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Becoming an NP with little to no nursing experience??

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by Blurr156 Blurr156 (Member)

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I'd love to see NP programs stop the classroom after year one and put us in clinic 100% full immersion just like the docs get in residency. It'll never happen though - too many single parents working part time etc. I have many friends who have done CRNA and are told from day one that it is a 100% effort program with no work allowed ever. People cop an attitude about it, but guess what - they don't get in and don't become CRNAs either. One friend worked crazy overtime as ICU charge for a year to save $$, then took out a 2nd mortgage, and then maxed out student loans. I don't think FNP School should be financially devastating, but it should be more structured like CRNA School and not so flexible - then we could get those real full-time residencies.

Schools get wrapped around the axle because they have to keep accounting records. When it shows enrollment down - they get antsy. So in order to keep the spreadsheet in the black, they have to let in everyone they can - hence, the no person left behind, we'll accommodate anyone, "when can you come to school" attitude.

Not true of all schools -- I went to an MSN program (I am a psych CNS, but the program also included a variety of NP tracks, plus CNM (no CRNA)) that was v. rigorous and demanding; there was no "part time" option -- you were in the program or you weren't. We were half-time (~20 hours a week) in clinical from the beginning of the program (within the first few weeks of starting), in addition to our full-time coursework. V. few students worked at all (I worked prn as an RN at the uni medical center -- I did one shift a week when school was in session (any more than that I would have had trouble keeping up with the reading and assignments) and loaded up on the hours during holidays breaks and summer) -- the school didn't make a point of telling us not to work, but nearly everyone found that the program was demanding enough that there just wasn't time. The program was also v. competitive and certainly didn't take just anyone to keep the enrollment up -- my second year, there were no first year students admitted to our specialty track -- none of the applicants met the school's standards, so they didn't take anyone.

I, too, would like to see nursing quit "watering down" nursing education across the board as the years go by, and have rigorous standards we can all be proud of.

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If people really want to separate NP practice from the notion of nursing experience, I have no problem with that personally, but, in that case, I really wish they'd take the word "nurse" out of the title and call it something entirely different (something that has nothing to do with nursing).

I can definitely see this argument come into play in regard to the idea that prior, related RN experience is not, and need not be, a requirement for some areas of "advanced nursing practice.

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FNPdude74 has 4 years experience and specializes in FNP-C.

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CRF250Xpert, you look like the kind of person I should be talking in about being an NP in the military. :) I know that certain limits such as cricoidotomy would be left to the MDs. But stuff like chest tube insertions in my state, even FNPs are allowed to do it from what I've been told by FNPs in the ER as long as they are adequately trained by MDs. I know the military trains you in more than what you "need to know" for the civilian world, but enough for the military world. Then again, I agree its important to know the limits of scope of practice and ask before I do!

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I completely agree that NP school should have a residency instead of the willy-nilly didactic here - a couple of clinical hours there.

I'd go even further and say RN training/certification, at least for acute care settings and many other specialities, should involve residencies as well. All of that valuable experience that RNs bring to the table as NPs is often learned in the same way that is by non-RN-experience NPs... on-the-job-tossed-to-the-wolves-sink-or-sink-style.

Is it really any better for a new RN with nil experience outside of school to have *full* RN responsibilities in an acute care setting after just 6-8 weeks, relying on harried colleagues for backup & guidance, than for a new NP with nil experience outside of school to have *full* NP responsibilites just a short time after graduation, relying on busy colleagues for back up & guidance?

Either way, all of that valuable experience that a nursing background provides is often gained AFTER training instead of being part of training. That's inevitable to some point, but I think several areas of nursing would be well-served by a more rigorous transitional clinical training model.

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PMFB-RN has 16 years experience as a BSN, RN and specializes in burn ICU, SICU, ER, Traum Rapid Response.

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I'd go even further and say RN training/certification, at least for acute care settings and many other specialities, should involve residencies as well. All of that valuable experience that RNs bring to the table as NPs is often learned in the same way that is by non-RN-experience NPs... on-the-job-tossed-to-the-wolves-sink-or-sink-style.

