Education vs Experience

[Airforce1]

Hello Everyone,

I am a BSN student who is interested in pursuing a graduate degree in the future, probably a year after I graduate. I have read some posts and found that many here believe that an RN with that little experience has no place in Advanced Practice programs. This is where I disagree.

I believe that Nursing culture is shooting itself in the foot here, and here's my cents why. A prospective doctor does not have to leave college after a bachelors degree to gain experience in the field of biology or chemistry before going on to Med school. A prospective college professor does not have to leave college after his bachelor's degree to get experience teaching at the grade school level. So WHY do so many believe that an RN has to leave school after their bachelor's degree to gain whatever many years of experience at the clinical level before going on to grad school?

:nono:I believe that it is counterproductive for the nursing profession as a whole to discourage students who wish to complete their education (MSN or beyond) before beginning clinical or other types of practice. You would think that the sensible thing to do is get your education, and THEN get your experience. Am I the only one who feels like this?

[MAISY, RN-ER, BSN, RN]

How do you rate perfectly fine or working at the same level as someone with background? I guess that's the point....

Many people can go through programs and talk the talk, but not walk the walk. Every year I realize how much I didn't know the year before. Nowhere is this more evident then with a cocky new grad...we all were one at some time or the other...or those who haven't graduated yet.

In the ER, belly pain, cp, numbness and tingling are such common complaints YET based on symptoms and appearance we judge those to be the sickest to come in. It is a skill to identify very sick people, and yet another skill to know when to say WHEN! It is a skill to triage people to proper areas and identify a pericardial effusion or fractured sternum from sternal bruising from an MVA. No one just KNOWS how to do things....you must be taught, you must be mentored and you must have a good foundation.

Case in point is nursing education.....there isn't a nurse I know who hasn't had terrible educators.....people have their Doctorates yet would be horrible nurses as evidenced by their lack of practical knowledge or inability to relate real life to BS book learning.

You must always have education, but education without experience MUST fall short. Nothing takes the place of hands on, real life, patient care!!

[jjjoy, LPN]

It depends a lot on the person as well. I know some NP's who I think are horrible at their jobs, not because they are theoretically incompetent but because they aren't used to the healthcare environment. They aren't used to having something bad happen to a patient, then having to "get over it" and move on and help the next patient. They aren't used to medical hierarchial politics. They aren't used to being pulled in several different directions at once. These are all skills that experience, not education, can teach you.

There are other NP's however who went straight through without getting experience who are perfectly fine, who don't need the transition.

Similarly, a new RN grad without experience may have a very difficult time transitioning to the unpredictability, the chaos, etc and struggle greatly that first year on a med-surg floor. I think BOTH new grad RNs and new grad NPs should have the opportunity for a transitional residency OR have the training programs include a residency-type component. Some may not need it; but currently there are few options for those who do. It's just trial by fire, which isn't ideal for either new nurses or new NPs.

[MAISY, RN-ER, BSN, RN]

One of the NPs I work with was an RN, then a paramedic(they use the medical model) before she became a NP. She is very hands on, comfortable in ER medicine and it's just another day for her. She still rides as a paramedic and intubates patients under that guise-our hospital does not allowv NPs to do intubation as we are a teaching hospital. So that's how she keeps up that skill.

Our other NP is also good with people, however she relies heavily on the physician, was never taught to read xrays and explained to me that once you are hired after licensing unless it is a specialty in which a doctor is training you specifically for his practice-you are expected to be ready to role! She told me she struggles daily with decisions and feels the need to bounce everything off the doctor; yet she knows her stuff.

Two very different women, different experiences but different because of background!

Most schools have no formal program and the NP students must make clinical arrangement....easy is not necessarily better. Full exposure is best....as is working in the inner city. Go to the sickest patients, not only will you be appreciated but you will see it all! Anyway as I am endeavoring to this myself...I'll let you know.

M

[Lisa1203]

And outside of tradition, why should becoming an NP require having earned an RN license and BSN degree? Why not just require the relevant courses from those programs and a bachelors degree in any field?

You CAN become an NP with just having your RN license & a bachelors degree in any field. You would just need to take a few undergrad courses like nursing assessments & then go right into the NP program. I know because I've done the research & this is exactly what I'm doing!!!

[PostOpPrincess, BSN, RN]

Similarly, a new RN grad without experience may have a very difficult time transitioning to the unpredictability, the chaos, etc and struggle greatly that first year on a med-surg floor. I think BOTH new grad RNs and new grad NPs should have the opportunity for a transitional residency OR have the training programs include a residency-type component. Some may not need it; but currently there are few options for those who do. It's just trial by fire, which isn't ideal for either new nurses or new NPs.

There are residencies for new grads of ADNS/BSNs. Our hospital system has instituted the Versant Residency program. It is excellent.

Whatever capacity/specialty a DE-NP (decides) to work in--he/she should have a residency.

I'll state this again. THERE IS NO STANDARDIZATION.

And I know what's going to happen...studies will be done and years later they will figure out this is not a good thing.

[diane227, LPN, RN]

Well, I have worked with PA'a and advanced practice nurses who had experience before they got their advanced degree and ones that did not. And all I can say is the learning curve is HIGH for those who have not had some work experience. They write orders for things that are totally wrong because they do not know enough about direct patient care to know that what they are asking for will not work. I have to give them orientation to equipment, supplies and procedures. It is like teaching the nursing students or a new grad. I don't mind doing it because I love teaching but I have to be extra careful with their orders because I just have to make sure they know what they are doing.

