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.

[Sheri257]

Its because its a much more lengthy legal process to go after someones personal assets and it is rarely done. I mean if what you are saying is true, for instance..why arent houses changing hands left and right after automobile accidents, i have seen some severe injuries resulting from automobile accidents yet I dont see the plantiff living in the defendants house. There is a very good reason for this, its because the cases practically always settle and the attorney go after the guy with the DEEP POCKETS - Again, because I have alot of friends who are attorneys I know this.

There are limits to outside parties they can sue if you're the one who's primarily responsible for a bad decision. And, quite frankly, by the time I become an NP, I will already have some fairly keep pockets. I have a lot of home equity to protect as it stands now.

All it takes is one bad case to ruin your life. It's not like the insurance company will pay and that will be the end of it (assuming, of course, they do pay ... which is another debate all together).

There's other consequences to consider. Who's going to want to hire you if you've had a big judgement or settlement against you? And even if you do get hired, who's going to want to insure you? Even if you can find insurance after a bad case, the premiums will probably cost a fortune.

And no, the plaintiff doesn't actually take the home and live in it. I was using "take the house" as a figure of speech. What the plaintiff does is take the home equity.

One of the best ways to collect judgements is to put a lien on someone's house or bank account. How do I know this? Because I've done it. If the bank account is empty you can always put a lien on the house, and they can't sell or borrow on the house without paying you.

That's why you don't see houses changing left and right but, what you do see is large judgement payments taking place during closings when people try to refinance or sell. Of course, you're not going to read this in the newspaper but, that's what happens.

House liens are actually the best way to collect otherwise uncollectable judgements. And even if it takes a couple of years ... you get interest in addition to the original judgement amount.

If you don't want to take this seriously, fine. I do. I have a lot of assets and home equity to protect. I'm not going to blow my retirement.

For me, it has nothing to do with the politics of taking more crap or having to pay more dues because somebody else had to do the same. It has everything to do with knowing what I'm doing through experience so I can protect myself.

Because, in the event of bad case, I have no delusions about what will happen: the MD, the insurance company and everyone else will probably try to hang me out to dry ... if they can.

:typing

[sirI, MSN, APRN, NP]

The above link that core0 references is from Medscape. Just click on it (log in problems) and will take you to Medscape. You might have to register in order to read the article. Free site.

Not sure what you mean by, "why is it unpublished" ..????

[core0]

Hmm, i cant access the article Ill check it out later. Why is it unpublished? lol.

You have to register with medscape to get it (this is free). The link works despite the log in problems. Re: The unpublished study on NP self confidence. I am not sure why the study is unpublished. It was done as a survey at a national nurses conference. I found it referenced in another nursing article as personal communication.

David Carpenter, PA-C

[mvanz9999, RN]

There is a similar debate in the PA field. There are programs that actively recruit students without medical experience. The claim is that they do not have to break the students of their bad habits. They can "mold" the students in their own program. The interesting thing in the PA programs is that inexperienced PA's do the same as experienced PA's on the certifying exam. Is there similar data for NP's (if you actually believe that certifying exams measure clinicial competence)?

David Carpenter, PA-C

This is exactly what I said earlier. New students are much easier to mold, therefore inexperienced NPs get higher marks.

[core0]

This is exactly what I said earlier. New students are much easier to mold, therefore inexperienced NPs get higher marks.

But that doesn't answer the real question. Is this a valid test. The real problem is that there is relatively little data on what qualifies for "quality care" by either NP's or PA's. An interesting way to do this would be to look at rural health clinics that are independent and have no physician presence and compare those that do have physician prescence.

David Carpenter, PA-C

[FutureNP10]

Sounds liek a very interesting program, but I would be leary of that due to the fact that most NP's have had experience as an RN for at least 2 years prior to even going back to NP school. You may not have a little trouble getting a job because I'd figure they'd choose the NP with some type of experience versus the one that has none.

Also...not only job wise, but just for you, when becoming an NP, just so you can feel confident and comfortable with what you are doing..you might decide to go with a program that makes it mandatory for RN experience before going to NP school.

[traumaRUs, MSN, APRN]

I will revisit the scenario that all APN students must know what their market will hold too. In Chicago, as one poster found out, the nurse recruiters for hospitals weren't interested in inexperienced RN NPs. I live in central IL and work for a private practice. I was the most inexperienced RN (new CNS) with 15 years of nursing experience. I got the job because the MDs liked my emergency dept experience and the fact that I could make decisions on my own. The ability to know when something is serious or not is very important and I'm sorry, but its not a skill you learn in school.

