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

shibaowner, MSN, RN, NP · Sep 17, 2017

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.

shibaowner, MSN, RN, NP · Sep 17, 2017

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?

Dodongo, APRN, NP · Sep 17, 2017

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.

Dodongo, APRN, NP · Sep 17, 2017

OYou are not an NP, so you have no idea what an NP does, nor do you know anything about NP education.

I really fail to follow this logic. I am not a physician but I have heavily researched their educational process and I have formed opinions on it - as I think most of us have. Just because you're not a NP or in NP school does not mean you don't know what it, or the job itself entails.

KeepinitrealCCRN · Sep 17, 2017

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?

no i don't and i think it is totally fine and valid to become an NP without RN experience. if you know that is what you want to do then go for it; the roles are very different as we both know. i think NP residencies are a great idea as well. all i'm saying is it is common sense that if, for example, i listen to more peoples lungs than another person without RN experience i am more knowledgeable about lung sounds and it would be more beneficial to me if i were to go to NP school vs. me not having those experiences. this can be applied to anything in life, the more you do it, the better you are.

Rekt · Sep 18, 2017

no i don't and i think it is totally fine and valid to become an NP without RN experience. if you know that is what you want to do then go for it; the roles are very different as we both know. i think NP residencies are a great idea as well. all i'm saying is it is common sense that if, for example, i listen to more peoples lungs than another person without RN experience i am more knowledgeable about lung sounds and it would be more beneficial to me if i were to go to NP school vs. me not having those experiences. this can be applied to anything in life, the more you do it, the better you are.

I think everyone agrees that having bedside experience would be beneficial; its usually from the salty older generations who feel as we didn't put in the work and they have to take orders from us.

shibaowner, MSN, RN, NP · Sep 18, 2017

I really fail to follow this logic. I am not a physician but I have heavily researched their educational process and I have formed opinions on it - as I think most of us have. Just because you're not a NP or in NP school does not mean you don't know what it, or the job itself entails.

You can have an opinion on anything. However, I would not presume to dictate to MDs what their education should be.

shibaowner, MSN, RN, NP · Sep 18, 2017

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.

First, I don't know where you went to school, but my school finds preceptors and they put a lot of effort into this.

Second, I wouldn't mind some more clinical hours during school, but there are also a lot of threads on this forum about how no one wants to be a preceptor or they only want certain kinds of students and how it is so hard to be a preceptor, etc. etc. So I doubt you could get many preceptors willing to take students 4 or 5 days a week, at least judging from this forum.

Third, I don't think it would be that hard to get Medicare or other funding for NP residencies, because there is a shortage of primary care and mental health providers. Since not enough MDs are going into these areas, I would think the federal and state governments could come up with the money. In addition, a resident can bill their time, while a student can't.

Fourth, residency doesn't pay a lot of $ because there is a lot of training time. At any rate, $40K is better than $0. MD residents only make about $50K a year.

My advice is that new grad NPs who want more time to feel ready for NP practice should apply to NP residency programs. Everyone I know who applied got into one. Some employers also provide excellent training for new grad NPs, so try to get a job with such an employer.

I don't know if anyone really feels "ready" to practice and that they know everything. I remember my epidemiology professor. He started out as a vet. He told the class that when he got his first job as a vet, he was super nervous and felt like he knew nothing. Since he was working with farm animals, he wore overalls to work. When he had to go see an animal and the farmer asked him questions, he would excuse himself to go to the bathroom, where he secretly pulled out a pocket guide stashed in one of his pockets so he knew what to say and do! (He went on to become a renowned epidemiologist and chairman of the department at major university.)

One of my good friends just graduated from med school and started his internship this year. He was terrified! Even with 4 years of med school.

No matter what profession, new grads are nervous and feel like they don't know anything. It takes a year or two to feel comfortable and competent.

AbstracRN, BSN, CNA, RN · Sep 18, 2017

I'm planning on going directly into NP school after I graduate. My first choice NP school requires you to have a job as a nurse. Other schools require you to have a full-time position as an RN. By the time you are finished depending on the length of your program and if you work through school, you will have a few years of experience under your belt.

SopranoKris, MSN, RN, NP · Sep 18, 2017

Only 32 states currently offer NP residencies, and of those, only a handful offer more than 1 program. Unless you live near a major university or large city, you would have to relocate for a $40K/year residency???? Who pays for that relocation? How could an NP afford to do so on such a pittance of a salary?

You keep touting residencies like it's the end-all-be-all for NP training. I don't know anyone who is going to go work for $40K/year and make less than an entry level RN and have to pay student loans on top of it. And in clicking on the residencies available, the majority are in the hospital setting. Peruse some of the requirements. Hey, look...they want to know about your prior nursing experience! :D

shibaowner, MSN, RN, NP · Sep 18, 2017

Only 32 states currently offer NP residencies, and of those, only a handful offer more than 1 program. Unless you live near a major university or large city, you would have to relocate for a $40K/year residency???? Who pays for that relocation? How could an NP afford to do so on such a pittance of a salary?
You keep touting residencies like it's the end-all-be-all for NP training. I don't know anyone who is going to go work for $40K/year and make less than an entry level RN and have to pay student loans on top of it. And in clicking on the residencies available, the majority are in the hospital setting. Peruse some of the requirements. Hey, look...they want to know about your prior nursing experience! :D

Anyone can apply for any residency in the U.S. Yes, some people would have to relocate. So what? A lot of people relocate for nursing school, anyway. And most nursing schools are located near hospitals. If we advocate for more residences, then they would be more widely available. There are also plenty of NP students that go to school full time. As I said, all of my primary care NP classmates that applied for residencies got in.

As for no one wanting an NP residency, give me a break. Those programs are competitive. You can't have it both ways - wanting NPs to have more clinical training, but scoffing at residency programs. And $40K a year is more than the $0 that a lot of students make.

I ask you, what is more valuable to an NP? RN experience or NP experience? I think an NP residency would provide far more useful experience to an NP than bedside nursing. And do you think it is fair to career RNs to have to train new grad RNs who are only going to stay for 1 or 2 years? Or would you rather have RNs spend time training new grad RNs that truly want to have RN careers? And is it fair to the new grad RNs who want a nursing career to have to compete for jobs with people who do not want RN careers?

At any rate, this ship has sailed and it is not reversing course. Direct entry BSN to MSN/NP programs are here to stay, so complain all you want. Thought and effort is better spent on ensuring that NP students have the right preparation in NP school and through expanding residencies.

SopranoKris, MSN, RN, NP · Sep 18, 2017

At any rate, this ship has sailed and it is not reversing course. Direct entry BSN to MSN/NP programs are here to stay, so complain all you want. Thought and effort is better spent on ensuring that NP students have the right preparation in NP school and through expanding residencies.

I'm not complaining about direct entry programs. My complaint is your opinion that this somehow makes you a better clinician, as you have stated multiple times in this thread. That is my "complaint".

I think residencies are great experience. However, I don't know too many people that can afford to take that severe of a pay cut. I think it's laughable to expect a professional to work for a pittance.