Becoming an NP with little to no nursing experience??

Nursing Students NP Students

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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.

I agree berk. being a nurse and nurse practioner (again two different professions) takes different sets of skills. just because you are a nurse does not mean you automatically possess the skills necessary to be a nurse practioner. Whatever makes someone a good NP can have nothing to do with them having been a nurse. My point is working as a nurse beforehand will probably only add to your competence as an NP overall, but to think that is the only place or the best place to gain the competencies necessary to be an NP is very premature. There are a vast number of opportunties in this world where we develop and hone our skills to be successful in the workforce.

...

I have worked along side 2 RNs--1 with an ADN and 1 with a BSN--both competent/great nurses that have worked in various parts of the hospital. 1 has 20+ years experience and 1 has alomst 30. In my opinion, neither of them would make a very good APN. They just do not have the gumption or critical thinking skills required. In their cases, I might actually argue that the more years RN experience, the more difficult it would be for them to pull out of their role and be able to work autonomously. ... -berk

What was I thinking, going to graduate school? I've been an RN since 1989. You have enlightened me. I am too old, have been a dumb ol' nurse waaaay too long, have no critical thinking skills, and insufficient intelligence to become a CNM.

Maybe I should just quit nursing after withdrawing from my program and returning my ACNM scholarship and start cleaning houses for a living.

What was I thinking, going to graduate school? I've been an RN since 1989. You have enlightened me. I am too old, have been a dumb ol' nurse waaaay too long, have no critical thinking skills, and insufficient intelligence to become a CNM.

Maybe I should just quit nursing after withdrawing from my program and returning my ACNM scholarship and start cleaning houses for a living.

Oh, I'm sorry ... was I talking about YOU? ... It is almost hilarious how people take things personally on these threads. I think I do actually need to "enlighten" you here. LOL. I have no doubt that in MOST cases 10, 20, 30 years of nursing experiences will be GREATLY beneficial to advanced practice nursing--there is no argument to that. My point, which I thought was obvious, is that there are also individuls who are great RNs, but are better off keeping their role. Thus leading to my point that the entire arugment on this thread is null because there are just too many exceptions from every angle.

I've been reading this thread with interest for some time. I've been an RN for just about 2 years now (got my BSN in 2005) and I'm also now an acute/critical care NP student. I am in an NP program that mixes traditional BSN students who wish to go back to school for their NP (me) with Graduate-Entry Students who have completed their one year RN. I have changed my opinion from being skeptical of Graduate Entry programs/students to accepting them, as long as each individual student who is going through the program is truly competent and is able to handle it. The reason i've changed my mind is because I have been a preceptor to new RNs at my job, and have precepted both new BSN graduates and new RNs through this graduate entry program. I can honestly say that out of every new nurse I've precepted, the very best one with wonderful assessment and critical thinking skills was one of my graduate entry student peers. She to me seems like she has already been a nurse for years due to her level of maturity, top notch assessment skills, always asks for help if she is over her head, and is so good already at being an RN in just a few short months. I truly believe that graduate entry programs are not for everyone. I feel that it is up to the individual to decide for him/herself if she/he can handle the fast paced 3 year roller coaster and still come out competent, and somewhat sane because it is a lot of work. But even just sitting in class listening to my classmates speak about their work experiences...I hear a level of maturity and competence that I didn't realize was there before. I think there are going to be nurses at both ends of the spectrum (really great vs. barely getting it) no matter which way they become RNs...whether it be diploma, ADN, BSN, GEP, etc...And as for the thought that 5 years as an RN are needed before getting your NP, I again disagree respectfully by stating that too depends on the individual nurse, and how quickly or slowly she/he grasps new material and can think on her/his feet and demonstrates competence and critical thinking skills. I began my NP program just with one year as an RN under my belt. I have received nothing but As in every single graduate class I've taken so far (I'll have completed 8 graduate classes by May). But more importantly, I can truly say that there is nothing I have learned in class that I felt was over my head. I am a fast learner and feel comfortable with the knowledge I have gained so far. I also feel 100 % ready for my NP clinicals to start in August 2007 and am eager to move on to the next phase of my nursing career. :)

I agree with you.

