Becoming an NP with little to no nursing experience?? - page 7

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   live_crow
    RN degrees equip people to practise as BEGINNER RN's. The only way to become experienced is to work as an RN. Read all the "First Year in Nursing" posts if you don't believe that. APRN degree equip people to work as BEGINNER APRNs. Sure, it can be done with no RN experience, however it is the harder way to do it.

    The OP asked for opinions, and got them from the people "in the trenches". If you don't like them, by all means do your thing, and good luck. It's kind of pointless to think this thread is going to change your mind, or anyone else's.
  2. by   Sheri257
    Quote from siri
    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.
    Thank you Siri. This is my point exactly, especially since NP's do have more liability.

    :typing
  3. by   Uberman5000
    Quote from lizz
    Thank you Siri. This is my point exactly, especially since NP's do have more liability.

    :typing
    Quote from lizz
    Thank you Siri. This is my point exactly, especially since NP's do have more liability.

    :typing

    ???? I dont think Siri is talking about solo practicing nurse practitioners but if you deduce that she is from her statement, hmm ok?

    Just curious Lizz, I was wondering if you would care to comment on some of the points that I made regarding the assertions you raised during your last post...? I broke some things down and I was wondering if you had any further thoughts because I found some of the points exaggerated(from a factual standpoint), page 7.

    Thanks for the clarifcation on that -

    Uber -> Man
  4. by   sirI
    I dont think Siri is talking about solo practicing nurse practitioners
    Well, no, not solo NPs, but yet again, solo NPs would not be ones just out of an NP program nor would they be NPs with zero RN experience and/or just out of an NP program. At least, I would hope not. That is a very scary thought.

    But, as for litigation, some NPs do not carry individual liability (which is VERY dangerous) and if working in a group with other NPs, will be covered by the entities liability carrier. They, if named in a suit, would share the limits of liability coverage as outline above.
  5. by   Uberman5000
    Quote from siri
    Well, no, not solo NPs, but yet again, solo NPs would not be ones just out of an NP program nor would they be NPs with zero RN experience and/or just out of an NP program. At least, I would hope not. That is a very scary thought.
    Ok, what about NP's working in primary care or working in speciality practice, i.e orthopedics or some other discipline. Can you provide me with any actual statistics regarding the frequency or APRN's being sued? Its easy to say anectdotally "I know of 5 people who have gotten sued" etc, I have seen alot of speculation to the point of ridiculousness thus far...people claiming things that have no basis in fact at all and blowing things out of proportion rather than looking at the cold, hard facts. Actually I am really interested to see statistics on:

    1) Number of malpractice suits against APRN's relative to other health disciplines, PA, RN, etc....

    2) Number of malpractice suits settled against these groups -

    3) Number of malpractice suits that have went to trial regarding these groups

    4) Number of jury awards in plaintiff favor in these groups -

    I mean do APRN's get sued MORE than these other groups? I am asking a research question here and I need some data to come up with the answers. I already know via FACTS that

    A) Malpractice cases are almost always settled out of court
    B) The settlement results in an award for the plaintiff toward the monetary benefit of the policy
    C) In settling the defendant admits NO WRONGDOING
    D) Despite some exaggerated claims people do not automatically get equity in your house because they decide to sue you, that requires a trial award in favor of the plaintiff, but the great chances are it will never go to trial.

    Quote from siri
    But, as for litigation, some NPs do not carry individual liability (which is VERY dangerous) and if working in a group with other NPs, will be covered by the entities liability carrier. They, if named in a suit, would share the limits of liability coverage as outline above.
    I agree, I think you would have to be a fool not to carry individual liability coverage. BUt I want to see the cold hard facts about these health professionals getting sued and how many of them actually become personally liable for damages suffered to the plaintiff...the way some people are talking you think it happens to everyone everday....its just gross exaggeration spitting in the face of factual evidence to the contrary.

