Becoming an NP with little to no nursing experience?? - page 38

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   DeadHead219
    I am just starting NS in May, and looking towards the future to continue with my education in become a NP. I was thinking that it would be wise to have experience first before entering school, but then also see the other side where being in the swing of school work would be quite helpful. Can any of you experienced RNs/NPs advise me in the right direction? Thanks so much for any input you can give!
  2. by   traumaRUs
    There are several threads - including a sticky at the top of this forum where there has been extensive discussion on this subject.

    Personally, I think you need a few years to be able to choose the right APN track that will fit what you want to do. Right out of nursing school w/o nursing exp it might be difficult to make a decision that you won't regret.

    However, that is only one opinion. Its kinda slow this weekend so hang in there and there will be other posters coming along. Good luck and congrats on starting NS.
  3. by   DeadHead219
    Thanks so much! I didn't even see the sticky on the top, and I read through the first 3 pages! I'll be reading that's for sure! Thanks for the advice, I appreciate it.
  4. by   jpRN84
    I've been an RN now for 3 years, working mostly in psych/chemical dependency. I'm glad I waited a little while before deciding to go back for my masters in nursing. I'm going to pursue an RN-BSN program first, then go right for MSN program in Psych, probably as a Clinical Nurse Specialist, as I dont really want the prescriptive authority, although at sometimes going the PMHNP route seems appealing...even 3 years later I'm still undecided which path to take for my MSN in Pysch...either CNS or NP. In my state, PA, CNS's don't have prescriptive authority, but NP's do, so I'm still debating which path to take. Good Luck to you, the options are endless. Be sure to research what you want to do thoroughly. Good Luck! :-)
    Last edit by jpRN84 on May 4, '09 : Reason: typo
  5. by   sirI
    Threads merged to maintain continuity.
  6. by   Dr. Tammy, FNP/GNP-C
    Quote from Blurr156
    What I think might be an even better option (cost wise that is...) is getting my Assoc. in Nursing through Excelsior's online program. It seems to be very convenient for those who work. Once I have that I can start working as a nurse and then apply for a master's program. Hmmm, sounds like a plan. Thanks for your help.
    I know someone who did that.
  7. by   shortlittleRN
    Quote from christvs
    I am a new NP (graduated from my acute care NP program in June). I am working in Hospital medicine. I like it so far, although since I just started everything is so new and a bit scary still. lol I enjoy working in the hospital setting, and before I graduated as an NP I worked in med/surg/tele as an RN for 3 years. I do feel those 3 years gave me a good background for what to expect to be the patient care issues for my current job. Once you are in your program and start clinicals, I bet you will have a better sense of what you like.
    Thanks for your input. I'm getting ready to start my clinical portion of my ACNP program in fall of this year and am very nervous since my RN experience is mainly in oncology since I graduated in Dec 07. I had 4 months in ICU then switched over to oncology. My NP director states I do not need ICU experience to be specialized in acute care, but I'm nervous nonetheless. Was your program difficult?
  8. by   hktoddRN
    I've been a nurse for 8 yrs and am currently in a Masters FNP program. Although, I applaud you for desiring to join the field of nursing and for your wonderful experience in emergency medicine, I believe that you need some experience as a nurse before becoming a NP. Although, many people think so...NP's are not the same as PA's nor are we "mini-doctors". We are nurses, with advanced training and skills. To be a good NP and truly understand the NP philosophy you have to first understand nursing philosophy...it is very different than EMT, PA, or physician philosophy. That takes experience as an RN. If you don't want to be a nurse...you may need to consider PA. Although, I will be an NP, I am first and foremost a nurse.
  9. by   magnolia nurse
    I would not have the confidence to move in the NP role and I did not have the experience of an NP, even though the school says you graduated.. you are putting your patients and your integrity as risk...
  10. by   mom and nurse
    Wow - this thread is still going strong.. I posted a little over a year ago when I was in school to be an NP and have now been an NP for over a year.

    I worked as an RN one year before heading part time to school to be an ANP. By the time I graduated I had been an RN in a hospital (full, part time, and PRN for 3 and 1/2 years). (my work hours increased as the work load and clinicals increased).

    I would not recommend to anyone to go straight through school to be an NP. Though it is definitely possible.



    #1. My relationship with the RNs I work with at the hospital is closer than it would have been had I never worked at the bedside, inserting the foleys, passing the medication, running room to room, cleaning the poop, pee, etc. transferring the patients from bed to wheelchair, wheelchair to bed, dealing with patient and family member complaints..

    I feel I can understand what they are going through and have a good relationship with the RNs I work with.

