importance.

Additionally, I'm not sure what your NP school experience was like, but to date mine has been very autonomous thanks to my work connections with my preceptors and their overwhelming trust of me. I independently see my patients, diagnose them, chart on them, suture wounds, and the only thing my preceptors do is sit in their office and sign off on the chart and sign the scripts that I personally write. While I realize it's different without that safety net when you graduate, I work in Texas where the state requires me to have a supervisory relationship with a physician. I already have my first job out of school lined up with one of my preceptors, so much of what I am doing in school feels more like on the job training, which I love. I'm establishing relationships with patients I will be treating out of school, and I will hit the ground running after I pass my boards.

Lastly, my only contention with the previous poster was when he said diagnosing is "totally not used as an rn", when in reality nurses do it all the time, especially those in higher acuity fields. While it's not within the scope of practice, when you work in certain areas, physicians expect you to know whats going, and to formulate an action plan immediately. Diagnosing is analyzing the nature or cause of a phenomenon, and as I said before, any nurse in a high acuity area that's worth anything is very adept at analyzing the cause of numerous phenomenon on a moments notice.

[futureeastcoastNP]

You're very right. I almost feel like the difference is similar to how an LVN that gets their RN has an advantage over new RN's in school and immediately following graduation. At first it's a large leg up, but over time the quality playing field evens out. I would imagine that long term, previous experience as an RN is of little value when you are an NP. Most of these topics address if previous experience helps, and at least in NP school, I feel it certainly does, but long term, it will be of little importance.

Additionally, I'm not sure what your NP school experience was like, but to date mine has been very autonomous thanks to my work connections with my preceptors and their overwhelming trust of me. I independently see my patients, diagnose them, chart on them, suture wounds, and the only thing my preceptors do is sit in their office and sign off on the chart and sign the scripts that I personally write. While I realize it's different without that safety net when you graduate, I work in Texas where the state requires me to have a supervisory relationship with a physician. I already have my first job out of school lined up with one of my preceptors, so much of what I am doing in school feels more like on the job training, which I love. I'm establishing relationships with patients I will be treating out of school, and I will hit the ground running after I pass my boards.

Lastly, my only contention with the previous poster was when he said diagnosing is "totally not used as an rn", when in reality nurses do it all the time, especially those in higher acuity fields. While it's not within the scope of practice, when you work in certain areas, physicians expect you to know whats going, and to formulate an action plan immediately. Diagnosing is analyzing the nature or cause of a phenomenon, and as I said before, any nurse in a high acuity area that's worth anything is very adept at analyzing the cause of numerous phenomenon on a moments notice.

I agree with you...this is I think, why most RNs with experience think experience is helpful. They have a leg up during school and for a bit after...but it's still a new role. And while early on you can rely on your RN experience, after a few years you realize that you don't do anything you did as an RN anymore. Non experienced RNs who become NPs have their own advantages - they are less inclined to think like an RN, and are typically younger and more in school mode. I think both routes are fine.

[BostonFNP, APRN]

Additionally, I'm not sure what your NP school experience was like, but to date mine has been very autonomous thanks to my work connections with my preceptors and their overwhelming trust of me. I independently see my patients, diagnose them, chart on them, suture wounds, and the only thing my preceptors do is sit in their office and sign off on the chart and sign the scripts that I personally write. While I realize it's different without that safety net when you graduate, I work in Texas where the state requires me to have a supervisory relationship with a physician. I already have my first job out of school lined up with one of my preceptors, so much of what I am doing in school feels more like on the job training, which I love. I'm establishing relationships with patients I will be treating out of school, and I will hit the ground running after I pass my boards.

Lastly, my only contention with the previous poster was when he said diagnosing is "totally not used as an rn", when in reality nurses do it all the time, especially those in higher acuity fields. While it's not within the scope of practice, when you work in certain areas, physicians expect you to know whats going, and to formulate an action plan immediately. Diagnosing is analyzing the nature or cause of a phenomenon, and as I said before, any nurse in a high acuity area that's worth anything is very adept at analyzing the cause of numerous phenomenon on a moments notice.

My situation was very similar to yours and my comments come from a perspective of reflection. I went to a rigorous NP program, had my job secured two semester before graduation, and I felt I was very autonomous. During my first year of practice, looking back I was shocked at what little autonomy and responsibility I actually had as a student. Spending a year of rotations where you are going to work helps ease that transition but it is still absolutely a transition. Again that's in hindsight.

Nurses do use diagnosis, and the higher acuity they are the better they may be at that. It all helps in some way. There are some drawback that go with that that may explain the data that demonstrates similar objective functioning of novice NPs. From my professional experience precepting I have seen both sides of extensive nursing experience in high acuity/speciality settings.

[zmansc, ASN, RN]

Let's hope any NP regardless of experience could make that diagnosis!

Which one, the CHF or the mad dog?