    Do you think that Nurse Practitioners that go straight from BSN to APRN without working as RNs first are incompetant?
  6. by   sirI
    Do you think that Nurse Practitioners that go straight from BSN to APRN without working as RNs first are incompetant?
    No, I do not think they are incompetant and no one here has intimated that. Just very very inexperienced, have zero situations to reflect upon other than those very few patients with whom they have had contact as students in clinicals, lack the astute diagnostic abilities as they relate to the disease process for they've not had the experience to work with and/or troubleshoot many scenarios/situations, and are woefully unprepared for the real world.

    On another note, if you are truly interested in liability stats as they relate to the RN and/or NP, I suggest you start another thread about this topic for we have ventured off topic discussing liability issues.

    Now, back to the topic at hand: "Becoming an NP with little to no nursing experience??"
  7. by   core0
    Quote from siri
    No, I do not think they are incompetant and no one here has intimated that. Just very very inexperienced, have zero situations to reflect upon other than those very few patients with whom they have had contact as students in clinicals, lack the astute diagnostic abilities as they relate to the disease process for they've not had the experience to work with and/or troubleshoot many scenarios/situations, and are woefully unprepared for the real world.

    On another note, if you are truly interested in liability stats as they relate to the RN and/or NP, I suggest you start another thread about this topic for we have ventured off topic discussing liability issues.

    Now, back to the topic at hand: "Becoming an NP with little to no nursing experience??"
    But can you assume all nurses have equal exposure to scenarios and situations just because they have experience. Surely you have seen NP's that are unable to process this information as NP's (unable to make the leap so to speak)? Or what about qualitative differences in experience? Is a med surg nurse the same as an ICU nurse? Nursing educators and at least one state BON state that the NP's only qualifications are what they learned as NP's not their previous experience as nurses.

    There are a number of assumptions here that may or may not be true about how useful nursing experience is as an NP. It is similar to a previous post asking why someone would want a nurse with less experience as an NP. This assumes that an NP that is an experienced nurse would be able to see patients faster than an NP that is an inexperienced nurse. I think these are two different skillsets.

    Finally a question to Siri - as someone who is looking at a Hospital job. My understanding is that since hospitals have relatively deep pockets that they have assets to use if an award goes over the amount of insurance they carry (alleviating the need for an NP or PA to pay out of pocket). In private practice it is common for the employer to pay for malpractice. Is th insurance. Is this common in institutional settings.

    David Carpenter, PA-C
  8. by   core0
    Quote from Uberman5000
    O

    C) In settling the defendant admits NO WRONGDOING
    I'll just address one of these issues. If you settle, you are entered in the national practitioner data bank. This is reportable on your license in most states and on credentialling in most hospitals. One of the things that you want to ensure is that you have the right to make a decision on settlements and not let the insurance company do it for you. This is also why you want your own policy, not the policy of the practice. You want to make sure whatever decisions are in your best interest.

    David Carpenter, PA-C
  9. by   Sheri257
    Quote from core0
    I'll just address one of these issues. If you settle, you are entered in the national practitioner data bank. This is reportable on your license in most states and on credentialling in most hospitals. One of the things that you want to ensure is that you have the right to make a decision on settlements and not let the insurance company do it for you. This is also why you want your own policy, not the policy of the practice. You want to make sure whatever decisions are in your best interest.

    David Carpenter, PA-C
    Thank you. Again, this is my point exactly.

    While the issue of lawsuits may seem off topic to some, to me, it's not.

    My original point was: the additional potential liability alone would be reason enough to want nursing experience as an NP, IMHO.

    I won't debate the legal aspects any further (as requested by the moderator) but, I just wanted to clarify why I brought it up in the first place.

    :typing
    Last edit by Sheri257 on Dec 17, '06
  10. by   Miss Ludie
    Been scanning this thread with some amount of interest. I feel that some here are playing devil's advocate, shaking cages, pulling chains. But all in all there has been some intriguing debate.

