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Discussion

Direct Entry MSN... Enough experience to be APNs??

Hey there! So I'm a little confused about something...

The other day I was talking to some first semester direct entry MSN program students who were discussing how to give SC injections -- something they had never done before and were nervous about. It sort of baffles me that these students will be eligible to be RNs w/ BSNs in one years time when they have barely any experience. I just don't see how one year of clinicals -- no matter how intense they are -- can make up for years of experience.

Now I'm not even an RN (I'm in my senior year of undergrad) so I'm really trying not to be judgmental... I could see how prior life experience in a different field could be valuable in preparation for a direct entry program. I personally don't think I'd be qualified to be an APN until I get a few years working in the field as an RN. Although maybe that doesn't apply to everyone since NPs do such different work than RNs anyway...

Thoughts?

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    Background: I just finished a direct entry program this past May, took boards over the summer, got a job offer today.

    For acute care, I agree that experience as an RN on a hospital floor would be extremely valuable. I think ACNPs can function without RN experience, but would probably need more training/orientation at the beginning. For outpatient or primary care, I'm not sure I believe that RN experience makes a huge difference. I have a little bit of office RN experience, and it's very different from what I'll be doing in a clinic. The other NP where I'll be working is also a recent grad, though her program required med-surg nursing experience while in school. She told me that she enjoyed her experience and is glad she did it but doesn't think it makes a difference in her practice as an NP. Then again, neither of us made the transition from "expert" RN to NP.

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    uhhh... that sounds like a really weird program. They never learned SC injections? That just sounds really bizarre to me. I'm in a direct entry MSN program and I've given all types of injections (subq, IM, subdermal, etc.), and I'm barely in the beginning of my second quarter. Sounds like a weird program if they haven't even done that. Still, at the end of the day, how much does being able to do an injection add to NP practice? Plus, it's not like it's particularly hard to do, you can learn in 5 minutes. It's controversial, but whether or not you "need" extensive RN experience really tends to depend on the specialty and the individual, IMO.

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    • Guides

    I'm a direct entry grad and have been in practice for a few years now. You raise some valid questions about needing RN experience beofre becoming an NP. I agree with Dembitz that some experience would be very important for an acute care NP. They primarily work in inpatient environments, and walking into that without some hospital experience would be tough.

    I have worked in internal medicine and am now in a specialty practice. I had never worked as an RN prior to becoming an NP. I felt my program left me well prepared to be a novice, entry level NP. My clinicals were great and I learned a lot, but most of what I know I learned on the job. You will hear the same thing from experienced RNs who became NPs. I use very little of what I learned in the RN portion of my program. RN and NP roles are very different. I think the key to success in becoming an NP is the ability to think critically, whether you've been an RN for years or are new to nursing. People who are in DE programs have often acquired that skill in different careers prior to entering nursing. These programs are very selective and don't admit people who are not likely to succeed in the classroom and as an NP down the line.

    RN experience is certainly valuable, but not absolutely essential to be a good NP (except in the acute care role, IMHO). You can take different paths to arrive at the same destination.

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    • Experts

    A lot of us agree with you, but TPTB in nursing have decided that it's not a problem ...

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