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Graduating With A DNP Without Prior Nursing Experience. Thoughts? Suggestions?

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Hi everyone!

This is my first time posting on here so I hope I’m doing things correctly.

I’m currently in school completing prereqs for an ABSN program in hopes to become an NP. I was doing research the other day and found an APNI program at Seattle U. It’s a four year program going from a BSN to a DNP. Because it’s a consistent four years, they state in the description that it may only be possible to work part time as an RN.

My question is, is how ready would I be to work as an Advance Practice Nurse without previous RN experience? I’m extremely interested in this program, but also don’t feel 100% comfortable to take on that role if I don’t have previous experience. How would hiring look like if I did not work as an RN? I’m hoping to work in acute care.

😲 I didn't think that was possible! Personally I wouldn't recommend it. Imagine climbing to one of the highest ranks in nursing with zero actual nursing experience. After you get your BSN I would try to work for at least a year. You pick up a lot on the job and I think it would be a benefit for you.

Edited by nursepaloma
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BONBON, BSN, RN

Specializes in Surgical Transplant.

I personally would not feel okay having little to no RN experience to then be working under the title of NP. I feel this is a hot topic with MD's and NP's. I don't doubt that there are those who do go straight into NP school and turn out well on the other side but I know I personally would not feel ready. Seems like too big of shoes to fill with too little experience.

I think schools just need better structure for NPs, it's a big part of what made me change my plans for what I want to eventually do. Working as a bedside nurse isn't necessarily going to give you the knowledge you're going to need to fill an NP role. An NP shouldn't need the amount of time working under supervision that a new physician would need, but maybe it needs to be a little longer than 3 months average? There is an expectation that even though they're still working under the MD's supervision, that they start off at a better competency than the new physicians and PAs.

Numenor, BSN, MSN, NP

Specializes in Internal Medicine. Has 9 years experience.

Possible, yes. Bad idea for 95% of candidates though. It's setting you up to fail. I have worked with direct entry students and many didn't have a clue. It was actually kind of scary.

I was an experienced RN but still needed a 1 year "residency" to make me feel competent.

Edited by Numenor

simba and mufasa

Has 17 years experience.

Its a bad idea, Many NP schools require certain number of years as a nurse. Take your time, you need experience at the bedside for some of the assignments. Do not set yourself up for failure. Colleges are there to make money, so keep your interests in place but proceed with caution!

Dr Madenya

MotoMonkey, BSN, RN

Specializes in ED. Has 2 years experience.

I was accepted into a DNP program prior to graduating from my BSN program. The school I was accepted to had never accepted a student without experience. They were hesitant and made it clear that I would be an experiment. I initially accepted my spot but ultimately decided not to matriculate because I felt strongly that I would be doing a disservice to my future patients. I have been working as a nurse for 10 months now and I learn something new every day. I also realize how little I knew about being a nurse when I first graduated. I feel strongly that It would have taken significantly more time an effort to prepare me to be an adequate provider at graduation. NP schools generally use the knowledge you've gained as a nurse as a foundation for which to build.

DowntheRiver

Specializes in Urgent Care, Oncology. Has 7 years experience.

Is this a thing now? My MSN program has a requirement of being a practicing nurse for at least 2+ years and currently practicing.

I found a better link for the research I cited above. Full article

https://onlinelibrary.wiley.com/doi/full/10.1002/2327-6924.12381

Here is the pertinent excerpt:

Quote

There is a strong perception by nurses and NPs that prior work experience as an RN is advantageous to success in the NP role (Rich & Rodriguez, 2002). Nurses and NPs alike perceive the NP role as highly specialized and difficult for a novice, and prior RN experience ranging from 1 to 10 years was recommended prior to the NP role (Rich & Rodriguez, 2002). A lack of socialization into the nursing role and nursing intuition, as well as an inability to “work the system” within a healthcare institution were some of the concerns raised about nontraditional graduates (Rich & Rodriguez, 2002). However, Rich (2005) found no correlation between duration of prior RN experience and level of competency in NP clinical skills as determined by NP self‐report, but physicians working with the NPs rated those with fewer years of RN experience as having greater competency in clinical skills than those with more years of RN experience. More recent studies have shown mixed results, as more RN experience led to improved adaption to the NP role (Cusson & Strange, 2008; Kelly & Mathews, 2001), while others validated the lack of correlation between prior RN experience and NP role transition (Barnes, 2015; Steiner et al., 2008).

7 minutes ago, DowntheRiver said:

Is this a thing now? My MSN program has a requirement of being a practicing nurse for at least 2+ years and currently practicing.

Most MSN programs that are not generalist will require experience, but more and more are cropping up that let you shoot straight through to the top if you can find the preceptors. A bit scary indeed, but ideal for a real self starter who will reinforce their education on their own time. But... how many people really are like that? Most people learn through trial and error.

Edited by damianus

CommunityRNBSN, BSN, RN

Specializes in Community health. Has 3 years experience.

On 6/30/2020 at 2:36 PM, scribe1290 said:

Hi everyone!

This is my first time posting on here so I hope I’m doing things correctly.

I’m currently in school completing prereqs for an ABSN program in hopes to become an NP. I was doing research the other day and found an APNI program at Seattle U. It’s a four year program going from a BSN to a DNP. Because it’s a consistent four years, they state in the description that it may only be possible to work part time as an RN.

My question is, is how ready would I be to work as an Advance Practice Nurse without previous RN experience? I’m extremely interested in this program, but also don’t feel 100% comfortable to take on that role if I don’t have previous experience. How would hiring look like if I did not work as an RN? I’m hoping to work in acute care.

