Becoming an NP with little to no nursing experience?? - page 5

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   ginger58
    Personally I think the idea is ludicrous! I became an RN first, worked in my area for several years and went to NNP school.
  2. by   Uberman5000
    Quote from ginger58
    Personally I think the idea is ludicrous! I became an RN first, worked in my area for several years and went to NNP school.
    Yeah, well if it was really really really crazy like everyone is making it out to be they wouldnt offer the option. But since they do, take advantage of it.

    "When I was young boy I used to walk 20 miles to school, even in the snowstorms!"

    :-)
  3. by   mvanz9999
    Quote from Uberman5000
    Yeah, well if it was really really really crazy like everyone is making it out to be they wouldnt offer the option. But since they do, take advantage of it.

    "When I was young boy I used to walk 20 miles to school, even in the snowstorms!"

    :-)
    Exactly! If it was so horrible, grad programs for direct entry would never have been approved.
  4. by   core0
    Quote from lizz
    Thank you for this insight because it seemed very strange to me that NP's with more experience would actually be rated less favorably. You might expect them to be rated the same but worse? That would be truly bizarre. It doesn't make much sense.

    :typing
    There is a similar debate in the PA field. There are programs that actively recruit students without medical experience. The claim is that they do not have to break the students of their bad habits. They can "mold" the students in their own program. The interesting thing in the PA programs is that inexperienced PA's do the same as experienced PA's on the certifying exam. Is there similar data for NP's (if you actually believe that certifying exams measure clinicial competence)?

    David Carpenter, PA-C
  5. by   core0
    Quote from Uberman5000
    Hmm..I believe you are making a big assumption. I mean, if I wanted to assume things from the article...i could make the assumption that the reason why the seasoned nurses scored lower from the physicians standpoint is that they have been out of school longer and have not kept on top of their continuing education. So if I assume this, it makes sense to me why the younger nurses scored better in terms of how the collaborating physician rated their skills, the physician viewed them as more competant, i.e having a greater skillset. But this line of reasoning would be assumings things -- in looking on a whole -->

    Did you look at the instrument used to analyze the data? The Nurse Practitioner Skills Inventory is reliable and valid with repect to assessing the skills of an NP, kind of hard to argue with that.

    Also you are not examining the article collectively, you are taking one area of assessment(physicians), drawing a conclusion from an assumption and completely dispelling the other salient parameter by which nurses rated competancy(Self report).

    No study can be perfect obviously and people see things in different ways. Regardless, this was a study whereby empirical data demonstrated that the level of competancy of an inexperienced APRN was on the level of an experienced APRN, i guess that is the bottom line.
    Depending on the situation, the physician assessment may be appropriate. While there is disagreement, a significant proportion of NP's are employed by physicians so it would be nice to have them have a decent opinion of NP's clinical skills.

    I find it interesting that this article which I will point out is an abstract not a pear reviewed article. There have been other articles that have found different results. I would reference this one:
    Log In Problems
    There is also an unpublished study that has been referenced a couple of times that purports to show a negative corrolation between self confidence as an NP and experience as a nurse.

    David Carpenter, PA-C
  6. by   christvs
    Quote from core0
    Depending on the situation, the physician assessment may be appropriate. While there is disagreement, a significant proportion of NP's are employed by physicians so it would be nice to have them have a decent opinion of NP's clinical skills.

    I find it interesting that this article which I will point out is an abstract not a pear reviewed article. There have been other articles that have found different results. I would reference this one:
    Log In Problems
    There is also an unpublished study that has been referenced a couple of times that purports to show a negative corrolation between self confidence as an NP and experience as a nurse.

    David Carpenter, PA-C

    Thanks for referencing that article. I love to read about new NPs. Can you tell I'm an NP student or what?
  7. by   Uberman5000
    Quote from core0
    There is a similar debate in the PA field. There are programs that actively recruit students without medical experience. The claim is that they do not have to break the students of their bad habits. They can "mold" the students in their own program. The interesting thing in the PA programs is that inexperienced PA's do the same as experienced PA's on the certifying exam. Is there similar data for NP's (if you actually believe that certifying exams measure clinicial competence)?

    David Carpenter, PA-C
    Yes David, check out the thread, in it you will find a link to a study that said there was no difference between the skills of experienced NP's vs novice NP's, like I said earlier, its just the good old boy mentality that some people think you should have to eat crap because they had to back in the day. But it makes no difference really, people will use every excuse they can come up with to justify a position, but the facts should be what makes the ultimate decision, and I think in this instance, the facts have spoken.
  8. by   Uberman5000
    Quote from core0
    Depending on the situation, the physician assessment may be appropriate. While there is disagreement, a significant proportion of NP's are employed by physicians so it would be nice to have them have a decent opinion of NP's clinical skills.