I can also say a little about the job market (where I'm at) for FNP's with little RN experience/direct entry. I have a year of RN experience and am working while in school. A friend of mine has no nursing experience.

My first clinical, I was offered a job when I graduate. They said I was the best student they'd ever had.

She was also highly praised and offered a job.

It depends on how you perform. I feel that I will be a safe practitioner. My nursing experience, in critical care (adults & children), is great for a lot of things but did not give me a knowledge base for primary care peds or women's health. We all have some areas that are stronger than others. I'm thankful for my nursing experience (and have TREMENDOUS respect for those with a lot of experience!!!!), but those who don't have it seem to be doing fine. I was skeptical at first that this could be so... but they proved me wrong.

It's how quickly you can learn, apply it, and show your patients/preceptor that you know what you're doing. = job ;)

Just my two cents.

Specializes in CRNA, Finally retired.
I agree berk. being a nurse and nurse practioner (again two different professions) takes different sets of skills. just because you are a nurse does not mean you automatically possess the skills necessary to be a nurse practioner. Whatever makes someone a good NP can have nothing to do with them having been a nurse. My point is working as a nurse beforehand will probably only add to your competence as an NP overall, but to think that is the only place or the best place to gain the competencies necessary to be an NP is very premature. There are a vast number of opportunties in this world where we develop and hone our skills to be successful in the workforce.

Is the converse true - a good NP does not have to possess the skills to be a good nurse? 'splain, Lucy (ala Ricky).

The reality of this whole thing is that the nursing profession is going through some changes, largely due to the fact that there is a huge shortage of nurses, both regular RNs and APNs. The supply can't keep up with the demand. That is why you see these schools adapting and changing to meet the needs of the industry. My mother used to work at a community college (a few years ago) and told me that there were over 1200 applications for 40 nursing slots (ADN). Many of the applicants were professionals in other fields trained at the Master's level doing everything they could to get one of these slots.

I know back when I was looking into BSN programs in 1997, there weren't many accelerated BSN or MSN entry programs in Texas. Now schools have post BS to BSN programs, etc etc. OFF TOPIC: This is also why you see more allied health types being used in places like the ER. I recently read a discussion on the pluses and minuses of using Paramedics in the ER. I think the answer is two fold. One its cheaper and cost effective. Two, hospitals are having to make adjustments due to the shortage of RNs. I am not going to debate whether its right or wrong, this is just merely a statement on what I've read and seen.

Now to the topic at hand, does one need to have RN experience before becoming an APN? In my opinion, NO. Would it be beneficial? Yes it might depending on what area of advanced practice you are going into. People have said that one needs a year or two on the Med-Surg floor before moving to a specialty (ICU, ER, etc) Now, new grads can go straight there through internsip programs and OJT. Again, another adaptation to fill the shortage.

Bottom line, I think it all depends on the INDIVIDUAL and his/her abilities to learn and adapt. Each person should examine themselves first when considering an APN role. If you are confident in your skills, abilities, etc. then go for it. If you think, maybe I need a little more patient care time then get it. It all boils down to YOU, want YOU'RE comfortable with, and what is going to be the best for YOUR patients.

I think too often we resort to petty arguments and mud slinging about who is a better provider or has more training, so on and so forth. The REALITY is, there's a shortage and a need out there, the question is what are we doing as a profession to fill the needs and fix this problem. THAT is the question that we all should be trying to answer and fix.

Just my two little cents....Happy Friday,

Jack

Well said Jack. I am in complete agreement with you. April of 2008 is when the first round of baby boomers are eligible for retirement. That is less than a year away. We already have a huge shoratge in this country in most if not all health care professions. We should be trying to find ways to make it feasible for those who are willing to be on the front lines of health care and not jump through a ton of hoops.

