Becoming an NP with little to no nursing experience?? - page 52

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   jjjoy
    Quote from CRF250Xpert
    I completely agree that NP school should have a residency instead of the willy-nilly didactic here - a couple of clinical hours there.
    I'd go even further and say RN training/certification, at least for acute care settings and many other specialities, should involve residencies as well. All of that valuable experience that RNs bring to the table as NPs is often learned in the same way that is by non-RN-experience NPs... on-the-job-tossed-to-the-wolves-sink-or-sink-style.

    Is it really any better for a new RN with nil experience outside of school to have *full* RN responsibilities in an acute care setting after just 6-8 weeks, relying on harried colleagues for backup & guidance, than for a new NP with nil experience outside of school to have *full* NP responsibilites just a short time after graduation, relying on busy colleagues for back up & guidance?

    Either way, all of that valuable experience that a nursing background provides is often gained AFTER training instead of being part of training. That's inevitable to some point, but I think several areas of nursing would be well-served by a more rigorous transitional clinical training model.
  2. by   PMFB-RN
    Quote from jjjoy
    I'd go even further and say RN training/certification, at least for acute care settings and many other specialities, should involve residencies as well. All of that valuable experience that RNs bring to the table as NPs is often learned in the same way that is by non-RN-experience NPs... on-the-job-tossed-to-the-wolves-sink-or-sink-style.

    Is it really any better for a new RN with nil experience outside of school to have *full* RN responsibilities in an acute care setting after just 6-8 weeks, relying on harried colleagues for backup & guidance, than for a new NP with nil experience outside of school to have *full* NP responsibilites just a short time after graduation, relying on busy colleagues for back up & guidance?

    Either way, all of that valuable experience that a nursing background provides is often gained AFTER training instead of being part of training. That's inevitable to some point, but I think several areas of nursing would be well-served by a more rigorous transitional clinical training model.
    *** As a new RN I started in a 9 month nurse residency program. Most of the hospitals in this region have gone to some sort of extended orientation / residency program for new nurses. Are they really just tossed to the wolves anymore any place? If so that is areal shame. Bad for the hospital, bad for the nurses and bad for their patients.
  3. by   FNPdude74
    Quote from PMFB-RN
    *** As a new RN I started in a 9 month nurse residency program. Most of the hospitals in this region have gone to some sort of extended orientation / residency program for new nurses. Are they really just tossed to the wolves anymore any place? If so that is areal shame. Bad for the hospital, bad for the nurses and bad for their patients.
    You'd be surprised. 6 week orientation and then you're thrown into the fire. As an FNP student, the MDs just threw me into the fire too but I've managed to do well since I could pick things up pretty quickly and have strong memory retention as a young man I am. not saying anything about those older than I am. 25. Fortunately, these MDs were very helpful.
  4. by   jjjoy
    Quote from PMFB-RN
    Are they really just tossed to the wolves anymore any place?
    I'd be pleasantly surprised if every hospital in a 50 mile radius of where you offers 9 month new grad residencies, unless it's also that area hospitals aren't hiring many new grads at all. These days, new grads are having a hard time landing any job these days in many geographic areas and end up in the catch-22 of "need experience to get a job, need a job to get experience".

    But, yes, many places would still consider more than 8 weeks of preceptorship for a new grad RN *incredibly* generous and would want to count the newbie as a fully qualified RN FTE for staffing purposes ASAP.
  5. by   GM2RN
    Quote from PMFB-RN
    *** As a new RN I started in a 9 month nurse residency program. Most of the hospitals in this region have gone to some sort of extended orientation / residency program for new nurses. Are they really just tossed to the wolves anymore any place? If so that is areal shame. Bad for the hospital, bad for the nurses and bad for their patients.
    New grads in my ED get 6 weeks. I got 2 weeks, IF you could call what I got "orientation." My preceptor basically told me that I was an RN just like her, and to let her know if I had any questions, then cut me lose to "practice."
  6. by   PMFB-RN
    Quote from GM2RN
    New grads in my ED get 6 weeks. I got 2 weeks, IF you could call what I got "orientation." My preceptor basically told me that I was an RN just like her, and to let her know if I had any questions, then cut me lose to "practice."
    *** I am curious about something. IS this (new grad orientation) an isolated case of irresponsibility on the part of the hospital, or does their careless attitude carry over to other areas? Are nurses pay and benefits poor? What are your rates for things like pressure ulcers, central line infection, VAP? Are nurses treated like disposable and easily replaceable that the sort of orientation you received indicates? Does your hospital ignore evidenced based practice in all areas or just in new grad orientation?
  7. by   RN1980
    3month orientation here at my fulltime job and certainly not called a residency..it was refered to as going to work and learning the ropes. however at larger teaching hospitals in my area they have nurse residency positions available but when i started to work there part time i was excluded from those postiions and placed in a fast track orientation about 3wks, i suppose cause i had exp. at smaller hospitals in my area <150 to 200beds the nsg dept and nsg education depts often get cut out of funding as far as setting up 6 mos residencies for new hires and new nurses. all hospitals follow evidence based pratices and set forth by joint comission to obtain and keep cert. unfortunately many smaller hospitals lack the staff and funding to support a true educational and practical nurse res. programs. as far as pay in my location of the state.. newly minted rn in icu/er will make around 55k-60k.
  8. by   PMFB-RN
    at smaller hospitals in my area <150 to 200beds the nsg dept and nsg education depts often get cut out of funding as far as setting up 6 mos residencies for new hires and new nurses.