    I find it interesting that this article which I will point out is an abstract not a pear reviewed article. There have been other articles that have found different results. I would reference this one:
    Log In Problems
    There is also an unpublished study that has been referenced a couple of times that purports to show a negative corrolation between self confidence as an NP and experience as a nurse.

    David Carpenter, PA-C
    Hmm, i cant access the article Ill check it out later. Why is it unpublished? lol.
    Last edit by Uberman5000 on Dec 15, '06
  9. by   Sheri257
    Quote from Uberman5000
    Its because its a much more lengthy legal process to go after someones personal assets and it is rarely done. I mean if what you are saying is true, for instance..why arent houses changing hands left and right after automobile accidents, i have seen some severe injuries resulting from automobile accidents yet I dont see the plantiff living in the defendants house. There is a very good reason for this, its because the cases practically always settle and the attorney go after the guy with the DEEP POCKETS - Again, because I have alot of friends who are attorneys I know this.
    There are limits to outside parties they can sue if you're the one who's primarily responsible for a bad decision. And, quite frankly, by the time I become an NP, I will already have some fairly keep pockets. I have a lot of home equity to protect as it stands now.

    All it takes is one bad case to ruin your life. It's not like the insurance company will pay and that will be the end of it (assuming, of course, they do pay ... which is another debate all together).

    There's other consequences to consider. Who's going to want to hire you if you've had a big judgement or settlement against you? And even if you do get hired, who's going to want to insure you? Even if you can find insurance after a bad case, the premiums will probably cost a fortune.

    And no, the plaintiff doesn't actually take the home and live in it. I was using "take the house" as a figure of speech. What the plaintiff does is take the home equity.

    One of the best ways to collect judgements is to put a lien on someone's house or bank account. How do I know this? Because I've done it. If the bank account is empty you can always put a lien on the house, and they can't sell or borrow on the house without paying you.

    That's why you don't see houses changing left and right but, what you do see is large judgement payments taking place during closings when people try to refinance or sell. Of course, you're not going to read this in the newspaper but, that's what happens.

    House liens are actually the best way to collect otherwise uncollectable judgements. And even if it takes a couple of years ... you get interest in addition to the original judgement amount.

    If you don't want to take this seriously, fine. I do. I have a lot of assets and home equity to protect. I'm not going to blow my retirement.

    For me, it has nothing to do with the politics of taking more crap or having to pay more dues because somebody else had to do the same. It has everything to do with knowing what I'm doing through experience so I can protect myself.

    Because, in the event of bad case, I have no delusions about what will happen: the MD, the insurance company and everyone else will probably try to hang me out to dry ... if they can.

    :typing
    Last edit by Sheri257 on Dec 15, '06
  10. by   sirI
    The above link that core0 references is from Medscape. Just click on it (log in problems) and will take you to Medscape. You might have to register in order to read the article. Free site.

    Not sure what you mean by, "why is it unpublished" ..????
    Last edit by sirI on Dec 15, '06
  11. by   core0
    Quote from Uberman5000
    Hmm, i cant access the article Ill check it out later. Why is it unpublished? lol.
    You have to register with medscape to get it (this is free). The link works despite the log in problems. Re: The unpublished study on NP self confidence. I am not sure why the study is unpublished. It was done as a survey at a national nurses conference. I found it referenced in another nursing article as personal communication.

    David Carpenter, PA-C
  12. by   mvanz9999
    Quote from core0
    There is a similar debate in the PA field. There are programs that actively recruit students without medical experience. The claim is that they do not have to break the students of their bad habits. They can "mold" the students in their own program. The interesting thing in the PA programs is that inexperienced PA's do the same as experienced PA's on the certifying exam. Is there similar data for NP's (if you actually believe that certifying exams measure clinicial competence)?

    David Carpenter, PA-C
    This is exactly what I said earlier. New students are much easier to mold, therefore inexperienced NPs get higher marks.
  13. by   core0
    Quote from mvanz9999
    This is exactly what I said earlier. New students are much easier to mold, therefore inexperienced NPs get higher marks.
    But that doesn't answer the real question. Is this a valid test. The real problem is that there is relatively little data on what qualifies for "quality care" by either NP's or PA's. An interesting way to do this would be to look at rural health clinics that are independent and have no physician presence and compare those that do have physician prescence.

    David Carpenter, PA-C

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