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.

[mvanz9999, RN]

Whether you like it or not, direct-entry APN's are here to stay.

I don't see anywhere in my post that makes any claim that I know what nurses or doctors or electrical engineers know specifically. But I will say that many of my friends as well as my own mother are all nurses, and that certainly counts.

I do not believe that direct-entry students are any less capable than any other method of becoming an APN. I will also say that the programs I'm looking at....I don't see anyway to actually get certified as an APN without first working as an RN for several years. It's built into the program. Maybe it can be done elsewhere, but not in Illinois.

Finally, I fully intend to become an APN. Am I somewhat deluded? Of course. Certainly not more (and probably less) than any pre-nursing student anywhere else. Did I just pick this profession out of a hat and decide to pursue it? No. Don't think I would have been accepted if I had.

I'm not going to be the first direct-entry student, nor will I be the last. My hope is that I would be welcomed into nursing. If some choose not to do that, so be it. I have already made my decision, and I'll just have to find the place that DOES welcome me.

For those that don't...what can I say? Good luck...

[CrufflerJJ, BSN, RN, EMT-P]

I also think direct-entry Nurse Practitioners will be just as capable of providing service as someone with 20 years nursing experience. They are different jobs, with different requirements and so on.

I dunno about that. I guess it depends a lot on the level of service to be provided. I am not an RN (give me another 15-16 months), but have been a medic since 1991, and an EMT for a few years before that.

It's important to realize & accept the value gained by DOING, not just "knowing" theoretical factoids and passing certification tests.

I've seen too many "shake-n-bake" paramedics. They've typically been very bright people, and have gone straight from the EMT program directly into the paramedic program without any field experience in between. They graduate as a certified paramedic, and may all too soon find themselves as the "person in charge" of experienced EMTs on a scene. Yes, they've got the certification & "book-smarts", but they have to work so very hard to stay on top of each & every little thing on the scene, and each & every little part of the patient assessment.

A medic with even 2-3 years prior experience as an EMT, however, has already seen & done so much more. He's seen loads of patients, in all sorts of situations. Even as a newbie paramedic, he's more able to step back & look at the big picture (handling those routine items on "autopilot"), focusing his attention on stuff that will kill the patient quickly (sometimes apparently minor things until it's crash-time). Yes, the shake-n-bake medic and the EMT experienced medic hold the same certification (NREMT-P), but their abilities are very different. If I was the patient, I'd rather have somebody with some real world experience backing up their "book smarts."

As you know, I'm going into an accelerated nursing program in another month. I had already paid big $$$ to do a distance learning program through Excelsior, but I still had nagging doubts. The distance learning (medic-->RN) program might have gotten me my RN, but I would have been lacking the clinical experiences needed to truly internalize new concepts & skills. I didn't want to be a "shake-n-bake" nurse - I wanted to be a nurse with strong clinical & intellectual skills. {NOTE: this isn't a slam against those that successfully took the distance learning path - I just didn't feel comfortable that it was right for me.}

I'm benefiting from an accelerated pathway program, allowing me to enter the nursing profession after a 22+ year career as a chemical engineer. When I graduate, I will be a newbie nurse. I expect to be as skilled as a newbie RN who has gone through a standard 4 year BSN program, but we would both still be newbies.

Before going for an advanced nursing degree, I would think that some period of working as a "regular" nurse is invaluable. If nothing else, to let me become more comfortable in my basic nursing skills and to be exposed to a wide range of patient experiences.

[zenman]

Before going for an advanced nursing degree, I would think that some period of working as a "regular" nurse is invaluable. If nothing else, to let me become more comfortable in my basic nursing skills and to be exposed to a wide range of patient experiences.

I really think my 30 + years of experience will be invaluable even if it is not necessary. As an NP, I'll still be listening to heart sounds, breath sounds, bowels sounds etc but with years of experience to expand upon. As a bedside nurse, I actually handed out meds. I won't as an NP, but I'll already know my meds forwards and backwards. As a bedside nurse, I "played" NP by second guessing physicians and even agreeing or disagreeing with their plan of care...done it for years. I've seen 30 + years of patient conditions. I could say much more here. Now, the physician that I start my clinicals with in the Fall is a recent graduate but I'm already working with her some. I really hope I learn something new. It's funny; she'll sat down and start telling me stuff I knew a long time ago and I just smile and ask her questions. I've already taught her some things she hadn't thought of. It's going to be an interesting experience, lol! At least I'll get that signature I need for clinical.

