GN to NP in <1yr

[OhioCCRN]

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..

[OhioCCRN, MSN, NP]

I just have to say, to the poster who mentioned the bitter "old" nurses who remain at bedside is ridiculous! Yes, ridiculous!!!! and i literally laughed out loud. I work at a top 4 Hospital which recently had a hiring freeze of the NP's. Heed me well... This is going to be like the nursing glut where NP's will not have jobs and will be forced to go back to school and become ...what, i have no idea. An intelligent prudent person is able to guage the market and not fall into the old "bandwagon" of "well,everyone is doing it".....

[mamagui]

...and either way, nature has a way of not cooperating with human timelines

[BostonFNP, APRN]

No dear. It begins to decline at around 35 while remaining steady from about 24-35. When does fertility start to decline?

" Fecundability (ie, the probability of achieving a pregnancy in one menstrual cycle) begins to decline significantly in the early 30s (about age 32), with a more rapid decline a few years later (about age 37)" per UpToDate.

[dudette10, MSN, RN]

Neither exam is equatable to the USMLE exam (save for one very advanced NP exam which was based on the step 3). They are both simply minimum entry-to-practice exams for nurses. Again. Speed bumps not a solution.

We agree on this then. I guess I'm getting a bit confused, and you drew me so much into this conversation that I switched from my iPad to my laptop so I can type faster!

I'm going to reiterate what I think your perspective is. Correct me if I'm wrong.

While you feel that being a bedside RN was helpful in your NP practice, you don't feel it should be mandated in the absence of a residency. While a residency would be helpful, you don't feel it should be mandated; however, you would encourage all novice NPs to do an apprenticeship (sorta/kinda, not the word I want) of some sort. If they don't, well, that's their loss. The NCLEX-RN and NP boards are "speed bumps" to ensure competency to practice, and you would like to see step exams of a structure similar to the USMLE.

So, really, the only thing you feel should be mandated is a changing of the exams?

[Fiona59]

" Fecundability (ie, the probability of achieving a pregnancy in one menstrual cycle) begins to decline significantly in the early 30s (about age 32), with a more rapid decline a few years later (about age 37)" per UpToDate.

Guess I'm extremly fertile. 31, 33, 34 all at the first try. No genetic defects.

Graduated nursing school at 41 and completed my BA at 52.

No nannies involved, just waited, planned, and budgeted. I learnt along my life journey that I don't come first in everything.

[BostonFNP, APRN]

We agree on this then. I guess I'm getting a bit confused and you drew me so much into this conversation that I switched from my iPad to my laptop so I can type faster! I'm going to reiterate what I think your perspective is. Correct me if I'm wrong. While you feel that being a bedside RN was helpful in your NP practice, you don't feel it should be mandated in the absence of a residency. While a residency would be helpful, you don't feel it should be mandated; however, you would encourage all novice NPs to do an apprenticeship (sorta/kinda, not the word I want) of some sort. If they don't, well, that's their loss. The NCLEX-RN and NP boards are "speed bumps" to ensure competency to practice, and you would like to see step exams of a structure similar to the USMLE. So, really, the only thing you feel should be mandated is a changing of the exams?[/quote']

I do think RN experience was helpful and certainly not a waste. I think some people benefit from it more than others. I think some RN experience is more valuable depending on where you practice and an NP. Do I think it should be mandated? No, I think that is too strong without evidence to support it. I think applicants should be given preference if they have some RN experience, especially by some programs.

I do think formal orientations/residencies are beneficial; research supports this. I don't think they can be mandated at this time but in one of those forms they should be encouraged.

Entry into a supportive practice with a clinical mentor is one of the most important parts of NP role socialization in my opinion; this is also supported by research. Apprentice or mentorship or collaborative practice all describe this.

I would love to see national standardization mandated. I think that NPs are competent providers but I worry about the direction/trajectory of NP preparation right now.

[BostonFNP, APRN]

Guess I'm extremly fertile. 31 33, 34 all at the first try. No genetic defects. Graduated nursing school at 41 and completed my BA at 52. No nannies involved, just waited, planned, and budgeted. I learnt along my life journey that I don't come first in everything.[/quote']

Rock on!

