Do you have to be a Nurse before a NP?

Nurse Ratched, RN · Feb 5, 2003

Originally posted by sjoe
Postscript: If it is someone's goal to be a NP without doing nursing first, why not skip nursing altogether and just go for a PA?

Interesting point, sjoe. I was under the impression previously that PA's were "higher on the food chain," if you will, than NP's. In my state, PA's have to have all scripts cosigned, but NP's only have to have those for narcs co-signed.

Edited to add: so I guess, the difference is whether one is willing to be a "practitioner" or an "assistant" - almost seems to imply in the titles that there is a greater degree of autonomy in one. I personally wouldn't want the greater autonomy without the experience.

EmeraldNYL, BSN, RN · Feb 5, 2003

I have heard of people who have gone to those straight-to-NP programs and they couldn't get jobs as NPs because they had no nursing experience, even though there's a nursing shortage. It's interesting though, because PAs usually have little health care experience when they start work. I would say the previous nursing experience would be extremely helpful-- hence the reason some metro-area hospitals will only hire NPs and not PAs. It might not matter though if you are willing to work in a rural area.

fab4fan · Feb 5, 2003

Ummmm...exactly when will you be getting the experience dealing with various diseases to be an effective NP?

I don't mean that to be flaming, but holy heck, the thought of it just terrifies me. As it is students don't get much experience in clinical; good Lord, if an NP doesn't spend some time in a clinical setting, how in the world will he/she know how to diagnose????

Scary, very scary. I sure wouldn't let someone like that touch me with a ten foot pole.

LaurieCRNP2002, MSN, RN, APRN · Feb 5, 2003

Having just finished an NP program (adult acute care), I can't imagine that I would have done as well if I had not had some acute care experience behind me. Depending on what your ultimate goal is, ICU experience would certainly be very helpful. That being said, I entered my program having experience in telemetry/stepdown settings and did fine. So naturally, I agree with all those posters who said to get the "floor" experience. Nowadays, you can go right into ICU as a new grad if you so desire. Good luck to you and feel free to contact me privately if you have any other questions/concerns

Laurie

Newly minted MSN

karenG · Feb 5, 2003

well as an NP I sure couldnt do the job without the years put in at the coal face! a lot of what we do is pattern recognition- and if you havent seen the pattern............. also its about being able to develop a relationship with your patients, working at the bedside allows you to learn the skills needed. I dont see myself as a mini doctor- I have other skills that I bring to the role- nursing skills. I take a holistic approach and am percieved to have more time than the docs I work with, even though we have the same appt times! so to be a good NP, I would say you need to get a good basic grounding in what being a nurse is all about. If you want to go straight to being an NP then why not do a medical degree? Because at the end of the day, I am a nurse and thats what I want to be! even if it is 15yrs since I worked in a hospital, I'm sure I can remember how to do a bedbath!!!

Karen

dianacs · Feb 5, 2003

Once you pass the NCLEX, could you work part-time as an RN while going to school? Then you'd have what? a year or two of experience before becoming an NP?

l.rae · Feb 5, 2003

l find the idea totally unacceptable and a threat to the "experienced" NP's reputation.......l would NEVER seek the care of such a practitioner for myself or my family.........LR

fab4fan · Feb 5, 2003

Originally posted by l.rae
l find the idea totally unacceptable and a threat to the "experienced" NP's reputation.......l would NEVER seek the care of such a practitioner for myself or my family.........LR

Exactly...it took a long time for NP's to get a foothold into pt. care., and I would hate to see everything they fought for ruined because of some people that are afraid of geting their hands dirty, or having to be "lowly" bedside nurses.

If this is what it's coming to, I want to know up front what clinical experience an NP that's caring for me has had...if he/she hasn't put some time in the trenches, adios!

fab4fan · Feb 5, 2003

Originally posted by Nurse Ratched
Fascinating question - like others, I can't imagine one NOT being a nurse first. It just seems intuitive. However, we have to ask, is a nurse practitioner more like a nurse or more like a doctor? (Not joking, not flaming, just asking a genuine question...) They have prescriptive authority, diagnose, etc., and no one ever assumes that a doctor ought to be a nurse first - maybe they should be, but that's another thread .

Just throwing that out to chew on...

Yes, but doctors spend a lot of time in the clinical setting, starting with 3rd year med school. Then they have an internship and residency to complete before they are out there practicing independently.

It almost comes across as an elitist attitude, like doing some floor nursing is beneath them...at least, that's the way it seems to me.

CraigB-RN, MSN, RN · Feb 5, 2003

It always amazes me how this battle keeps erupting. I think maybe it has to do with some asumptions about NP training and nursing practice in general.

I fired an NP who had 5+ years of nursing experience. I think she was scared of the patients and was basicly incompitent. On the other hand I've got a PA that had no previous clinical experience before starting PA school who epitomises what the ideal of the NP is supposed to stand for.

Given a choice if I had two individuals in front of me applying for the same job, I'd prob have to give it to the PA over the NP. 600 hours of clinical experience during school doesn't begin to compare to 2400 hours. But I'm going to take a advantage of that 600 hours myself. My nursing experience prob isn't going to help me much, but the 20 years of military medic and civlian paramedic experience is helping me.

I have no problems with anyone becoming an NP with no "floor" experience. I would suggest that anyone without some kind of medical experience take the PA route.

tiquicia · Feb 5, 2003

In many areas, it is far easier to get into master's entry programs than community college ADN or state school BSN programs. If one is looking to obtain an advanced degree at some point (not necessarily to be an NP, but perhaps to work in management or education), what's the harm in going for it? Especially if he or she has a committment to spending quality time both during and after school to gain experience at the bedside before proceeding to advanced roles? Any thoughts?

I realize that it would be preferable to have bedside experience BEFORE grad school in order to have a greater context for the advanced education and practice that a grad program entails. However, for those who already hold non-nursing degrees and are looking to enter the nursing profession AND continue with higher education, can it work?

Soon2BNP · Feb 6, 2003

Well thanks for all the responses-the good and bad. I take my NCLEX in June and I will start a new grad program and then work 24 hours a week while I work on my NP (which will take 2 years)-so I will have 2 years of RN experience before I become a NP. I know this may not sound like enough experience to most of you. My program gives a RN and a MSN. Basically it looks like we went to a hospital diploma program if we decide to quit the masters and stick with the RN role.

Speaking for myself-I chose Nursing over PA school b/c it is more holistic. The role of the NP is better then the role of the PA too b/c there is more focus on teaching and prevention (my opinion). I think I would always recognize myself as a RN first and then a NP.

Now for others in my class-who knows. Most want to be in clinics not at the bedside while they work on the RN-they believe it will make them a better NP. But hey-that's them-not me (no blasting please).

Oh and I know the NP market is most areas is not too hot so worst comes the worst I will work PT as a NP and PT as a floor nurse. I have already invested too much money and time in school and I won't back down now.

Thanks again