Becoming an NP with little to no nursing experience?? - page 14

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... Read More

  1. by   traumaRUs
    I agree with Mvanzz999 - I would like to see the stats and here some success stories from the NPs that become NPs with little to no RN experience. In my area, we don't have these programs, so I have not come across any grads. However, I would love to hear first-hand accounts of experiences of these grads.

    Anyone???
  2. by   neuronightnurse
    "i agree with mvanzz999 - i would like to see the stats and here some success stories from the nps that become nps with little to no rn experience. in my area, we don't have these programs, so i have not come across any grads. however, i would love to hear first-hand accounts of experiences of these grads.

    anyone???"

    and to expand on traumarus question, what is either a minimum or ideal amount of experience an rn should have before starting an np program? nursing is a second career (and loving it, btw) and i'm not getting any younger!
  3. by   nurse4theplanet
    Everyone has an opinion and I respect those who differ from my own, so please show the same courtesy...

    In MY opinion, experience as a bedside nurse should be required before entering NP school. I agree with the rationale of others who say, ADVANCED practice nursing is just that, ADVANCED. Meaning you have MASTERED basic nursing principles and can now ADVANCE not only your knowledge base, but your skill proficiency, and your scope of practice.

    Passing the NCLEX only determines whether a nurse posesses the MINIMUM level of knowledge needed to provide safe bedside care. You have enough knowledge not to harm your patient, and hopefully enough knowledge to help the patient improve. To go directly into the NP program, although I am not disputing that it gives you a great wealth of information and you may feel confident in acting in such a role, you still haven't had enough patient contact and experience to have MASTERED basic nursing care and possess the proper competency to ADVANCE your practice into DIRECTING the treatment plans for your client in the EXPANDED scope of NP.

    It has always boggled my mind why there were direct entry programs for NPs, and to hear students say that once they graduate they will not even look for a nursing job but go directly for NP.

    There are still areas of nursing that do require you to have a min 1 yr of experience before you can work as a new grad (some surgery/trauma/ICU/PACU units...etc.) To advance your degree to CRNA a minimum of 1 yr in critical care is required. So if I have to gain a year's experience out of school to be considered safe to recover a pt from surgery in the PACU, then why do I not have to have a year's experience before I am considered safe enough to diagnose and treat an illness?

    Before anyone gets bent out of shape over that last statement...I understand the difference between providing beside nursing care and acting in a NP role...I understand that it is a different type of nursing. But the whole RATIONALE behind being eligible to attend NP school is to build on the knowledge base of basic nursing concepts. That was your foundation. You must first have become an RN and possess a nursing license. This is NOT a technicality...there is a REASON for that. The whole idea of expanding the role of the nurse into the NP scope of practice is to take that basic nursing foundation and build upon it. You cannot ADVANCE without first having become proficient in the basic aspects of care.

    Is there a magic number of years? No. What you take from your education and your life experience is highly individualized. I can only say that it seems like it would be at least appropriate to require a MINIMUM of one year of bedside nursing experience before allowing one to take their new degree (with newly acquired skills, minimum competency and proficiency, minimum experience) and then allow then to advance that degree and build upon those skills, expanding their responsibility, liability, and scope of practice.

    It would BEHOOVE you to gain some working knowledge/experience, excercise your critical thinking ability, and master basic nursing concepts before attempting to take on more responsibility and expand your nursing role.

    That's my opinion for all its worth.
  4. by   traumaRUs
    Thanks asoldierswife05 - I appreciate your rationale and agree with it.

    I would also like to see and talk with some grads of these programs to get their insight also. As with anything new, sometimes some refining must take place to make this a viable option.

    Do we have any grads on the board????
  5. by   juan de la cruz
    Quote from asoldierswife05
    Everyone has an opinion and I respect those who differ from my own, so please show the same courtesy...

    In MY opinion, experience as a bedside nurse should be required before entering NP school. I agree with the rationale of others who say, ADVANCED practice nursing is just that, ADVANCED. Meaning you have MASTERED basic nursing principles and can now ADVANCE not only your knowledge base, but your skill proficiency, and your scope of practice.

    Passing the NCLEX only determines whether a nurse posesses the MINIMUM level of knowledge needed to provide safe bedside care. You have enough knowledge not to harm your patient, and hopefully enough knowledge to help the patient improve. To go directly into the NP program, although I am not disputing that it gives you a great wealth of information and you may feel confident in acting in such a role, you still haven't had enough patient contact and experience to have MASTERED basic nursing care and possess the proper competency to ADVANCE your practice into DIRECTING the treatment plans for your client in the EXPANDED scope of NP.

    It has always boggled my mind why there were direct entry programs for NPs, and to hear students say that once they graduate they will not even look for a nursing job but go directly for NP.

