BSN straight to NP or gain work experience

[clint.parsch]

I am currently active duty military and plan on getting out and pursuing a BSN! I have made the decision to get at least my Masters as an NP. I know both are difficult programs but I am motivated and determined and the military has given me a great work ethic. On top of that I have a wife and 1 child at the moment and I want to provide for them the best I can. Enough about my background though on to the question. I am curious on people's opinion on whether it makes sense to go straight from a BSN to NP or to take a few years off of school and get work experience as a RN? Any input would be an immense help towards the direction of my career!

[SmilingBluEyes]

Hmmm $$$$? As an experienced RN, esp working overtime (If I choose) and weekends, I can easily make more than my FNP friend just being a plain old nurse. My FNP friend sees patients every 15 to 20 minutes for 9 or more hours a day and spends more time afterward dealing with endless charting and paperwork. My shift is done when it's done. I leave on time every time.

The $$$ investment would never be worth it, to go to school and put myself through hundreds of hours of clinicals on top of my working full time. So not worth it. The debt of school would be crushing on my finances and put off my retirement, which I plan to enjoy someday not too far off.

NOW if you want to be an NP because it's a goal or dream, DO IT. Far be it from me to stop anyone wanting to advance themselves for their goals or aspirations. But don't think you'll be making that much money, especially as the market becomes saturated with people thinking just like you; a desire to go quickly into advanced practice and skipping being an staff nurse. I understand the desire by many not to spend much time at the bedside; it's a hard grind, on the body, mind and spirit. The more NPs there are, the cheaper they will come, in many cases. Especially for inexperienced NPs. A saturated market does not look good for making tons of money.

You will make a comfortable living and have the satisfaction of very nearly independent practice. That, no one could take away from you. My friend became an FNP because that is what she wanted to do, not because she stood to make a ton of money. I think she did it for the right reasons. But she has school loan debt that won't just go away and will have to work a long time to pay it off.

If you are going to do this: It's got to be because you want to be an NP. Really, really, want to. Or else, it won't be worth it. The path is not easy and it should not be.

I do fine as just a plain old RN.

[KatieMI, BSN, MSN, RN]

Going through RN on the way to NP makes sense for those who never had any direct patient care experience and no health care experience in general. BTW, it is much better to go through BSN nowadays - in many places ADNs become less welcomed in teaching/Magnet and higher acuity level units, and these are places where doors for the future can be seen behind every corner. ADN - bridge to BSN CAN be less expensive and save up on the long run, but it is the only benefit of it that remains.

If one had direct patient care experience, in pretty much any capacity, I would strongly advice to do direct MSN/NP EXCEPT narrow specialty schools (PMH/NP, CNM, NNP, CRNA). Employers care notably little about "previous experiences" outside of specialty areas, and one saves himself from years of exhausion and cruelty of bedside nursing, which more often than not adds little to "clinical thinking skills" required at provider's level.

Nowadays, not all specialty schools except CRNA mandate years of bedside experience, but it is still would be a good idea to expose himself to the area. One must know for sure that he or she could stand seeing a preemie lingering on the edge between life and death for months or being attacked by critically agitated, psychotic patients before throwing years of hard work and $$$$$ in NP specialty school.

[Jedrnurse, BSN, RN]

The term is "advanced practice". How do you practice in an advanced way if you've never practiced at all?

Get some experience first.

[LovingLife123]

Employers are having a hard time hiring NPs with no clinical experience. Heard this directly from HR people. Get some bedside experience. You can make more than an NP if you take the right job with OT. Find yourself a weekend option job, maybe even night shift and then pick up bonus OT. Nurses can make over $100k in my area doing that. It can be a sacrifice, but that's why they make so much more.

As a PP stated an NP is considered an Advanced Practice Nurse. A masters degree means you have mastered that field. Nursing is one of those fields where you have to practice it in order to master it.

