Becoming an NP with little to no nursing experience?? - page 16

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   mvanz9999
    Quote from Tinker08
    Im a little confused...after i finish my BSN, and go 2 more years for my masters...do i have to again go to school for NP??
    LOL! I think we're all confused.

    I cannot say for all programs, but for those in Illinois yes....and no.

    The way the programs work are this (there are two).

    A) UIC: You enter the masters program, attend 15 months of core nursing courses and take the NCLEX. You do not have a degree at this point. You then start working as an RN and complete the second portion of the program, which is the NP part. It takes 4+ years to complete it.

    B) DePaul: You enter the masters program. After 22 months, you are awarded the degree of MSN (Master Science Nursing). You pass the NCLEX and become an RN.
    You then re-apply to the school to get a post-masters certificate as a nurse practitioner.

    In either case, you do not get the NP education in 2 years. It is additional training beyond a masters, regardless of whether the additional training is incorporated into the program, or is a separate post-masters process.
  2. by   core0
    Quote from mvanz9999
    LOL! No, that's not what I mean.

    Nurses are trained as nurses and doctors are trained as doctors. It's apples and oranges.

    I think the point of the post that I was making is that med school students are not required to have medical experience in order to attend medical schools, nor are they required to have any health care experience to become physicians after their training.

    The poster is simply saying WHY are Nurse Practitioners allegedly required to have nursing experience before becoming mid-level nursing providers? Doctors don't need pre-training experience, so why do nurses insist that nurse practitioners must have pre-training experience?
    In theory NP competency builds on nursing experience. The reason that MD's don't need pretraining is that they have 4 years of coursework in medicine and a minimum of three years in residency to develop clinical competency. The theory is that a nurse should have basic clinical competency in nursing, and then expand the nursing role through advanced practice. This is the foundation that the original NP programs were built on.

    To contrast the original PA programs were built on the foundation of dependent medical practitioners advancing their medical practice by expanding their roles as dependent medical practitioners. Since there was a wide variety of entry points the curriculum was standardized in a manner similar to medical school curriculum (no credit for past experience).

    In nursing the two APN practices with the heaviest didactic and clinical component (CRNA and CNM) have specific requirements for nursing experience relevant to the advanced practice nursing. One of the NP roles the ACNP also requires this. However there are no experience requirements for the other NP specialties. So given the uneven requirements even within NP specialties it is reasonable to ask is nursing experience necessary to be an NP? The problem is that there has been no real vailidation of these newer models (direct entry or distance learning). With fractured certification requirements it is difficult to see if any work has been done to look at even minimal differences such as pass rates for certification.

    To compare physicians training to NP training misses the point. The real point is - is there any objective evidence that direct entry produces a competetent provider or evidence that it doesn't? If there is no need for nursing experience - then is there a need for advanced practice nursing?

    David Carpenter, PA-C
  3. by   core0
    Quote from Tinker08
    Im a little confused...after i finish my BSN, and go 2 more years for my masters...do i have to again go to school for NP??
    There are essentially two (or three) options after a BSN. A traditional MSN usually has either a teaching or management focus. The other option is an APN which may be a MSN but sometimes has a different degree. In this category there is CRNA, CNM, NP and CNS. The CNS is considered an APN in some states an not in others. To answer your question an NP degree is usually an MSN so if you want to go to NP school take that MSN. If you want to manage or teach get your MSN (If you want to teach NP's look at the DNP programs).

    David Carpenter, PA-C
  4. by   Tinker08
    ok. so i think i understand after reading 23746 posts now. I finish my BSN..start working as an RN...and then do my masters(about 2 years) and thereafter i can be a NP! Right??? haha i hope so..so much information and so many routes to take!
  5. by   sirI
    Yes, you must enter an NP program where upon completion, you will be awarded MSN with the NP track. You will select a specialty NP concentration such as Acute Care NP, Geriatric NP, WHNP, Ped NP, FNP, etc.

    While working as an RN, you will get a feel for the type of nursing which interests you and that makes it easier to select the specialty area in your NP program.

    I was OB-GYN NP and then did a post-masters certificate as FNP a few years later. That's always an option.

    There are also dual certification programs as well as combination NP/CNS programs.

