NO experience new graduate BSN student applying for MSN-FNP graduate school? - page 3

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 Wuzzie
    So there is not one nursing role that actually does do this? Not one? Are you absolutely sure about that?
    Do you know an RN who is diagnosing and prescribing? If so, they are performing illegal acts.
  2. by   shibaowner
    Quote from 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)"
    Interesting, but it is just the responder's personal opinion, as she clearly states. If RN experience should be required, why doesn't AANP or ANCC take an official stand?
  3. by   Wuzzie
    Quote from shibaowner
    Do you know an RN who is diagnosing and prescribing? If so, they are performing illegal acts.
    I'm sorry but you are misinformed. CCT/Flight nurses do it every single day.
  4. by   shibaowner
    Let's say NPs with RN experience are better. This would be reflected in malpractice insurance cost. So do such NPs pay less? No, they do not.
  5. by   Castiela
    I don't know, I was interested in that too. Barnes (2015) found orientation to be more helpful in transitioning to becoming an np than previous experience, but it doesn't report patient outcomes between the two groups.
    (Barnes, H. (2015). Exploring the Factors that Influence Nurse Practitioner Role Transition. The Journal for Nurse Practitioners : JNP, 11(2), 178–183. Redirecting)

    I guess it comes down to individuals. I don't doubt that you are a good fnp, and that people can be good fnps without additional Rn experience. I guess I wonder if you are the exception and not the rule per say, and out of those who go straight to be an fnp, what are their pass rates compared to those with experience? Patient outcomes? You sound like a mindful individual who rightfully takes pride in their eduction and work. However, what worries me is those who are only in the practice for the pay check; who do not have the critical thinking and cause patient harm. i worry about the non Yale/ John Hopkins programs that do not the same stringent practices as you experienced. Schools where their first goal is to create money and secondarily, make safe nurses.

    I know that there are still Rn and Lpn programs that are the same, and I am not a NP or from the us, so I cannot speak to your regulation and safe checks. However, as an RN/ LPN, we tend to have what I imagine are more supports, people to ask questions to and regulation than say a new NP on their own (again, this is speculation on my part).

    I think NPs are the future of healthcare, and they are gaining (sometimes it feels very slowly) the trust and respect of the government and the public. I'd be worried about what a sensationalist news story/ stories could do harm to that trust.

    Again, I recognize there are "what ifs" to my fears, and I know that all nurses of all experience levels make mistake. However, they do tend to make less as they gain more experience, and don't see how having hands on experience practicing would ever work against someone/ be a negative thing before going to train to be an np.
  6. by   SICUmurseCCRN
    Quote from shibaowner
    Most primary care NP graduate programs no longer require bedside nursing experience. Note that is primary care. If you want to be an acute care NP, then most programs require some bedside nursing experience. Check with your schools for their requirements.

    This has been a controversial topic. But NP schools have been accepting new grad BSNs w/o bedside experience since the 1990s. The evidence, although limited, indicates NP students w/o RN experience actually do better in grad school and also have better clinical exam skills than students with RN skills.

    I went straight thru to get my AGNP and many others do, too. Ignore the negativity here and do what you want.
    so i believe you can do just fine as an NP without RN experience but seriously??? NP students without RN experience have better clinical exam skills???? how can you even type those words and believe that to be the truth? additionally, there are so many other things that happen when you are actually taking care of patients on top of just assessing a pt that no book, lab or clinical in school can teach you (meds, education, assessment skills, lab values and what they really mean and look like etc). experience as an RN in any capacity will help you be a stronger NP hands down.
  7. by   shibaowner
    Quote from SICUmurseCCRN
    so i believe you can do just fine as an NP without RN experience but seriously??? NP students without RN experience have better clinical exam skills???? how can you even type those words and believe that to be the truth? additionally, there are so many other things that happen when you are actually taking care of patients on top of just assessing a pt that no book, lab or clinical in school can teach you (meds, education, assessment skills, lab values and what they really mean and look like etc). experience as an RN in any capacity will help you be a stronger NP hands down.
    You're not an NP, are you? I am basing my statements on evidence. Where is your evidence?
  8. by   shibaowner
    To the defensive RNs here: do you really want a bunch of prospective NPs flooding RN jobs for just 1 or 2 years? Or would you rather hire RNs that truly want to be career RNs? There is an interesting thread in General Nursing about how many RNs are sick and tired of training new nurses who leave after 1 or 2 years to go to NP school.

