Becoming an NP with little to no nursing experience?? - page 6

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   FutureNP10
    Sounds liek a very interesting program, but I would be leary of that due to the fact that most NP's have had experience as an RN for at least 2 years prior to even going back to NP school. You may not have a little trouble getting a job because I'd figure they'd choose the NP with some type of experience versus the one that has none.
    Also...not only job wise, but just for you, when becoming an NP, just so you can feel confident and comfortable with what you are doing..you might decide to go with a program that makes it mandatory for RN experience before going to NP school.
  2. by   traumaRUs
    I will revisit the scenario that all APN students must know what their market will hold too. In Chicago, as one poster found out, the nurse recruiters for hospitals weren't interested in inexperienced RN NPs. I live in central IL and work for a private practice. I was the most inexperienced RN (new CNS) with 15 years of nursing experience. I got the job because the MDs liked my emergency dept experience and the fact that I could make decisions on my own. The ability to know when something is serious or not is very important and I'm sorry, but its not a skill you learn in school.

    Another thing to consider if going for a clinic position - why would a doctor want to train a new NP while not being able to see the same number of patients that an experieced NP can see? It is always the bottom line and important to consider you must perform billable services.
  3. by   mvanz9999
    Which puts me in quite the conundrum. (<--is that spelled correctly? LOL!).

    I've gone over and over and over this, I don't see any other way for ME to become an RN (money, time, blah, blah, blah).

    The question for me is would a hospital hire an RN if they were trained in a graduate program, but had little experience (like any RN from any program). The nurse recruiter seemed perplexed by my question - she didn't know how to answer it. It was almost as if she said "Why would you go to grad school to be an RN?)

    The direct entry programs around here are SO new (meaning less than 5 years) that there really isn't any way to judge this. I know one guy that graduated from one program and works as an RN (not a APN). So....it seems he is not actually using his grad level education.

    As for the other program, it is so new that there are NO graduates. Therefore I can't really tell from the grads of the programs, and I don't think many of the smaller, non-teaching hospitals or health care settings have much experience with the question. When I call a smaller place, it's almost as if they never heard of direct entry. Local hospitals or other health centers basically don't know what the program is, and seem hesitant to even discuss whether they would hire an APN with no clinical experience.

    Even though all the opposing arguments above may be valid and true, the fact of the matter is -- it doesn't matter what is correct/true/proven by studies. If employers flat out REFUSE to hire an APN with no experience, it makes no difference. A stack of studies is not going to convince them to hire you.

    They will simply say "But you have no clinical experience. NEXT!"
  4. by   traumaRUs
    Mvanz999 - I think going ahead with the entry level MSN is fine. You are going into it with eyes open, realizing that your chances of landing an NP job right out of school might not be possible in your area. However, I think as a new grad RN, you will be happy with your job choices and you will have enough variety to go where you want.

    Good luck and please let us know how things go, please.
  5. by   Uberman5000
    Quote from lizz
    there are limits to outside parties they can sue if you're the one who's primarily responsible for a bad decision.
    Quote from lizz
    i dont follow exactly what you mean by this statement. are you referring to the defendant in a medical malpractice suit?

    Quote from lizz
    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.
    Quote from lizz
    ok - that is good, i own property as well - i have equity as well -

    Quote from lizz
    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).
    the statements reflect a clear lack of understanding of this type of thing, just an objective observation. unless you do something purposely, i.e, pulling out a gun and shooting a patient, the insurance company 99% of the time will pay, look at any malpractice policy there are stipulations regarding this type of thing. this is why you have malpractice? seriously, do you think that you pay premiums, get sued and the malpractice carrier can just say "oh, i dont feel like defending you", and not do it? if that does happen(very very rarely) it is due to something in the contract that says the insurer is able to do it, or because of severe severe severe negligence on your part.

    Quote from lizz
    there's other consequences to consider. who's going to want to hire you if you've had a big judgment 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.
    Quote from lizz
    again, not following you at all here -- it is a fact---> a large percentage of medical malpractice cases are settled. when a case is settled the defendant admits no wrongdoing. cant be held against you in a settlement because the defendant admits no wrongdoing in a settlement. did you know that? if you get sued multiple times, yes your rates probably will increase, but that is like anything in life. if i drive around getting into 5 accidents in a year my rates will go up, makes sense to me. but this assumes gross incompetence.

    Quote from lizz
    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.
    Quote from lizz
    oh thank you for clarifying that, because the previous statement was not accurate.



    [quote=lizz;1971334]one of the best ways to collect judgments is to put a lien on someone's house or bank account. how do i know this? because i've done it.
    [quote]

    so you know this because you have put a lien on someone's house? was this for a medical malpractice like we are talking about or is this in regard to you suing someone for something else... if it is unrelated then it is irrellevant to this discussion because we are discussing malpractice awards here.....

