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?

[nursegottabe]

Hi Moogie, I agree. I decided to continue my education from an LPN to an RN. I would like to continue my education but the school I WAS attending burned me out. I want to return but to a different college. Some how I'm not getting the electrolytes to good or the acidosis or alkalosis. i don't know what to do. I'm 45 and getting older by the day. I'm gonna try to get some experience all because I need to take a break from school. But yeah, I really do want to climb the educational ladder really bad. Just need some fresh teaching Some different teaching.

[kanzi monkey]

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.

I work in acute care. Not as long as you maybe, but yes, I have put a foley in a post-op pt. That kind of tension ought to have been noted by the person putting the catheter in. Who made the 10 cath attempts? The NP?

I'm not saying experience hurts anyone. I am saying acute care experience is not necessary for all APNs. Residency would be awesome for any APN, it's just not the standard yet.

And I looked back--this is a thread about advanced practice nursing. Not specifically acute care. If you want to talk only about acute care, it would be appropriate for you to clarify that. It's pretty clear that you have no interest in any other advanced practice setting, so you really have no business making comments that could be misconstrued as being related to anything other than acute care.

My purpose is in clarity, not argument. I mean nothing personal against you JoPACU.

[Katie5]

He was a lap appy.

Why? Because 10 people tried to put in a foley.

TEN.

Yes, if you are 19--that is YOUR BIGGEST FEAR.

No one went to the basic.

I told him to chill out...gave Ativan IV....he started peeing...2 hours later he was having his dinner and getting ready to go home.

What got me was the 16 hours of no peeing....

What the heck did everyone miss here?????????

I'm curious. Did you have a physician's order forr the ativanIV

[PostOpPrincess, BSN, RN]

I'm curious. Did you have a physician's order forr the ativanIV

The NP ordered it. Anesthesia MD/House MD always covers.

Why?

[PostOpPrincess, BSN, RN]

I work in acute care. Not as long as you maybe, but yes, I have put a foley in a post-op pt. That kind of tension ought to have been noted by the person putting the catheter in. Who made the 10 cath attempts? The NP?

I'm not saying experience hurts anyone. I am saying acute care experience is not necessary for all APNs. Residency would be awesome for any APN, it's just not the standard yet.

And I looked back--this is a thread about advanced practice nursing. Not specifically acute care. If you want to talk only about acute care, it would be appropriate for you to clarify that. It's pretty clear that you have no interest in any other advanced practice setting, so you really have no business making comments that could be misconstrued as being related to anything other than acute care.

My purpose is in clarity, not argument. I mean nothing personal against you JoPACU.

It's because the 10 different people assessing the situation didn't know--co-workers of the primary nurse, and then the NP. This is something you learn after seeing these types of patients for a long time.

It's not something that automatically comes to mind unless you've seen it before.

That's where experience comes to play.

[PostOpPrincess, BSN, RN]

i work in acute care. not as long as you maybe, but yes, i have put a foley in a post-op pt. that kind of tension ought to have been noted by the person putting the catheter in. who made the 10 cath attempts? the np?

i'm not saying experience hurts anyone. i am saying acute care experience is not necessary for all apns. residency would be awesome for any apn, it's just not the standard yet.

and i looked back--this is a thread about advanced practice nursing. not specifically acute care. if you want to talk only about acute care, it would be appropriate for you to clarify that. it's pretty clear that you have no interest in any other advanced practice setting, so you really have no business making comments that could be misconstrued as being related to anything other than acute care.

my purpose is in clarity, not argument. i mean nothing personal against you jopacu.

it ought to be the minimum standard.

the de-nps don't know what they don't know.

that includes nps with minimal experience. you don't know what you don't know until someone points it out.

i mean nothing against you. i'm stating an observation and i do not like what is happening to this profession. we are watering down what it means to have a msn-arnp. it means anyone and everyone can get it.

tired of being an office mucky muck? be an arnp instead....tired of being an executive secretary? be an arnp--you too can be an arnp...just go to this university and we will credential you!!!.

diagnose someone's aaa after working on your new microsoft windows 7 upgrade....tired of actuary work? come on--hang up those tables and figures and start someone on the newest ace-inhibitor..you too can be an arnp....

[BmoreCRNP]

acute care is where many of these nps try to end up. we are in a committee meeting now and reviewing the credentialing of these new arnps and gathering evidence on their pros and cons for our specific areas.

i was reading earlier about someone going into a neonatal practitioner role without nicu experience.

wow; that's unbelievable. i have nicu experience, and i wouldn't even think that would qualify me--not even the 3 years i was in level 3.

all the nursing students that i've been orienting with to the hospital has been incredible in their resolve that they won't be around long because they want to go for their arnps and crnas.

wow and i mean wow.

