Education vs Experience

MedSurgeMess · Oct 24, 2009

I just want to toss my thoughts into this discussion.
A registered nurse and a nurse practitioner (or CRNA, CNS, whatever) encompass two distinct fields of health care. The practice is different and the qualifications are different. While any experience toward something is always beneficial, it's not completely necessary. As an advanced practice nurse, you'd be learning new deliveries of care. Basically what I'm trying to say is that while having experience is always a good thing, when that experience is in an area that you no longer wish to pursue, it may not be as necessary. I don't think you would need to spend years working as a dental hygienist to become a successful dentist or a CNA to become a successful nurse. The same logic should apply to those nurses who wish to advance their education and expand their scope of practice.

There are some requirements, because to be able to have advanced practice, you should at least know something about basic practice, like monitor readings, etc., and how to associate them with physiologic conditions and changes. These modes of thinking come from experience, not just education. A book and a professor can discuss scenarios all day, but only experience can teach you how you will react to each one. I have nothing against advancing your education, but to just get out of school and try to be in the role of advanced practice with no experience can be dangerous to the patient. And no, a registered nurse and a nurse practitioner are not 2 different distinct fields of health. The NP, CRNA, CNS or whatever, has to pass the same NCLEX and be a registered nurse as the rest of us!

SunnyAndrsn · Oct 24, 2009

I guess I have mixed feelings on this. While I understand the point you're trying to make, having been a nurse for the past two years now (wow, time flies...I joined Allnurses as a student) the experience I have gained has had me thinking back to some of the schooling I had. It's kind of the "aha" moments. "Oh that's why they said that in school...or that's why so many nurses say you'll understand x,y,z after you've been out for a few years...

There IS a lot about nursing that you just can't teach. You have to experience it.

OTOH, I do want to finish an advanced degree, but I have to pay off some debt and with a spouse in grad school, our budget just can't handle THAT many student loans! I would have been frustrated having to wait to go to school to fulfill the experience requirement.

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?

Lisa1203 · Oct 25, 2009

Good for you - go for your education - yes - I do agree with you that you can gain experience after your education & yes for the reasons you stated. As for the person who posted about a 22 yr old nurse with her BSN & less experience becoming the supervisor - I hear your pain & annoyance - but not all MSN programs lead to being the supervisor/manager of the floor RN's. For example many nurse practitioners are not necessarily telling the floor RN's what to do - they work in a different capacity diagnosing, prescribing medication, ordering tests - these are different tasks - I've worked with nurse practitioners in a women's clinic - nothing they do would make them better nurse practitioners if they had med surg experience as a regular nurse- NOTHING! It's a different job in many ways. I say - go for your education - & I also say - don't listen to anyone that tries to keep you down. I bumped into a former classmate who said she did her required 1 year of med surg to get into a nurse practitioner program & said it was the best thing she ever did.

PostOpPrincess, BSN, RN · Oct 25, 2009

Good for you - go for your education - yes - I do agree with you that you can gain experience after your education & yes for the reasons you stated. As for the person who posted about a 22 yr old nurse with her BSN & less experience becoming the supervisor - I hear your pain & annoyance - but not all MSN programs lead to being the supervisor/manager of the floor RN's. For example many nurse practitioners are not necessarily telling the floor RN's what to do - they work in a different capacity diagnosing, prescribing medication, ordering tests - these are different tasks - I've worked with nurse practitioners in a women's clinic - nothing they do would make them better nurse practitioners if they had med surg experience as a regular nurse- NOTHING! It's a different job in many ways. I say - go for your education - & I also say - don't listen to anyone that tries to keep you down. I bumped into a former classmate who said she did her required 1 year of med surg to get into a nurse practitioner program & said it was the best thing she ever did.

A women's clinic would bore me to tears. Anything that didn't involve intensive and high acuity would bore me to tears-- that is just me. I do not think we are telling the OP NOT to go to school--I say go for it. Just don't expect to work for that heart surgeon up the road and putting in lines and what have you without getting that necessary bedside experience. Our two ARNPs that work for the surgeon's group have a combined 40 years of experience.