    Quote from lizz
    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.
    Quote from lizz
    so you know this because you have put a lien on someone's house? was this for a medical malpractice like we are talking about or is this in regard to you suing someone for something else... if it is unrelated then it is irrelevant to this discussion because we are discussing malpractice awards here.....

    again, not following the logic. i dont know how many times i can stress factual information, but facts are needed many times to dispel assertions and clear up misunderstandings. assuming someone does get sued, the malpractice carrier defends them, there is an extremely high percentage chance that the case will be settled out of court at which point in time the defendant admits no wrondoing and the prosecutor takes the some or in rare cases all of the insurance cap. do you think defendants settle by saying "ok, yes i will settle, here take the whole policy and the equity in my house" lol that doesnt happen..news flash -- cases dont get settled via malpractice whereby the plaintiff takes equity in the defendants house....so again, i think this matter is being way over dramatized and over exaggerated.

    you are making many assumptions - and its never good to assume so much in life -


    1) you assume that a less experienced aprn will get sued more frequently than an aprn with more experience, with no factual data to support your assertion.
    2) you assert that an aprn with less experience will be held more liable(i.e. greater award) then an aprn with more experience, again with no factual data to support the assertion.
    3) you assume that in the event an aprn with less experience is sued, that case will automatically go to trial without being settled.
    4) you assume that the trial will automatically be in the plaintiffs favor and the jury will award the the plaintiff equity in the defendants house, along with the entire insurance policy cap.

    as you can see you are making a great deal of assumptions with little factual data to support it. what is the chance of this scenario happening? very very rare unless someone is completely and utterly incompetent.

    again let me clarify-

    chances of being sued -> its possible
    chances of being sued and having your carrier drop you -> maybe if you shoot the patient instead of treat him
    if a suit goes forward against you chances of it being settled -> very high
    if the suit is settled chances you lose equity in your house -> 0%

    Quote from lizz
    that's why you don't see houses changing left and right but, what you do see is large judgment 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.
    Quote from lizz

    house liens are actually the best way to collect otherwise uncollectable judgments. and even if it takes a couple of years ... you get interest in addition to the original judgment amount.

    just curious, what type of "judgments" are you referring to....are these medical malpractice "judgments?". if you are assuming this, you are assuming that malpractice awards frequently result in the awarding of the defendants house equity to the plaintiff....which is factually incorrect. just wanted to clarify, maybe you are referring to some other type of judgment not related to malpractice award, if that is the case it is irrelevant to this discussion.

    Quote from lizz
    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.
    Quote from lizz
    i don't understand why you don't think i am taking it seriously...can you explain that a bit for me? i am trying to be as factually accurate as possible...i am just trying to clear up some things that facts demonstrate are being greatly exaggerated.

    Quote from lizz
    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.
    Quote from lizz
    again you are assuming that the insurance company is going to "hang out out to try." medico legally there are grave issues with this and it very very rarely happens(gross gross negligence) and if you feel like you are likely to be grossly grossly negligent then this is a possibility. it is your malpractice carriers job to provide you with a legal defense in the event you are sued, do you think they want to give 5 million to someone lol? they will do whatever they can to not pay.

    so i believe i have cleared up some issues with regard to the assertions made on this, if you would like to have a logical debate i am more than willing to engage but lets try to use facts instead of assertions and exaggerations.

    warm regards -

    uber man
  6. by   Uberman5000
    Quote from FutureNP10
    Sounds liek a very interesting program, but I would be leary of that due to the fact that most NP's have had experience as an RN for at least 2 years prior to even going back to NP school. You may not have a little trouble getting a job because I'd figure they'd choose the NP with some type of experience versus the one that has none.
    Also...not only job wise, but just for you, when becoming an NP, just so you can feel confident and comfortable with what you are doing..you might decide to go with a program that makes it mandatory for RN experience before going to NP school.
    Yeah...that sounds like the politically correct way to do it but I dont feel its necessary in my instance hence I am not going to waste my time working in a hospital doing enemas for a year to get enough "experience" to do primary care in a different setting. Doesnt make any sense to me at all really.....
  7. by   Uberman5000
    Quote from traumaRUs
    Another thing to consider if going for a clinic position - why would a doctor want to train a new NP while not being able to see the same number of patients that an experieced NP can see? It is always the bottom line and important to consider you must perform billable services.
    Hmmm, I could see the advantages to this as a business owner.....I would hire an inexperienced NP so that I could pay them less, train them and save myself some money, which is the bottom line in business. I dont understand why inexperienced NP's necessarily need to take longer with patients either thats kind of like saying that inexperience = incompetance in all cases....people learn quickly u would be surprised...
  8. by   traumaRUs
    Hi Uberman - my point was that from a business sense, a practice that hired an entry level NP (with no RN experience), would have to train you to be an RN first prior to even starting the NP training. This prolongs the orientation.