[ProudGayRN]

As you know, I'm going into an accelerated nursing program in another month. I had already paid big $$$ to do a distance learning program through Excelsior, but I still had nagging doubts. The distance learning (medic-->RN) program might have gotten me my RN, but I would have been lacking the clinical experiences needed to truly internalize new concepts & skills. I didn't want to be a "shake-n-bake" nurse - I wanted to be a nurse with strong clinical & intellectual skills. {NOTE: this isn't a slam against those that successfully took the distance learning path - I just didn't feel comfortable that it was right for me.}

I'm benefiting from an accelerated pathway program, allowing me to enter the nursing profession after a 22+ year career as a chemical engineer. When I graduate, I will be a newbie nurse. I expect to be as skilled as a newbie RN who has gone through a standard 4 year BSN program, but we would both still be newbies.

Wow that sounds so admirable - but it is complete BS - You don't learn much of anything in clinical except having some ussually anal nutjob instructor break your chops for stupid things "Did you properly change the bed?" etc.. yeah, sorry pal but you dont learn much of ANYTHING in the beloved clinical experience. You learn by doing and working and being on the job -

The salient issue is, depending on what type of advanced degree in nursing you pursue, it may be highly unrelated to what you are doing as a bedside nurse. Just use some common sense and think about it, how long does it take to be able to effectively learn how to do blood pressures, stick a thermometer in peoples mouth, read a temperature gauge - do a head to toe assessment -take some notes in a chart - Not long, well at least for me it didnt take that long to master some of those very fundamental basic skills - now please tell me what the hell wiping peoples A$$es and changing linens has to do with writing scripts or interpreting diagnostic tests as an FNP? Ummm...NOTHING - exactly - so what you learn as a bedside nurse might have some relevance to what you do as an APRN but it very well MIGHT NOT HAVE MUCH TO DO WITH IT AT ALL GET IT?

Point being - some of the people, usually the real academic types on this forum think you should have 10 years of experience washing bottoms, changing sheets and taking blood pressure(electronically) before you are able to pursue an Advanced Practice Nursing degree - but like most academics, they are detached from the reality of the situation.

So basically they can whine all they want and you should just turn the volume down on people like that, they tell you can cant do something because they didnt do it that way etc....

When they fail in convincing you that you shouldnt get your APRN immediatley, the next route by those type of people is to say "well yes you can go to graduate school right away, but you cant get a job because you have no experience as an APRN." Sorry WRONG AGAIN - I know many people that have done it and are doing very well -

Bottom line, dont let people from the Ivory tower tell you what you should and shouldn't do because they are usually wrong anyway

Peter

[prairienp]

i dunno about that. i guess it depends a lot on the level of service to be provided. i am not an rn (give me another 15-16 months), but have been a medic since 1991, and an emt for a few years before that.

it's important to realize & accept the value gained by doing, not just "knowing" theoretical factoids and passing certification tests.

i'm benefiting from an accelerated pathway program, allowing me to enter the nursing profession after a 22+ year career as a chemical engineer. when i graduate, i will be a newbie nurse. i expect to be as skilled as a newbie rn who has gone through a standard 4 year bsn program, but we would both still be newbies.

before going for an advanced nursing degree, i would think that some period of working as a "regular" nurse is invaluable. if nothing else, to let me become more comfortable in my basic nursing skills and to be exposed to a wide range of patient experiences.

sounds as if you will be an outstanding member of the nursing profession. you are carefully thinking before proceeding into your new role. don't let the disenchanted distract you from the importance of theory in building your knowledge base. many will concentrate on the nursing theorists and how they are a waste of time. in reality you will be exposed to nursing theorist for a very minor part of your overall curriculum. there are a variety of other non nursing theories that will enable you to guide your knowledge and practice applications. with all that experience you may be tempted to do things as you always have, don't be afraid of change based on your new knowledge acquisition. i really liked your post!

