Becoming an NP with little to no nursing experience?? - page 8

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   sirI
    Quote from traumaRUs
    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.
    Excellent comment, traumaRUs.
  2. by   core0
    Quote from siri
    Quote:
    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.
    OK lets look at three scenarios. One is a nurse that has 4 years med-surg experience, one is a nurse that has 4 years ICU experience and one is a nurse that has 4 years of inpatient psych experience. They all have four years of nursing. Are they all equal? Do they all have the same exposure to disease conditions and illness? This is my point here. The assumption seems to be that all nursing experience is equally valuable. I would assert that it is not just the type and quality of experience but the way the nurse processes that experience that matters.

    David Carpenter, PA-C
  3. by   sirI
    Quote from core0
    OK lets look at three scenarios. One is a nurse that has 4 years med-surg experience, one is a nurse that has 4 years ICU experience and one is a nurse that has 4 years of inpatient psych experience. They all have four years of nursing. Are they all equal? Do they all have the same exposure to disease conditions and illness? David Carpenter, PA-C
    No, they do not have equal exposure to disease conditions/illnesses. That's impossible and to think this is inaccurate.

    The assumption seems to be that all nursing experience is equally valuable
    Again, no assumptions. An accurate statement, however.

    YES, all experience has a hand in preparing the RN for the role of APN. All experience opens a door to how disease entities are handled; how the HCP arrives at said dx; why and how dx studies are performed; how to interpret said dx studies and apply to the disease process; how/why/when additional consult/referral is necessary as it applies to said disease process; all seen day in and day out as an RN. This helps shape one's own abilities to process information and apply to one's future as an APN.
    Last edit by sirI on Dec 17, '06
  4. by   bluesky
    Quote from core0
    OK lets look at three scenarios. One is a nurse that has 4 years med-surg experience, one is a nurse that has 4 years ICU experience and one is a nurse that has 4 years of inpatient psych experience. They all have four years of nursing. Are they all equal? Do they all have the same exposure to disease conditions and illness? This is my point here. The assumption seems to be that all nursing experience is equally valuable. I would assert that it is not just the type and quality of experience but the way the nurse processes that experience that matters.

    David Carpenter, PA-C

    Complete red herring. 99.9 % of nurses who pursue NP degrees pursue it in their own specialty.
  5. by   core0
    Quote from bluesky
    Complete red herring. 99.9 % of nurses who pursue NP degrees pursue it in their own specialty.
    Do you actually have any figures on this. The quote on the Psych nurse was from experience with an NP in an FNP program. I have seen plently of ICU nurses in FNP programs also. What is "their specialty" from a nursing perspective? What "specialty" does Med-surg go into?

    David Carpenter, PA-C
  6. by   core0
    I've been thinking about this a little more and some of the responses. I think that in answering the original poster, some divisions have been exposed. When looking at this I think that I have heard a lot of anectdotal experience but no true studies that show a difference.

    In examining this lets make a couple of (what I consider reasonable) assumptions:
    1. There are no studies that show that direct entry nurse practitioners are worse as clinicians than NP's with nursing experience.
    2. There are no studies that show that direct entry NP's have any other measureable diffences than NP's with nursing experience (patients seen, higher malpractice etc).

    Now, I think that one of the main items that everyone seems to be dancing around is that to admit that there is no difference between direct entry and other NP's is to denigrate nursing experience as part of being an NP. If in fact there is no difference between direct entry and others then the logical follow on question is, is nursing school necessary for entry as an NP? While viscerally this takes one away from the origins of the profession, I would maintain that this is an outgrowth of the direct entry programs themselves and to a lesser extent the rise of direct entry BSN programs.

    At some point a decision was made not to include nursing experience as one of the requirements for NP. If you look at the CRNA requirements there is a requirement for one year of acute care nursing experience prior to CRNA school. This is a clear example that this specific type of nursing is considered valuable for CRNA's. On the other hand the lack of such a requirement for NP's either indicates a tactit acknowledgement that this is not valuable or (more likely) an acknowledgement of the difficulty quantifying the value of previous experience. In addition NONPF seems to tactically acknowledge this.

    With at least 24 direct entry programs this is a problem that nursing will have to address. There are relatively simple studies that probably could be done (for example compare certification rates for experienced vs. direct entry NP's). There is a growing body of research on the value of bedside nursing including at least one study that shows a link between nursing education level and death rate in hospitals. I have seen little or no outcomes research from NP's particulary in the various educational environments that have cropped up.

    Just my thoughts from a non-nurse.

    David Carpenter, PA-C
  7. by   traumaRUs
    I think that the experience one gets from being an RN, provides you a pathway to what type of NP you want to be. If for example, you work in an ER and decide you really like caring for kids, you migh want to get Peds ICU experience before committing to a PNP program. Likewise, if you think that L&D might be what you want to do, working in a busy L&D unit might prove beneficial.