Another thing to consider if going for a clinic position - why would a doctor want to train a new NP while not being able to see the same number of patients that an experieced NP can see? It is always the bottom line and important to consider you must perform billable services.

[mvanz9999, RN]

Which puts me in quite the conundrum. (

I've gone over and over and over this, I don't see any other way for ME to become an RN (money, time, blah, blah, blah).

The question for me is would a hospital hire an RN if they were trained in a graduate program, but had little experience (like any RN from any program). The nurse recruiter seemed perplexed by my question - she didn't know how to answer it. It was almost as if she said "Why would you go to grad school to be an RN?)

The direct entry programs around here are SO new (meaning less than 5 years) that there really isn't any way to judge this. I know one guy that graduated from one program and works as an RN (not a APN). So....it seems he is not actually using his grad level education.

As for the other program, it is so new that there are NO graduates. Therefore I can't really tell from the grads of the programs, and I don't think many of the smaller, non-teaching hospitals or health care settings have much experience with the question. When I call a smaller place, it's almost as if they never heard of direct entry. Local hospitals or other health centers basically don't know what the program is, and seem hesitant to even discuss whether they would hire an APN with no clinical experience.

Even though all the opposing arguments above may be valid and true, the fact of the matter is -- it doesn't matter what is correct/true/proven by studies. If employers flat out REFUSE to hire an APN with no experience, it makes no difference. A stack of studies is not going to convince them to hire you.

They will simply say "But you have no clinical experience. NEXT!"

[traumaRUs, MSN, APRN]

Mvanz999 - I think going ahead with the entry level MSN is fine. You are going into it with eyes open, realizing that your chances of landing an NP job right out of school might not be possible in your area. However, I think as a new grad RN, you will be happy with your job choices and you will have enough variety to go where you want.

Good luck and please let us know how things go, please.

[Uberman5000]

there are limits to outside parties they can sue if you're the one who's primarily responsible for a bad decision.

i dont follow exactly what you mean by this statement. are you referring to the defendant in a medical malpractice suit?

and, quite frankly, by the time i become an np, i will already have some fairly keep pockets. i have a lot of home equity to protect as it stands now.

ok - that is good, i own property as well - i have equity as well -

all it takes is one bad case to ruin your life. it's not like the insurance company will pay and that will be the end of it (assuming, of course, they do pay ... which is another debate all together).

the statements reflect a clear lack of understanding of this type of thing, just an objective observation. unless you do something purposely, i.e, pulling out a gun and shooting a patient, the insurance company 99% of the time will pay, look at any malpractice policy there are stipulations regarding this type of thing. this is why you have malpractice? seriously, do you think that you pay premiums, get sued and the malpractice carrier can just say "oh, i dont feel like defending you", and not do it? if that does happen(very very rarely) it is due to something in the contract that says the insurer is able to do it, or because of severe severe severe negligence on your part.

there's other consequences to consider. who's going to want to hire you if you've had a big judgment or settlement against you? and even if you do get hired, who's going to want to insure you? even if you can find insurance after a bad case, the premiums will probably cost a fortune.

again, not following you at all here -- it is a fact---> a large percentage of medical malpractice cases are settled. when a case is settled the defendant admits no wrongdoing. cant be held against you in a settlement because the defendant admits no wrongdoing in a settlement. did you know that? if you get sued multiple times, yes your rates probably will increase, but that is like anything in life. if i drive around getting into 5 accidents in a year my rates will go up, makes sense to me. but this assumes gross incompetence.

and no, the plaintiff doesn't actually take the home and live in it. i was using "take the house" as a figure of speech. what the plaintiff does is take the home equity.

oh thank you for clarifying that, because the previous statement was not accurate.

one of the best ways to collect judgments is to put a lien on someone's house or bank account. how do i know this? because i've done it.

so you know this because you have put a lien on someone's house? was this for a medical malpractice like we are talking about or is this in regard to you suing someone for something else... if it is unrelated then it is irrellevant to this discussion because we are discussing malpractice awards here.....

if the bank account is empty you can always put a lien on the house, and they can't sell or borrow on the house without paying you.

so you know this because you have put a lien on someone's house? was this for a medical malpractice like we are talking about or is this in regard to you suing someone for something else... if it is unrelated then it is irrelevant to this discussion because we are discussing malpractice awards here.....

