Becoming an NP with little to no nursing experience?? - page 46

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   JenRN30
    Jobless, you are getting good advice here. Understand that this is not others trying to knock you down, it is real advice based on their clinical experience. The same goes for med/surg. Being a new grad, I believe it is good advice to do med/surg/telemetry for a year or so to get your feet wet. Just because people aren't telling you what you want to hear doesn't mean their trying to knock you down.
    The problem with being a new grad is that you don't know what you don't know. There is so much to learn, and going on to grad school with no experience...well, I just cannot imagine it and would never want to do it myself. The best advice I can give you is to keep searching for that first RN job.
  2. by   OCNRN63
    Quote from JoblessNewGradRN
    I agree with all of you. I mean I certainly do want to put my time in as a RN.

    I'm still confused why the nursing community would allow NP programs (that require no RN experience) to exist if there is a perceived deficiency in the graduates' knowledge base and competence. Maybe they should make all NP programs like the ones for CRNAs. If you want to do FNP, you have to do 2 years in primary care or ER... CNM?---two years in L&D...etc.

    Uhm...$$$?

    FWIW, I would never go to an NP with no experience. Then again, <putting on flame-retardant suit> I'm not really an advocate of any midlevel practitioners, period. If I'm sick, I want a doctor directing my care.
  3. by   grannyrn65
    Quote from JoblessNewGradRN
    Thanks ebear...lol. I'm happy I'm getting honest responses though, because truthfully, the harshest critics I've encountered about this issue are nurses----nurses in clinicals, nurses that teach in college, nurses on this forum...

    I really hope there's not a theme of nurses trying to knock each other down. This NP issue reminds me a lot of when I first started nursing school and faculty told us we all have to absolutely start in med-surg, then my group started hearing about grads getting specialty positions right out of school and doing well in them. God forbid any of us have to be put under by a CRNA since their 1-2 years in critical care pales in comparison to any kind of training a real anesthetist goes through...
    I don't think anyone is being critical of you, they are just responding to your questions. NP's have been in existence for more then forty years. Until 2000, programs actually required applicants to have several years of clinical experience. And when I went to graduate school, in 1974, physician assistant programs also required several years of practical experience- such as EMT,nursing,military MASH. Also, until then 1980's,most hospital specialty units required general med-surg experience, plus in-house training. And CRNA's, they had to have several years of clinical general med-surg plus two years of critical care. I am assuming you mistyped anesthetist. Physicians who administer anesthia are required to spend several years in their specality residency. And upon passing their speciality board, supervise CRNA's.

    I have reservations about anyone jumping right into a speciality program without any clinical experience. Yes, there are some who can manage to do it and provide good care. More power to them. But it has been my experience, of some forty plus years, the vast majority are not. And now that I am retired, I don't want to depend on someone who has no experience taking care of me in a special area, suc as ICU or an NP or PA with only the clinical experience in teir program. I need someone who has several years of practical clinical experience plus advanced education, to draw on this, to make the correct decisions about me and my care. Sorry but that is just my way. I also require any physician to be board certified and we know what that takes.

    Color me a that way.

    GrannyRN65
  4. by   JoblessNewGradRN
    Thank you all. I think I got my butt handed to me on this one. I still want to wish the best for all the jobless BSNs like me who went strait into grad school. Who knows, maybe they'll be the best NPs ever... PS I am not in grad school yet! lol

    I would love to hear from advanced practice nurses who went strait into it without the RN experience. I doubt that they'd be brave enough to post on here. People have strong opinions about this issue.
  5. by   nerdtonurse?
    What you're running into here (and will in the real world) is something called heuristics. I've got a degree in English, a Master's in Computer Science, and an ADN in nursing. While I had good teachers, I will tell you bluntly that most nursing instruction is heuristic learning -- you learn by seeing, by doing, by observing how a patient responds during an illness, NOT in a book or classroom. When I was a brand new nurse, it would floor me when a nurse could walk in a patient's room, cock her head to one side and say, "Hm...let's check that blood sugar," or "Go get me a BP machine right now!" It wasn't magic, it was time in title, boots on the ground experience. You can't get that from a book or school, no matter how book smart you are. I know. I'm smart, and I'm in MENSA. I, too want to eventually become an advance practice nurse, but right now, I'm still learning how to be a good RN while getting in the pre-reqs. The more days you're at the bedside, the more you realize the depth of what you don't know. When I was starting, I was sure this would be a snap and I'd be in NP school in a flash. Now I'm going to work my tail off at being a good ICU nurse and hope I feel confident enough in a couple of years to to the NP route. I know enough now to know if there had been a straight of the street to NP class, I'd never take it because I'd be terrible at it, simply because clinicals are never, never, EVER like the real world. You'd graduate smart enough to be extremely dangerous. I like NPs. I want to be one some day. But I don't want to see NPs fail because they're sold a bill of goods by a school.
  6. by   Annaiya
    It makes me sad that so many nurses are are being so negative. I would not want to do grad school without any RN experience, but that doesn't mean someone going straight through school can't be a good NP. And I don't see the need to have more than a year of experience. I feel this way for a couple of reasons. First, NPs do not do RN work. Yes they understand it, and some of what they do incorporates it, but it is not the same. So much of what an NP needs to learn will be brand new even with a lot of RN experience. Secondly, the educational programs are designed to provide everything a person needs to know to be competent and pass boards. Yes there are bad schools and bad students out there who may on an individual basis not meet the standards, but that doesn't mean everyone should be stereotyped.