    Everyone wants NPs to be well trained. As another poster has pointed out, they need experience that will make them better NPs. The best way to accomplish this is NP residencies, which are growing in number. That way, the RNs have RN jobs and the NPs get directly applicable experience without disrupting the RN workforce.
  9. by   Dodongo
    Quote from shibaowner
    As another poster has pointed out, they need experience that will make them better NPs. The best way to accomplish this is NP residencies, which are growing in number. That way, the RNs have RN jobs and the NPs get directly applicable experience without disrupting the RN workforce.
    Quote from shibaowner
    What is the best way for NPs to get more clinical experience and training? It is NP residencies, which are growing in number.
    Why are NP residencies more desirable than increasing clinical hour requirements within NP programs themselves? Instead of 600 hours we can require 2000 hours. That way NPs can graduate and hit the ground running, rather than needing extensive "orientation". That is something programs and, theoretically, accrediting bodies can implement easily and swiftly. Increasing the number of NP residencies would be quite costly and take a long time.
  10. by   SICUmurseCCRN
    Quote from shibaowner
    You're not an NP, are you? I am basing my statements on evidence. Where is your evidence?
    my evidence is in common sense. I'm not an NP and have zero desire to be one, if i did i would go back to school and become one (its really not that hard). the fact that i am not an NP means nothing though so I'm not sure why you are asking.
  11. by   shibaowner
    Quote from Dodongo
    Why are NP residencies more desirable than increasing clinical hour requirements within NP programs themselves? Instead of 600 hours we can require 2000 hours. That way NPs can graduate and hit the ground running, rather than needing extensive "orientation". That is something programs and, theoretically, accrediting bodies can implement easily and swiftly. Increasing the number of NP residencies would be quite costly and take a long time.
    I appreciate what you are saying. However, increasing clinical hours would not be "free." It could mean more time in school, which costs money. It is also hard to find preceptors. Residencies could be funded by Medicare or a similar program and NPs in residency are productive and the NPs themselves can earn a salary.
  12. by   shibaowner
    Quote from SICUmurseCCRN
    my evidence is in common sense. I'm not an NP and have zero desire to be one, if i did i would go back to school and become one (its really not that hard). the fact that i am not an NP means nothing though so I'm not sure why you are asking.
    Oh, is "common sense" now a type of evidence? You are not an NP, so you have no idea what an NP does, nor do you know anything about NP education. Do you really want to have to train a bunch of new RNs who are only going to quit in a year or two to become NPs? Or would you rather have new NPs go into NP residency programs to get more clinical training?
  13. by   Dodongo
    Quote from shibaowner
    I appreciate what you are saying. However, increasing clinical hours would not be "free." It could mean more time in school, which costs money. It is also hard to find preceptors. Residencies could be funded by Medicare or a similar program and NPs in residency are productive and the NPs themselves can earn a salary.
    Definitely not saying it would be free to all stakeholders. But let's assume the average NP program has about a year of clinical time. Telling students you must attend clinical 4-5 days of the week, rather than 2, would significantly increase the amount of hours accrued during the program. This would require most students who continue to work as a RN to drop down and earn less salary during the program, but it would be super easy for the programs and accrediting bodies. They already don't care about their students finding preceptors (which is another issue entirely). Further, medicare is already funding physician residencies (which has its own issues) and I would assume it would require a massive campaign/lobbying effort on the part of NPs, plus, from where will this money come? No, it will be similar to the residencies already in place where the NP is earning $40,000 for a year working as cheap labor. I think the former option is easier overall.

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