Specializes in Accepted...Master's Entry Program, 2008!.

I agree with you as well Jack. Very nicely stated.

In regards to the arguments both for and against, I think the entire medical conglomerate is very, very, very resistant to change. That isn't just nursing, it's all of it. I wouldn't argue that this is right or wrong. It just is.

Ask any heath professional why they do a procedure X way, and they will tell you "because it's always been done that way". If you want to get into the philosophical aspect of it, you can troll through decades of history and eventually come up with the answer of why "this way" was ever started. Sometimes this is frightening (and trust me, it's true).

There is always resistance to change in health care. I really don't know where it comes from, or why that is, but it's true. Look at anatomy. Gross anatomy has relatively little to do with medicine, and doesn't even need to be in the medical curriculum. Is it likely to be removed? NO. That class has always been taught...and so it goes.

If you're a thoracic surgeon, you'll learn the anatomy of what you need to know. You don't need to know every muscle/nerve/artery/vein/tendon/bone/connective tissue/fat deposit in the foot or the hand if you're going to be working in the chest (just watch the cries of protest.......)

As you said, nursing is going through some huge changes and there is a lot of resistance to that. There's also a great deal of protecting your turf. Mostly due to politics. Internist fighting alternative health care providers, nurse practitioners fighting physician's assistants, MD's fighting DO's. Everyone wants to protect their turf.

Nurse Practitioners and Physician's Assistants are perfectly capable of doing essentially the same job equally well. That's all the really needs to be said. I also think direct-entry Nurse Practitioners will be just as capable of providing service as someone with 20 years nursing experience. They are different jobs, with different requirements and so on.

I agree with you as well Jack. Very nicely stated.

In regards to the arguments both for and against, I think the entire medical conglomerate is very, very, very resistant to change. That isn't just nursing, it's all of it. I wouldn't argue that this is right or wrong. It just is.

Ask any heath professional why they do a procedure X way, and they will tell you "because it's always been done that way". If you want to get into the philosophical aspect of it, you can troll through decades of history and eventually come up with the answer of why "this way" was ever started. Sometimes this is frightening (and trust me, it's true).

There is always resistance to change in health care. I really don't know where it comes from, or why that is, but it's true. Look at anatomy. Gross anatomy has relatively little to do with medicine, and doesn't even need to be in the medical curriculum. Is it likely to be removed? NO. That class has always been taught...and so it goes.

If you're a thoracic surgeon, you'll learn the anatomy of what you need to know. You don't need to know every muscle/nerve/artery/vein/tendon/bone/connective tissue/fat deposit in the foot or the hand if you're going to be working in the chest (just watch the cries of protest.......)

As you said, nursing is going through some huge changes and there is a lot of resistance to that. There's also a great deal of protecting your turf. Mostly due to politics. Internist fighting alternative health care providers, nurse practitioners fighting physician's assistants, MD's fighting DO's. Everyone wants to protect their turf.

Nurse Practitioners and Physician's Assistants are perfectly capable of doing essentially the same job equally well. That's all the really needs to be said. I also think direct-entry Nurse Practitioners will be just as capable of providing service as someone with 20 years nursing experience. They are different jobs, with different requirements and so on.

Exactly - And its also because the old crotchety RN's get mad when they see someone go directly into a graduate program without doing all the crappy work they had to do. If only they could have done it maybe they wouldn't be so bitter!!!!

i agree with you as well jack. very nicely stated.

in regards to the arguments both for and against, i think the entire medical conglomerate is very, very, very resistant to change. that isn't just nursing, it's all of it. i wouldn't argue that this is right or wrong. it just is.

ask any heath professional why they do a procedure x way, and they will tell you "because it's always been done that way". if you want to get into the philosophical aspect of it, you can troll through decades of history and eventually come up with the answer of why "this way" was ever started. sometimes this is frightening (and trust me, it's true).

most of this these days is based on ebm. now sometimes ebm changes what we do (watch what will happen with stents now).

