Becoming an NP with little to no nursing experience?? - page 51

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   elkpark
    Quote from remifentanil
    If you CAN become an FNP without nursing experience... why bother? If the organization that accredits FNP programs and the FNP community itself does not think it is needed.. Why worry about it?

    Only one APN speciality absolutely requires it. You can be any kind of APN you desire except that one.
    (Two, actually -- both CRNA and NNP (neonatal NP) programs require previous specific clinical experience.)
  2. by   JeanineG2885
    FYI I had only about 1 year of nursing experience before getting into the program of my choice :-)
    Last edit by tnbutterfly on Mar 23, '11 : Reason: Please do not post links to off-site personal blogs
  3. by   lckrn2pa
    My PA program is 24 months full time, no part time. By the end of it I will have just over 1700 hours of classroom instruction (35 +/- per week x48wks) the 1st year and second year will be 1700 hous of clinical time (32hrs +/- per week x12 months) along with 4 hours of class time each week. 32hrs is the min but we've been told we will be there til the preceptor goes home. A guy on the CV surg rotation in the class ahead of us told me this morning he was at the hospital 14-15 hours per day 4 days week for the 4week rotation. For those that think PA school is skimpy then let me know if this sounds skimpy.
  4. by   zenman
    Bummer. Hope you learn something after you finish.
  5. by   CRF250Xpert
    after 66 pages, I'm sure someone addressed it; how many doctors were doctor helpers before they became doctors? How may PAs were PA helpers beore they became a PA? Being required to work as a RN before being a NP is silly. I was a RN for 10 years before being a NP and of course I look back on experiences, but wiping butts, thining charts, and signing consent forms has nothing to do with what my day consists of now.
  6. by   zenman
    Quote from CRF250Xpert
    after 66 pages, I'm sure someone addressed it; how many doctors were doctor helpers before they became doctors? How may PAs were PA helpers beore they became a PA? Being required to work as a RN before being a NP is silly. I was a RN for 10 years before being a NP and of course I look back on experiences, but wiping butts, thining charts, and signing consent forms has nothing to do with what my day consists of now.
    I had 37 yrs nursing experience and it was great prep for my current role as an NP. I made a big list once (maybe on this thread) of how my experience served in my current role. Too bad you think your time was wasted. NP school was book learning. The experience is where you learn. I'm a PMHNP and you'd be surprised how much I have to correct FNP's on "medical stuff!"
  7. by   elkpark
    Quote from CRF250Xpert
    after 66 pages, I'm sure someone addressed it; how many doctors were doctor helpers before they became doctors? How may PAs were PA helpers beore they became a PA? Being required to work as a RN before being a NP is silly.
    A moot question, because they're entirely different educational and professional models.

    If people really want to separate NP practice from the notion of nursing experience, I have no problem with that personally, but, in that case, I really wish they'd take the word "nurse" out of the title and call it something entirely different (something that has nothing to do with nursing).
  8. by   zenman
    Quote from CRF250Xpert
    after 66 pages, I'm sure someone addressed it; how many doctors were doctor helpers before they became doctors? How may PAs were PA helpers beore they became a PA? Being required to work as a RN before being a NP is silly. I was a RN for 10 years before being a NP and of course I look back on experiences, but wiping butts, thining charts, and signing consent forms has nothing to do with what my day consists of now.
    If this is the case then we need to increase our clinical hours to at least 2,000 hrs to makeup for lack of some kind of experience. You're basically an idiot when you came out of an NP program never having had any health care experience with our level of clinical hours. It's only my opinion but of course I'm correct, lol!
  9. by   FNPdude74
    Quote from zenman
    If this is the case then we need to increase our clinical hours to at least 2,000 hrs to makeup for lack of some kind of experience. You're basically an idiot when you came out of an NP program never having had any health care experience with our level of clinical hours. It's only my opinion but of course I'm correct, lol!
    I agree with this. RN experience is a must. There's little to no residencies. Physicians are trained after medical school through residencies and thats where they learn most of their clinical training. For APRNs, they expect you to have at least some RN experience. I had less than 1 year of RN experience when starting the FNP program and I was struggling initially, but fortunately I had RNs and Physicians who were willing to teach me as I went along especially in the PICU/NICU, Pediatric sedation clinic, adult ICU, family practice, pediatrics (especially this), OBGYN, GI, emergency medicine, OR/surgery, neurology, cardiology/cath lab, orthopedics, radiology, nephrology, oncology, etc. Yes I chose to rotate through all these specialties and most of the RNs there expected me to know what I'm doing technically as an RN. I struggled.

    I was trained mostly by physicians, but RNs helped me out in many things like technical skills of mixing sedatives, inserting IVs in kids (i know how to do in adults, but children it was difficult especially in the ED when they're not sedated like in the pediatric sedation clinic). Right now I'm COMFORTABLE, but I still feel incompetent and still need more exposure to patients and RN skills. Those skills will help you survive in times of being alone, especially as a provider. Although you will be practicing a whole different scope, your RN skills and judgement will fall through and save your professional competence.