    *** it is the same in my area. the smaller hospitals got together and work with a larger hospital and they do a regional nurse residency program for their new grads.

    all hospitals follow evidence based pratices

    *** clearly not.
  9. by   RN1980
    clearly so, i stated that hospitals followed joint commission evidence based guidlines or attempted to comply with them. not every evidence based concept is supported or pushed by joint. not one survey i've ever been through have we ever been hit with issues concerning not having a nurse residency program.
    Last edit by RN1980 on Apr 22, '11
  10. by   lckrn2pa
    Well, in 1991 when I got out of nursing school I got my temporary license on a fri (back then it was a 2 day written exam ordeal at my state capital in a convention center with 1500 of my closest friends lol) and went to work at my local ER on Sat where I was a tech and made the announcement that I had my temp, guess how much orientation I got.....here's the narc keys lets go count, this pt has this, that pt has that, the guy in room so and so has whatever and there are 4 on lobby to for triage. I'll see you at 7pm. I was it, nobody else, just me a CNA pulled from the floor and a really, really, really, really, really, awesome ER doc that was also the medical director. The doc got me through that 1st day. Things have really changed in the past 20yrs. Back then I took notes on the things I was coming across in the ER and went home after every shift and looked things up and researched it on my own. We didn't have smart phone apps or computers to look things up just a pile of every kind of drug book you could think of, PDR's at the nursing stated (floor and ER) and if you were really lucky to be working when the new PDR's arrived they would let you have one of the old ones. Now if I want to look up a drug, open skyscape, epocrates or pharmacopia, type the 1st few letters on my phone and there it is. Things have changed.
  11. by   GM2RN
    Quote from PMFB-RN
    *** I am curious about something. IS this (new grad orientation) an isolated case of irresponsibility on the part of the hospital, or does their careless attitude carry over to other areas? Are nurses pay and benefits poor? What are your rates for things like pressure ulcers, central line infection, VAP? Are nurses treated like disposable and easily replaceable that the sort of orientation you received indicates? Does your hospital ignore evidenced based practice in all areas or just in new grad orientation?

    My hospital is part of a network of 13 hospitals/facilities. The pay for a new grad is 23.99/hr, which is $3/hr less than a sister hospital that is 30 minutes away, and is also less than a couple of other hospitals that are within 10 minutes or so of the sister hospital. Benefits are comparable to the sister hospital, and more or less as good as the other two hospitals not in the network.

    Oddly enough, our Press Ganey scores are second highest of those in the network, and our hospital was recently scored in the top 5% of hospitals in the region in clinical safety and one of the best hospitals in terms of survival rates in the ED, while at the same time we have the highest acuity of patients in the ED of all hospitals in the network. Our rates of infection and pressure ulcers are low. And I'm not aware of other evidenced based practice being ignored throughout the hospital, but I haven't really followed what the other floors are doing either.

    Are far as being treated as disposable, it does feel like that. In reality, the NM has ignored the concerns of more experienced nurses when it comes to the new grads practicing unsafely, and none have been let go for any reason whatsoever. The ones who have left are the experienced nurses who have had enough of the BS, leaving us with an ED full of inexperienced nurses, some of which are not open to constructive criticsism and are not open to learning.
  12. by   priorities2
    No comments on this thread since '11... any updates on people's thoughts on becoming an NP with little to no nursing experience? I'm thinking about taking the plunge and applying during my senior year of BSN to PMHNP programs. I would probably choose to spend more and try to attend a longer program (like OHSU or U of Washington) rather than an accelerated one like Vanderbilt.
  13. by   Ellen NP
    I still believe that experienced RN's bring more to the NP role than do those without experience. That doesn't mean that it can't be done. There is an understanding of patient and staff needs that comes from providing direct care. The NP's whom I have known who went directly to graduate school without working miss that experience and are more like PA's in their approach (PA's are great, just different than nurses). I think that this is most important for those of us who practice in the inpatient role. My ability to work with staff RN's and their patients is definitely enhanced by my RN experience.

    You can certainly get experience by working while in graduate school! That experience will add to what you are learning in school. School may help you to have a better understanding of the care you provide and working will give you the nurse's perspective on caring for patients in many different situations.

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