NP Student not working in direct patient care

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Hey everyone,

Are there any NP student not currently working direct patient care? Do any of you feel like you are missing something by being in the program and not currently working with patients? Are you planing to work direct care after graduating? I getting nervous because I am the only one in my class not working patient care. Starting to wonder if I chose the right career, even though this is something I have wanted to do for a long time..

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Hi Kgantt,

I asked a similar question yesterday about working during NP programs. I start in the Fall, but do not plan to be working direct patient care during my program (I do have previous direct patient care experience). Without striking a nerve, I believe there is a study that shows similar patient outcomes from direct-entry nurse practitioners (with minimal direct patient care experience) and those with several years of experience. The advice that I have been given is that continuing to work in direct patient care will open doors for networking. I recall reading several times on these boards from practicing nurse practitioners that the role of the nurse practitioner is so different from their previous role as a RN that they did not feel the experience helped much. Then there are those that say their direct patient care experience shaped their ability to be competent as an advanced practice nurse, and that the term advance practice nurse implies one has contributed years and years of service to the nursing profession. I am kind of in the same boat as you, and feel that these differing opinions are really confusing for someone wanting to pursue this field. I really wish there was more congruent or conclusive thought on this - either nurse practitioners working in direct patient care are "better" in the end or they're not.

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It is driving me crazy because right now I am a health promotion manager for an insurance company. I have been out of direct care for about 4 years. I am wondering how this will affect my ability to be a good FNP..

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Specializes in Adult Internal Medicine.
It is driving me crazy because right now I am a health promotion manager for an insurance company. I have been out of direct care for about 4 years. I am wondering how this will affect my ability to be a good FNP..

Most studies have shown not net effect on FNP practice from prior nursing experience.

Personally, I think must depends on the individual.

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It is driving me crazy because right now I am a health promotion manager for an insurance company. I have been out of direct care for about 4 years. I am wondering how this will affect my ability to be a good FNP..

I've been out of direct patient care for about a year. I definitely know where you're coming from with nervousness, but I also believe it is unfounded given that (as mentioned by BostonFNP) nurses with no prior direct patient care experience have the ability to become safe/competent nurse practitioners. Maybe some practicing NPs can chime in on whether recent direct patient care experience affects one's ability to perform competently as a nurse practitioner, but I am going to venture to say it probably does not. Forgive me if I sound crass, but I personally fail to see how IV/foley insertion, trach care, ng placement, wound care, nursing assessments, medication administration and oh yes, yes, yes...peri-care, are going to make or break me as a FNP. The bits and pieces of pathology that we pick up as a floor nurse, lab values, and possibly the typical treatment pathways used by providers seem like they can only get you so far. Furthermore, I do not recall writing SOAP notes, diagnosing, prescribing medications, or performing minor office procedures as a direct care RN. Until I meet a RN that does all of these at their medsurg unit at X hospital, I'm going to have to say that they probably have no real advantage over anyone.

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You made a lot of valid points and I must say that I agree with you. I guess we will have the opportunity to test the theory :)..

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Specializes in Nephrology, Cardiology, ER, ICU.

I've been a nurse for 20 yrs, an APRN for 7. My 13 yrs exp as a nurse definitely provided me with some solid assessment skills. It's not about procedures, its about assessments and knowing when a pts condition is changing.

I have an MSN and two post masters certificates. Im no super person, but I do draw on my RN skills frequently. I see pts in dialysis units and the reason I got this job was because the docs liked my ER experience and my ability to think on my feet and handle emergencies well.

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I've been a nurse for 20 yrs, an APRN for 7. My 13 yrs exp as a nurse definitely provided me with some solid assessment skills. It's not about procedures, its about assessments and knowing when a pts condition is changing.

I have an MSN and two post masters certificates. Im no super person, but I do draw on my RN skills frequently. I see pts in dialysis units and the reason I got this job was because the docs liked my ER experience and my ability to think on my feet and handle emergencies well.

I agree that RN experience does provide a solid foundation to pull from for assessment, but I suppose our question (maybe unanswerable) is how long does it take to have this basis to draw from and it must vary from individual to individual. To say that you must have that foundation though seems like kind of like saying NP courses are unnecessary because one can just go off of what they learned on the floor as a RN.

I'm also curious how much of this varies depending on the practice setting. As you mentioned, you work in dialysis which I would definitely imagine has a sense of urgency at times where ER experience would be beneficial.

The other thing that I'm curious about is how PA's manage to land jobs and perform competent assessments when they are, most of the time, drawing from a blank canvas in terms of previous nursing assessments completed (I know many/most PA's enter the field with healthcare experience in some capacity but not one with assessments).

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Thank you for the feedback, so as a NP the RN experience really comes in handy for assessments. Have you meet any NP that were direct entry (no nursing background)? If so, were they different from NPs with a RN background.

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Met* any NP

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Digging around at previous posts, there seem to be numerous threads about these topics and some of them do answer some of the questions regarding the direct entry models and NP vs PA pathways. There seems to be much debate over all of it with no conclusions.

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I guess the only way to find the answer is to continue on our path and make the best of it. I know for me I don't want to diagnose and treat patients forever. I would love to move to develop health promotion programs or working a public health clinic.

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