    There are still areas of nursing that do require you to have a min 1 yr of experience before you can work as a new grad (some surgery/trauma/ICU/PACU units...etc.) To advance your degree to CRNA a minimum of 1 yr in critical care is required. So if I have to gain a year's experience out of school to be considered safe to recover a pt from surgery in the PACU, then why do I not have to have a year's experience before I am considered safe enough to diagnose and treat an illness?

    Before anyone gets bent out of shape over that last statement...I understand the difference between providing beside nursing care and acting in a NP role...I understand that it is a different type of nursing. But the whole RATIONALE behind being eligible to attend NP school is to build on the knowledge base of basic nursing concepts. That was your foundation. You must first have become an RN and possess a nursing license. This is NOT a technicality...there is a REASON for that. The whole idea of expanding the role of the nurse into the NP scope of practice is to take that basic nursing foundation and build upon it. You cannot ADVANCE without first having become proficient in the basic aspects of care.

    Is there a magic number of years? No. What you take from your education and your life experience is highly individualized. I can only say that it seems like it would be at least appropriate to require a MINIMUM of one year of bedside nursing experience before allowing one to take their new degree (with newly acquired skills, minimum competency and proficiency, minimum experience) and then allow then to advance that degree and build upon those skills, expanding their responsibility, liability, and scope of practice.

    It would BEHOOVE you to gain some working knowledge/experience, excercise your critical thinking ability, and master basic nursing concepts before attempting to take on more responsibility and expand your nursing role.

    That's my opinion for all its worth.
    This is such an insighful and mature outlook on an advanced practice nursing especially coming from a nurse who is just beginning her professional career. Kudos to you asoldierswife05!
  6. by   mvanz9999
    I've been told by some hospitals that the minimum no. of years for NP is 2-3 years RN experience.

    While I do respect the opinions on the board, and agree with them to some extent, I have to wonder what the difference is between direct entry and doctors. A medical student leaves school and enters an internship with no experience at all. They've had their nose in books throughout medical school and have no bedside care experience. I don't see how that makes a medical school graduate competent and a nursing school graduate incompetent. I really don't.

    Before anyone argues that doctors have an internship while NPs do not, an NP is not expected to practice solo. They work in conjunction with doctors, so that reduces the need for an internship. Anyone who attempts to practice "solo" without any experience is very likely to fail.

    Lastly, I have looked at only the programs in Illinois, and feel that the direct entry is misunderstood. It's true that you can go directly to grad school for nursing as opposed to undergraduate entry, but there is no way to complete either of these without several years of RN experience. I've been told that other programs do not require any experience, but I wouldn't believe that just because I know of the misunderstanding about the Illinois programs.

    I feel that this is sort of self-limiting. You may be able to complete other programs without any RN experience, but that will make a person so unemployable that they will never find a job.
  7. by   juan de la cruz
    Quote from mvanz9999
    I've been told by some hospitals that the minimum no. of years for NP is 2-3 years RN experience.

    While I do respect the opinions on the board, and agree with them to some extent, I have to wonder what the difference is between direct entry and doctors. A medical student leaves school and enters an internship with no experience at all. They've had their nose in books throughout medical school and have no bedside care experience. I don't see how that makes a medical school graduate competent and a nursing school graduate incompetent. I really don't.

    Before anyone argues that doctors have an internship while NPs do not, an NP is not expected to practice solo. They work in conjunction with doctors, so that reduces the need for an internship. Anyone who attempts to practice "solo" without any experience is very likely to fail.

    Lastly, I have looked at only the programs in Illinois, and feel that the direct entry is misunderstood. It's true that you can go directly to grad school for nursing as opposed to undergraduate entry, but there is no way to complete either of these without several years of RN experience. I've been told that other programs do not require any experience, but I wouldn't believe that just because I know of the misunderstanding about the Illinois programs.

    I feel that this is sort of self-limiting. You may be able to complete other programs without any RN experience, but that will make a person so unemployable that they will never find a job.
    I've gotten in trouble in the past for comparing NP's with other professionals so I will refrain from commenting on the NP and physician analogy as far as training goes. In my humble opinion, the ultimate decision about knowing when you're ready for advanced practice is really up to you. There is no magic number just like the previous poster wrote. Some people are just fast learners and pick up on stuff right away. I was older when I started NP school and noticed that a lot of the younger students are quick to pick up on new concepts than I was. Who am I to say that they won't do well in their career even though they had less experience than I did?

    The required number of RN experience that employers mandate for NP's varies a lot. In my current role, the physicians prefer some kind of ICU experience as an RN but I was an ER nurse prior to becoming an NP and was considered for the position nevertheless and even landed the job. I did have remote ICU experience but a lot has changed since then so my ICU skills weren't that current. However, my ACNP program carried some weight given that I had a semester of MICU rotation.

    The question that we haven't answered is whether direct entry graduates have more difficulty finding jobs than those who were in traditional programs. But then, like you said direct entry does not mean that the NP did not have any RN experience at all because some programs actually require the student to work as an RN while completing the NP component of the program. So by virtue of that fact, a simple study merely comparing the 2 programs will not yield valuable results.
  8. by   mvanz9999
    Excellent post Pinoy.