    Good luck!!!!!!
  6. by   prairienp
    Quote from siri
    yes, you must enter an np program where upon completion, you will be awarded msn with the np track. you will select a specialty np concentration such as acute care np, geriatric np, whnp, ped np, fnp, etc.

    while working as an rn, you will get a feel for the type of nursing which interests you and that makes it easier to select the specialty area in your np program.

    i was ob-gyn np and then did a post-masters certificate as fnp a few years later. that's always an option.

    there are also dual certification programs as well as combination np/cns programs.

    good luck!!!!!!
    agreed, other than you enter a graduate program (ms/msn/dnp) in your desired specialty area (educator/cns/np/other), you complete the degree requirements at your institution and proceed to take the national certification exam in your specialty area.
  7. by   catamounts303
    Hi Blurr,

    I'm actually going through the same thing. These entry level NP programs are very selective and I'm actually ready to just enroll in a BSN program. I worked for over two years in a Trauma ICU and noticed that RN's with Critical Care experience just have an ease in dealing with complex cases at the NP level especially when it came to Neuro Trauma and managing ICP's. The PA's just come in with no real world clinical experience and it really shows.

    One thing though if you are interested let's say in Acute Care NP and can't get hired in as an Acute Care NP search for a job in as an ICU Nurse. People will tell you that you can't get hired out of school into the ICU, that simply is not true and i've met dozens who've done it. You progress so much faster and learn so much.. Then it's an awesome springboard for NP or CNA whatever you decide.

    let me know how things turn out for you burr nad best of luck
  8. by   rmc2
    In my hospital for example, you could still be hired as a NP with no RN experience but your salary would be less than a NP with RN experience. However, as a PA, we would count your paramedic experience. Somehow, we only look at RN experience (in addition to NP experience of course) when deciding how much to offer a NP; but for PAs, in addition to the RN experience (most PAs don't) we also look at their EMT (Emergency Medical Tech) experience.
  9. by   morganvibes
    I'm not a new Grad but I hope to be by Fall of 2009.
    I just got accepted to Vanderbilt's "Bridge" direct entry NP program (FNP) and I have no prior nursing experience.
    To let people know what this program entails, as it seems some people think it is so incredibly short to get your MSN:
    Although the program is only 24 months long, it is actually the equivelent of 3 years of college- it is 6 semesters which are completed in 2 calendar years. so it is not really only 2 years of schooling, it is 3 years. (we will attend full time semesters in the summer months).
    Also, you cannot just walk off the street and get your MSN and NP with this program, you must have many pre-requisitie classes equivelent to 3 years of college (minimum is 78 credits) including all science classes that you would have been taking if you had been on a BSN track.
    I will actually end up having over 100 college credits and I already have an Associates degree (non-nursing).
    So in actuality, a person who graduates from this accelerated program will have a minimum of 6 years of college, which is the same as having gotten the BSN in 4 years and then the MSN in 2 years which is the "normal" route. The only way that this differs is that they let you do it faster calendar-wise and they give you credit for your previous college courses instead of making you jump through hoops for an extra year because you need to take a specific history or sociolgy class that they require. Many schools for BSN have such strict requirements for these non-nursing courses that they make it problematic for an older student to graduate in a reasonable amount of time.

    These direct entry programs have obviously been created to fill a need for NP's that some of the posters here seem to think does not exist. But I have heard from friends in the program that last year's graduates all got jobs right after school and many had several offers to choose from. Maybe Nashville is a good market, but I don't feel at all that I won't be able to get a job right away after graduation.
    I think some nurses are just annoyed by these programs because they didn't exist before and they had to do it the long way. But they are here now and since I am an older student and time is very important, and money is important, I have to do the best I can. I think some of us will be great NP's right out of school and some will need time, but that is like anything else. From the articles that were posted earlier in this thread, it seems that there is no data that shows that new grad NP's without RN experience were nay different than those with nursing experience.

    I think it would be great to perhaps add one year of "residency" for new grad NP's. It sounds like that would make everyone on both sides happier and probably make us all more competent as well.

    I am really excited and can't wait to start.
    Morgan
  10. by   Psychaprn
    Congratulations Morgan! As an old timer, I have no objection to the shortening in time of your academic path-rather I worry about your clinical experience. How much of your schooling is spent actually working with patients? How much is spent working with pts. in your specialty area? You cannot replace practical nursing/clinical experience with book learning!! I also don't think you can become an advanced practice nurse(NP) without first BEING a nurse(RN with work experience.)

    There are many nuances of both pt. care and workng with others as a nurse that can't be taught-they have to be experienced. I just worry that NP's who start practicing without solid clinical experience will be thrown to the wolves! I shudder when I remember a BSN studuent from another school that I precepted. She was graduating in year and didn't know how to take blodd pressures!!