[Simplistic]

Hmmm $$$$? As an experienced RN, esp working overtime (If I choose) and weekends, I can easily make more than my FNP friend just being a plain old nurse. My FNP friend sees patients every 15 to 20 minutes for 9 or more hours a day and spends more time afterward dealing with endless charting and paperwork. My shift is done when it's done. I leave on time every time.

The $$$ investment would never be worth it, to go to school and put myself through hundreds of hours of clinicals on top of my working full time. So not worth it. The debt of school would be crushing on my finances and put off my retirement, which I plan to enjoy someday not too far off.

NOW if you want to be an NP because it's a goal or dream, DO IT. Far be it from me to stop anyone wanting to advance themselves for their goals or aspirations. But don't think you'll be making that much money, especially as the market becomes saturated with people thinking just like you; a desire to go quickly into advanced practice and skipping being an staff nurse. I understand the desire by many not to spend much time at the bedside; it's a hard grind, on the body, mind and spirit. The more NPs there are, the cheaper they will come, in many cases. Especially for inexperienced NPs. A saturated market does not look good for making tons of money.

You will make a comfortable living and have the satisfaction of very nearly independent practice. That, no one could take away from you. My friend became an FNP because that is what she wanted to do, not because she stood to make a ton of money. I think she did it for the right reasons. But she has school loan debt that won't just go away and will have to work a long time to pay it off.

If you are going to do this: It's got to be because you want to be an NP. Really, really, want to. Or else, it won't be worth it. The path is not easy and it should not be.

I do fine as just a plain old RN.

The key word in your argument is "EXPERIENCED RN". A brand new NP that goes straight through school and finishes at age 23-24, will make money then you do at 40. End of discussion.

[BostonFNP, APRN]

A quick word of warning to the OP: as other have said, this is a hotly debated topic, and as such there are many people with passionate feelings on the topic. Take all comments with a grain of salt, from both sides, and remember that not everyone with an opinion has experience or perspective with the topic at hand.

In my experience, as a practicing NP and NP educator, there is far more variability between individuals than between those with and those without RN experience at the APN level, with the caveat that in specialty APN practice having pertinent RN experience may likely be a more significant factor. In the end, only you and your educators will know what RN experience you truly need to practice: I have had students with none that have done wonderful and those with extensive experience that have failed multiple times, conversely, I have failed students with no experience that are no safe to practice. In the end, your educators and you will dictate what you need, provided you go to a quality program.

[/username, BSN, RN]

The NP is designed with experienced RNs in mind so they could put their years of clinical expertise to good use. I feel many ways about the shift to "direct entry" NP programs, and people starting NP programs before they have laid a hand on a patient as a RN. Of all the ways I feel, none of them are good.

[BostonFNP, APRN]

Hmmm $$$$? As an experienced RN, esp working overtime (If I choose) and weekends, I can easily make more than my FNP friend just being a plain old nurse.

I have always said that no one should be an NP for the money, it's just not worth it for that, you need to want the role.

That being said, you really can't compare income of an experience RN working overtime and differentials to a novice NP working a M-F 9-5 salary job. What do you think the comparison is between that and an experience NP working a profit sharing job (many experience NPs here will tell you they are in the $200k+ range) and moonlighting one hospitalist/UC/ED shift a week (here, the shift pay is $85/hr or about $1000/shift). The money argument just isn't a good one.

[ThePrincessBride, MSN, RN, NP]

Most NP postings in my area state that 3-5 years of bedside experience is required for an interview.

Good luck graduating with an advanced degree but no experience to back it up. Kind of like a MD without a residency.

[ThePrincessBride, MSN, RN, NP]

No offense but you cannot say that your opinion isn't bias. Didn't you go to a direct-entry NP school and graduate never laying hands on a patient as a bedside nurse?

It is easy to minimize bedside experience when you don't have any. General you,of course.

A quick word of warning to the OP: as other have said, this is a hotly debated topic, and as such there are many people with passionate feelings on the topic. Take all comments with a grain of salt, from both sides, and remember that not everyone with an opinion has experience or perspective with the topic at hand.

