NO experience new graduate BSN student applying for MSN-FNP graduate school? - page 2

I am torn on what I should do with my application to graduate school. I have no bedside experience in the nursing workforce, but I don't believe that it would change my abilities to be a competent,... Read More

  1. by   shibaowner
    Quote from Dodongo
    To the first point here - it couldn't possibly be driven by $$$$ on the part of the nursing institution. No. They care more about each individual graduate and the profession as a whole than their bottom line, I'm sure...

    And to the second, I think a lot of the BSN posters are either in NP school, or, and get this, they work with NPs. That's like saying no one can comment on anyone else's career. Anyone can evaluate a career path and make an informed (personal) decision about it. Especially if they are pursuing it.

    Ultimately, yes, I agree, the quality of the NP (or any professional for that matter) lies with their own inherent abilities and the time/energy committed. But there is a best way to go about most anything, and we should be promoting the pathway that produces the best NP. Especially as NPs are attempting to gain varying levels of independence.
    Obviously, you can express your opinion. However, as a BSN you are not qualified to sit in judgment of NP training. The evidence that does exist does not support your view.

    Personally, I trust the judgment of schools like Hopkins, Yale, UCLA and so forth that allow for direct BSN to MSN. There are a lot of us out there and we are fine, thank you.
  2. by   WestCoastSunRN
    Quote from Dodongo
    My opinion:

    Come watch an ICU nurse do a full head to toe assessment 3 times a shift on two different patients and tell me that they don't do a detailed assessment. ICU RNs do more detailed assessments than any physician or NP I have seen in any setting - including the ones also practicing in ICU. Also, come to the ICU and tell me those nurses haven't gained practical knowledge applicable to diagnosing and prescribing. I'm not going to sit here and say that all RN experience is worthwhile for NP school, because we all know that isn't true. And I'm also not going to sit here and say that a knowledgable RN is anywhere close to an NP in terms of diagnosing, prescribing, etc. Because they're not (no matter what some of them think). But there are select areas that prior experience as an RN is extremely valuable - ICU being one. And a smart, driven RN with some worthwhile and practical experience under their belt will thrive in NP school and after graduation in ways a direct entry grad simply can not.

    I think where experienced RNs fail, is when they over estimate their abilities because they're experienced nurses. I've met my fair share of nurses who think physicians and NPs are incompetent compared to their own clinical acumen. A recipe for disaster.
    Very well said. Thank you. If you haven't worked in ICU, you may not be able to appreciate the scope of an RNs practice and knowledge there.
  3. by   WestCoastSunRN
    Quote from shibaowner
    Obviously, you can express your opinion. However, as a BSN you are not qualified to sit in judgment of NP training. The evidence that does exist does not support your view.

    .
    Wow Dodongo. Looks like she put you in your place. Maybe you'll be worthy once you get that MSN. Lol.
  4. by   DTWriter
    Bedside nursing is not a necessity to be a NP, let alone to get into a NP program.

    BUT-

    You should get nursing experience in something (i.e public health, clinics, school, LTC, etc.). IMO, you will be doing yourself a disservice if you become a NP without RN experience. I do not know about you but working as a RN has helped me retain nursing knowledge better than just reading about it in the books. Plus, there are employers that require NPs to have at least a year of RN experience.

    No qualms if you managed to get into a program without the experience but at least get experience while you are a student. There are NP programs that allow students seven years to complete their programs; if you managed to get into one of those programs, then take advantage of that time to get experience.
  5. by   Dodongo
    Quote from shibaowner
    Rich, E. R. (2005). Does RN experience relate to NP clinical skills?. The Nurse Practitioner, 30(12), 53-56.

    Assessing successful entry into nurse practitioner practice: a literature review. By: Rich ER, Jorden ME, Taylor CJ, Journal of the New York State Nurses Association, 00287644, 2001 Fall-Winter, Vol. 32, Issue 2

    El-Banna MM, Briggs LA, Leslie MS, Athey EK, Pericak A, Falk NL, Greene J. Does Prior RN Clinical Experience Predict Academic Success in Graduate Nurse Practitioner Programs? J Nurs Educ. 2015 May;54(5):276-80. doi: 10.3928/01484834-20150417-05.
    For the first - response bias - enough said. So many flaws with this type of design it's hardly useful.

