Becoming an NP with little to no nursing experience?? - page 30

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   jjjoy
    Quote from core0
    Now I have argued that not all experience is similar or even relevant, but you bring up a deeper issue here which I believe has also been stated before. If nursing experience in not needed for nurse practitioners then logically why is nursing needed for nurse practitioners.
    This seems odd to me as well. Nursing school and it's pre-reqs covers some anatomy and physiology. Nursing courses in med-surg, geriatrics, etc give snapshots of s/s, pathophys, txts and prognosis. But much of nursing school is about nursing... the specific roles and tasks of the nurse in different clinical settings. And the nursing role is different than diagnosing and prescribing. So someone fresh out of nursing school still isn't going to have much depth of understanding of pathophys, txts etc (though there are probably a few shinging stars who have the exceptional previous life experience and advanced coursework, the average new grad nurse does not).

    As has been noted, if experience as a nursing in a specialty area isn't required for entry to a NP program such that the incoming NP student already knows the critical labs, s/s, pathophys, meds off hand, then that would seem to mean that the NP program is comprehensive in and of itself. Which leads to the question of why nursing is needed for DE nurse practitioners. In other words, how much does the RN portion of the training contribute to the preparation of the direct-entry NP?
  2. by   amzyRN
    Quote from jjjoy
    This seems odd to me as well. Nursing school and it's pre-reqs covers some anatomy and physiology. Nursing courses in med-surg, geriatrics, etc give snapshots of s/s, pathophys, txts and prognosis. But much of nursing school is about nursing... the specific roles and tasks of the nurse in different clinical settings. And the nursing role is different than diagnosing and prescribing. So someone fresh out of nursing school still isn't going to have much depth of understanding of pathophys, txts etc (though there are probably a few shinging stars who have the exceptional previous life experience and advanced coursework, the average new grad nurse does not).

    As has been noted, if experience as a nursing in a specialty area isn't required for entry to a NP program such that the incoming NP student already knows the critical labs, s/s, pathophys, meds off hand, then that would seem to mean that the NP program is comprehensive in and of itself. Which leads to the question of why nursing is needed for DE nurse practitioners. In other words, how much does the RN portion of the training contribute to the preparation of the direct-entry NP?
    From what I learned of basic nursing so far (I'm doing a second degree accelerated BSN), the RN's (basic assessment) is to tell the difference between normal and abnormal. (the medical component) It's an introduction to a general diagnostic physical exam that a more advanced practitioner would perform with more skill and knowledge of medical science, etc. It's still an intro and makes further study easier, just being introduced to the terminology and such. The other part, the "nursing process" is conceptual framework to do a broad range of things for patients are not purely curative. In short, I do find that this is somewhat relevant to what is learned at a more advanced level. It's an introduction and a process of familiarizing and getting acquainted with the western health care system. It may help someone find out what they want to do w/in that system and what they may want to specialize in and if they want a further study in nursing or the medical model to treat illness. I'm hoping that RN experience is relevant to more advanced study b/c that's the route I've chosen, so maybe I'm a little biased.

    It seems to me that critical care experience in particular may be usefull for later practice. But I'll have a more informed opinion later on. Thanks for your post,
    J
  3. by   patrick1rn
    Quote from jzzy88
    From what I learned of basic nursing so far (I'm doing a second degree accelerated BSN), the RN's (basic assessment) is to tell the difference between normal and abnormal. (the medical component) It's an introduction to a general diagnostic physical exam that a more advanced practitioner would perform with more skill and knowledge of medical science, etc. It's still an intro and makes further study easier, just being introduced to the terminology and such. The other part, the "nursing process" is conceptual framework to do a broad range of things for patients are not purely curative. In short, I do find that this is somewhat relevant to what is learned at a more advanced level. It's an introduction and a process of familiarizing and getting acquainted with the western health care system. It may help someone find out what they want to do w/in that system and what they may want to specialize in and if they want a further study in nursing or the medical model to treat illness. I'm hoping that RN experience is relevant to more advanced study b/c that's the route I've chosen, so maybe I'm a little biased.