[futureeastcoastNP]

I am extremely worried about the saturation of the market. I'm angry at the nursing advocacy groups, which are supposed to protect the profession, who care more about money and quantity. They allow these NP programs to open with little oversight and crank out far too many unprepared NPs. It's disgusting and I am questioning my decision to take on debt and go back to school. I don't understand why they don't see what they're doing: quantity does not trump quality. Physicians limit the number of medical students to protect their job security and the prestige of the profession. Why can't the NP boards do they same? Who are the idiots that are allowing this entire profession go down the toilet? I'm PRAYING I am able to just get a job when I graduate before the market is entirely flooded. It's why I am only looking at top ranked, reputable schools - when each job starts getting 100+ applicants the Walden and Chaplain graduates who are causing the glut certainly won't be getting jobs over the Duke, UPenn, UCSF, Simmons, etc grads.

[Krzysztof]

"Fecundability"

There's just something about that word.

Sorry... I'll grow up now.

[uRNmyway, ASN, RN]

1. What a lot of you don't realize is not everyone lives in an area of the country where they can just "go work" for two years. So many people on here are criticizing people who go straight from RN to NP, but for people in oversaturated markets, they may have no choice. After looking for an RN job for 1+ year, it is unrealistic to expect people to continue to be unemployed if becoming an NP will help them find a job.

2. I do think being a bedside RN is overrated for NP. Beyond learning to deal with patients and maybe do assesments, there's little overlap. Having said that, I think NP school is lacking on clinical hours anyway, whether the student has RN experience or not, so I think residency should be required.

3. Even if you can find a job, some people just hate bedside nursing. It's certainly not easy, and if someone's ultimate goal is to be an np anyway I see no reason to delay that while dealing with 12 hour, minimal break shift work that wears down the body. I was miserable as a bedside nurse.

4. It is not schools that take inexperienced students that are hurting the profession. Many of the schools graduating the best NPs have graduate entry programs where students get their BSN and MSN in one swoop with no experience. This is at schools such as Columbia and UPenn, both known for amazing NPs. The real issue hurting the profession is for profit online schools that have no standards for admission and crank out NP degrees like candy. It is the accreditation boards, giving full accreditation to these half baked programs that do not even provide clinical instructors, that is ruining the profession.

5. I still think much of the vitriol aimed at NPs without bedside experience is from experienced nurses who think it is "unfair" they didn't pay their dues. There's a belief that a new nurse NEEDS to be miserable for a few years before moving on to greener pastures. Some of the "eat their young" style nurses are sad they didn't get a chance to berate that person for a few years first and are jealous that despite 0 bedside experience they now have no control over them. All part of the abuse culture in nursing - advancing and achieving higher degrees is not celebrated, but attacked.

To reference the latter part of your quote: No, I don't think that much of the issue is from jealousy. Personally, I can easily tell from the NPs I work with 1) who practiced at bedside before going NP 2) who STILL respects bedside nursing after having done it themselves 3) who went to NP school with very little bedside background 4) who still has way too much to learn to hold the positions they do.

Don't get me wrong, at this point in my career, of course I couldn't do what they do. And no, I'm not jealous lol. I'm in this boat because of my own choices and I'll be in it til I do things differently. I don't resent anyone the fruits of their toils. I just think it's obvious who toiled a bit harder. And if I can see it, I'm sure many can.

[PMFB-RN, RN]

To reference the latter part of your quote: No, I don't think that much of the issue is from jealousy. Personally, I can easily tell from the NPs I work with 1) who practiced at bedside before going NP 2) who STILL respects bedside nursing after having done it themselves 3) who went to NP school with very little bedside background 4) who still has way too much to learn to hold the positions they do.

Don't get me wrong, at this point in my career, of course I couldn't do what they do. And no, I'm not jealous lol. I'm in this boat because of my own choices and I'll be in it til I do things differently. I don't resent anyone the fruits of their toils. I just think it's obvious who toiled a bit harder. And if I can see it, I'm sure many can.

We have both direct entry students and tradional NP students who do clinicals in my hospital. I work with them all the time and all of them are assinged to follow RRT for a few shifts. The all seem smart and well prepared. One big difference I see between them is, I am not sure how to best describe this, but the DE students seem to be in Awe of the doctors. I think the DE students haven't yet figured out that the doctors sometimes miss things and don't know it all and even, (SHOCK!) make bad decisions that should be clairified, or even challenged, before being carried out.

It appears to be that eventualy even the DE students overcome this.

[futureeastcoastNP]

I think people are being too hard on new grad NPs. Of course they're not as well prepared as full fledged physicians - the physicians have completed residency. A new graduate NP should be compared to a new graduate MD (pre residency). I've seen first year residents in action, and it's not pretty, because everyone needs a few years to get used to practicing independently. For physicians, it happens during residency, for NPs it happens either during residency or during the first 3-4 years on the job. That's the apples to apples comparison, and NPs with 3-4 years of good experience their specialty are very, very competent.