[kanzi monkey]

You CAN become an NP with just having your RN license & a bachelors degree in any field. You would just need to take a few undergrad courses like nursing assessments & then go right into the NP program. I know because I've done the research & this is exactly what I'm doing!!!

Really? I haven't heard of this. Do you mind giving an example of one of these programs? I know that Midwives don't necessarily need to come from an RN background, but I didn't think that was the case for NPs.

[Lisa1203]

Originally Posted by Lisa1203

You CAN become an NP with just having your

RN

license & a bachelors degree in any field. You would just need to take a few undergrad courses like nursing assessments & then go right into the NP program. I know because I've done the research & this is exactly what I'm doing!!!

Really? I haven't heard of this. Do you mind giving an example of one of these programs? I know that Midwives don't necessarily need to come from an RN background, but I didn't think that was the case for NPs.

StonyBrook University, SUNY New paltz college (New paltz only has the masters in clinical nursing, not an np program - an advisor there told me that once I get my RN (I have a bachelors in another field) to definately sign up for classes as I would get floor experience while getting my masters. & here's a link to Albany Medical College - it should open up to a page on the entrance requirements for a nurse anesthetist program - (the hardest & most difficult to get into of all masters nursing programs) http://www.amc.edu/Academic/NurseAnes/Admission_Requirements.html - as you can see you can have a degree in this program with a bachelors in a science field OR obtain the necessary requirements (biology, micro, physics at a community college w/a bachelors degree would fit this & with good grades)

I can't say for sure if ALL NP programs require any bachelors degree - but I think most if not all do. Do you really think any BSN program would let you in on this unless you asked? No - colleges are a business.

[kanzi monkey]

Originally Posted by Lisa1203

You CAN become an NP with just having your

RN

license & a bachelors degree in any field. You would just need to take a few undergrad courses like nursing assessments & then go right into the NP program. I know because I've done the research & this is exactly what I'm doing!!!

Really? I haven't heard of this. Do you mind giving an example of one of these programs? I know that Midwives don't necessarily need to come from an RN background, but I didn't think that was the case for NPs.

StonyBrook University, SUNY New paltz college (New paltz only has the masters in clinical nursing, not an np program - an advisor there told me that once I get my RN (I have a bachelors in another field) to definately sign up for classes as I would get floor experience while getting my masters. & here's a link to Albany Medical College - it should open up to a page on the entrance requirements for a nurse anesthetist program - (the hardest & most difficult to get into of all masters nursing programs) http://www.amc.edu/Academic/NurseAnes/Admission_Requirements.html - as you can see you can have a degree in this program with a bachelors in a science field OR obtain the necessary requirements (biology, micro, physics at a community college w/a bachelors degree would fit this & with good grades)

I can't say for sure if ALL NP programs require any bachelors degree - but I think most if not all do. Do you really think any BSN program would let you in on this unless you asked? No - colleges are a business.

Sorry, for some reason I read your post wrong. For some reason I thought you said you could become an NP WITHOUT your RN license. Which is not what you said (doh!). Sorry sorry, my bad.

Thanks for your reply though :sofahider

[BmoreCRNP]

You CAN become an NP with just having your RN license & a bachelors degree in any field. You would just need to take a few undergrad courses like nursing assessments & then go right into the NP program. I know because I've done the research & this is exactly what I'm doing!!!

I'm curious to know what school that is, because all of the NP programs here require a BSN in nursing. Also, the state where I am requires NPs to have and maintain RN licensure.....which requires a degree in nursing. Be careful about choosing an NP program that allows you to bypass having a nursing degree. It will limit which states you can practice in.

[BmoreCRNP]

Well it looks like there are two camps here. One that thinks experience is necessary for advanced practice, and one that thinks all it takes is someone who's really smart and catches on quickly. All I know is my NP program stank! Not everyone had the same quality of clinicals/practicums. Some people were able to get into places where they learned a lot, did a lot of procedures, read x-rays, etc. Others did crappy things like the minute clinic, hospital employee health office, etc. The program directors' hands were tied because he had to worry about placing 40+ students. Not only was he competing with area NP programs, but PA programs, and Med-school programs. Guess who gets top priority? You guessed it....the Med students. The University I went to has it's own clinics throughout the city. We couldn't even get placed in those because the Med students took all the open slots. From what I understand ours was not a unique problem. A lot of NP students have this issue when trying to get clinical experience. There needs to be the type of consistency in nursing education across the board. Unless we start doing this, no one will respect us.

[Lisa1203]

I'm curious to know what school that is, because all of the NP programs here require a BSN in nursing. Also, the state where I am requires NPs to have and maintain RN licensure.....which requires a degree in nursing. Be careful about choosing an NP program that allows you to bypass having a nursing degree. It will limit which states you can practice in.

Sorry if my post was confusing - you were the 2nd person - I said the NP programs take a non-BSN bachelors degree AND your RN license which you can obtain (as we all know how) thru an ADN or diploma program. I never meant bypass having a license - but YES to bypassing having the BSN part - but WITH a bachelors in something else. I know it sounds crazy because as I said before the schools are a business - they're not going to tell you this unless you ask Also - check out the requirements online to get into those programs near you - they'll say either have a BSN or a bachelors in something else plus nursing assessments (which is a typical BSN course that's not in an ADN program) and maybe a few other undergrad classes.