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.

Specializes in trauma,cvicu,micu.

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.

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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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Sorry to just jump in the middle of all this, but I (like so many others) have been considering nursing as a second career, with my ultimate goal being to become Women's Health Nurse Practitioner. I've read through several pages of this thread and there are some good insights, however, I still have some questions.

My Bachelor's is in Secondary English Ed, so it's quite different from Nursing. I've been trying to decide which avenue would be better for pursing a career as a WHNP:

1 - Getting an Associate's in Nursing, practicing as an RN for a year or so, and then going back to school (while working) to get my Master's.

2 - Going straight into a direct entry program and working as an RN while I complete the Master's portion.

Would there really be any difference between the two options? With either one, I would be getting a little bit of experience as an RN, but I'm not sure which program would give me a better background to support my career goals. I don't know any nurses personally, so trying to figure all of this out is a little stressful.

Thanks!

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I'm with traumamike on this...I live in a town that is in Nashville's back yard. School of Nursing cranks out NPs through the bridge program and you don't need ANY nursing experience to enter! All you need is a bachelor's degree in SOMETHING...ANYTHING...and they bridge you in. You become a RN in one year and your next two years are spent becoming a NP. The program is renowned and the grads are very well received in our community. RN and NP are such different roles in healthcare that many physicians seem to like new grads, as traumamike explained. I'm a RN with no experience working toward FNP...in some instances it is all about who you know. I have many friends in many different areas of nursing and medicine. I hope and believe you can sell yourself and your willingness to learn in nursing, as in any career! Good luck!

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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.

I will have to admit, I've seen plenty of direct entry graduates PERFORM BETTER as a NP than the ones with 20 plus years of RN experience. I TOTALLY AGREE WITH YOUR DAD ON THIS ONE! My role as a NP couldn't be more different from my role as a RN. First off, as a RN, I worked in a hospital. Now, I'm primarily working in internal medicine and urgent/ER care.

About the only advantage my RN experience gave me in NP school was in pharmacology b/c I already knew the medications, dosages, side effects, etc. As far as everything else - NADA! HOWEVER, if I had been in an Acute Care NP program, then my RN experience would have paid off - absolutely! Not in primary care though!

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About the only advantage my RN experience gave me in NP school was in pharmacology b/c I already knew the medications, dosages, side effects, etc. As far as everything else - NADA! HOWEVER, if I had been in an Acute Care NP program, then my RN experience would have paid off - absolutely! Not in primary care though!

In that case, do PNPs *need* that foundational RN training? Why not simply license PNPs directly through a 3 year program that grants it's own PNP licensure that is completely different from RN licensure? Isn't that what some of these direct-entry fast-track 1 yr RN training + 2 yr PNP training are essentially doing? Cram the RN portion into a really short time period in order to be able to grant them the RN license so that they can get on with the *real* training.

I realize that these programs recommend working part-time as a new grad RN while completing their NP studies (assuming one can land a part-time job as a new grad RN). However, during much of that two years, the NP student may have only worked half as many hours as a full-time nurse AND during that time was likely spending a lot more time with their NP studies than on honing their RN practice. Why take up spots in a RN schools for student who never plan to practice as RNs? Why take up a new grad RN slot and have a hospital invest in training up a new bedside nurse when that nurse has concrete plans to leave the bedside in two years?

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Why take up spots in a RN schools for student who never plan to practice as RNs? Why take up a new grad RN slot and have a hospital invest in training up a new bedside nurse when that nurse has concrete plans to leave the bedside in two years?

Um, many would argue that NPs and other advanced practice nurses (I'm a CNS, myself) do "practice as RNs." Also, LOTS of RNs move into roles other than bedside nursing (other than advanced practice) at some point in their career, quickly or later on. Is there something wrong with that? Those roles/positions are out there, provide valuable services to clients, and need to be filled. Are you suggesting that only bedside nursing is "real" nursing??

For many of us, a large part of the appeal of nursing in the first place is the incredibly wide range of possibilities within nursing.

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The thing about this debate that gets me is this...why are we as a profession so divisive about our own? The title RN carries much prestige in our society and has an incredible reputation...we all agree that this role is indispensible and held in high regard. So is that of the NP. As many NPs that are trained in this manner...something is working because from what i've read the role of the NP is developing the same great reputation! As a RN in a teaching hospital I had NP students in this 3 year program, 1+2yrs, follow me. They could not perform my duties and lacked my assessment skills and training. However, as we all know the education that supports these skills is a huge foundation (ADN vs BSN). They were being trained for a different role and will attain those skills needed in their specific role as they proceed. I say more power to them and let us support this, as it is a system that is working. They are not watering down the profession of "nursing". Every single patient i've ever talked to, has told me they prefer their NP over their doctor because "nurses listen". The NPs I know who have went through this type of training do indeed grasp the concepts of nursing and are patient care focused providers. We are so desperate for nurses...in our community we will take all the help we can get. I say let's push on and support these programs. As long as we are providing quality care and fostering the fundamentals of nursing as a profession...I say rock on!

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It's not that I think bedside nursing is the only "real" nursing. I specifically referred to PNPs in my post as CNS does seem to build upon foundational nursing practice. However, many NP roles (not all) are essentially identical to PA roles and *primarily* focus on diagnosing and medical treatment. I agree with many that a nurse will bring something special to that type of mid-level role. But the concern here was when nursing experience is actually a *hindrance* to NP practice.

As opposed to thinking that bedside nursing is the only "real" nursing, instead, I think that nursing is too broad to fall under one broad foundational curriculum & licensure. Basic nursing school does primarily focus on acute care nursing and other specialties get a few minutes or weeks of attention along the way.

Imagine if all teachers, not matter what kind of teaching they are planning on doing, even teaching as a college professor, had to do several rotations through the different levels of elementary ed and then had one experience each with pre-school, high school, adult ed, & phys ed. Teachers, then, could theoretically decide to switch to just about any other area of teaching as long as a facility was willing to take a risk on them and let them learn on the job. Certain specific specialties (maybe such as coaching & music instruction) would require another couple of years on top of the basic elementary-school-heavy teaching curriculum since it's quite different from most other kinds of teaching. Isn't that similar to what today's nursing education and licensure looks like?

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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.

Hmmm most doctors (at least in my area) don't want to take the time to do much more training.... But it must be something about cardiothoracic surgeons because my Internal Medicine/Nephrology doctor sent me to train with them when I first started...

I would say a RN working with a patient in CVICU is way different that the RN working on a medical surgical nurse. The training before a RN is let loose in a CVICU is much more extensive than the training of the RN on medical surgical floor (at least in my area)...

Interesting topic, interesting twists on the topic.

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Blurr, I just graduated as an FNP from the Masters Entry program at Boston College and as far as I know, 100% of the FNP students - with no RN experience - got NP jobs within 2 months of graduation. You can do this without working as an RN. You just have to look for the jobs. We are in very high demand across the country.

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Blurr, I just graduated as an FNP from the Masters Entry program at Boston College and as far as I know, 100% of the FNP students - with no RN experience - got NP jobs within 2 months of graduation. You can do this without working as an RN. You just have to look for the jobs. We are in very high demand across the country.

NPs positions are in demand at this time. My concern is that like many other professions, the cycle of TOO MANY NPs will be in the near horizon. My current class number is 200+, while the ACNP program is under 100. The new RN grads are having a hard time finding jobs. Will I face the same hardship when I graduate with my FNP in 1 1/2 years? Cause me to wonder what the ratio of PAs to NPs is?

The direct entry to NPs may have undesirable effect to the ANP profession in the long run.

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