Is it really any better for a new RN with nil experience outside of school to have *full* RN responsibilities in an acute care setting after just 6-8 weeks, relying on harried colleagues for backup & guidance, than for a new NP with nil experience outside of school to have *full* NP responsibilites just a short time after graduation, relying on busy colleagues for back up & guidance?

Either way, all of that valuable experience that a nursing background provides is often gained AFTER training instead of being part of training. That's inevitable to some point, but I think several areas of nursing would be well-served by a more rigorous transitional clinical training model.

*** As a new RN I started in a 9 month nurse residency program. Most of the hospitals in this region have gone to some sort of extended orientation / residency program for new nurses. Are they really just tossed to the wolves anymore any place? If so that is areal shame. Bad for the hospital, bad for the nurses and bad for their patients.

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FNPdude74 has 4 years experience and specializes in FNP-C.

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*** As a new RN I started in a 9 month nurse residency program. Most of the hospitals in this region have gone to some sort of extended orientation / residency program for new nurses. Are they really just tossed to the wolves anymore any place? If so that is areal shame. Bad for the hospital, bad for the nurses and bad for their patients.

You'd be surprised. :rolleyes: 6 week orientation and then you're thrown into the fire. As an FNP student, the MDs just threw me into the fire too but I've managed to do well since I could pick things up pretty quickly and have strong memory retention as a young man I am. :D not saying anything about those older than I am. 25. Fortunately, these MDs were very helpful.

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Are they really just tossed to the wolves anymore any place?

I'd be pleasantly surprised if every hospital in a 50 mile radius of where you offers 9 month new grad residencies, unless it's also that area hospitals aren't hiring many new grads at all. These days, new grads are having a hard time landing any job these days in many geographic areas and end up in the catch-22 of "need experience to get a job, need a job to get experience".

But, yes, many places would still consider more than 8 weeks of preceptorship for a new grad RN *incredibly* generous and would want to count the newbie as a fully qualified RN FTE for staffing purposes ASAP.

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*** As a new RN I started in a 9 month nurse residency program. Most of the hospitals in this region have gone to some sort of extended orientation / residency program for new nurses. Are they really just tossed to the wolves anymore any place? If so that is areal shame. Bad for the hospital, bad for the nurses and bad for their patients.

New grads in my ED get 6 weeks. I got 2 weeks, IF you could call what I got "orientation." My preceptor basically told me that I was an RN just like her, and to let her know if I had any questions, then cut me lose to "practice."

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PMFB-RN has 16 years experience as a BSN, RN and specializes in burn ICU, SICU, ER, Traum Rapid Response.

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New grads in my ED get 6 weeks. I got 2 weeks, IF you could call what I got "orientation." My preceptor basically told me that I was an RN just like her, and to let her know if I had any questions, then cut me lose to "practice."

*** I am curious about something. IS this (new grad orientation) an isolated case of irresponsibility on the part of the hospital, or does their careless attitude carry over to other areas? Are nurses pay and benefits poor? What are your rates for things like pressure ulcers, central line infection, VAP? Are nurses treated like disposable and easily replaceable that the sort of orientation you received indicates? Does your hospital ignore evidenced based practice in all areas or just in new grad orientation?

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RN1980 specializes in icu/er.

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3month orientation here at my fulltime job and certainly not called a residency..it was refered to as going to work and learning the ropes. however at larger teaching hospitals in my area they have nurse residency positions available but when i started to work there part time i was excluded from those postiions and placed in a fast track orientation about 3wks, i suppose cause i had exp. at smaller hospitals in my area

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PMFB-RN has 16 years experience as a BSN, RN and specializes in burn ICU, SICU, ER, Traum Rapid Response.

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at smaller hospitals in my area

*** it is the same in my area. the smaller hospitals got together and work with a larger hospital and they do a regional nurse residency program for their new grads.

all hospitals follow evidence based pratices

*** clearly not.

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RN1980 specializes in icu/er.

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clearly so, i stated that hospitals followed joint commission evidence based guidlines or attempted to comply with them. not every evidence based concept is supported or pushed by joint. not one survey i've ever been through have we ever been hit with issues concerning not having a nurse residency program.

Edited by RN1980

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