Clinical experience before FNP

figuringitout09 · Feb 8, 2009

Hm, good question. I too was wondering what the best experience would be for someone who thought they may be interested later in becoming a FNP.

ANPFNPGNP · Feb 8, 2009

Hi!
I am in the last semester of BSN program and I am planning on going back to school to get my masters in FNP probably about a year after the graduation. It will be great to know the kind of clinical experience I need to have before the start of FNP program because that will help me decide where and what speciality I should work to gain the experience I need to prepare for school.
I thought ER was a good place to see variety and practice assessment skills... Any suggestions plz? :icon_roll

See if you can get a job in an ER with a "fast track." We see a lot of patients with primary care problems in the fast track. Also, urgent care clinics and primary care practices are excellent places to gain experience. Even though you would make less $$ working for a primary care doctor, that's the best place to gain experience as a FNP.

Trauma Columnist · Feb 8, 2009

Depends on your state and where an FNP is allowed to practice. Some states are beginning to limit FNPs to outpt or primary care while other states have no restrictions and FNPs can work in the acute care setting too.

jennysong81 · Feb 9, 2009

Thank you guys for your responses. In speaking to my clinical instructor, she said critical care experience will definitely help a lot with preparing to become a FNP. She also added that although a lot of people may have different opinions but starting out on med/surg unit will give me confidence in time management and seeing patients with various types of illnesses with different levels of acuity will help me understand pathophysiology... do you agree with her?

Editorial Team / Admin · Feb 9, 2009

Yes, I agree with her. Med-Surg gives you a good variety of patients disease processes and treatments. I think you'll fair well doing this.

Critical Care environment is excellent if you can get that for you will see a lot of the same over-lapping in patients. But, you'll have firsthand experience with managing acute vs. chronic.

LisaDNP · Feb 9, 2009

When I was in my FNP program, the students who seemed to have the easiest time were the ER nurses.

If you have an opportunity to work in the ER, I'd recommend you consider that position.

ANPFNPGNP · Feb 9, 2009

Thank you guys for your responses. In speaking to my clinical instructor, she said critical care experience will definitely help a lot with preparing to become a FNP. She also added that although a lot of people may have different opinions but starting out on med/surg unit will give me confidence in time management and seeing patients with various types of illnesses with different levels of acuity will help me understand pathophysiology... do you agree with her?

I don't agree with your instructor. I had several years of med/surg experience and I don't think it really helped prepare me for practicing in primary care. However, if you're planning on working in the hospital, then that's exactly what you need. The problem is that the patient almost always has a diagnosis before being admitted to the hospital. The toughest part is coming up with the diagnosis...after that you can pick up a "cook book" and figure out what to do about it.

I know a NP student who had 20+ years of ICU experience and she had a horrible time in the primary care setting. Has your instructor actually worked as a NP in the primary care setting?

Editorial Team / Admin · Feb 9, 2009

The problem is that the patient almost always has a diagnosis before being admitted to the hospital. The toughest part is coming up with the diagnosis...after that you can pick up a "cook book" and figure out what to do about it.

I respectfully disagree with this.

The initial admitting dx may or may not contain co-morbid dx and certainly will not contain dx obtained after admission.

The astute FNP is one who recognizes (pathology), applies to the patient accordingly, able to differentiate dx, and treat adequately. This takes well-rounded experience. Obtained from many areas.

Experience (well-rounded) is really the key to an astute diagnostician. Anyone doing "cook-book" medicine can be setting oneself up for failure.

So, in saying this, if you can get into an area where you have "well-rounded" experience, you will do well. Med-Surg, CCU, ED.......all will allow you to gather this experience.

VivaRN · Feb 10, 2009

I'm going to go out on a limb and say that critical thinking skills as applied to your RN job are more important than the area per se. Do what you love.

Dr. Tammy, FNP/GNP-C · Feb 10, 2009

I pretty much thought the same thing. With 20 years of paramedic exp and 14 years in the ER, I thought it would be a natural transition when I started FNP school. Now that I'm close to graduating, I'm not so sure. Unfortunately, I never did have any gun shot wounds, acute psychotic reactions, mechanical falls with marked neuro deficits in the primary care clinic. Then again, in 20 years in the emergency care arena, I was never asked to counsel a patient on birth control methods, the meaning of A1C's, or do prostate exams with PSA elevation counseling.

I've discovered the real meaning of the specialities of primary care - family practice, pediatrics, internal medicine, geriatrics and in some cases OB/GYN are very much, in and of themselves, every bit of a specialty as much as emergency nursing. Although much knowledge and skill is the same, priamry care requires quite the different skill set than emergency nursing.

Hi!
I am in the last semester of BSN program and I am planning on going back to school to get my masters in FNP probably about a year after the graduation. It will be great to know the kind of clinical experience I need to have before the start of FNP program because that will help me decide where and what speciality I should work to gain the experience I need to prepare for school.
I thought ER was a good place to see variety and practice assessment skills... Any suggestions plz? :icon_roll

bayouchick02 · Feb 10, 2009

I was kinda wondering what kind of experience would be good prior to starting FNP school myself. I currently work in the nicu, and looking at most of these program requirements, they just want at least one year of nursing prior to starting the fnp track. so basically, does it really matter what you have previous experience in since they teach you these things in school??