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?

[november17, ASN, RN]

From the consumer point of view:

I go to a pediatrician for my kids. He employs an NP - she's awesome for sick visits.

However, lets say she quit, and he hired a new one. A new grad.

Given the choice, which one would I prefer to take my kid to?

A)The nurse practitioner that worked as a pediatric nurse for a year or more prior to going back to school and getting their masters.

B)The nurse practitioner that worked as a computer programmer and got their degree through some accelerated program - and has never done a full time week of bedside patient care in their life.

tough one.

[PostOpPrincess, BSN, RN]

I can tell you this--my hospital system doesn't hire direct entries.

And if they did, it would be an at research/data gathering level--no direct care.

Don't know about the docs--but that would be them.

As far as having the experience or not--I see it as caring.

I see nurses who truly care about NURSING--not just being advanced or anything else.

I know for a fact when I get my APN, I have no plans of EVER forgetting I am first and foremost a nurse--a caring one--and that I won't just look at my patient as a disease process.

THAT'S what is being forgotten here--see all of the DEs questions and you will see what I mean.

It's all about "how can I skip and directly go to being an expert in a field that requires a lot of expertise with people's lives."

If that doesn't scare you, it ought to.

When you are in a place when your clinician has NO years of experience EXCEPT for 800 clinical hours....even the NP above said she would prefer more of a residency. I TOTALLY advocate that. I think that will make it safer.

These DE programs are money making institution and NONE of them have the same standards. That doesn't SCARE YOU? It scares me!

Good luck...

[misplaced1]

I did not make it clear that I had two illnesses that probably made me hard to diagnose although lots of people with lots of experience and education were trying. I think the problem was they were all stuck in their own little specialty. AND the biggy that no one ever talks about- doctors and others who diagnosis do so typicallly without the aid of computers which could change everything. If anyone had even typed my symptoms into the internet my diagnosis would have come up without years of illness for me.

There are reasons no software specific to diagnosis is used but that is definitely for another day.

[PostOpPrincess, BSN, RN]

From the consumer point of view:

I go to a pediatrician for my kids. He employs an NP - she's awesome for sick visits.

However, lets say she quit, and he hired a new one. A new grad.

Given the choice, which one would I prefer to take my kid to?

A)The nurse practitioner that worked as a pediatric nurse for a year or more prior to going back to school and getting their masters.

B)The nurse practitioner that worked as a computer programmer and got their degree through some accelerated program - and has never done a full time week of bedside patient care in their life.

tough one.

I'll take A for $100.00, Alex....

[misplaced1]

Oh and before I go off to bed, I am in total agreement that there should be more clinical time AND a residency. i dont think everyone has to be trained in acute care though because many people are not interested in acute care. As far as a hospital NP though, yes I certainly want the one that has years of RN experience- as an ACUTE CARE nurse or has done a residency in acute care. I do understand the experience issue but I dont think you can discount education.

As far as the peds NP goes. Either one year experience in peds or former computer program. Sorry once again I will take the smart one. I hope its the peds experience one that is the smart one but if not I will go with the former programmer. When it comes to diagnosis, I want the one that is the best at putting things together- and honestly that may well be someone with a mind like a programmer. I also want the one that does not think they know it all because that way they will be more likely to refer me out if I need it. That has to do less with education/experience and more to do with self esteem. So yes I will take the one that is the smartest with the highest self esteem and I would prefer them to have experience. But honestly, high self esteem so they are comfortable enough to refer me out if necessary is probably the most important.

[kanzi monkey]

acute care is where many of these nps try to end up.

so now the op wants to go "directly" to nursing without the experience and compares it to an engineering degree.

seriously?

these are people.

this career isn't just so someone can be a diagnostician or someone can get paid well.

this is about lives.

these are people.

they have kids.

they are someone's child.

they are someone's mother.

they are someone's daughter/son/uncle/father/friend/neighbor/sister/brother.....

jopacu, you really don't get it, do you? i don't care if new nps are trying to become acute care nps at your institution. they should probably have some experience in acute care before being an advanced clinician there. but that's not what many people are talking about. i have no interest in working in acute care. acute care is not better than other types of advanced nursing. it is not the ultimate achievement. i would not feel satisfied in that role since my interest is in developing relationships over time with my patients and helping them live healthy lives outside the hospital. this role is just as important as an acute care np's, and experience in a hospital setting will not necessarily assist a new primary care np working in an outpatient setting.

and your whole spiel about "these are people. they have kids..." etc etc--do you think we're stupid? i don't think anyone is underestimating the gravity of a health care clinician's role. but keep it real--don't insult a person who chose an accelerated route to another profession because his role isn't as "important" as yours. it's different, but may be just as important when considered in its appropriate context.

and my point about "anecdote" is that your own personal experiences do not explain the ways of the world for all people. they are your experiences--what they meant to you does not make them "truth" or "fact" for anyone else.

and ativan for the poor kid who couldn't pee--nicely done. your experiences with patient's like him helped you intuit what he needed. but it's not an "aha" moment--it was merely a good call.

