Becoming an NP with little to no nursing experience?? - page 36

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   core0
    Quote from jjjoy
    snip

    I think in reality there is a disconnect between the training nursing schools offer to students and what level of competence employers expect from both RNs and advanced practice nurses. Many nursing schools encourage students to go straight through to becoming an NP, or perhaps just work part-time for a year, and that previous experience need not be directly related to the specialty one is preparing for. The big question is whether or not NP programs adequately prepare their students for their role as NPs or if they have them jump through some hoops, give them a license/certification, and then leave them to sink or swim professionally.
    I think that in a large sense the market place does this. I work in a large university system which has an MEPN program. However, those same NP students cannot get hired by the system since the system requires a minimum of 2 years full time work as an RN to be hired as an NP. "Traditional" NP students do get hired. Also I don't think that the MEPN students are allowed to do clinicals as NPs (at least at the mother ship). While the nursing faculty has one idea, the market has another.

    There has been anectdotal discussion here that many MEPN students end up working as RNs. Ultimately this probably effects long term prospects. If you have a choice between an NP that had RN experience then got their NP or one who got their NP and then worked as a nurse you have to consider how stale the advanced practice skills are. On the other hand we have also heard anectdotal discussion of MEPNs not having any problem finding APN jobs. YMMV.

    I think that as in many other issues (DNP) nursing academia is at odds with the nursing market. In the long run these things will probably sort themselves out.

    David Carpenter, PA-C
  2. by   ANPFNPGNP
    Generally speaking, one would assume that an advanced practice nurse has several years of experience working as a nurse. On the other hand, in the REAL world, I don't see my nursing background as being beneficial in preparing me for my primary care job. Although, depending on the specialty, I think it's beneficial to have nursing experience, i.e. ACNP with ICU background, Psych NP with psych background, NNP with neonatal background, etc.
  3. by   subee
    Quote from ANPFNPGNP
    Generally speaking, one would assume that an advanced practice nurse has several years of experience working as a nurse. On the other hand, in the REAL world, I don't see my nursing background as being beneficial in preparing me for my primary care job. Although, depending on the specialty, I think it's beneficial to have nursing experience, i.e. ACNP with ICU background, Psych NP with psych background, NNP with neonatal background, etc.
    You don't "see" it because your skills have become innate and its impossible to remember what it was like when you were a newbie. You can recall the emotion but you can't recall the "facts" that you didn't have at your disposal. If you never were a nurse, how can you know if a few years of experience was worth it - you can't "know" what you don't know.
  4. by   patrick1rn
    I have always been opposed to Direct Entry NP programs.
    You get to see a disease process face to face as a RN, which is just as good as doing clinical hours. I would not be opposed to direct entry NP programs if the person worked as a military medic, Paramedic, or some other direct care profession.
    I guess the NP students who are in the direct entry programs are motivated, which is good, but they miss out of seeing and learning while working as a RN or as a army medic etc...
  5. by   jjjoy
    Perhaps part of the experience disconnect is particularly problematic in regard to NPs going into well-patient primary care - as opposed predominantly geriatric or chronic care where inpatient experience with common conditions would still be of use. Inpatient RN experience clearly is a benefit for acute care NP roles. Since medical assistants dominate as assistive personnel in primary care offices, very few licensed nurses will have *directly* relevant experience related to well-patient primary care. I'd imagine ED experience would be of most direct relevance for a nursing planning to become a primary care NP.
  6. by   psychonaut
    Quote from jjjoy
    Perhaps part of the experience disconnect is particularly problematic in regard to NPs going into well-patient primary care - as opposed predominantly geriatric or chronic care where inpatient experience with common conditions would still be of use. Inpatient RN experience clearly is a benefit for acute care NP roles. Since medical assistants dominate as assistive personnel in primary care offices, very few licensed nurses will have *directly* relevant experience related to well-patient primary care. I'd imagine ED experience would be of most direct relevance for a nursing planning to become a primary care NP.
    I find it ironic that I feel much more comfortable going into NP education with little nursing experience (just over one year), versus how I would feel if I was going for CNS or nursing ed. I would feel absolutely out of place as a CNS, the best ones I've known (and I have great love for the CNSs out there) have had many, many years of "front line" RN experience under their belt.

    Similar for the nursing instructors. I would feel silly trying to teach a clinical group with my limited RN experience. Students in that position need an instructor who knows what they are doing, and has "seen it all" as an RN.