They are that damn good. and I mean damn good.

If you think the skills are good enough to work in a clinic, go for it. The really experienced ARNPS are grabbed by the high acuity areas and get the best of both worlds.

BmoreCRNP · Oct 25, 2009

I personally believe getting a little experience before going into Advanced Practice is the best thing. However, I realize that my opinion is somewhat biased because that's what I did. I think it also depends on what kind of nursing experience you get, and what kind of APRN you're trying to become. For example, I wouldn't be any better off than a nurse with no experience had I decided to become a Neonatal Nurse Practitioner. I have never worked in the NICU or newborn nursery. So me and the straight to gradschool NP would be in the same boat! I decided to go the Family Practice route, and while my experience in med-surg and PACU is somewhat helpful, practicing in the outpatient primary care setting is a totally different world. I'm a brand new NP and even after being a RN for 13 years I still feel like I don't have the slightest clue! Someone else mentioned that the Advanced Practice role is different. I couldn't agree more. It really is a different animal. Diagnosing, prescribing, and following up on patient illnesses is not the same as functioning as an RN or LPN. It requires a different set of assessment and critical thinking skills. You need to be familiar with the gold standards of care for certain illnesses. These are things that I certainly didn't know about as an RN.

CASTLEGATES · Oct 25, 2009

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?

Because med school has a residency requirement and their hours are exponentially more than any nurse ever, and nursing education alone does not make a safe nurse. This is why on top of nursing school and NCLEX there's an orientation period which, in effect is like a residency. You see nearly unanimous recommendation from RN's that one should gain experience yet those who are not there and do not have the same knowledge disputing this. That alone is why I would not want an NP working on me who cannot learn from others. It is by the teaching of others we learn and become more competent practitioners.

When was the last time you saw an NP being precepted by a floor nurse?

vlmusicalsound, BSN, RN · Oct 25, 2009

Advanced practice programs do have clinical hours. It's not like you graduate an NP with no experience. Hospitals hire new graduates right out of school with no experience. Why should it be any different with graduates of an advanced nursing program? It's just silly to think that people who undergo 2+ years of graduate course work and tons if clicial hours aren't qualified because they didn't have some work experience as an RN. I plan on working before graduate school but that's only because I need to save money. I know some students who are planning to go straight to grad school after graduating with their BSN and I have no doubt they'll be just as good if not better than other APNs with work experience. Experience does not always equal success. I can think of plenty of teachers, health care professionals, and others who have had years of experience in their field that don't do as good a job as they should.

MAISY, RN-ER, BSN, RN · Oct 25, 2009

Advanced practice programs do have clinical hours. It's not like you graduate an NP with no experience. Hospitals hire new graduates right out of school with no experience. Why should it be any different with graduates of an advanced nursing program? It's just silly to think that people who undergo 2+ years of graduate course work and tons if clicial hours aren't qualified because they didn't have some work experience as an RN. I plan on working before graduate school but that's only because I need to save money. I know some students who are planning to go straight to grad school after graduating with their BSN and I have no doubt they'll be just as good if not better than other APNs with work experience. Experience does not always equal success. I can think of plenty of teachers, health care professionals, and others who have had years of experience in their field that don't do as good a job as they should.

You base this statement on what exactly?

Practice makes perfect and the longer you perform as a nurse, the larger the base of knowledge you establish. As for new grads...our orientation is 20-22 weeks in the ER, other critical care areas have similar orientations. It is learn by doing and a type of residency....clinicals DO NOT prepare you for real life unless you have great instructors willing to immerse you and themselves into nursing actions.

Other thoughts that come to mind is the many studies regarding the full development of the brain and the judgement center....if 25 is the magic age....hmmmmm. Working in an Advance Practice Role requires more than just knowing the material.....life is full of many experiences....many the average college student has not had yet. To me, it's similar to a Catholic priest working as a marriage counselor....he may learn about it but never truly understands. It's that way with young new grads...in the ER I cringe at their excitement for a code or new illness as something to be "experienced"....whereas, I always looked at the whole picture, and the overall sadness affecting all parties as the code is performed.