    To the last part of your post, there is another thread on that which references other threads, the end result being "good luck on finding an answer".

    Either there aren't enough direct entry grads, OR there aren't any that post here.

    http://allnurses.com/forums/2011300-post1.html
  9. by   ThinkingBoutNursing
    Quote from mvanz9999
    I have to wonder what the difference is between direct entry and doctors. A medical student leaves school and enters an internship with no experience at all. They've had their nose in books throughout medical school and have no bedside care experience. I don't see how that makes a medical school graduate competent and a nursing school graduate incompetent. I really don't.
    I dont understand either. No wonder why more and more second career people are changing careers to being Physician Assistants rather than Nursing or Nurse Practitioning. They come here, see the negativity, hear the rumors about "nursing eating their young," and don't want to be a part of it.

    I've been doing research because I want to change professions. I've always been interested in the Health field and reading about the new "mid-level" practitioners (read: NPs and PAs) are becoming the future of General and Family practice.

    There is a reason why the Nursing education/accreditation board allows the Direct-Entry NP to exist. When they graduate, they know they WON'T be the best practitioner in the world, but neither will new graduates of ANYTHING.

    Should new Accounting graduates be REQUIRED to work at book-keepers? Should new Lawyers be REQUIRED to first be paralegals? Should new physicians be REQUIRED to be PAs first???

    There are a LOT of people who read this site, and don't understand the hostility. People simply ask questions regarding this topic, but get no answers... just ranting about how terrible of a practitioner they'll be because they decided to enter a direct-entry program.

    Believe it or not, but the nursing world has probably lost some very caring, intelligent, and driven people that were thinking about being NPs through a Direct-Entry channel, but after reading some comments ON THIS PAGE by nursing colleagues completely bashing the program... shifted to the PA world.
  10. by   core0
    Quote from ThinkingBoutNursing
    I dont understand either. No wonder why more and more second career people are changing careers to being Physician Assistants rather than Nursing or Nurse Practitioning. They come here, see the negativity, hear the rumors about "nursing eating their young," and don't want to be a part of it.

    I've been doing research because I want to change professions. I've always been interested in the Health field and reading about the new "mid-level" practitioners (read: NPs and PAs) are becoming the future of General and Family practice.

    There is a reason why the Nursing education/accreditation board allows the Direct-Entry NP to exist. When they graduate, they know they WON'T be the best practitioner in the world, but neither will new graduates of ANYTHING.

    Should new Accounting graduates be REQUIRED to work at book-keepers? Should new Lawyers be REQUIRED to first be paralegals? Should new physicians be REQUIRED to be PAs first???

    There are a LOT of people who read this site, and don't understand the hostility. People simply ask questions regarding this topic, but get no answers... just ranting about how terrible of a practitioner they'll be because they decided to enter a direct-entry program.

    Believe it or not, but the nursing world has probably lost some very caring, intelligent, and driven people that were thinking about being NPs through a Direct-Entry channel, but after reading some comments ON THIS PAGE by nursing colleagues completely bashing the program... shifted to the PA world.
    I think the major barrier to entry for NP's as a second career is time. You have to get a BSN then get your NP. Outside of the direct entry it is extremely hard to get into nursing school. Also as you have seen stated on this board it is difficult to get a job with little nursing experience. On the other hand this population has been one of the traditional populations that the PA profession has relied on. For the most part these students have their bachelors so they only need the science requirements for the PA school. In terms of job market, given the choice between a younger or older PA, most physicians will choose the older PA with more life experience (at least in primary care).

    David Carpenter, PA-c
  11. by   traumaRUs
    coreO - I agree that even as a new grad CNS, it was continually brought up that the physicians and other mid-levels liked the idea that I had done more than nursing.
  12. by   zenman
    Quote from ThinkingBoutNursing
    There are a LOT of people who read this site, and don't understand the hostility. People simply ask questions regarding this topic, but get no answers... just ranting about how terrible of a practitioner they'll be because they decided to enter a direct-entry program.

    Believe it or not, but the nursing world has probably lost some very caring, intelligent, and driven people that were thinking about being NPs through a Direct-Entry channel, but after reading some comments ON THIS PAGE by nursing colleagues completely bashing the program... shifted to the PA world.
    I personally think that experience is beneficial prior to going the NP route but also realize that some will do fine with direct entry.

    But experience never hurts. At the studentdoctor site, you hear about practicing NPs who do not know things I learned a long time ago and consider to be elementary knowledge...and I'm not an NP yet.
  13. by   core0
    Quote from traumaRUs
    coreO - I agree that even as a new grad CNS, it was continually brought up that the physicians and other mid-levels liked the idea that I had done more than nursing.
    I agree with this. The one place that I see a difference in is surgery. This is really a young person's field. I worked in the OR in my 30's. I am not sure that I could keep up anymore in my 40's.

    David Carpenter, PA-C

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