again, not following the logic. i dont know how many times i can stress factual information, but facts are needed many times to dispel assertions and clear up misunderstandings. assuming someone does get sued, the malpractice carrier defends them, there is an extremely high percentage chance that the case will be settled out of court at which point in time the defendant admits no wrondoing and the prosecutor takes the some or in rare cases all of the insurance cap. do you think defendants settle by saying "ok, yes i will settle, here take the whole policy and the equity in my house" lol that doesnt happen..news flash -- cases dont get settled via malpractice whereby the plaintiff takes equity in the defendants house....so again, i think this matter is being way over dramatized and over exaggerated.

you are making many assumptions - and its never good to assume so much in life -

1) you assume that a less experienced aprn will get sued more frequently than an aprn with more experience, with no factual data to support your assertion.

2) you assert that an aprn with less experience will be held more liable(i.e. greater award) then an aprn with more experience, again with no factual data to support the assertion.

3) you assume that in the event an aprn with less experience is sued, that case will automatically go to trial without being settled.

4) you assume that the trial will automatically be in the plaintiffs favor and the jury will award the the plaintiff equity in the defendants house, along with the entire insurance policy cap.

as you can see you are making a great deal of assumptions with little factual data to support it. what is the chance of this scenario happening? very very rare unless someone is completely and utterly incompetent.

again let me clarify-

chances of being sued -> its possible

chances of being sued and having your carrier drop you -> maybe if you shoot the patient instead of treat him

if a suit goes forward against you chances of it being settled -> very high

if the suit is settled chances you lose equity in your house -> 0%

that's why you don't see houses changing left and right but, what you do see is large judgment payments taking place during closings when people try to refinance or sell. of course, you're not going to read this in the newspaper but, that's what happens.

house liens are actually the best way to collect otherwise uncollectable judgments. and even if it takes a couple of years ... you get interest in addition to the original judgment amount.

just curious, what type of "judgments" are you referring to....are these medical malpractice "judgments?". if you are assuming this, you are assuming that malpractice awards frequently result in the awarding of the defendants house equity to the plaintiff....which is factually incorrect. just wanted to clarify, maybe you are referring to some other type of judgment not related to malpractice award, if that is the case it is irrelevant to this discussion.

if you don't want to take this seriously, fine. i do. i have a lot of assets and home equity to protect. i'm not going to blow my retirement.

i don't understand why you don't think i am taking it seriously...can you explain that a bit for me? i am trying to be as factually accurate as possible...i am just trying to clear up some things that facts demonstrate are being greatly exaggerated.

because, in the event of bad case, i have no delusions about what will happen: the md, the insurance company and everyone else will probably try to hang me out to dry ... if they can.

again you are assuming that the insurance company is going to "hang out out to try." medico legally there are grave issues with this and it very very rarely happens(gross gross negligence) and if you feel like you are likely to be grossly grossly negligent then this is a possibility. it is your malpractice carriers job to provide you with a legal defense in the event you are sued, do you think they want to give 5 million to someone lol? they will do whatever they can to not pay.

so i believe i have cleared up some issues with regard to the assertions made on this, if you would like to have a logical debate i am more than willing to engage but lets try to use facts instead of assertions and exaggerations.

warm regards -

uber man

[Uberman5000]

Sounds liek a very interesting program, but I would be leary of that due to the fact that most NP's have had experience as an RN for at least 2 years prior to even going back to NP school. You may not have a little trouble getting a job because I'd figure they'd choose the NP with some type of experience versus the one that has none.

Also...not only job wise, but just for you, when becoming an NP, just so you can feel confident and comfortable with what you are doing..you might decide to go with a program that makes it mandatory for RN experience before going to NP school.

Yeah...that sounds like the politically correct way to do it but I dont feel its necessary in my instance hence I am not going to waste my time working in a hospital doing enemas for a year to get enough "experience" to do primary care in a different setting. Doesnt make any sense to me at all really.....

[Uberman5000]

Another thing to consider if going for a clinic position - why would a doctor want to train a new NP while not being able to see the same number of patients that an experieced NP can see? It is always the bottom line and important to consider you must perform billable services.

Hmmm, I could see the advantages to this as a business owner.....I would hire an inexperienced NP so that I could pay them less, train them and save myself some money, which is the bottom line in business. I dont understand why inexperienced NP's necessarily need to take longer with patients either thats kind of like saying that inexperience = incompetance in all cases....people learn quickly u would be surprised...