    2. I knew all those labs and medications from working as an RN and this helped me as an NP (I am in a hospital). I knew when the sodium was low that the patient would often be put on a fluid restriction, I knew that the INR goal for treatment with Coumadin was usually between 2 - 3. I knew that when the potassium was elevated that there was Kayexalate to be given. I knew that Ciprofloxacin could cause the INR to become elevated when the patient was on Coumadin. etc. etc. Not sure about all NP programs but when I started mine the teachers assumed you already knew these things. Many more things would have been "Greek" to me had I not worked as an RN (however little it was) before I started the NP program.


    Looking back over this first year as an NP. I'm glad I had that RN experience before I began practicing as an NP.

    That being said...I enjoy being an NP and am very happy I returned to school.

  11. by   jjjoy
    Quote from mom and nurse
    2. I knew all those labs and medications from working as an RN and this helped me as an NP (I am in a hospital). I knew when the sodium was low that the patient would often be put on a fluid restriction, I knew that the INR goal for treatment with Coumadin was usually between 2 - 3. I knew that when the potassium was elevated that there was Kayexalate to be given. I knew that Ciprofloxacin could cause the INR to become elevated when the patient was on Coumadin. etc. etc. Not sure about all NP programs but when I started mine the teachers assumed you already knew these things. Many more things would have been "Greek" to me had I not worked as an RN (however little it was) before I started the NP program.
    Let me also point out that when you say "know" you probably mean more than just having studied it before and being able to comprehend the rationales for treatments. It takes repeated experience to not just "know" that info, but to have it be an automatic association that you quickly integrate with other incoming information (not having think about it awhile before it comes back to you, or go look it up to confirm a fuzzy memory, or having little background with which to automatically be aware of relevant variables such a certain comorbidities, lab results etc).

    I can't say anything about how NP programs work, but I do know that my entry-level nursing education didn't get me anywhere close to having that level of experience and tip-of-my-tongue knowledge. My RN/BSN program did cover such info as you noted above but so much info was dumped on us in such a short time and covered in a rather cursory manner that there was no way that we had mastery of the info. I can only imagine how steep the NP learning curve would be without having a higher level of automatic, integrated knowledge reinforced by experience.

    And IF that nursing experience ISN'T a key foundation to being an NP, then that opens a whole other can of worms in regard to keeping straight what it is that makes a nurse a "nurse" and not a different sort of health care provider.
    Last edit by jjjoy on Jul 17, '09
  12. by   traumamike
    My dad is a cardiothoracic surgeon, and he has 5 np's working for him.. I have asked him about this very topic, and he said he would rather hire a person with little or no nursing experience. His rationale is that he is training them to act and react like physicians, not like nurses. The jobs they do are to diagnose, nurses in the units don't do this, sure auscultation is a big thing and pt history is also, but the main thing for him is he can get them before they develope habits that they can't break... The rest of it is treating the patient,diagnosing, and prescribing meds. R.N.'s take care of the patients in a different way, according to him.. That is his practice's preference. After all the NP's and PA's are filling the roll of doctor now, so they must be able to perform like one, and not so much as a nurse in the way they think and approach a plan of care for the patient. His words not mine! I do see where he is coming from though, i have a friend of mine who went into a direct entry program. She came out and went to work for one of our groups in the trauma center where i work and she is wonderful, well respected and the 1st and 2nd year residents ask her what is the best way to do a certain procedure or whatnot... She isn't in the minority either, there are plenty of NP's i know that went the same route and are great practitioners...I don't know why so many people have this negative attitude towards those who do the direct entry way, but the ones I have seen are great. I guess basically what my dad was saying is true afterall, it is a different mode of thinking than what we nurses do on a daily basis; Both equally important, but just different.
  13. by   jjjoy
    If RN experience is more of a hindrance than a help to certain areas of NP practice, then I have to ask why RN training and licensure is part of NP training; maybe it's time better spent training as an NP. If "lower" level nursing practice doesn't contribute to "advanced" practice, then can it really be call "advanced"? Or is it something else entirely? Can NP practice that is hindered by prior nursing experience be considered "nursing practice" at all? In such cases, is the term "nurse practitioner" a misnomer since nursing doesn't seem to factor into their work at all?

    I personally tend to see many forms of NP practice that *don't* seem include much, if any, "nursing" and then the current system of training up NPs doesn't seem to address the realities of student learning needs. With the big pool of applicants prestigious grad schools have to choose from, they can pick students likely to succeed regardless of how thorough or lackluster their training program is. And now that the NPs are much more commonplace & well-known, more non-nurses who otherwise are not interested in nursing ARE interested in pursuing becoming NPs. To such students, I imagine that the "foundational" RN training and licensure doesn't seem very relevant and is more or less just a necessary hoop to jump through to be able to access the "fast-track" "less science pre-reqs" entry into medical provider practice (ie, faster for many than getting into and completing PA training and much faster for most than becoming an MD; and as PA programs also become more popular, the requirements are quickly coming to mimic those for med school which means more math and science than most nursing programs currently require).

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