    It seems to me that critical care experience in particular may be usefull for later practice. But I'll have a more informed opinion later on. Thanks for your post,
    J
    Good, if you want to be a nurse practitioner, you need experience as a RN, people are crazy if they think otherwise. I dont know what they are thinking.
  4. by   PMFB-RN
    Quote from patrick1rn
    Good, if you want to be a nurse practitioner, you need experience as a RN, people are crazy if they think otherwise. I dont know what they are thinking.
    *** Why not then for PAs who do much the same job, and often exactly the same job?
  5. by   amzyRN
    Quote from PMFB-RN
    *** Why not then for PAs who do much the same job, and often exactly the same job?
    Maybe b/c NPs technically practice nursing which is supposedly broader than medicine, where PAs practice medicine per se, so they would require less training. Also, PAs do more clinical hours and many have medical experience. In fact RNs sometimes go into PA school rather than going on to get a masters in nursing. Also, PA training is more "science based" like med school, so that's supposed to trump everything else possibly. BTW, I'm not arguing that RN exp is required, but just listing possible reasons why people may think NPs need exp as RNs. My opinion is that prior med experience can only help future practice. I am finding that in my program (2nd degree accelerated BSN) the assessment part of the training sets the stage for more advanced skills, since that is part of medical diagnosis for the advanced practitioner. I don't know yet if actual exp is required for me, I guess I'll have to wait and see. I would guess that the experienced RN has a broader knowledge base of pharmacology and pathophysiology, etc. just from being exposed to more of that at work, than someone who was completely new to the medical field. I don't think that RN experience is necessary though to be a good NP, just that it is probably helpful.
    J
  6. by   jjjoy
    Quote from PMFB-RN
    *** Why not then for PAs who do much the same job, and often exactly the same job?
    If you're asking this, I have to wonder if you've taken the time to read this entire thread as this is the main topic of the thread.

    The reasoning as I understand it is that in the past most NP program were geared to educate nurses who already had plenty of experience in their chosen field of advanced nursing practice. That is, they had already had ample opportunity to hone their assessment skills and that for their specialty area they already knew the expected treatments, complications, etc. And then NP school only would need to quickly cover such topics, just filling in any gaps in an individuals' knowledge. The main focus, then, of NP training would be learning the new role of diagnostician and treatment-prescriber. I don't know if that's actually how such programs have worked.

    When I looked in to PA programs some years back, some kind of health related experience was recommended but wasn't required. The material I reviewed made it sound as if PA programs were complete unto themselves in preparing the students for clinical practice... unlike NP programs which mostly have required previous RN training at the least, and usually at least some experience as a practicing RN.

    Of couse, it seems that many NP programs these days also don't require previous clinical experience outside of school for acceptance to a program - direct entry programs certainly don't. Hopefully, direct entry programs adequately address the different issues between training clinically experienced RNs for an NP role and training up NPs who don't have a lot of clinical experience. If the programs do this well, then, I'd agree that there's no need for nursing experience.

    My own experience with nursing school at the RN level was that we were underprepared for the "real world" and had no real clinical judgement skills upon graduation. We'd be introduced to nursing skills and knew the "how" and the "what" but had very little opportunity to see and do and apply skills in the clinical arena as students. Mostly, we wrote care detailed care plans and scrambled for the few opportunities to check off our skills list for graduation. I certainly hope NP programs instill more experience in students before turning them loose with their own licenses.
  7. by   shah
    Go for it, and don't listen to the nay sayers!
    As a paramedic, you have just the right kind of experience for the NP role. That of taking independent decisions. Nurses on the other hand, still take orders on the floor and 'fetch' most of the time, in spite of their more in depth preparation.
    Your ACLS training and experience is better than of nurses.
    The direct programs will first make you a nurse. You will sit for the NCLEX.
    Then they will not let you take any clinical courses till you have completed about a 1000 hours of clinical experience as an RN.
    For God's sake do not go for Excelsior as they are not recognized in CA or IL.
  8. by   zenman
    Quote from shah
    Go for it, and don't listen to the nay sayers!
    As a paramedic, you have just the right kind of experience for the NP role. That of taking independent decisions. Nurses on the other hand, still take orders on the floor and 'fetch' most of the time, in spite of their more in depth preparation.
    Your ACLS training and experience is better than of nurses.
    The direct programs will first make you a nurse. You will sit for the NCLEX.
    Then they will not let you take any clinical courses till you have completed about a 1000 hours of clinical experience as an RN.
    For God's sake do not go for Excelsior as they are not recognized in CA or IL.
    You make a lot of blanket statements that are not correct. I'm sure someone will point them out to you, lol.

    ....Ex ARMY medic and Helicopter Flight Nurse and Excelsior grad.
  9. by   Michigan Man 09
    In a BSN program right now and am contemplating how I want to go about obtaining an Advance Practice degree, likely in Cardiology or Cardiovascular services. I will be graduating in May 2009, and my goal is to work full time and apply and earn acceptance into a program part time. How long do most nurse practitioner program's take to complete? I have heard full time programs are about 2.5 years and part time varies.

    If I work full time as a nurse for the 3-5 years of a part-time NP program, would that serve as an adequate clinical base? Would I have 'enough experience' to function in the NP role.
    Currently, I've been a nurse aide for two years and a nurse tech for six months (which I will continue to work as through graduation).

    Your thoughts? Advice? Things I 'should do'/'should know'? I plan on shadowing some NP's this summer to really see what the role entails outside of my own observations thus far.

    -Thanks

    Michigan Man 09
  10. by   sirI
    Sounds as if you have the right idea, Michigan Man. Shadowing is a wonderful idea. Gives you some perspective.

