Becoming an NP with little to no nursing experience??

[Blurr156]

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 certain practical reasons (including my union not helping to pay for it) I have been looking at other options, nursing/NP.

I was very excited to learn of a school near me that has a combined BSN/NP program for people with non-nursing bachelor degrees. I was about to start looking deeper into this program when a good friend of mine who is a member of an interview committee at a nearby hospital told me that I shouldn't do the program because I would have trouble getting a job.

The reason stated was because I wouldn't have been seen as having "paid my dues" as a nurse first.

Is this true?

I could understand why someone might feel that way about someone who went through this type of program never having worked in healthcare before. However, I like to think that to a certain degree I've paid my dues (I know it isn't nursing, but from a time in healthcare perspective).

My friend did say that I might be considered an exception to that rule. The program is at a VERY well known school and I was told by my friend even then it wouldn't matter. I was wondering what people here thought regarding this topic.

Thank you for any guidance you can provide.

[GM2RN]

Have you read the literature on the topic?

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I have not read any literature on the subject. It does not affect me personally so I don't have a great interest in it. I'd be willing to read an article or two though, if you care to post them, but unless they are seriously going to conclude that every single new grad NP without nursing experience will have the same level of assessment and judgment skill as the new grad NP with several years of nursing experience, I don't see how their opinion can possibly differ from mine.

[GM2RN]

I actually agreed with you on this before starting my NP education. I don't anymore. There is very little correlation between my extensive RN experience and the role of NP. It's a totally different ball game and all students are equal. Nurses do not diagnose and manage patients; NPs do. I'm learning just as much as my classmates with very little experience -- sometimes, I've even found my nurse brain hindered my learning. Never expected that!

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Nurses cannot LEGALLY diagnose, but I don't know of a nurse that has not used their knowledge and experience, however much that may be, to come up with a diagnosis for their patients, at least in the ER. Maybe not so much with floor nursing, but I work in the ER and we do this all the time, and on occasion we get it right when the doc is wrong. The difference is that nurses cannot act on a diagnosis without an order, even when the doc is wrong.

Do you consider NPs to be better able to manage patients than residents? How many times have you experienced residents who don't know what they are doing and you roll your eyes at them behind their back when they give you orders? Happens all the time in the ER at least. Not to mention that I know ICU nurses who call the doc when they need something for their patients and the doc tells them to order what they want because they have that much confidence in the nurse to know how to treat that patient. I'd be willing to bet you'd be hard pressed to find a new grad NP with no nursing experience that can do that. I just don't see how anyone can seriously believe that an inexperienced NP can measure up to the NP that has that kind of nursing experience.

[BostonFNP, APRN]

I don't know of a nurse that has not used their knowledge and experience, however much that may be, to come up with a diagnosis for their patients, at least in the ER.

How many times have you experienced residents who don't know what they are doing and you roll your eyes at them behind their back when they give you orders?

You realize, I trust, that taking a stab at (or making the correct) medical dx as an ED RN is different from being the provider that needs to consider that differential and make the final decision and order to treat is a subtle but important difference. I didn't fully appreciate it until I changed roles.

Residents are learning. Just like novice NPs. As are experienced MDs and experienced NPs. Everyone makes mistakes. If you take a peek behind the curtain, there are plenty of providers that role their eyes at nurses who request inappropriate orders. The good nurses and good providers don't do either.

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[edmia, BSN, RN]

You realize, I trust, that taking a stab at (or making the correct) medical dx as an ED RN is different from being the provider that needs to consider that differential and make the final decision and order to treat is a subtle but important difference. I didn't fully appreciate it until I changed roles.

Residents are learning. Just like novice NPs. As are experienced MDs and experienced NPs. Everyone makes mistakes. If you take a peek behind the curtain, there are plenty of providers that role their eyes at nurses who request inappropriate orders. The good nurses and good providers don't do either.

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I completely agree. Until I started my graduate education, I did think diagnosis of a problem was something I did as an ED and an ICU nurse. But it is very different as Boston states, when diagnosing involves differentials and deciding on proper treatment. The shift from thinking as a nurse to thinking as a provider is a big one and I'm excited to do it.

The only thing my nursing experience gives me is having been exposed to a lot of stuff. I have classmates who have only done pediatric nursing for 15 years for example, and they are learning the adult now and having to study more as it is new information. I've at least dealt with all kinds of ages and populations.

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[zmansc, ASN, RN]

You realize, I trust, that taking a stab at (or making the correct) medical dx as an ED RN is different from being the provider that needs to consider that differential and make the final decision and order to treat is a subtle but important difference. I didn't fully appreciate it until I changed roles.

Residents are learning. Just like novice NPs. As are experienced MDs and experienced NPs. Everyone makes mistakes. If you take a peek behind the curtain, there are plenty of providers that role their eyes at nurses who request inappropriate orders. The good nurses and good providers don't do either.

Sent from my iPhone.

We have a very experienced ED nurse, who is great at guessing the dx. He loves to do it too. He comes back to the nursing station after his initial assessment and tells anyone there, providers and nurses alike, what his dx is. He's usually right too.

When I told him I was going back to school for my NP he said, "No way I could do that". I asked why, he said, it's so much easier to guess the dx than to have to actually make a dx and treatment plan, and be responsible for the their accuracy. Up to that point, I had never made that distinction, but it is a very big one.

[PMFB-RN, RN]

If you take a peek behind the curtain, there are plenty of providers that role their eyes at nurses who request inappropriate orders.

It's OK. There are plenty of nurses rolling our eyes when NPs and physicians give inappropiate orders.

Just a couple weeks ago, during a code, we had a resident who kept ordering Ativan when atropine would have been the appropiate drug. To be fair english isn't his first language and he was excited to be "running" his first real code. We ignored his orders and gave the appropiate drug, just as nurses have been, and will continue to do when recieving inappropiate orders.

[BostonFNP, APRN]

It's OK. There are plenty of nurses rolling our eyes when NPs and physicians give inappropiate.

Obviously you didn't read the previous post.

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