[CrufflerJJ, BSN, RN, EMT-P]

sounds as if you will be an outstanding member of the nursing profession. you are carefully thinking before proceeding into your new role. don't let the disenchanted distract you from the importance of theory in building your knowledge base. many will concentrate on the nursing theorists and how they are a waste of time. in reality you will be exposed to nursing theorist for a very minor part of your overall curriculum. there are a variety of other non nursing theories that will enable you to guide your knowledge and practice applications. with all that experience you may be tempted to do things as you always have, don't be afraid of change based on your new knowledge acquisition. i really liked your post!

i had hoped that my post wasn't seen as too "lecturing" or "preachy". sometimes i tend to get a little (ok, big) case of verbal diarrhea.

i hope that the nursing theory stuff won't seem like so much "fluff." the syllabus for our program has no obvious "nursing theory" courses, but the key concepts will likely be worked into all the other fun-filled courses.

as to your comment "with all that experience you may be tempted to do things as you always have, don't be afraid of change based on your new knowledge acquisition.", that's a very valid concern. in every field, it's important to keep your "knowledge cup" half empty. it's hard to absorb new knowledge/concepts when your teachers are trying to pour their knowledge into an already full cup. experience is a good thing, but it's important to make sure that all that experience doesn't put blinders in front of your eyes:nono:. if you're not willing to do things differently, you will never achieve your best possible performance level.

during my engineering career (especially in the latter years when i was mentoring/leading others), i tried to keep a healthy sense of self-doubt at all times. when you're convinced that you're absolutely right on an issue, you're probably blind to your own faults, and are overlooking something critical. when you're absolutely convinced that you're right, you may very well be wrong. this doesn't mean to helplessly waffle on each & every issue or decision, but try to maintain a healthy skepticism about what you hear/see/read/believe/accept/"know".

openness is the key. extremism and closed-mindedness leads to evil deeds or painful mistakes. this seems to be the case with individuals, governments, and religions.

as an experienced street medic, i'm already trying to give myself the "heads up" that doing things the hospital way will likely differ from doing things in the field. such is life! there are bound to be times that i'll be frustrated at the scope of practice limitations as a rn, thinking "if this happened on the street, i'd have the guy tubed or criced or chest-decompressed or...". such is life - i'll try to accept it & move on.

at 45 years old, i feel lucky to be able to start a second career this late in life. i'm determined to do as well as i can in every school course, and to try & learn something from each & every patient interaction.

that's the plan!

[mvanz9999, RN]

Before going for an advanced nursing degree, I would think that some period of working as a "regular" nurse is invaluable. If nothing else, to let me become more comfortable in my basic nursing skills and to be exposed to a wide range of patient experiences.

That's what I'm doing. While the program is labeled as Master's Entry, the design is essentially Accelerated Bachelor's plus Mater's courses. What will happen after 15 months is I'll take the NCLEX and go to work as an RN. Then over the next 4 or 5 years, I'll complete the Masters portion. I'll have 4-5 years experience as an RN, and then be ready to move up to NP.

[ProudGayRN]

thanks for telling us the grades you received on the 3 tests, after seeing the grades are high and confirming the validity of the scores with the university you attend, i will take what you say more seriously now. please let us know the grades you receive in the future as we are all very interested and it is highly relevant to this topic.

peter.

[ProudGayRN]

don't let the disenchanted distract you from the importance of theory in building your knowledge base.

yes, dont let the disenchanted academics distract you with things you will never use once you get out of school. just get your bsn, pick up 3 12 hours and get your aprn immediately. than again, if you want you can always work for 8 years with a bachelors, writing 12 page care plans on each patient, inventing new nursing diagnoses, studying crap nursing theories and finally go for your aprn; you may lose a decade of your life but at least the academics won't be so bitter.