    I think nurse's views are influenced by the fact that being an NP didn't always require a master's degree, and instead you needed experience and just a certificate program. Also, I've found a lot of nurses really don't understand what NPs do. I've asked so many nurses at my hospital about what the NPs do in different areas and it's rare that I find someone who actually knows. I've also noticed that some RNs seem to think NP work is advanced RN work, so they need to master all things RN before they can move on to an NP. This is just NOT the case.

    I applied to NP school with only 4 months RN experience and was amazed at how judgemental a lot of the experienced nurses were. Honestly, I think a lot of them were just jealous that they never made the committment to go to school. NP school is A LOT of work. They do not just hand out degrees. If you don't have any RN experience, I would think it would be more work to get through school but not impossible.

    With that said, you may find it difficult to get a job once you graduate if you don't have any RN experience. With the economy and the looming DNP requirment, NP schools are seeing record numbers of applicants and are accepting as many students as they can possibly accomodate. There are going to be a lot of new NP grads in the next 3-6 years at least, so if you are one of the ones graduating with no RN experience, it may be really hard to get a job.
  7. by   JStollRN
    Quote from ukstudent
    Not all PA schools require a health care back ground, but a lot do.

    As for CRNA's, they do require clinical experence, a very vigorous interview selection process ( only few get accepted) and a huge amount of clinical hours. NP schools on the other hand do not require experence, as long as you have the basic pre-req's just about anyone can get accepted and have minimal amount of clinical hours.

    I think that once you get a job and start working you will have a greater understanding just how little nursing school prepares you for actually working as a nurse and just how much you still need to learn just to fuction as an independant working floor/unit nurse.

    Believe her Jobless! I am a new grad RN and have been working in Med-Surg Oncology for a month now and being a nurse is ENTIRELY different from being a nursing school student! It is hard to even try to explain to people who aren't nurses HOW MUCH you do in one shift! There is soooo much to learn and it is overwhelming. The amount of responsibility and the little amount of time you have to take care of X amount of patients...

    I am not trying to say that if you went straight on to grad school that you would be a bad NP, but I think if you worked on the floor, even just for a year, you would have a greater appreciation for floor nurses and truly be a better practitioner. The skills and tricks you learn on the floor are invaluable and there are so many experienced people to use and pick their brains! I love that! Now I think I am just rambling but you get the gist : )

    Good luck to whatever you end up doing!
  8. by   elkpark
    Quote from grannyrn65
    NP's have been in existence for more then forty years. Until 2000, programs actually required applicants to have several years of clinical experience.
    I am not a fan of direct entry program (MSN programs for non-nurses), but, just for the sake of accuracy, the above is not exactly true. My graduate program (which I attended as a traditional, experienced-RN student) included a direct entry program for non-nurses with NO required healthcare background and graduated them as NPs, CNSs, or CNMs in three years, without having ever worked a single day as an RN (just their clinicals during the year of basic nursing education in their program). I graduated in 1994, and the school's direct entry program had been around for many years at that time (in fact, the school claims to have originally invented the concept of the direct entry program, and is vl proud of that). And there were plenty of other direct entry programs around before 2000 that didn't require applicants to be licensed nurses or have any prior experience.
  9. by   madwife2002
    I think it depends on where you want to work as a NP to whether you need nursing experience to be truthful. I am not a NP I have 20 plus years of nursing experience and now I am not sure whether you need to have nursing experience to do any job. In my vast career I have moved around specialities yet each time I have to return to novice from expert when I work in a new speciality. Yes I know how to nurse the sick patient and i can walk into a room and can without thinking know what is happening and what I need to do.
    But in my opinion and you can tell me if I am wrong that is not what a NP's job is all about they are not hands on nurses, they tend to be experts in the field of what ever speciality they are working in but as they are not expected to be a floor nurse they complement us the floor nurses, why do they have to be experienced in nursing!
    My expertise is in Renal nursing I can live, think and dream in Renal Nursing I learnt most of what I know about renal medicine by doing courses! I know what tests, what interventions and what is going on inside their bodies but not from hands on nursing from books and further education.
    I can how ever look after them when they are acutely, chonically sick because I have been hands on floor nurse all my life.
    I dont want to be a NP it really doesnt interest me however I am a manager and I like being an expert because I can support my staff
  10. by   GM2RN
    Quote from JoblessNewGradRN
    I don't know any PA programs that require a medical work history before acceptance...maybe volunteer hours in a hospital or something like that but nothing like being a CNA or tech. I know some people that went to grad school for PA as well and just had to take the GREs and the required pre-reqs.

