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.

[ANPFNPGNP]

Generally speaking, one would assume that an advanced practice nurse has several years of experience working as a nurse. On the other hand, in the REAL world, I don't see my nursing background as being beneficial in preparing me for my primary care job. Although, depending on the specialty, I think it's beneficial to have nursing experience, i.e. ACNP with ICU background, Psych NP with psych background, NNP with neonatal background, etc.

[subee, MSN, CRNA]

Generally speaking, one would assume that an advanced practice nurse has several years of experience working as a nurse. On the other hand, in the REAL world, I don't see my nursing background as being beneficial in preparing me for my primary care job. Although, depending on the specialty, I think it's beneficial to have nursing experience, i.e. ACNP with ICU background, Psych NP with psych background, NNP with neonatal background, etc.

You don't "see" it because your skills have become innate and its impossible to remember what it was like when you were a newbie. You can recall the emotion but you can't recall the "facts" that you didn't have at your disposal. If you never were a nurse, how can you know if a few years of experience was worth it - you can't "know" what you don't know.

[patrick1rn, MSN, RN, NP]

I have always been opposed to Direct Entry NP programs.

You get to see a disease process face to face as a RN, which is just as good as doing clinical hours. I would not be opposed to direct entry NP programs if the person worked as a military medic, Paramedic, or some other direct care profession.

I guess the NP students who are in the direct entry programs are motivated, which is good, but they miss out of seeing and learning while working as a RN or as a army medic etc...

[jjjoy, LPN]

Perhaps part of the experience disconnect is particularly problematic in regard to NPs going into well-patient primary care - as opposed predominantly geriatric or chronic care where inpatient experience with common conditions would still be of use. Inpatient RN experience clearly is a benefit for acute care NP roles. Since medical assistants dominate as assistive personnel in primary care offices, very few licensed nurses will have *directly* relevant experience related to well-patient primary care. I'd imagine ED experience would be of most direct relevance for a nursing planning to become a primary care NP.

[psychonaut]

Perhaps part of the experience disconnect is particularly problematic in regard to NPs going into well-patient primary care - as opposed predominantly geriatric or chronic care where inpatient experience with common conditions would still be of use. Inpatient RN experience clearly is a benefit for acute care NP roles. Since medical assistants dominate as assistive personnel in primary care offices, very few licensed nurses will have *directly* relevant experience related to well-patient primary care. I'd imagine ED experience would be of most direct relevance for a nursing planning to become a primary care NP.

I find it ironic that I feel much more comfortable going into NP education with little nursing experience (just over one year), versus how I would feel if I was going for CNS or nursing ed. I would feel absolutely out of place as a CNS, the best ones I've known (and I have great love for the CNSs out there) have had many, many years of "front line" RN experience under their belt.

Similar for the nursing instructors. I would feel silly trying to teach a clinical group with my limited RN experience. Students in that position need an instructor who knows what they are doing, and has "seen it all" as an RN.

Contrast this to the NP. As you note, it is such a radically different role from the RN. And while I certainly would never be dismissive of a very experienced RN, and I'm sure it could be an advantage, the research does show that the role transition can potentially be more difficult for an experienced RN moving into the new role of provider. I figure I'm going to be unsure of myself enough going into it, and will be able to take it in as a completely new experience (though I will draw on what little nursing knowledge I have accumulated).

[zenman]

Contrast this to the NP. As you note, it is such a radically different role from the RN. And while I certainly would never be dismissive of a very experienced RN, and I'm sure it could be an advantage, the research does show that the role transition can potentially be more difficult for an experienced RN moving into the new role of provider.

I think Siri and others have mentioned many times the actual experience of preceptors with NP students who have no experience working as a nurse so I won't belabor that. I think I posted waaaaay back in this thread about the many benefits that an experienced nurse brings to NP education. I start wondering why people have difficulty seeing it. As for role transition, I don't think I'll personally have one whit of a problem. Experience is a great benefit...just sit back for a minute and imagine what I've seen in 35 plus years. Even my experience at other types of education have enabled me to transition into NP education. So far, I've turned in assignments one month ahead of schedule and I've missed one half a point. How the heck do you miss half a point, lol!

[psychonaut]

I think Siri and others have mentioned many times the actual experience of preceptors with NP students who have no experience working as a nurse so I won't belabor that. I think I posted waaaaay back in this thread about the many benefits that an experienced nurse brings to NP education. I start wondering why people have difficulty seeing it. As for role transition, I don't think I'll personally have one whit of a problem. Experience is a great benefit...just sit back for a minute and imagine what I've seen in 35 plus years. Even my experience at other types of education have enabled me to transition into NP education. So far, I've turned in assignments one month ahead of schedule and I've missed one half a point. How the heck do you miss half a point, lol!