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.....

how come in all of this--it never comes across that this is what it is about??????

i know for a fact, having been a nurse for a long time, there were times that i don't know why i do what i do. but i wouldn't even think for a second that what i did wasn't important--enough for my advanced practice that i know would eventually help. and i mean truly help--acute care or not.

this profession is a people profession and no comparisons to engineering should even be brought up.

i think you are talking about my post. but i was giving an example of a situation that would not make sense. i was saying hypothetically if i went into the nicu as an np without prior nicu experience, that would be just like an np who went straight through without stopping to get any work experience. i agree that getting experience as an rn is best before going into advanced practice. however, the kind of nursing experience you get also matters.

[BmoreCRNP]

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.

I've only seen one person get a urology consult post-op because they couldn't void or be catheterized. They ended up using a coude' catheter. His member was really, really small and I honestly think the 14 french was just too big for him. Of course that was compounded by the whole muscle constriction thing.

[MAISY, RN-ER, BSN, RN]

One other thing I'd like to point out is that some areas never act in an independent manner as nurses; others like mine have standing orders for so many things(including meds). If a nurse needs anything she orders it herself...if she is uncomfortable the physician can order it. My point, acting independently is learned through doing not reading..

It is beyond knowing why you do something....it's knowing all the ins and outs of doing it and the back door routes.

All professions will graduate with a degree in something...until you actually work in that field and hone your skill....that degree is in NAME ONLY! Sorry I don't want anyone writing prescriptions, or diagnosing my illness without some experience in patient care! School alone does not cut it!

Maisy

[nursel56]

Doctors typically make a diagnosis without the aid of computers? That's not true.

Computers are integral to the work of a doctor in many ways. Maybe you're talking about some sort of WebMD thing for making a differential diagnosis? As a matter of fact there are a lot of these already. Also, why didn't you type in your symptoms on Google? If that's all it took to diagnose you, it seems like you wasted a lot of time visiting all those doctors. They were "people with lots of experience and education" and yet you believe NONE of them got the idea that they could fire-up the old internets in case they were stumped?

How exactly did your Chiropractor come to make this diagnosis? As far as I know, they don't have any way of testing you with traditional medicine beyond what was probably already done. That leaves non-traditional forms of testing and an intuitive diagnosis otherwise known as a good guess. I don't begrudge a person who has been successful in one field to change to nursing, but a lot of those people mistakenly believe they can apply models of other professions to nursing.

As of right now, you have no experience. Yet you are presuming to tell people who do have experiece that they are wrong and you are right. If they disagree, that must mean they are just jealous of you, are dullards, or pulling at the crab legs. That's a really unfair generalization.

[kanzi monkey]

it ought to be the minimum standard.

the de-nps don't know what they don't know.

that includes nps with minimal experience. you don't know what you don't know until someone points it out.

i mean nothing against you. i'm stating an observation and i do not like what is happening to this profession. we are watering down what it means to have a msn-arnp. it means anyone and everyone can get it.

tired of being an office mucky muck? be an arnp instead....tired of being an executive secretary? be an arnp--you too can be an arnp...just go to this university and we will credential you!!!.

diagnose someone's aaa after working on your new microsoft windows 7 upgrade....tired of actuary work? come on--hang up those tables and figures and start someone on the newest ace-inhibitor..you too can be an arnp....

you are saying the same thing again and again without addressing the fact that there are many routes an arnp can take, many of which have very little or nothing at all to do with acute care. yes, residency should be a standard for any new np regardless of rn experience. however, your years in acute care nursing would not necessarily make you any more qualified to hold the position i am looking for, which is in a clinic setting. i would be more qualified for it, technically, because i've completed the academic and clinical program.

the elephant in the room here is whether or not i would prefer to see a new grad np (with or without rn experience) or an experienced np (again, with or without rn experience). the answer is i'd rather see the experienced np--because she has experience as an np.

another scenario--i'd much rather my pcp be an an np of 5 years with no acute care rn experience than an np of 5 months with 20 years acute care rn experience. so yes. experience in the appropriate setting does matter.

[PostOpPrincess, BSN, RN]

You are saying the same thing again and again without addressing the fact that there are many routes an ARNP can take, many of which have very little or nothing at all to do with acute care. Yes, residency should be a standard for any new NP regardless of RN experience. However, your years in acute care nursing would not necessarily make you any more qualified to hold the position I am looking for, which is in a clinic setting. I would be more qualified for it, technically, because I've completed the academic and clinical program.

The elephant in the room here is whether or not I would prefer to see a new grad NP (with or without RN experience) or an experienced NP (again, with or without RN experience). The answer is I'd rather see the experienced NP--because she has experience as an NP.

Another scenario--I'd much rather my PCP be an an NP of 5 years with no acute care RN experience than an NP of 5 months with 20 years acute care RN experience. So yes. Experience in the appropriate setting DOES matter.

You haven't a choice but to defend your stance because you yourself have stated that you don't have much experience.

I wouldn't see a PCP with no experience--because getting to 5 years means they are going to have to get through years 1, 2, 3 and 4.

I wouldn't want to be their guinea pig for those years.

I will say this again. Acute care or not--people are signing up to work as an ARNP because schools are making it way too easy.

They aren't doing service to patients--just their bankrolls.

That's the bottom line.