    Then you haven't looked at many PA programs because the few that I have looked at ALL require a certain number of hours of direct patient care to be admitted. My sister is a PA and had the same requirement for the program she attended in Ohio.

    I have been following the thread in which you made your comment/post on this topic, and no one who responded to the OP in that thread was "looking down" on nurses wanting to become APNs. Your comments there, as well as here, come across as very defensive. You have gotten some excellent responses to your questions but still pound away at this like you have a chip on your shoulder. Maybe you need to take a step back and reflect on why that is.
  11. by   pinksugar
    You would be doing yourself a disservice if you went into your NP in this manner. You will be way behind your classmates that have experience, and when the nurses on the unit you work on realize that you don't have any idea what you are doing (and believe me, they will know right away) they will not trust you as a practitioner, not to mention that you will be putting yourself and your license at risk due to your inexperience.

    Most PA programs in my area require 700 hands-on clinical hours and prefer 1400 hours. YMMV.
  12. by   Ruby Vee
    Quote from joblessnewgradrn
    hi everyone,

    i posted a comment on a post and didn't get any comments on why advanced practice nurses (nps in particular) need to have years of rn experience to be hire-able or gain the respect of fellow medical professionals. i'm a new grad and still looking for my first rn job. in the future, i do plan to become a np, but my goals right now are to start working and pay off my student loans. i also think that it would benefit me to pursue my master's degree while employed so that i can benefit from the tuition reimbursement most hospitals offer. however, if i find nothing after months of searching, then i may apply for grad school.

    anyway, i do know some people who graduated with their bsn who went directly to master's programs to get their np. a lot of nurses seem to look down on this and i don't understand why. why is that pas don't get the same criticism as nps who have little or no rn experience. while i have been looking for jobs, i have seen job postings that state, "pa new grad or np with x years of rn experience." i don't get it. it suggests that np programs are not as strong as pa programs. to me it's like saying a doctor shouldn't be a doctor unless he/she has been a pa first. same goes for pharmacists... do they need to be a pharmacy tech first to be a good pharmacist? a lot of people go into nursing without a medical background and become successful nurses.

    please share your insight because if master's programs are producing unhire-able nps or nps who don't deserve the respect of other health professionals simply because they haven't done their time as an rn, then maybe we should just do away with these programs.
    pa education is different than np. np education has traditionally been structured on the assumption that students already have a certain body of knowledge and skill set from working as nurses -- if you haven't worked as a nurse, you don't have that skill set. besides -- how do you know you want to be an np if you haven't worked as a nurse? maybe you think you'll want to be an np in ob, then work as an rn in ob for a year and find out you hate it. it's easier to change specialties as an rn than after you've already paid for the education in graduate school!

    and the nurses you work with will respect you more if you've been an actual rn.
  13. by   ominous
    Quote from Annaiya
    It makes me sad that so many nurses are are being so negative. I would not want to do grad school without any RN experience, but that doesn't mean someone going straight through school can't be a good NP. And I don't see the need to have more than a year of experience. I feel this way for a couple of reasons. First, NPs do not do RN work. Yes they understand it, and some of what they do incorporates it, but it is not the same. So much of what an NP needs to learn will be brand new even with a lot of RN experience. Secondly, the educational programs are designed to provide everything a person needs to know to be competent and pass boards. Yes there are bad schools and bad students out there who may on an individual basis not meet the standards, but that doesn't mean everyone should be stereotyped.

    I think nurse's views are influenced by the fact that being an NP didn't always require a master's degree, and instead you needed experience and just a certificate program. Also, I've found a lot of nurses really don't understand what NPs do. I've asked so many nurses at my hospital about what the NPs do in different areas and it's rare that I find someone who actually knows. I've also noticed that some RNs seem to think NP work is advanced RN work, so they need to master all things RN before they can move on to an NP. This is just NOT the case.

    I applied to NP school with only 4 months RN experience and was amazed at how judgemental a lot of the experienced nurses were. Honestly, I think a lot of them were just jealous that they never made the committment to go to school. NP school is A LOT of work. They do not just hand out degrees. If you don't have any RN experience, I would think it would be more work to get through school but not impossible.

    With that said, you may find it difficult to get a job once you graduate if you don't have any RN experience. With the economy and the looming DNP requirment, NP schools are seeing record numbers of applicants and are accepting as many students as they can possibly accomodate. There are going to be a lot of new NP grads in the next 3-6 years at least, so if you are one of the ones graduating with no RN experience, it may be really hard to get a job.

    There is NO looming dnp requirement, just a recommendation.

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