[PostOpPrincess, BSN, RN]

Oh and before I go off to bed, I am in total agreement that there should be more clinical time AND a residency. i dont think everyone has to be trained in acute care though because many people are not interested in acute care. As far as a hospital NP though, yes I certainly want the one that has years of RN experience- as an ACUTE CARE nurse or has done a residency in acute care. I do understand the experience issue but I dont think you can discount education.

As far as the peds NP goes. Either one year experience in peds or former computer program. Sorry once again I will take the smart one. I hope its the peds experience one that is the smart one but if not I will go with the former programmer. When it comes to diagnosis, I want the one that is the best at putting things together- and honestly that may well be someone with a mind like a programmer. I also want the one that does not think they know it all because that way they will be more likely to refer me out if I need it. That has to do less with education/experience and more to do with self esteem. So yes I will take the one that is the smartest with the highest self esteem and I would prefer them to have experience. But honestly, high self esteem so they are comfortable enough to refer me out if necessary is probably the most important.

No one is dismissive of education. The more the education, the better...but education without experience is just as bad. All theory..no intuitive guidance from lack of tactile history.....

self-esteem =?

Any clinician who attempts to push through because of ego, is going to run into problems eventually. Don't know many, known a few. They are not practicing anymore.

If you are thinking that some of us are less than Mensa material, I suggest you do a study on how many of us ARE....

Think like a programmer? Only if you are a computer.

The last I checked, a human is a very, very, very complex machine. But SO NOT A COMPUTER.

[november17, ASN, RN]

Oh and before I go off to bed, I am in total agreement that there should be more clinical time AND a residency.

Why would you need all that clinical time if you had already been a nurse for a year or two?

[PostOpPrincess, BSN, RN]

JoPACU, you really don't get it, do you? I don't care if new NPs are TRYING to become acute care NPs at your institution. They should probably have some experience in acute care before being an advanced clinician there. But that's not what many people are talking about. I have no interest in working in acute care. Acute care is not better than other types of advanced nursing. It is not the ultimate achievement. I would not feel satisfied in that role since my interest is in developing relationships over time with my patients and helping them live healthy lives OUTSIDE the hospital. This role is just as important as an acute care NP's, and experience in a hospital setting will not necessarily assist a new primary care NP working in an outpatient setting.

And your whole spiel about "these are people. they have kids..." etc etc--do you think we're stupid? I don't think anyone is underestimating the gravity of a health care clinician's role. But keep it real--don't insult a person who chose an accelerated route to another profession because his role isn't as "important" as yours. It's different, but may be just as important when considered in its appropriate context.

And my point about "anecdote" is that your own personal experiences do not explain the ways of the world for all people. They are your experiences--what they meant to you does not make them "truth" or "fact" for anyone else.

And ativan for the poor kid who couldn't pee--nicely done. Your experiences with patient's like him helped you intuit what he needed. But it's not an "aha" moment--it was merely a good call.

You're very sensitive and I think it has to do with many people not giving you the credit you have worked for.

I do not dismiss people and their education. I have two degrees--one in business...and the other in nursing.

I wouldn't even think that being a business person would've prepared me for nursing. SO DIFFERENT.

As for acute care, I've yet to see anything significant about "clinic" care on this forum. Everything I've seen has been about acute care.

As far as anecdotal, don't be condescending. I know what it means.

And the "aha" moment. The aha moment came from the NP. I already knew the issue after 10 people.

Good call?

Nope. Experience--seen it, done it, been there.

Something the NP didn't have--because if she did, she wouldn't stop and thought a minute about the holistic care and not just diagnosing the "clinical" aspect.

She has minimal experience dealing with young kids. So this was a little too much for her.

Another "Aha" moment? How about the CRNA trying to extubate an obese, dehisced 10 days post AVR placement, diabetic to top it off.

His reasoning? I sympathetic blocked her and her tidal volumes were 300....