    This is not to say that all works out like we think it should. Most of my RN experience is in the ER. I really, really wanted to stay in the ER, but there were no positions so...I went with what was available. Nephrology had never even entered my head. However, my assessment skills and ability to handle emergencies very independently has helped tremendously. The staff know that even if I can't handle a dialysis machine issue, I can take care of the patient and know what I'm doing is the right thing in the right order. If I had no experience as an RN, I truly would be scared.
  8. by   PANurseRN1
    Also bear in mind that you will be held to the standard of care of an advanced nurse practitioner. A med-mal atty. or a BON isn't going to care if you went straight through a direct-entry program and didn't get experience first...they are going to hold you accountable for the level of knowledge and skill and advanced nurse practitioner should have.

    Which did you learn how to do first, walk or run?
  9. by   PANurseRN1
    FYI: I recognize three posters here from SDN. Something to consider.
  10. by   PANurseRN1
    Quote from 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:



    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.
    I noticed that, too, and that is definitely not the only related word. I believe the misspelling is very intentional, it's just that no one has called him on it yet.
  11. by   mvanz9999
    Quote from core0
    I've been thinking about this a little more and some of the responses. I think that in answering the original poster, some divisions have been exposed. When looking at this I think that I have heard a lot of anectdotal experience but no true studies that show a difference.

    In examining this lets make a couple of (what I consider reasonable) assumptions:
    1. There are no studies that show that direct entry nurse practitioners are worse as clinicians than NP's with nursing experience.
    2. There are no studies that show that direct entry NP's have any other measureable diffences than NP's with nursing experience (patients seen, higher malpractice etc).

    Now, I think that one of the main items that everyone seems to be dancing around is that to admit that there is no difference between direct entry and other NP's is to denigrate nursing experience as part of being an NP. If in fact there is no difference between direct entry and others then the logical follow on question is, is nursing school necessary for entry as an NP? .......
    Interesting post. I did want to point out the bold part...my understanding of the direct entry....the first part essentially IS nursing school. It's not until you finish that program and pass the NCLEX that you actually start the NP part of the program.
  12. by   mvanz9999
    Quote from traumaRUs
    I think that the experience one gets from being an RN, provides you a pathway to what type of NP you want to be. If for example, you work in an ER and decide you really like caring for kids, you migh want to get Peds ICU experience before committing to a PNP program. Likewise, if you think that L&D might be what you want to do, working in a busy L&D unit might prove beneficial.

    This is not to say that all works out like we think it should. Most of my RN experience is in the ER. I really, really wanted to stay in the ER, but there were no positions so...I went with what was available. Nephrology had never even entered my head. However, my assessment skills and ability to handle emergencies very independently has helped tremendously. The staff know that even if I can't handle a dialysis machine issue, I can take care of the patient and know what I'm doing is the right thing in the right order. If I had no experience as an RN, I truly would be scared.
    This is a tremendously valuable and relevant point. The experience you get as an RN leads you to what type of NP you want to be. This is the exact dilmena I am in.

    It states ON MY APPLICATION, that I must choose a specialty, on the application, and that I am applying for ONLY the program I choose (ie, Family Nurse Practitioner, Acute Care Nurse Specialist, Pediatric Nurse Practitioner), and that I will not be considered for any other type of program, nor can I change programs once I am accepted.

    They had an info session where there was a current student, and he said to make SURE that we choose the specialty we really want, as all the above was true. He applied for and was accepted to the Pediatric Nurse Practitioner, but in order to achieve his goals, he realized he should actually be a Family Nurse Practitioner, but that the school would not let him change programs.

    So how am I, a person with no clinical experience, excpected to choose a nursing specialty, when I have never had any nursing experience whatsoever?

    The programs are not designed to allow you to rotate through specialties and decide which you prefer. You can say all you want about shadowing and volunteering, but I have a full time job and cannot spend months shadowing different types of nurses (and I don't even know if you CAN shadow NPs or CNS on account of HIPAA)

    So I can choose one, I suspect I might like X, but I'm not really going to know that until I try it. And if I choose the wrong one today, I'm out $ 50K and many years.
  13. by   core0
    Quote from mvanz9999
    Interesting post. I did want to point out the bold part...my understanding of the direct entry....the first part essentially IS nursing school. It's not until you finish that program and pass the NCLEX that you actually start the NP part of the program.
    Yes this is the way that it works. The discussion here is about becoming an NP without experience working as an RN. My point, if this is not necessary to have experience working as an RN, then the RN part of direct entry becomes "provider" experience and the logical next step is to look if this is necessary.

    David Carpenter, PA-C

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