    I was unable to access the second.

    And the third - a limited, retrospective cohort study conducted at one university with n=106 that used gpa as the only outcome variable.

    Forgive me for completely disregarding these pieces of "literature".
  6. by   Dodongo
    Quote from shibaowner
    Obviously, you can express your opinion. However, as a BSN you are not qualified to sit in judgment of NP training. The evidence that does exist does not support your view.

    Personally, I trust the judgment of schools like Hopkins, Yale, UCLA and so forth that allow for direct BSN to MSN. There are a lot of us out there and we are fine, thank you.
    Absurd. I am more than qualified to sit in judgement of whatever I darn well please - and I do it often. Haha. But seriously, schools want money. It doesn't matter which school it is. The schools you listed are some of the most expensive ones, and for what? So that you can harp on and on in post after post that you attended "X" school?
  7. by   jaderook01
    Quote from shibaowner
    RNs do not hire NPs, so who cares what you think? I don't.
    If you didn't care, you wouldn't be responding to us about it.
  8. by   SopranoKris
    Quote from shibaowner
    Rich, E. R. (2005). Does RN experience relate to NP clinical skills?. The Nurse Practitioner, 30(12), 53-56.

    Assessing successful entry into nurse practitioner practice: a literature review. By: Rich ER, Jorden ME, Taylor CJ, Journal of the New York State Nurses Association, 00287644, 2001 Fall-Winter, Vol. 32, Issue 2

    El-Banna MM, Briggs LA, Leslie MS, Athey EK, Pericak A, Falk NL, Greene J. Does Prior RN Clinical Experience Predict Academic Success in Graduate Nurse Practitioner Programs? J Nurs Educ. 2015 May;54(5):276-80. doi: 10.3928/01484834-20150417-05.
    Of the evidence you've posted, the first 2 are older than 5 years. The third only relates to success in an NP program, not success as an actual practitioner.

    And, by the way, I'm in an NP program and I'm also an ICU RN. I wouldn't dream of jumping in to the NP arena without having any RN experience whatsoever. In that case, what's the point of being an NP when you've never been an RN?

    You can justify yourself all you want to, but you're going to have a hard time persuading those of us who have actually done the job you brag you HAVEN'T done. Especially using suspect "evidence" that wouldn't pass muster on a paper written in an ADN program, let alone the master's level.

    You feel proud of yourself out there in family practice land. Let the "real" nurses who know what they're doing take care of the complex cases in the hospital. Wouldn't want you to sprain your non-nursing brain trying to wrap your head around titrating pressors or running a code.
    Last edit by SopranoKris on Sep 16
  9. by   Wuzzie
    Quote from shibaowner

    RNs, and I totally respect them, do not do the detailed assessments necessary to diagnose, nor do they diagnose or prescribe treatments.
    So there is not one nursing role that actually does do this? Not one? Are you absolutely sure about that?
  10. by   Castiela
    I emailed the AANP out of curiosity of their position on the debate, as I was willing to concede there might be a cultural bias on my part, as potential nps will not be considered for schooling without a minimum of 2 years. I got quite a lengthy response, and will share below.

    "AANP does not take a position on advancing straight into an NP programs or getting RN experience first.

    However, I can offer my own personal experience as a NP. I think before you invest in the time and financial resources, it would be helpful to know if you want to take the additional responsibilities as an NP. The only way to find out is to work as an RN. Some RNs may find that they don’t enjoy taking the responsibility of providing nursing care to others. Maybe they even find they don’t like working with the public as much as they thought they would. Those responsibilities and commitments to your patients become even greater as a NP provider. The work duties alter with a higher level of responsibility, but the bottom line is you still have to like being an RN or you won’t like being an APRN. Additionally, the more experience you have with seeing various therapeutic conditions, treatments and opportunities to educate your patients, the better you will be as a NP. There is no substitution for the experience you will have as an RN. Though you gain scholarly and clinical knowledge and experience as an NP student, applying that information is likely to be more difficult without the foundation of experience as an RN. Experienced RNs rely on their experience as a RN to apply and understand the next level as a NP. Granted, PAs go straight from undergraduate to graduate school, but most physicians and ancillary medical professionals (administrators, for example) find our prior RN experience of great value over the lack of medical experience of new PAs.