    There is one word that has bothered me Uberman and that is:

    Hence the double phallacy
    Is this intentional misspelling in order to proclaim your Uber-station in life? It just jumps off the page. The closest I could find to a definition of the P word is that of phallacea which is a family of fungi.

    Meanwhile, I will return to my silent spot and read on.
  11. by   bluesky
    Quote from core0

    There are a number of assumptions here that may or may not be true about how useful nursing experience is as an NP. It is similar to a previous post asking why someone would want a nurse with less experience as an NP. This assumes that an NP that is an experienced nurse would be able to see patients faster than an NP that is an inexperienced nurse. I think these are two different skillsets.
    David Carpenter, PA-C
    The whole point is, that bedside nursing develops all
    those skillsets. Now, can an experienced nurse see patients faster than an inexperienced RN? Well, if you are trying to assert that an inexperienced practitioner of any ilk can make as effective and comprehensive an assessment as an experienced one (who has been assessing for years), on average, then you are quite a brave person. As a patient, for myself, I will take the NP with the nursing experience, Thank You.
  12. by   traumaRUs
    Bluesky - that is my point also. I am a new APN (graduated May 06) and I came to a large nephrology practice where there are many chronic patients. They are well-versed consumers and know what an APN is. They ask good questions too. Many have asked me over the past few months about my professional background. When they hear I'm a new grad APN they always ask what else I've done. When I tell them that I have 10 years experience in our local level one trauma center and another year in the ICU, they all relax and know they are in experienced hands.

    Most patients nowadays are good consumers - many of the lay public are aware of what an APN is and what they do and many prefer them as their primary care provider. I think though that we stand a chance to lose some credibility if we as a profession allow the MSN direct entry NP programs to proliferate.

    The schools are the ones that push this course of education: its more money in their pockets and gives way to the "let's have it now" generation.
  13. by   sirI
    Surely you have seen NP's that are unable to process this information as NP's (unable to make the leap so to speak)? Or what about qualitative differences in experience? Is a med surg nurse the same as an ICU nurse?
    Yes, many times I see NPs who have difficulty with the transition from RN to NP. The ones (NPs) who have had greater difficulty are the ones without RN experience (and, no, that is not the ONLY reason they have difficulty). I know you do not want to "hear" this statement (NPs need RN experience), but that's my own personal experience as I serve as NP mentor. Mentor to both DE NPs as well as NPs who have RN experience.

    I rather find that ICU nurses possess a great deal of Med-surg experience. And, of course they (ICU, Med-Surg) are not the same. Former is acute and latter is chronic.


    Nursing educators and at least one state BON state that the NP's only qualifications are what they learned as NP's not their previous experience as nurses.

    True. Graduation from an APN program and successfull certification is what qualifies you to be recognized as APN. But, you have many RNs who are considering APN and as RNs are restructuring their minds to apply the knowledge gained as RN to their futures as APNs. And, I speak as an Educator as well as an APN.

    There are a number of assumptions here that may or may not be true about how useful nursing experience is as an NP.
    If you are referring to my comments, no, I do not assume. My observations are from personal experience over many years.


    This assumes that an NP that is an experienced nurse would be able to see patients faster than an NP that is an inexperienced nurse.

    I highly doubt that previous experience has anything to do with the speed with which the NP sees patients.



    But can you assume all nurses have equal exposure to scenarios and situations just because they have experience.
    I've tried to address this statement and really not sure what you are driving at here.


    Finally a question to Siri - as someone who is looking at a Hospital job. My understanding is that since hospitals have relatively deep pockets that they have assets to use if an award goes over the amount of insurance they carry (alleviating the need for an NP or PA to pay out of pocket). In private practice it is common for the employer to pay for malpractice. Is th insurance. Is this common in institutional settings.

    And, as I have pointed out with a previous question/statement regarding liability issues, this question needs to be addressed in another thread for it is off-topic from the OPs original intent: Becoming an NP with little to no nursing experience??

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