It isn't about young or old, or even disparaging ability....in about 5 years re examine your thoughts...I will bet you will see things differently.

SiennaGreen · Oct 25, 2009

Can anyone speak to whether you would choose an RN to BSN, work for a few years, then attend grad school -OR- work as an ADN prepared RN, and attend an RN to MSN program (less time & money, for me, in the end)

This thread has helped solidify that I do want to be in the trenches for several years prior to attending grad school for advanced practice nursing. Now...I wonder what path?

PostOpPrincess, BSN, RN · Oct 25, 2009

Advanced practice programs do have clinical hours. It's not like you graduate an NP with no experience. Hospitals hire new graduates right out of school with no experience. Why should it be any different with graduates of an advanced nursing program? It's just silly to think that people who undergo 2+ years of graduate course work and tons if clicial hours aren't qualified because they didn't have some work experience as an RN. I plan on working before graduate school but that's only because I need to save money. I know some students who are planning to go straight to grad school after graduating with their BSN and I have no doubt they'll be just as good if not better than other APNs with work experience. Experience does not always equal success. I can think of plenty of teachers, health care professionals, and others who have had years of experience in their field that don't do as good a job as they should.

You would be laughed out of my unit.

Don't embarrass yourself.

A CRNA had to eat **** the other day because he dealt with something he had never seen before. His ego is so big that he was chastised by the attending. "The next time," yelled the anesthesiologist",LISTEN to the nurses."

Not a pretty sight.

CASTLEGATES · Oct 25, 2009

Work for a couple years, step back and see what the new grads are doing. Some highly inappropriate and they've got no clue (like mentioned above) the enthusiasm look during a code. Something so subtle can turn a family-death situation into chaos.

That's one minor one; the majors are critical decisions. Ask a 2 year old grad what they've learned since hitting the streets and that will help. Remember, those giving advice here ARE your potential employers.

Looking up this disorder, I found a request of one blogger to add this to the DSM IV

Cranial Four Point Of Contact Disorder Formerly known as “Head in butt”.

Throw this term out in the next treatment or planning meeting you have. Someone will nod their head like they know exactly what your talking about and may even say something about themselves writing a college paper about it. Chances are they suffer from this very disorder.

Moogie · Oct 25, 2009

Can anyone speak to whether you would choose an RN to BSN, work for a few years, then attend grad school -OR- work as an ADN prepared RN, and attend an RN to MSN program (less time & money, for me, in the end)
This thread has helped solidify that I do want to be in the trenches for several years prior to attending grad school for advanced practice nursing. Now...I wonder what path?

That's an excellent question. Honestly, I think you answered it yourself when you said that you'd save money and time going to an ADN program first, then doing an RN to MSN bridge. The biggest disadvantage of the ADN is that it might be more difficult for you to find a job because many employers prefer BSNs. Then again, that situation could change dramatically by the time you graduate.

My experience was that my ADN program was very task-oriented whereas my BSN program gave me a broader perspective on nursing. While my ADN program was excellent, I felt that the BSN helped me to become a well-rounded nurse. I am not sure if I would have felt that way had I gone directly into an entry-level BSN program. On the one hand, I think doing an RN to BSN bridge helped me to appreciate my bachelor's degree but on the other, I felt that I missed out on a lot of humanities courses and the "college experience".

When I did my RN to BSN program, the concept was fairly new and there weren't many programs that offered the option. Now there are many bridge programs, some better than others, some that offer LPN to BSN, RN to BSN, RN to MSN, even BSN to PhD. I think a lot depends on what's available in your area, what seems to be the best fit in your life in terms of geography, time and money, and how the programs you're considering differ from each other.

Good luck to you in the future, whatever you decide! HTH!