Becoming an NP with little to no nursing experience?? - page 27

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
    jzzy88 - I'll take a stab at this question. Particular skills honed as an RN that would make someone a better primary care NP?

    1. Assessment is the first thing that comes to mind. Nowadays, people are sicker and sicker being handled totally as outpatients. For instance, I work in nephrology - knowing the difference types and reasons for renal failure, insufficiency is extremely important when dosing meds. It is also important that the primary care NP understand how the different disciplines work for the one goal of health.

    2. Awareness of resources in the community. For instance, what insurance plan will cover which med. How to word a script in order to get what you want as an off-label.

    3. The abilty to work within the medical system. With years of experience, you know who you can go to. Not everyone wants APNs to succeed. It is important that the new APN know who they can rely on and who might sabotage their efforts. This comes from knowing the hx and experiencing the medical system first hand.

    4. Without experience as an RN, you are an untried resource. Physicians have a built-in system of med student, intern, residency, fellowship. We in nursing think we can take shortcuts and get as much respect as those that "have paid their dues." Medicine is still a good old boys network. You are respected for your experience, your publications, your experience (did I just say that)?
  2. by   sirI
    1. Learn how to identify facts relating to the case and evaluate their reliability and relevance to reach a diagnosis and prescribe and implement treatment.
    2. Observation of the PCP in troubleshooting the provisional and differential dx
    3. Reading and interpreting dx studies as they apply to the pt. dx and how the results direct the PCP in the tx
    4. Recognizing subtle s/s that indicate change in dz process warranting need for further dx studies
    5. Rationale behind rx drugs ordered
    6. Rationale behind why certain dx studies are ordered
    7. Professional interaction with not only PCP, but fellow colleagues, and other healthcare workers
    8. Hone the ability to properly educate the patient in preventive health maintenance
    9. Learn how to be a leader
    10. Learn how to deal with uncertainty and make the best possible decision for the well-being of the patient
    11. Learn to recognize and appreciate ones limitations as they apply to the role of the APN
    12. Know how to utilize all resources available in treating the patient and coordinate the interdisciplinary care team and specialists
    13. Know when to refer
    Just a few off the top of my head. The nurse wishing to advance his/her nursing career as APN will take the time with the above. And, this takes experience.
  3. by   jjjoy
    Quote from traumaRUs
    jzzy88 - I'll take a stab at this question. Particular skills honed as an RN that would make someone a better primary care NP?

    1. It is also important that the primary care NP understand how the different disciplines work for the one goal of health.
    Would the average acute care nurse really have a good idea of how the health care system works outside of the hospital?

    2. Awareness of resources in the community. For instance, what insurance plan will cover which med. How to word a script in order to get what you want as an off-label.
    I don't see that experience working in acute care would give nurses any real insight into such issues.

    3. The abilty to work within the medical system. With years of experience, you know who you can go to.
    This would really only apply to those nurses planning to continue working in a related field after earning their NP. If they move to a completely different field, they still won't have the connections. I don't know how many experienced nurses pursing advanced practice are planning to work in related area or how many might be planning a bigger change or how much weight admissions committees put on having related experience versus not, especially given that DE students are admitted without having any prior related experience.
  4. by   traumaRUs
    jjjoy I'll try to address this:

    1. Yes, the average RN working in acute care had better have some idea of how the healthcare system works outside the hospital. Most care nowadays isn't provided in the hospital, its in the outpatient world.

    2. Working in acute care, the RN works in a multidisciplianary environment should know in general what will be covered, and/or how to get things started for the pt.

    3. Most NPs and other APNs that I know DO work in the general area of where they have experience. The RN experience gives you the ability to accurately choose where you would fit best. Without the RN experience, you are just shooting in the breeze that you might be happy working in primary care. How do you know that maybe the ER or ICU might not be your forte and love? Answer....without the RN experience, you don't.
  5. by   peddler
    I have a couple thoughts on the original topic...NP with little or no RN experience.

    On one hand:

    It requires zero experience to go to Med School. It requires zero experience to go to PA School. Why should it require experience to go to NP school? Are NPs so hard to train that they have to arrive to college "pre-trained"?