To be sure, I in no way mean to devalue previous RN experience. My point is simply that of all the APN roles (NP, CNS, CRNA, CNM, education), I think the easiest to transition into with a minimum of RN experience would be the NP.

As for imagining what you've seen...zenman, I've been reading your posts here and at SDN for many years now, and I think I'd be a bit frightened to imagine what you've seen over the years...your quantum physics is more than I could handle, I'm a simple Newtonian boy at heart

Now, your point about previous educational experience is dead on. I have way too many years of college classes under my belt, and find the academic portion of things pretty manageable (and enjoyable, but that's why I have taken all of those classes in the first place). I'm also right with you in having a great appreciation for distance ed in didactic courses.

[zenman]

...I think I'd be a bit frightened to imagine what you've seen over the years...your quantum physics is more than I could handle, I'm a simple Newtonian boy at heart

ROFLMAO...guess you don't want to hear about the house clearing last week...

[ANPFNPGNP]

I think Siri and others have mentioned many times the actual experience of preceptors with NP students who have no experience working as a nurse so I won't belabor that. I think I posted waaaaay back in this thread about the many benefits that an experienced nurse brings to NP education. I start wondering why people have difficulty seeing it. As for role transition, I don't think I'll personally have one whit of a problem. Experience is a great benefit...just sit back for a minute and imagine what I've seen in 35 plus years. Even my experience at other types of education have enabled me to transition into NP education. So far, I've turned in assignments one month ahead of schedule and I've missed one half a point. How the heck do you miss half a point, lol!

I've precepted several NP students and all of them have RN experience. The ones who had the most difficulty were the RN's with extensive ICU experience. Primary care is an entirely different game and those students were very much out of their element. Of course, the ones I've precepted are also attending an online program, so they're just thrown out there with limited assessment skills.

Also, I hate to point this out, because I've always been an advocate for previous RN experience. But, I've read a couple of studies and they show that NP competency isn't related to RN experience. In fact, MD's prefer NP's who weren't nurses before becoming NP's. However, I agree with a previous poster who stated that ER experience can be of help in primary care.

[zenman]

I've precepted several NP students and all of them have RN experience. The ones who had the most difficulty were the RN's with extensive ICU experience. Primary care is an entirely different game and those students were very much out of their element. Of course, the ones I've precepted are also attending an online program, so they're just thrown out there with limited assessment skills.

Yes, primary care is very different from ICU nursing, but even a nurse with ICU experience should bring more to the table than a nurse with no experience. I've seen ICU nurses who were pulled to a med-surg floor almost come unglued but I'd rather have one of them than someone with no experience!

And are you saying that all online programs throw their grads out with limited assessment skills?

Also, I hate to point this out, because I've always been an advocate for previous RN experience. But, I've read a couple of studies and they show that NP competency isn't related to RN experience. In fact, MD's prefer NP's who weren't nurses before becoming NP's. However, I agree with a previous poster who stated that ER experience can be of help in primary care.

How was this "competency" measured? I've heard just the opposite; MD's want prior experience as nurses...and most NP jobs I've seen prefer 2-3 yrs of NP experience.

[Astock]

I will be gradating with my BSN in nursing this may. I will getting married, and moving to Charlotte, NC afterwards. I have been speaking to the NP Director at my school about my desire to go FNP with another year of psy. training. I want to be able to treat the entire person and not just focus on the body or the mind. She stated after nursing school it is best to work 2-3 years in general-med surg before applying for NP school in Charlotte. She stated yes, you can go NP school directly after nursing school, but many places will not want to hire you because of a lack of experience. During this time I will be paying off school loans.

I have been trying to find advice on how to prepare for FNP school. I'm currently working at a hosptial on a Cardiac/Telemetry floor. I love Psych. but I don't think I will get enough gen-med experience working there. I was also wondering about working on a pedi floor. In december I will be applying for jobs, and I would like to get on the best floor for me in the big picture.

What type of floors would you recommanded me working on? Any advice/words of wisdom you have for me?

[KatieRN04]

Med-surg will give you a good foundation, but there are people in my program that have nver even worked with adults, just peds. And the FNP focuses on adults and peds and geriatrics, so I think you just need to get at least 2-3 years experience first to get a good foundation.