[Barbiegirlnurse]

To reply to the first comment on the forum-I don't think that there is anything wrong with doing the bridge program to become a NP. While getting your degree, you would do clinical rotations to become a RN. That would be a prerequisite to any NP training. As a new NP graduate, who has been a nurse for over 3 years, I still get the "she hasn't paid her dues" vibes from some nurses. Other professions in healthcare don't operate with that same mentality. For example,physicians don't practice medicine before they go to medical school, and pharmacists don't practice pharmacy before they go on to pharmacy school. I think that many of the people who feel you would need to practice as a RN, think that you would need to work on your technical skills. However, as a NP your skills become more integrated with your knowledge. You become more focused on synthesizing information to form a diagnosis, than the technical skills.

In all honesty, I think that a lot of the "attitude" comes from nurses' own insecurities. Maybe they are threatened that someone who has been in the profession a shorter amount of time than they have, will have a more advanced nursing role. What they need to be reminded of is that the world will always need nurses who are involved with staff nursing at hospitals, health clinics, and in public health. The real "attitude" should be shifted towards the public, who don't value our nurses and reward their hard work as much or as often as they should. If you do work somewhere after getting your RN license, (even if it is just PRN) let the other nurses on the floor know how much you value their help and expertise. Sometimes a simple thank you goes a long way! And if you do have some bad times, just know that whatever negative experiences you encounter with such nurses, should only remind you of how you want to treat others in the profession and students that you may precept.

[zenman]

Other professions in healthcare don't operate with that same mentality. For example,physicians don't practice medicine before they go to medical school, and pharmacists don't practice pharmacy before they go on to pharmacy school.

You know someone is really going to call you on this one, lol!

[Barbiegirlnurse]

I stand by my posting, as I am sure that those with differing views than my own, stand by their beliefs. This is supposed to be a discussion forum. If nurses can't discuss issues among each other and keep it friendly and professional, how are we supposed to be able to make actual changes in health care policies and reform? It is quite easy to make a "jab" at someone's comment and a much more complex process to read someone elses thoughts and opinions and empathize where they are coming from.

I respect your views and am very sorry you are having a difficult time understanding where I am coming from. That said- let me elaborate some more on the topic of NPs entering the profession with little or no working RN experience. The traditional entry level into healthcare for other professions is usually the doctoral level, although now-more and more pharmacists and some in psychology are entering into patient care at the Master's level. No other health care related field that I know of, suggests that it's academically prepared individuals go into the field for a few years and work at the beginning level. They strongly encourage students to go straight through and get their masters degree or doctorate. It is only at these levels that they even begin to operate in clinically based settings and see patients. I think that it is so interesting that other professionals in healthcare (physicians, pharmacists, clinical psychologists, etc.) don't even see patients until they are in advanced degrees and in nursing, the entry level into patient care is the LPN, ADN, ASN, or diploma program. (When I say entry level into nursing, I am talking exclusively about nursing and not about assistive personnel such as CNTs, MAs, or other delegatory staff members.) I think that this says a lot for nursing, as traditionally we are clinically preparred at earlier training.

Professional agencies are taking note of such factors and urging that the entry level into professional nursing practice (not to be confused with the entry level into clinical nursing practice) be the BSN and that the entry level into advanced nursing practice become the doctorate. Although these changes likely won't come for a few years, they will come. The thought behind the changes is to increase parity among healthcare professionals. Professional nursing organizations that set the standard of nursing care are supporting these changes. With their support, comes no urging of NPs to work as a RN before completing their education. While working as a RN can be fulfilling and helpful to some NPs, it is NOT necessary for all individuals to do so.

I can see how the concept is very foreign and strange to many nurses, because you do learn so much working as a RN. You learn something new and perfect your assessment skills each time you work. So the idea of someone "skipping" this stage seems a bit, impulsive. However, what you must realize is that NPs will learn something new and perfect assessment

skills each time they work, as well. It is still the practice of nursing, just in an advanced role. The two roles are interelated and in many ways overlapping, not disconnected as some would believe.

In closing, I would like to say that I feel that all levels of nursing are integral to our healthcare. I have the utmost respect for all nurses, regardless of their educational or clinical backgrounds. It should be understood that NP practice was created to improve access to healthcare. Many NPs provide care to individuals, who might otherwise go without.( By way of, practicing in remote or rural areas; being able to accommodate more patients in a busy practice setting; etc.) If that type of caring is not a core concept of nursing practice, I don't know what is.