    On the other hand:

    My personal thought are that some people may do well wilth limited RN experience while others may make poor practicioners. 50% of doctors, nurse, and PAs graduated in the bottom half of thier class. I'd be for an RN experience rquirement with certification (ie, acute care NP program could require CEN) prior to acceptance into a NP program. It would just produce high quality, smart, learned people that take very good care of the patient. Money drives that education train, though so don't expect to see my version any time soon.
    Last edit by peddler on Sep 8, '07
  6. by   sirI
    why should it require experience...
    apn=advanced practice nursing

    rns advancing their practice of nursing. period. how can you advance something that does not exist?

    why should it require experience to go to np school?
    i'd be for an rn experience rquirement with certification prior to acceptance into a np program. it would just produce high quality, smart, learned people that take very good care of the patient.
    these quotes are in opposition to the other.


    (edited to add: my original post above was made prior to member editing for clarification)
    Last edit by sirI on Sep 8, '07
  7. by   peddler
    sirI,

    I thought it might be cumbersome to read intially, but opted to let go "as is". I edited it to show the opposing rationales as natural. Thanks.
  8. by   sirI
    Thank you, peddler. That does make more sense to compare/contrast opposing viewpoints as you have now edited.
  9. by   Bree124
    Quote from sirI
    APN=advanced practice nursing

    RNs advancing their practice of nursing. Period. How can you advance something that does not exist?
    Honestly, I hear this argument on this board frequently, and it doesn't make sense. It is inaccurate.

    An advanced degree in nursing does NOT require experience as an entry level nurse. The experience might be helpful, and for some people necessary - but it is not required legally or, for the majority of people who choose a direct-entry option, intellectually.

    An "advanced practice nurse" is, by definition, a nurse who holds either a master's or a doctorate. It is not, by definition, someone who has been a nurse for _ years and then got a masters or a doctorate. You are ADVANCING upon your education. You are an ADVANCED practice nurse because you are practicing in a role that is, by definition, advanced beyond the role of an RN.

    I have the utmost respect for people working in the nursing field, but the cynical attitudes and downright disrespect for people who are non-nursing DE MSN majors is frustrating. The reason we are able to complete these DE MSN programs in three years is that we possess these skills already in another field, and are able to translate that experience into nursing and adapt quickly.

    The fact is, these programs are here, and they aren't going anywhere. The nurses that graduate from these programs are prepared individuals who will, of course, still need on the job training. Just as an NP who was an RN will need. We are all united by the fact that we are nurses (or in the process of becoming nurses).
    Bree
    Last edit by sirI on Sep 18, '07 : Reason: TOS
  10. by   traumaRUs
    I respectfully disagree with you Bree - "As nurses move along the
    continuum of experience and education, they acquire additional
    competencies that are incorporated into their practice." This presumes a basic body of knowledge. While I do agree critical thinking skills are present in many professions nowadays, that is not the end-all of nursing practice.


    cna-nurses.ca/CNA/.../pdf/publications/ANP_National_Framework_e.pdf
  11. by   sirI
    an "advanced practice nurse" is, by definition, a nurse who holds either a master's or a doctorate.

    i respectfully disagree. the legal definition of an advanced practice nurse is:

    a registered professional nurse who holds a certificate or license of qualification from the board of nursing to function as a professional nurse in an expanded role; and this expanded role is defined by rules and regulations adopted by the state board of nursing.

    my bon definition:

    [color=#081c5a]what is an advanced practice nurse?

    an advanced practice nurse is a registered nurse (rn) who has completed a nurse practitioner educational program and holds national certification as a nurse practitioner from a board approved certifying body.
  12. by   sunnyjohn
    Quote from siri

    i respectfully disagree. the legal definition of an advanced practice nurse is:

    a registered professional nurse who holds a certificate or license of qualification from the board of nursing to function as a professional nurse in an expanded role; and this expanded role is defined by rules and regulations adopted by the state board of nursing.

    my bon definition:

    what is an advanced practice nurse?


    an advanced practice nurse is a registered nurse (rn) who has completed a nurse practitioner educational program and holds national certification as a nurse practitioner from a board approved certifying body.


    q?:

    wouldn't a graduate from a direct- entry program hold an rn license and the ability to obtain national certification for np practice?
    Last edit by sunnyjohn on Sep 18, '07 : Reason: spelling
  13. by   traumaRUs
    Sunnyjohn - that is correct. However, what Bree stated was:

    "An "advanced practice nurse" is, by definition, a nurse who holds either a master's or a doctorate. "

    This was w/o mention of licensure as RN and/or national certification. That is where the discussion centers.

close