    I'm just curious what part of the country do you live in? What is the demand for the entry level NP (no RN experience)? Do you have job offers in writing? I live in central IL and the job market for APN's is tight.
  9. by   sirI
    unless you do something purposely, i.e, pulling out a gun and shooting a patient, the insurance company 99% of the time will pay, look at any malpractice policy there are stipulations regarding this type of thing. this is why you have malpractice?
    off topic:


    i've seen nurses (insert title) involved in litigation. nurses who did not carry individual malpractice insurance. they were covered under the hospital liability insurance. remember that all liability carriers have limits of liability. the policy covered all parties (nurses) involved in the suit. the total cost of the lawsuit surpassed the limits of coverage and the nurses were required to pay out-of-pocket, the difference.
  10. by   Uberman5000
    Quote from traumaRUs
    Hi Uberman - my point was that from a business sense, a practice that hired an entry level NP (with no RN experience), would have to train you to be an RN first prior to even starting the NP training. This prolongs the orientation.
    Hello Trauma -

    I am disputing the fact that you need previous work experience in order to work as a Nurse Practitioner. Do Registered Nurses need experience to get a job as a registered nurse?

    I am not disputing the fact that individuals with more experience will have a greater chance at being selected over a canidate with less experience.

    The fact is that there are more and more APRN programs that do not require previous experience for entry, despite the fact that many people "dont like it". And it is also a fact that people that graduate from these jobs are able to actually get a job working as an APRN rather than first working as a registered nurse for 2 years.

    Quote from traumaRUs
    I'm just curious what part of the country do you live in? What is the demand for the entry level NP (no RN experience)? Do you have job offers in writing? I live in central IL and the job market for APN's is tight.
    I am from the east coast...There is demand for NP's and depending on the individual/institution doing the hiring new grads will be hired. Like I said, if an employer feels as though they can pay a new grad less money rather than pay someone more money that has greater expereince they may. I have plenty of friends who have gotten jobs as APRN's with NO previous experience and they are very happy. One of them works in primary care, again no RN experience and they are doing great. I dont see how RN experience would exactly help them anyway..she is more like a mini physician than anything, not like she is sitting there giving people catheters and IV's. And yes, I work in a multidisciplinary practice, primarily specializing in musculoskeletal/neuromuscular pain and I dont see how I need previous RN experience in orthopedic nursing to do what I do, I learned great information in school and I merely apply it, hence the term "practice". I did my clinicals and passed my boards....I have my license, I can do my job and do it well.

    I have heard the job market is tight in IL/Chicago....some markets are very tight, Boston is a good example, its difficult to even land a decent RN job there....
  11. by   Uberman5000
    Quote from siri
    off topic:


    i've seen nurses (insert title) involved in litigation. nurses who did not carry individual malpractice insurance. they were covered under the hospital liability insurance. remember that all liability carriers have limits of liability. the policy covered all parties (nurses) involved in the suit. the total cost of the lawsuit surpassed the limits of coverage and the nurses were required to pay out-of-pocket, the difference.
    hmm, what i am referring to is the likelyhood of a single aprn being the target of a lawsuit and the phallacies and assumptions associated with that, not a lawsuit involving 20 people on a hospital ward etc......
  12. by   traumaRUs
    Advanced practice nursing - still has the "nursing" part in it. Being an RN isn't about tasks like putting in catheters and/or IVs, its about having basic assessment skils to know when someone is sick. This is the most important tenet to take from being an RN. You have to know when you are out of your league or when you need to be a strong advocate for your patient. I just don't think that entry-level to practice APNs have the assessment skills. Its not something taught in school - it comes from years of experience.
  13. by   Uberman5000
    Quote from traumaRUs
    Advanced practice nursing - still has the "nursing" part in it. Being an RN isn't about tasks like putting in catheters and/or IVs, its about having basic assessment skils to know when someone is sick. This is the most important tenet to take from being an RN. You have to know when you are out of your league or when you need to be a strong advocate for your patient. I just don't think that entry-level to practice APNs have the assessment skills. Its not something taught in school - it comes from years of experience.
    Really? From what I understand RN's learn basic assessment skills during their undergraduate education. Things like being able to take a persons pulse, blood pressure, temperature and respirations...as well as cardiac and pulmonary ausculation...the rudimentary stuff, APRNS learn advanced physical examination procedures...neurological exams...these are psychomotor skills that as you practice, you will become better at, just like anything else in life. How many times do you need to take a blood pressure before you become proficient at it? What about a temperature reading? Do you think these skills really require decades to hone? As for the other skills, cardiac/pulmonary auscultation, palpation etc...maybe slightly longer but if you are determined you can learn them quickly...The key thing is being able to recognize something abnormal with a physical examination so that you can refer out or order further(more accurate) diagnostic testing. What about my setting, do you think I sit there listening to peoples hearts and lungs and palpating peoples spleens. diagnosing an S4 gallop w/ mitral valve prolapse like I am some kind of cardiologist? No.... Again it depends on the setting that you work in. Moreover, how much information do you usually get from a physical exam, you get much more from the history...do you think it takes someone 10 years as an RN to learn how to take a history? Come on I think you are selling alot of people short....LMOPQRST - FAOMASH - etc...As far as advocacy goes, I am not sure what I sure i follow that....If someone comes into my office and has pain I try to get them better, if i cant help them or If I feel someone else can help them better I refer out...The patient comes to me for help, i attempt to help them what do you mean "advocate" what else do you want me to do?

    I understand that you dont like the idea, why are so many schools offering the option if new graduates are as incompetant as you assert?

close