In my experience, as a practicing NP and NP educator, there is far more variability between individuals than between those with and those without RN experience at the APN level, with the caveat that in specialty APN practice having pertinent RN experience may likely be a more significant factor. In the end, only you and your educators will know what RN experience you truly need to practice: I have had students with none that have done wonderful and those with extensive experience that have failed multiple times, conversely, I have failed students with no experience that are no safe to practice. In the end, your educators and you will dictate what you need, provided you go to a quality program.

[BostonFNP, APRN]

No offense but you cannot say that your opinion isn't bias. Didn't you go to a direct-entry NP school and graduate never laying hands on a patient as a bedside nurse?

It is easy to minimize bedside experience when you don't have any. General you,of course.

Everyone's opinion is biased, hence my comment about "from both sides". Bias is one thing, a lack of experience with the topic is another. I do think it is ironic that some posts here about how APNs absolutely need experience come from people that have no experience with APN education or the APN role.

I went to one of the top NP programs in the country. I worked as a floor RN on heme/onc floor for a year and a half prior to working as an NP. I have been involved in NP and MD education, both clinical and didactic for many years.

So what is your experience, where did you go to NP school and how long have you been practicing as an APN? What is your bias?

[ThePrincessBride, MSN, RN, NP]

Everyone's opinion is biased, hence my comment about "from both sides". Bias is one thing, a lack of experience with the topic is another. I do think it is ironic that some posts here about how APNs absolutely need experience come from people that have no experience with APN education or the APN role.

I went to one of the top NP programs in the country. I worked as a floor RN on heme/onc floor for a year and a half prior to working as an NP. I have been involved in NP and MD education, both clinical and didactic for many years.

So what is your experience, where did you go to NP school and how long have you been practicing as an APN? What is your bias?

My experience? I work in a specialty (NICU) that requires its NNPs to have a minimum of two years of clinical bedside experience prior to clinical practicums. Neonatal NPs were some of the first NPs to emerge from the advanced practice nursing force.

It would be an injustice to the neonates to go into to AP with the bare minimum. Hence why I am now just starting the application process so that, by clinicals, I have more than the minimum.

I also had the interesting opportunity while in undergrad to take classes side-by-side the direct-entry students. They were just a few months away from graduating from the RN portion and entering the NP part of the program. Some of them couldn't take a blood pressure manually. Nor did they seem to have an understanding of basic pharmacology. For example, some didn't know that heroin is consider a "downer" not an "upper" and that heroin and morphine work and metabolize similarly in the system.

That is terrifying.

And make no mistake. This is also a reputable and highly-ranked NP program. That is scary.

If bedside experience isn't so important, then why are many advanced practice schools (NNP, CRNA and, up to a certain point, Acute Care AGNP) requiring their applicants to get that bedside experience? Why aren't MDs being hired without residencies? And more importantly, what is the point of being called an advanced practicing nurse if one doesn't have the BASICS down?

I can also speak from a less specialized field: med-surg. Do you know how many patients and how many different diagnoses a bedside RN can see and learn how to manage on a fundamental level? At my med/surg job, I can have up to seven patients with seven different CCs and multiple comorbidities.

As an NP, one has to know how to prioritize which diagnoses to treat, how to treat them and when to recognize even the slightest variation from a patient's baseline to prevent a patient from going down the tubes. Now I know some direct-entry NPs think that book smarts and a quick wit is all that is needed to be a good NP, but here is something one cannot learn in a classroom: intuition.

So while you think it is "ironic" that a bedside nurse is speaking to greater than thou NP, understand that bedside nursing provides the FOUNDATION from which NPs learn and grow. NP students were expected to already have a strong knowledge. As the bedside nurse, I need to feel confident in the APNs abilities and education because when SHTF, I am calling you (general you, of course).

If NPs feel that bedside nursing experience is no longer needed, then NP training should divorce itself from nursing altogether and just be called "practitioners."