    And, gaining that vital RN experience as you've described (working as you pursue your NP part-time) is an excellent plan. I think you will do well........
  11. by   yellow finch
    Quote from Michigan Man 09
    In a BSN program right now and am contemplating how I want to go about obtaining an Advance Practice degree, likely in Cardiology or Cardiovascular services. I will be graduating in May 2009, and my goal is to work full time and apply and earn acceptance into a program part time. How long do most nurse practitioner program's take to complete? I have heard full time programs are about 2.5 years and part time varies.

    If I work full time as a nurse for the 3-5 years of a part-time NP program, would that serve as an adequate clinical base? Would I have 'enough experience' to function in the NP role.
    Currently, I've been a nurse aide for two years and a nurse tech for six months (which I will continue to work as through graduation).

    Your thoughts? Advice? Things I 'should do'/'should know'? I plan on shadowing some NP's this summer to really see what the role entails outside of my own observations thus far.

    -Thanks

    Michigan Man 09
    It looks like you're already on the right path! Having worked at the bedside during nursing school gives you the experience and advantage over those new grads that did not complete the work you've done. I also worked as a tech during nursing school and always remember that first day of nursing clinicals where we had to transfer a patient from a stretcher to the bed. Two other nursing students just flattened their bodies up against the wall while I jumped in and helped out. You learn little things like throwing a little baby powder on a bedpan to prevent the patient's butt from sticking to it. Real world stuff that you don't learn in nursing school.

    As for NP school, my program (FNP) would have been 2 years full-time, but I broke it down into 3 years because the clinicals portion made it too difficult to work full-time and attend full-time courses. Once again, working at the bedside provides you ample opportunities to learn and apply your graduate knowledge and will honestly give you that advantage over NPs who have never touched a patient outside of clinicals. Plus, I've met some future clinical preceptors just by being a good RN and earning the respect from MDs and mid-level providers in order to gain their confidence that my presence won't mess up their day just by having a student.

    Best of luck to you! You already sound like someone who knows the right path for future success!

  12. by   juan de la cruz
    Quote from Michigan Man 09
    In a BSN program right now and am contemplating how I want to go about obtaining an Advance Practice degree, likely in Cardiology or Cardiovascular services. I will be graduating in May 2009, and my goal is to work full time and apply and earn acceptance into a program part time. How long do most nurse practitioner program's take to complete? I have heard full time programs are about 2.5 years and part time varies.

    If I work full time as a nurse for the 3-5 years of a part-time NP program, would that serve as an adequate clinical base? Would I have 'enough experience' to function in the NP role.
    Currently, I've been a nurse aide for two years and a nurse tech for six months (which I will continue to work as through graduation).

    Your thoughts? Advice? Things I 'should do'/'should know'? I plan on shadowing some NP's this summer to really see what the role entails outside of my own observations thus far.

    -Thanks

    Michigan Man 09
    Hi there fellow Michigander! full time NP programs can be finished in as fast as 18 months in some instances. It depends on how much of a courseload you are will to take on. Part-time NP programs can be finished at our own pace. Some universities however, require that you obtain the degree in 6 years or you're out.

    A graduate school advisor will help map out your timeline for NP program completion once you get accepted to a specific program. You can discuss your plans with this person and arrive at when you want to finish.

    Working as an RN while in NP school will give you an advantage over those who do not have any nursing experience to bring to the table. It also allows you to figure out which area in nursing is most applealing to you and will help you in deciding what specialization you want for your NP.

    Some programs allow you to take non-clinical courses (nursing theory and research) as well as pre-clinical courses (advanced assessment, pharm, patho) and will allow students to change tracks (ANP to ACNP for instance) after you've taken these initial courses. Some do not allow this.

    Ann Arbor eh, U of M student?
  13. by   Michigan Man 09
    Quote from pinoyNP
    Hi there fellow Michigander! full time NP programs can be finished in as fast as 18 months in some instances. It depends on how much of a courseload you are will to take on. Part-time NP programs can be finished at our own pace. Some universities however, require that you obtain the degree in 6 years or you're out.

    A graduate school advisor will help map out your timeline for NP program completion once you get accepted to a specific program. You can discuss your plans with this person and arrive at when you want to finish.

    Working as an RN while in NP school will give you an advantage over those who do not have any nursing experience to bring to the table. It also allows you to figure out which area in nursing is most applealing to you and will help you in deciding what specialization you want for your NP.

    Some programs allow you to take non-clinical courses (nursing theory and research) as well as pre-clinical courses (advanced assessment, pharm, patho) and will allow students to change tracks (ANP to ACNP for instance) after you've taken these initial courses. Some do not allow this.

    Ann Arbor eh, U of M student?
    Yes, I am in my junior year of the traditional BSN program at U-M. This is good to know, thank you for the advice! Once I get to the summer, I will be investigating (when I finally have some time) what programs, areas, requirements, time, prices, etc. are available in Metro Detroit area for an NP degree.

    Michigan Man 09

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