She could handle it. Never mind that the sedative used was fat soluble and she had pulmonary hypertension. No--he was determined that according to her "numbers" she was to be extubated.

Yeah, right.

She wasn't and stayed intubated another 18 hours on a slow wean. I looked at her from the get go without even seeing her history and LOOKED AT HER BREATHING and knew she was NOT to be extubated--even though her ABGs were excellent. Doc asked him--"Yes?" CRNA said, "YEs, let's got for it." Doc asked me, "Yes?" I said, "Nope--she's a slow wean." Doc listened to me and proceeded to lecture new CRNA about why she is a slow wean.

How about the CRNA giving RSI to someone who was completely dehydrated NOT THINKING IT would make her bradycardic???

OMG...I could go on..I know you've never seen this...these are sick patients...and sorry to say the obvious lack of experience is affecting these people...YOU may choose not to believe it....

But I know I see it everyday.

[MAISY, RN-ER, BSN, RN]

Why would you need all that clinical time if you had already been a nurse for a year or two?

Sarcasm I hope......

[kanzi monkey]

You're very sensitive and I think it has to do with many people not giving you the credit you have worked for.

No. I just mean you don't seem to understand what I'm saying.

As for acute care, I've yet to see anything significant about "clinic" care on this forum. Everything I've seen has been about acute care.

I didn't get this impression, but I haven't read the whole thread.

As far as anecdotal, don't be condescending. I know what it means.

I don't mean to be condescending. You have said that your views are "fact" and "truth". I'm saying that the basis of your argument is based on anecdotal evidence (in one specialty setting) and that it is not "fact" or "truth" that a fast track APN is better with years of acute care RN experience.

And the "aha" moment. The aha moment came from the NP. I already knew the issue after 10 people.

Good call?

Nope. Experience--seen it, done it, been there.

Something the NP didn't have--because if she did, she wouldn't stop and thought a minute about the holistic care and not just diagnosing the "clinical" aspect.

She has minimal experience dealing with young kids. So this was a little too much for her.

It was a good call you made based on experience. Obviously that's a good thing. But the fact that the NP didn't have the same thought does not mean she had poor judgment. The fact that a kid needs 10 attempts at catheterization (or that anyone would make so many attempts) indicates there may be an anatomical issue, and a urology consult would not have been a poor choice. The fact that the kid thought "his member was going to fall off" shouldn't have interfered with the ability to catheterize him, and if it did, it would have been apparent in his demeanor (and 10 attempts shouldn't have been made, OR the discussion about his fears should have come much sooner). Giving something to allay anxiety is obvious for a kid in that state--the fact that he peed afterward was just lucky.

[PostOpPrincess, BSN, RN]

No. I just mean you don't seem to understand what I'm saying.

I didn't get this impression, but I haven't read the whole thread.

I don't mean to be condescending. You have said that your views are "fact" and "truth". I'm saying that the basis of your argument is based on anecdotal evidence (in one specialty setting) and that it is not "fact" or "truth" that a fast track APN is better with years of acute care RN experience.

It was a good call you made based on experience. Obviously that's a good thing. But the fact that the NP didn't have the same thought does not mean she had poor judgment. The fact that a kid needs 10 attempts at catheterization (or that anyone would make so many attempts) indicates there may be an anatomical issue, and a urology consult would not have been a poor choice. The fact that the kid thought "his member was going to fall off" shouldn't have interfered with the ability to catheterize him, and if it did, it would have been apparent in his demeanor (and 10 attempts shouldn't have been made, OR the discussion about his fears should have come much sooner). Giving something to allay anxiety is obvious for a kid in that state--the fact that he peed afterward was just lucky.

You are showing our inexperience. If you ever cathed anyone, when the muscle tenses up, it is almost impossible to pass a tube when the bladder is full.

There was nothing anatomically wrong with him. That was my point. If you've ever cathed anyone post surgery, you would know that the area of surgery's swelling would interfere with regular urination. Sometimes all it takes is a deep breath in to raise the diaphragm and depending on the swelling a catheter can be placed. If the person is severely anxious, nothing will come. It is a sympathetic response to stress that tightens up all the muscles, particularly the smooth muscle of the bladder.

Had she seen this before, she wouldn't have pulled out all the stops.

Obvious for the kid? SHE MISSED IT because she didn't know. Poor judgment? LACK of EXPERIENCE.

Everything you defend her, you prove my point.

If you've never seen it, you wouldn't know what to do. The simple things cannot be taken from a book nor theory.