    Some advantages of getting RN experience first is that you would have working knowledge of the profession, less of a learning curve at the next level, more confidence, and the direction of your growth was made based on your experienced instead of perceptions of our profession. If you become an RN first but later discover you don’t want to be a provider, there are still other options you can pursue in the medical field before spending more time in school. Perhaps you might find that you like working in research, for example, or may want to pursue a graduate degree in Public Health or other medical-related fields, (AANP, personal communication, Sept 15/17)"
  11. by   umbdude
    To be a proficient NP, one needs NP experience, not RN experience. What student NPs need are more clinical hours and more opportunities for post-grad new NP residencies.
  12. by   Dodongo
    Quote from umbdude
    What student NPs need are more clinical hours.. .
    Very much agree. Student NPs should have a year of full time clinical hours. It's ludicrous to have an FNP get 600-800 hours of clinical in school and then graduate and think they're practicing in their scope working in psych, peds, OB, inpatient. Even the specialty programs that get 800 hours in their specialty are doing themselves and their patients a disservice.
  13. by   shibaowner
    At least I have provided some evidence on whether RN experience is necessary for NP success. Those who disagree with me have NO evidence to support their bias, except for anecdotes. I do feel there should be more studies done on this.

    Qualifications do matter. That is why "expert opinion" is a level of evidence. "Student and anyone who wants to opine" is not a level of evidence. As a practicing NP, I have more knowledge of the matter at hand than RNs and students. I do not debate RNs on matters pertaining to RN practice.

    Anyone who claims that all nursing schools just want money is equivalent to a conspiracy theorist.

    Just because a study is old does not make it invalid.

    "Confirmation bias" is the what people say when they don't agree with a study and have no evidence of their own.

    Why does ICU RN experience benefit a primary care NP or an NP going into psych, derm, sports medicine, schools, etc? It doesn't.

    Who cares what people on this forum think? I don't. Who hires most NPs? MDs. Do MDs care about RN experience? Most do not. Do primary care MDs care whether someone worked in the ICU? Most do not. Why don't primary care MDs care about ICU or ER experience? Because a primary care environment is DIFFERENT - most outpatient facilities do not have a vast army of healthcare professionals and equipment. Primary care requires a different mindset and many primary care MDs have told me they DO NOT want an NP or PA who only has hospital experience. Why? Because these MDs have had bad experiences with such individuals.

    That said, if a prospective NP wants to work in the hospital, then they should have some bedside nursing experience. Most schools with acute care NP tracks require this. They don't require it for primary care NPs.

    What is this obsession with the ICU? Most NPs work in primary care. How many NPs work in the ICU? So should only RNs who worked in the ICU be allowed to be NPs? I haven't worked in the ICU. If RNs with such experience have great assessment skills, wonderful! How come I wasn't dazzled by their exam skills during our assessment classes? Hmmmm. Could it be because ICU RNs are looking for different things than a primary care NP is?

    Has anyone here proved that NPs with RN experience have better assessment and exam skills? No. Are better at prescribing? No. Have better patient outcomes? No. Have better patient satisfaction? No.

    Yes, I am proud of the schools I attended. I see no reason to be coy about where I went to school - it has to be on my resume, after all. Yale, UCLA, Johns Hopkins. Damn right I am proud! I worked like a dog to get into and graduate from those schools, and pay for them MYSELF (I had nothing handed to me). Was it worth the money to go to top schools? Yes, it has benefited me greatly in my previous career (business) and in nursing. If you think prospective employers and graduate admissions officers disregard schools attended, you are deluded. In addition, finding an NP preceptor is much easier if you are attending a reputable school - the better the school, the easier it is.

    New grad NPs who wish for more clinical training can go for an NP residency program or work for an employer that provides intense training.

    What is interesting is I see so many posts on AN from former RNs who are new grad NPs and they complain they can't get a job, or their offers are for less money than they were making as an RN. I don't see posts from new grad NPs who can't get a job because they lack RN experience!

    Finally, there is a fascinating thread under General Nursing complaining that too many future NPs are just getting 1 or 2 year of RN experience, creating a lot of disruptive churn and wasting the time of the people who have to orient and train them. Perhaps RN jobs should be reserved for people who actually want to be RNs! There are more than enough RNs who truly want a nursing career and do not want to become NPs.

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