    Aside from this, I don't think as an RN I would have learned chest tube insertions, needle air aspirations for pneumothorax, lumbar punctures, CVC line insertion with CRNAs , anesthesia delivery, suturing/first assisting (although you can do this as an RN, I met an RN who was a first assist and boy did he know his stuff), radiologic interpretation, dislocated joint reductions, intubations/LMA insertion, ultrasounds, casting, colonoscopies, bronchoscopies. I had lots of physicians who was supportive of me...maybe because i'm going into the USAF and I was at a military teaching hospital? Nonetheless, RN skills is a must...I sort of regret not working for years after graduating, but what's done is done and I finish with my FNP this August. My capstone will be in a busy ER with calls...so I'll be doing shifts with a physician as well as being on call with another physician...so I'll be doing about 60-80 hours a week from what I've been told since I requested intensive ER training. So I'll get around 1280 hours in the summer...It all depends on how motivated you're willing to learn and how much commitment you're willing to put in to make up for lack of previous experience.
  10. by   CRF250Xpert
    NurseW74,
    Are you sure you are in a FNP program? It sounds like you’ll finish the requirements for ACNP soon. All kidding aside, more power to you, but don’t confuse experience as a prerequisite with the curriculum or training provided. I completely agree that NP school should have a residency instead of the willy-nilly didactic here – a couple of clinical hours there. Noone can learn anything that way. I too had MD preceptors (also the occasional NP mixed in) and really think that the MD should be the standard. The NP preceptors always said, “you are doing great – your background really shows”. The MDs said, “you background shows – now tell me everything there is to know about DM II – start with pathophys and go to prognosis, complications, etc”. Needless to say, I learned MUCH more from the latter and would like to see every NP student get the same quality time in clinic that I felt fortunate enough to have.

    On a different note, having spent years in the ER as a RN, NPs are used in fast track. If you find yourself getting out a chest tube, central line kit, or LP tray – you better take a step back and ask someone what day it is (coz, you might not be AAOX3). I trained on all of those procedures by having to do a bunch of trauma certs and skills for the mil and of course going to war. But – you will never see me asking my nurse to get me a 36 fr and a prep tray – never. I’ll leave cutting into a thorax to the MD and draining CSF to the PNP and MD. CLS, ATLS, ENCP, etc all cover the simple stuff like a 10ga into the chest for pneumo, but cutting into people (except for skin biopsy, nails, etc) wasn’t the focus of my FNP school. I hate to harp on BON and lawyaers – but I don’t know any of them and I really want to keep it that way. I see pts for money and have grown accustomed to a roof over my head and eating fresh food. Both of those entities can take that away tomorrow, so I keep myself and my practice well within my scope and the SOC.

    I’d love to see NP programs stop the classroom after year one and put us in clinic 100% full immersion just like the docs get in residency. It’ll never happen though – too many single parents working part time etc. I have many friends who have done CRNA and are told from day one that it is a 100% effort program with no work allowed ever. People cop an attitude about it, but guess what – they don’t get in and don’t become CRNAs either. One friend worked crazy overtime as ICU charge for a year to save $$, then took out a 2nd mortgage, and then maxed out student loans. I don’t think FNP School should be financially devastating, but it should be more structured like CRNA School and not so flexible – then we could get those real full-time residencies.

    Schools get wrapped around the axle because they have to keep accounting records. When it shows enrollment down – they get antsy. So in order to keep the spreadsheet in the black, they have to let in everyone they can – hence, the no person left behind, we’ll accommodate anyone, “when can you come to school” attitude.
    Last edit by CRF250Xpert on Apr 21, '11 : Reason: formatting
  11. by   elkpark
    Quote from CRF250Xpert
    I'd love to see NP programs stop the classroom after year one and put us in clinic 100% full immersion just like the docs get in residency. It'll never happen though - too many single parents working part time etc. I have many friends who have done CRNA and are told from day one that it is a 100% effort program with no work allowed ever. People cop an attitude about it, but guess what - they don't get in and don't become CRNAs either. One friend worked crazy overtime as ICU charge for a year to save $$, then took out a 2nd mortgage, and then maxed out student loans. I don't think FNP School should be financially devastating, but it should be more structured like CRNA School and not so flexible - then we could get those real full-time residencies.

    Schools get wrapped around the axle because they have to keep accounting records. When it shows enrollment down - they get antsy. So in order to keep the spreadsheet in the black, they have to let in everyone they can - hence, the no person left behind, we'll accommodate anyone, "when can you come to school" attitude.
    Not true of all schools -- I went to an MSN program (I am a psych CNS, but the program also included a variety of NP tracks, plus CNM (no CRNA)) that was v. rigorous and demanding; there was no "part time" option -- you were in the program or you weren't. We were half-time (~20 hours a week) in clinical from the beginning of the program (within the first few weeks of starting), in addition to our full-time coursework. V. few students worked at all (I worked prn as an RN at the uni medical center -- I did one shift a week when school was in session (any more than that I would have had trouble keeping up with the reading and assignments) and loaded up on the hours during holidays breaks and summer) -- the school didn't make a point of telling us not to work, but nearly everyone found that the program was demanding enough that there just wasn't time. The program was also v. competitive and certainly didn't take just anyone to keep the enrollment up -- my second year, there were no first year students admitted to our specialty track -- none of the applicants met the school's standards, so they didn't take anyone.

    I, too, would like to see nursing quit "watering down" nursing education across the board as the years go by, and have rigorous standards we can all be proud of.
  12. by   jjjoy
    Quote from elkpark
    If people really want to separate NP practice from the notion of nursing experience, I have no problem with that personally, but, in that case, I really wish they'd take the word "nurse" out of the title and call it something entirely different (something that has nothing to do with nursing).
    I can definitely see this argument come into play in regard to the idea that prior, related RN experience is not, and need not be, a requirement for some areas of "advanced nursing practice.
  13. by   FNPdude74
    CRF250Xpert, you look like the kind of person I should be talking in about being an NP in the military. I know that certain limits such as cricoidotomy would be left to the MDs. But stuff like chest tube insertions in my state, even FNPs are allowed to do it from what I've been told by FNPs in the ER as long as they are adequately trained by MDs. I know the military trains you in more than what you "need to know" for the civilian world, but enough for the military world. Then again, I agree its important to know the limits of scope of practice and ask before I do!

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