there is always resistance to change in health care. i really don't know where it comes from, or why that is, but it's true. look at anatomy. gross anatomy has relatively little to do with medicine, and doesn't even need to be in the medical curriculum. is it likely to be removed? no. that class has always been taught...and so it goes.

if you're a thoracic surgeon, you'll learn the anatomy of what you need to know. you don't need to know every muscle/nerve/artery/vein/tendon/bone/connective tissue/fat deposit in the foot or the hand if you're going to be working in the chest (just watch the cries of protest.......)

i'll bite. i think you have a poor understanding in what is involved in medical decision making. a good foundation in anatomy and physiology is essential here. does everyone need to spend several months dissecting their own cadaver? different question. i fall back on my anatomy every day. just because your a thoracic surgeon doesn't mean everything involves the chest.

as you said, nursing is going through some huge changes and there is a lot of resistance to that. there's also a great deal of protecting your turf. mostly due to politics. internist fighting alternative health care providers, nurse practitioners fighting physician's assistants, md's fighting do's. everyone wants to protect their turf.

nurse practitioners and physician's assistants are perfectly capable of doing essentially the same job equally well. that's all the really needs to be said. i also think direct-entry nurse practitioners will be just as capable of providing service as someone with 20 years nursing experience. they are different jobs, with different requirements and so on.

depends on your perspective. the core of the np profession is to take a nurse and expand their practice (hence apn). if you value this expansion then you will be against direct entry. also you are changing entry into a profession. while you may feel that the direct entry is as capable shouldn't there be some outcome studies. other apn's still require specific experience as nurses before moving into an apn (for that matter some of the np specialties do also). so obviously you have a difference of opinion within the profession.

note: this is dated 4-27 but this showed up as a new message

david carpenter, pa-c

Specializes in CRNA, Finally retired.

Mvans, you're not even a nurse so how could you possible know ANYTHING, NOT EVEN ONE LITTLE TEENY IOTA of what a nurse knows or doesn't know. A person who doesn't know what he doesn't know may not always be dangerous, but will certainly never be anything but mediocre. Now, if that's alright for you, you go right ahead and become a "nurse"practitioner without any nursing experience. Than twenty years from the day you started, put a post up here and thank your lucky stars that no one as deluded as you were when you were starting out, was taking care of YOU. As a CRNA, I lose a medical neuron every day. Yes, I'm learning a lot about that "useless" gross anatomy (I've read many an intern's note that indicated they didn't know which side the spleen was on vs. the gallbladder). I have to admit that I don't learn much about pathology from the OR nurses, but the old timers that work in PACU and ASU all worked in other areas and I can always go to them with questions about dialysis and other nursing problems I don't know ANYTHING about. However, I'm humble enough to ADMIT it. This is Planet Earth and on our planet we weed out the idiots with courses like gross anatomy. I have to leave now to wipe the drool from my keyboard. Jeez!

Depends on your perspective. The core of the NP profession is to take a nurse and expand their practice (hence APN). If you value this expansion then you will be against direct entry. Also you are changing entry into a profession. While you may feel that the direct entry is as capable shouldn't there be some outcome studies. Other APN's still require specific experience as nurses before moving into an APN (for that matter some of the NP specialties do also). So obviously you have a difference of opinion within the profession.

Note: this is dated 4-27 but this showed up as a new message

David Carpenter, PA-C

Hmm I dont know what you are talking about davey boy old chap....What is the problem with direct entry exactly? If someone can get a four year degree in biology and go to PA school, graduate and get a job as a PA..why should a registered nurse need to work for 10 years in a hospital doing bed baths and wiping bottoms in order to "qualify" to get their APRN. Sorry dave, doesnt make much sense to me. Hmmm what do you mean by, "specific experience" can you please elaborate on that? The majority of APRN programs dont require "specific experience" for enrolling. Maybe you are more familiar with nursing, being a PA, than a nurse is...care to enlighten us?

Peter

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