GN to NP in <1yr

Nurses General Nursing

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I read a recent post regarding new graduates who cannot find work jumping on the NP bandwagon.

At work the other day, a new grad co-worker (less than 5 months experience) launched into a bitter tirade against a well known school for having the gall to expect her to have 2 years experience, have been involved in EBP, Committees and to have precepted before being allowed to even apply to join their ACNP program.....

Mind you, this nurse can barely handle her assignment... what makes her think that the NP is going to be an easy way out of floor nursing.... The courses take time and dedication and contrary to popular belief, graduation and subsequent employment are not a given..:whistling:

This is not opinion, it is fact. Would you like citations to either component of that factual statement?

I have read some of the studies too, in regard to outcomes, as have other people on this thread, and I am not at all persuaded for a variety of reasons. We will have to agree to differ.

Specializes in Adult Internal Medicine.
I have read some of the studies too in regard to outcomes, as have other people on this thread, and I am not at all persuaded for a variety of reasons. We will have to agree to differ.[/quote']

Which studies do you see flaws in?

Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
This is the crux of the issue: in many ways (arguable, most ways) NPs are aside from LPN/RNs because the role is so much different.

I think many would argue that the APN role is so different that the experience and skills derived from years of RN experience don't directly (or at least, linearly) translate.

Doesn't it depend on the RN roll they were in before? I can see how an RN working on a med-surg floor would find the NP roll very different, but I wornder about for example, small town hosptial ER nurses who are used to functioning much more independantly than other types of nurses, or nurse in my job. We are called "expanded roll RNs" and have our own policies and standing orders unique to us. We have quite a bit of autonomy and a wide scope in the hospital. For example If I am called for a patient C/O new SOB and new tachycardia and I suspected a posisble PE it would be normal for no physician to see that patient until after the chest CT was completed (if not contraindicated). All of the work up, including EKGs, labs, IV acess and imaging, and any interventions required to stablize, would be completed by the RRT RN and the hospitalist may well first hear of this patient after they have been moved to a higher level of care and there were CT results ot be read.

A couple of our RRT NN have gone on to be acute care NPs and they don't find it a drasticaly different roll, except now they have to write a lot more notes.

Specializes in Adult Internal Medicine.

Depends both on the prior RN job area of practice and the NP are of practice. I have several NP colleagues working in retail clinics with 8+ years of ICU RN experience and it is a very different role for then even though they were very independent as RNs in a high acuity setting.

In fact they all admit it was quite a challenge to switch their thinking from micromanagement and heavy intervention to a primary setting.

Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
It's interesting you put it that way. In the literature about role socialization of novice NPs there has been identified a concept termed "role confusion" that is similar to this, however it is actually associated with positively with years of prior nursing experience rather than inversely as you describe. You see these DE and traditional NP students in the graduate portion of their education?

I didn't know that. I was just making my personal observation.

I see acute care NP students when they are doing NP clinicals in the hopsital. I also have tyhem as students in various courses like IO, ACLS, TNCC, Sim Man lab and others.

Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
Doesn't it depend on the RN roll they were in before? I can see how an RN working on a med-surg floor would find the NP roll very different, but I wornder about for example, small town hosptial ER nurses who are used to functioning much more independantly than other types of nurses, or nurse in my job. We are called "expanded roll RNs" and have our own policies and standing orders unique to us. We have quite a bit of autonomy and a wide scope in the hospital. For example If I am called for a patient C/O new SOB and new tachycardia and I suspected a posisble PE it would be normal for no physician to see that patient until after the chest CT was completed (if not contraindicated). All of the work up, including EKGs, labs, IV acess and imaging, and any interventions required to stablize, would be completed by the RRT RN and the hospitalist may well first hear of this patient after they have been moved to a higher level of care and there were CT results ot be read.

A couple of our RRT NN have gone on to be acute care NPs and they don't find it a drasticaly different roll, except now they have to write a lot more notes.

RN "roll"? Really?

Specializes in Urology NP.
I have read some of the studies too, in regard to outcomes, as have other people on this thread, and I am not at all persuaded for a variety of reasons. We will have to agree to differ.

I can respect your opinion in having a preference for seeing an MD/DO over a NP/PA. I do view it as only that - an opinion. I find it surprising that you are "not at all persuaded" by what many would consider strong evidence. It also leads me to wonder about (and fear) what other evidence, regarding more critical matters, you wouldn't be persuaded by.

In the near future, as the physician shortage grows, I wonder if you would encourage your loved ones to wait for necessary medical care rather than seeing one of us "mid-levels". For those of you who are so anti-NP/PA, i would love to hear your solution to filling the growing gap left by the physician shortage. Please enlighten me.

As one of the few urologic providers in several counties, I am more than aware of how appreciative my patients are to be able to see me, when they might otherwise wait weeks or longer to see the doctor. I know they also appreciate that i am available to see patients so that the surgeon can be freed up and more available to perform critical surgeries that I am not able to do. That being said, we do have a policy that our patients are allowed to see whom they prefer with the understanding that they will be scheduled based on availability.

All this being said, I also definitely agree that at the very least, NP education/curriculum needs to be standardized across the board.

Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
RN "roll"? Really?

I see I mispelled "role" throughout my post. Thank you for pointing it out. I will endevor to do better next time.

I find it surprising that you are "not at all persuaded" by what many would consider strong evidence. It also leads me to wonder about (and fear) what other evidence, regarding more critical matters, you wouldn't be persuaded by.

Thank you, but I suggest you worry about yourself.

Specializes in Adult Internal Medicine.
Thank you but I suggest you worry about yourself.[/quote']

What exactly does she have to worry about?

Specializes in Urology NP.
Thank you, but I suggest you worry about yourself.

Is that a threat? Just kidding :)

Anyways, I'm not exactly sure what I should be worrying about either. I can be persuaded by the evidence and i have the pleasure of seeing it benefit my patients every day.

I see I mispelled "role" throughout my post. Thank you for pointing it out. I will endevor to do better next time.

Endeavor. LOL.

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