    Contrast this to the NP. As you note, it is such a radically different role from the RN. And while I certainly would never be dismissive of a very experienced RN, and I'm sure it could be an advantage, the research does show that the role transition can potentially be more difficult for an experienced RN moving into the new role of provider. I figure I'm going to be unsure of myself enough going into it, and will be able to take it in as a completely new experience (though I will draw on what little nursing knowledge I have accumulated).
  7. by   zenman
    Quote from psychonaut
    Contrast this to the NP. As you note, it is such a radically different role from the RN. And while I certainly would never be dismissive of a very experienced RN, and I'm sure it could be an advantage, the research does show that the role transition can potentially be more difficult for an experienced RN moving into the new role of provider.
    I think Siri and others have mentioned many times the actual experience of preceptors with NP students who have no experience working as a nurse so I won't belabor that. I think I posted waaaaay back in this thread about the many benefits that an experienced nurse brings to NP education. I start wondering why people have difficulty seeing it. As for role transition, I don't think I'll personally have one whit of a problem. Experience is a great benefit...just sit back for a minute and imagine what I've seen in 35 plus years. Even my experience at other types of education have enabled me to transition into NP education. So far, I've turned in assignments one month ahead of schedule and I've missed one half a point. How the heck do you miss half a point, lol!
  8. by   psychonaut
    Quote from zenman
    I think Siri and others have mentioned many times the actual experience of preceptors with NP students who have no experience working as a nurse so I won't belabor that. I think I posted waaaaay back in this thread about the many benefits that an experienced nurse brings to NP education. I start wondering why people have difficulty seeing it. As for role transition, I don't think I'll personally have one whit of a problem. Experience is a great benefit...just sit back for a minute and imagine what I've seen in 35 plus years. Even my experience at other types of education have enabled me to transition into NP education. So far, I've turned in assignments one month ahead of schedule and I've missed one half a point. How the heck do you miss half a point, lol!
    To be sure, I in no way mean to devalue previous RN experience. My point is simply that of all the APN roles (NP, CNS, CRNA, CNM, education), I think the easiest to transition into with a minimum of RN experience would be the NP.

    As for imagining what you've seen...zenman, I've been reading your posts here and at SDN for many years now, and I think I'd be a bit frightened to imagine what you've seen over the years...your quantum physics is more than I could handle, I'm a simple Newtonian boy at heart

    Now, your point about previous educational experience is dead on. I have way too many years of college classes under my belt, and find the academic portion of things pretty manageable (and enjoyable, but that's why I have taken all of those classes in the first place). I'm also right with you in having a great appreciation for distance ed in didactic courses.
  9. by   zenman
    Quote from psychonaut
    ...I think I'd be a bit frightened to imagine what you've seen over the years...your quantum physics is more than I could handle, I'm a simple Newtonian boy at heart
    ROFLMAO...guess you don't want to hear about the house clearing last week...
  10. by   ANPFNPGNP
    Quote from zenman
    I think Siri and others have mentioned many times the actual experience of preceptors with NP students who have no experience working as a nurse so I won't belabor that. I think I posted waaaaay back in this thread about the many benefits that an experienced nurse brings to NP education. I start wondering why people have difficulty seeing it. As for role transition, I don't think I'll personally have one whit of a problem. Experience is a great benefit...just sit back for a minute and imagine what I've seen in 35 plus years. Even my experience at other types of education have enabled me to transition into NP education. So far, I've turned in assignments one month ahead of schedule and I've missed one half a point. How the heck do you miss half a point, lol!
    I've precepted several NP students and all of them have RN experience. The ones who had the most difficulty were the RN's with extensive ICU experience. Primary care is an entirely different game and those students were very much out of their element. Of course, the ones I've precepted are also attending an online program, so they're just thrown out there with limited assessment skills.

    Also, I hate to point this out, because I've always been an advocate for previous RN experience. But, I've read a couple of studies and they show that NP competency isn't related to RN experience. In fact, MD's prefer NP's who weren't nurses before becoming NP's. However, I agree with a previous poster who stated that ER experience can be of help in primary care.
  11. by   zenman
    Quote from ANPFNPGNP
    I've precepted several NP students and all of them have RN experience. The ones who had the most difficulty were the RN's with extensive ICU experience. Primary care is an entirely different game and those students were very much out of their element. Of course, the ones I've precepted are also attending an online program, so they're just thrown out there with limited assessment skills.
    Yes, primary care is very different from ICU nursing, but even a nurse with ICU experience should bring more to the table than a nurse with no experience. I've seen ICU nurses who were pulled to a med-surg floor almost come unglued but I'd rather have one of them than someone with no experience!

    And are you saying that all online programs throw their grads out with limited assessment skills?

    Also, I hate to point this out, because I've always been an advocate for previous RN experience. But, I've read a couple of studies and they show that NP competency isn't related to RN experience. In fact, MD's prefer NP's who weren't nurses before becoming NP's. However, I agree with a previous poster who stated that ER experience can be of help in primary care.
    How was this "competency" measured? I've heard just the opposite; MD's want prior experience as nurses...and most NP jobs I've seen prefer 2-3 yrs of NP experience.
  12. by   Astock
    I will be gradating with my BSN in nursing this may. I will getting married, and moving to Charlotte, NC afterwards. I have been speaking to the NP Director at my school about my desire to go FNP with another year of psy. training. I want to be able to treat the entire person and not just focus on the body or the mind. She stated after nursing school it is best to work 2-3 years in general-med surg before applying for NP school in Charlotte. She stated yes, you can go NP school directly after nursing school, but many places will not want to hire you because of a lack of experience. During this time I will be paying off school loans.
    I have been trying to find advice on how to prepare for FNP school. I'm currently working at a hosptial on a Cardiac/Telemetry floor. I love Psych. but I don't think I will get enough gen-med experience working there. I was also wondering about working on a pedi floor. In december I will be applying for jobs, and I would like to get on the best floor for me in the big picture.
    What type of floors would you recommanded me working on? Any advice/words of wisdom you have for me?
  13. by   KatieRN04
    Med-surg will give you a good foundation, but there are people in my program that have nver even worked with adults, just peds. And the FNP focuses on adults and peds and geriatrics, so I think you just need to get at least 2-3 years experience first to get a good foundation.

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