    All your employer will care about is your credentials-you won't get any longer precepting/mentorship and orientation than a seasoned RN who become an NP. Be careful of what your school promises-remember-they're out to make money. If I were you I'd work at least part-time while you're in school as a nurse's aide or student nurse in the area you want to specialize in. I am sincere about my concern for you and am not resentful you didn't have to go the long way but consider this-I had four years of BSN education which was 8 semesters of clinical work and academics-including the last year being in my specialty. I worked inpt. for 5 years and had a 2 year clinical practicuum, including a thesis for my master's. I worked inpt. and out. settings while in school with various age groups. To be perfectly honest-90% of my learning came from working not school! I also had to cope with nurses older than me who resented that I had a BSN rather than years of working behind me. I then studied to be an APRN while working and honing my prescribing skills. I think short cuts are fine as long as they don't make someone "short" on experience, comfort or competency! I admire anyone seeking to increase their education, I just want you to be aware of some of the pitfalls-please keep us posted on how you're doing.
    Last edit by Psychaprn on Mar 2, '07
  11. by   morganvibes
    Hi, psychapn, thatnk for responding.
    Obviously I am giving my opinion based on reading (a lot) online and talking to people - since I haven't even started yet.
    That being said, this is what I have found:

    Most of the 4 year BSN programs I looked into had 2 years of completely NON-nursng courses, and then the last 2 years of nursing classes. It sounds like your BSN prgram was completely different than that. maybe better.

    Also I have read that the NP's job is totally different than the RN's job. Due to that, many say it isn't neccessary to work as an RN first. I'm not saying that an NP should not have knowledge of what RN's do, of course they should!
    I will get my RN license of course before getting the NP license. I don't know what satisfactory amount of clinicals is, again I am a newbie, but here are the numbers for the Vanderbilt program:
    700 hours of clinicals for the RN, I know that the last semester of the first year is almost all clinicals.
    700 hours of clinicals for the FNP program.
    Does that sound like a good amount? let me know what you think.
    of course , this doesn't change the "on the job" experience, but at least it is not just "book learning".
    I'm interested to see how that compares to other programs if anyone knows.
  12. by   mvanz9999
    Well, the two I am looking at are different. One allows you to take the NCLEX after 15 months (but does not give you a degree). You then start working as an RN while completing the program over the next 4-5 years.

    The other one gives you a MSN general degree, which qualifies you to work as an RN. After that, you re-apply for a post-master's certificate, while continuing to work as an RN.

    So in each case, there is mandatory RN experience required before you get your NP.

    Programs require 830 clinical hours.
  13. by   Uberman5000
    Quote from mvanz9999
    I really don't understand where everyone is getting this "NP without experience" from. Maybe people don't understand how the programs work. Let me put it down:

    There are two types that I've seen:

    A). I go to the first 15 months of the direct entry program (Core nursing requirements). I then receive a "permission" to take the NCLEX. If I pass it, I am now an R.N., but I have not finished my degree. I then take a part time job as an RN while finishing the actual NP part of the program. This is expected to take 4-5 years. After I finish the second part (and pass the licensing exam) I am now a NP with 4-5 years of experience as an RN and then (and only then) I receive my degree. (University of Illinois at Chicago)

    B). I get a general MSN, take the NCLEX and am now a masters-degree RN. I then must re-apply to the school for the post-masters certificate program, to obtain certification as a NP. (DePaul)

    In neither case do I see anyone who graduates without stepping foot into a hospital or working first as an RN. Now, in the second case, you may say that a person could get the general masters and then immediately apply for the post-masters certificate, but one must remember that you will be competing with applicants that have 5 or 10 or 15 or 25 years of clinical experience as an RN, and the likelihood of being competitive without ever working as an RN is minute. It would be very unlikely that they would admit someone with ZERO experience, into the post-masters certificate program.

    So I'm not sure where all these NPs are coming from that have literally NO clinical experience. I think what may be happening is that some posters are unaware of how the programs work. In Illinois, these are your two choices, and from what I have read and heard, it would be virtually impossible to become an NP without significant clinical work as well.
    The problem is you have alot of people on this board that dont have a clue what they are talking about making broad based assertions that I are easily dispelled with logical reasoning and fact. There is a typical "good old boy" mentality amongst experienced nurses that they feel it is "ones duty" to do all kinds of BS work before one is able to enter into the "Higher auspices" of the nurse practitioner roles. That idea is all well and good however it is not necessary to follow the 30 year career path to NP lol, even though some may want you to because it damages their ego to realize that you can do it 2 years post grad BSN.

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