Experience?

rustersiel · Dec 4, 2008

I think I stumbled upon this conversation long after it was done, but re; the question of experience . I realize everyone is eager to "get out of the RN role", but after being an acute care NP for 10 years, and an RN on a very acute unit for 15 years, I realize that most of my clinical acumen, and what I know about patients comes from the 15 years of reading progress notes and participating in rounding w/ theMDs and hearing residents get pimped for that many years. I already knew the management of most of what I would see as a ACNP from that experience as an rn, differential dx was the primarily added info that was gained in the curriculum. I work with several people "fresh" out of school and they have no clinical judgement, little experience to base their judgements, and they just order lots of unnecessary tests . I'm not saying you need 15 years first, but I personally feel someone should have at least 5 years on a fairly acute unit to be able develop. I can walk into a room and immediately realize someone is likely hypercarbic (based on what I know about them, and prior experience), all my inexperienced colleages recognize is "theyre unresponsive" and order a litany of tests. Remember these are humans who will be in your care.

just_cause, BSN, RN · Dec 4, 2008

I agree in many respects ruster - but I think the onus of this has to be on the certifying agencies rather then on potential students.. if the institution needs to change I think the accrediting body needs to be the driving force.

v/r

zenman · Dec 4, 2008

I think I stumbled upon this conversation long after it was done, but re; the question of experience . I realize everyone is eager to "get out of the RN role", but after being an acute care NP for 10 years, and an RN on a very acute unit for 15 years, I realize that most of my clinical acumen, and what I know about patients comes from the 15 years of reading progress notes and participating in rounding w/ theMDs and hearing residents get pimped for that many years. I already knew the management of most of what I would see as a ACNP from that experience as an rn, differential dx was the primarily added info that was gained in the curriculum. I work with several people "fresh" out of school and they have no clinical judgement, little experience to base their judgements, and they just order lots of unnecessary tests . I'm not saying you need 15 years first, but I personally feel someone should have at least 5 years on a fairly acute unit to be able develop. I can walk into a room and immediately realize someone is likely hypercarbic (based on what I know about them, and prior experience), all my inexperienced colleages recognize is "theyre unresponsive" and order a litany of tests. Remember these are humans who will be in your care.

Exactly my thoughts. I've seen stuff some doctors have only read about in textbooks and I did the same thing you did... read progress notes, tried to figure out what the doc would do next, what meds to order, etc..

ANPFNPGNP · Dec 5, 2008

I think I stumbled upon this conversation long after it was done, but re; the question of experience . I realize everyone is eager to "get out of the RN role", but after being an acute care NP for 10 years, and an RN on a very acute unit for 15 years, I realize that most of my clinical acumen, and what I know about patients comes from the 15 years of reading progress notes and participating in rounding w/ theMDs and hearing residents get pimped for that many years. I already knew the management of most of what I would see as a ACNP from that experience as an rn, differential dx was the primarily added info that was gained in the curriculum. I work with several people "fresh" out of school and they have no clinical judgement, little experience to base their judgements, and they just order lots of unnecessary tests . I'm not saying you need 15 years first, but I personally feel someone should have at least 5 years on a fairly acute unit to be able develop. I can walk into a room and immediately realize someone is likely hypercarbic (based on what I know about them, and prior experience), all my inexperienced colleages recognize is "theyre unresponsive" and order a litany of tests. Remember these are humans who will be in your care.

I've seen NP students with years of ICU experience have problems in the primary care setting. However, I agree that all ACNP students have at least 5 years of experience in a high acuity setting.