Since they said “it may only be possible to work part-time”, could you at least do that? If you worked part time for several years while in school, you could have some real experience by the time you graduated.

Work part time! Find an outpatient clinic like allergy clinic or primary care. Maybe home healthcare that trains new grads? I know one new grad in patient residency accepting new grads part-time. You have so much time to network and find a part time opportunity.

Hey! I agree with lots of the comments above. Additionally, I find that RNs who don't get the necessary experience (I would say minimum 1 year, even that may be setting the bar too low) don't experience the entire ins and outs of the art of nursing as a whole. While it may be students' ultimate goal to become a nurse practitioner ASAP with very little experience as an RN first, it's difficult for me to believe that they become enriched with nursing practice, which is extremely vital to become a competent, compassionate, and wholehearted NP. However, this is not to say that you cannot become such a nurse practitioner with little experience - sometimes that's simply an individual's niche and they are able to thrive regardless, but that's likely a very small percentage of people. I've applied to a couple ABSN programs as well and want to get my MSN or DNP in the future too, so I understand where you're coming from.

My advice is to complete an ABSN program, get solid experience as an RN so that you could get a thorough understanding of various specialties that you may be interested in, then go for your DNP! This is what I plan on doing. I hope this helps, and I wish you the best of luck. 🙂

Year 1 Total Estimated Cost: $54,391

Seeing as you are doing prerequisites for an ABSN you would be on a 4 year plan. Assuming they don't hike up the costs you would be paying $217,564 + cost of living! There are MANY cheaper options. I wouldn't recommend taking an amount of debt akin to Med school or CRNA school for a DNP with much lower earning potential.

Undercat, BSN, MSN, CRNA

Specializes in Retired. Has 41 years experience.

On 7/1/2020 at 12:37 PM, nursepaloma said:

😲 I didn't think that was possible! Personally I wouldn't recommend it. Imagine climbing to one of the highest ranks in nursing with zero actual nursing experience. After you get your BSN I would try to work for at least a year. You pick up a lot on the job and I think it would be a benefit for you.

And you can't know what specialty suits you best without experience. No use taking the wrong road and then finding out a year later that it wasn't a good match.

42pines

Specializes in Occupational Health; Adult ICU.

“Rich (2005) found no correlation between duration of prior RN experience and level of competency in NP clinical skills as determined by NP self‐report, but physicians working with the NPs rated those with fewer years of RN experience as having greater competency in clinical skills than those with more years of RN experience.”

Uh, that blows my mind!

Read closely: “…as determined by NP self-report.” So much for that… As for the physicians, I just find that hard to believe.

I’ll never forget sending an injured worker to an urgent care center. The worker had a golf-ball sized lump above his diaphragm on the right side. He had fallen off a ramp, and oddly, he told me over the p hone, when he pressed the lump, “it disappeared.”

As an Occupational Nurse the thought that came to mind was a diaphragmatic hernia which could turn into an emergency. So, I instructed him to go to an urgent care center near where his truck was and he did.


Well, the just out of school, ANP, listened—did not palpate, did not even look, but sat there and berated him with “I won’t give you narcotics.” Mind you the fellow had not asked for anything at all—his nurse (me) had sent him there.

He drove back to the corporate clinic and I assessed him. Tenderness, but no lump. I did an accident report. He was sitting there answering questions, and all of a sudden said: “Look.” And there it was, a golf-ball sized lump to the right of the sternum. He put his hand on it—and it disappeared. Now that was neat, but my thought, “neat” (in an unusual way) so I sent him to his doc.

Eventually it was solved. The fellow had “costochondral separation.” He tore the cartilage from the ribs to the breastbone. He had torn several of his ribs right off the breastbone—no games involved, a real injury.

The just out of school ANP had assumed that because the lump had disappeared, he was playing a “get some narcotics” game. There’s a lot of room here for serious injury due to malpractice. I’m no NP but I do know when something is strangely amiss. That inexperienced ANP did not know.

My advice is: Be careful. If you work in an urgent care clinic, which is really, not “acute care,” and have good back-up, fine—but be careful, you will hold the title, and anyone working with you in real acute care has the right to expect that you know quite a lot, experience or not.

I’ve plenty more stories like that one. Get the right job—sure, get the wrong job, good luck with that.

Undercat, BSN, MSN, CRNA

Specializes in Retired. Has 41 years experience.

1 hour ago, 42pines said:

“Rich (2005) found no correlation between duration of prior RN experience and level of competency in NP clinical skills as determined by NP self‐report, but physicians working with the NPs rated those with fewer years of RN experience as having greater competency in clinical skills than those with more years of RN experience.”

Uh, that blows my mind!

Read closely: “…as determined by NP self-report.” So much for that… As for the physicians, I just find that hard to believe.

I’ll never forget sending an injured worker to an urgent care center. The worker had a golf-ball sized lump above his diaphragm on the right side. He had fallen off a ramp, and oddly, he told me over the p hone, when he pressed the lump, “it disappeared.”

As an Occupational Nurse the thought that came to mind was a diaphragmatic hernia which could turn into an emergency. So, I instructed him to go to an urgent care center near where his truck was and he did.


Well, the just out of school, ANP, listened—did not palpate, did not even look, but sat there and berated him with “I won’t give you narcotics.” Mind you the fellow had not asked for anything at all—his nurse (me) had sent him there.

He drove back to the corporate clinic and I assessed him. Tenderness, but no lump. I did an accident report. He was sitting there answering questions, and all of a sudden said: “Look.” And there it was, a golf-ball sized lump to the right of the sternum. He put his hand on it—and it disappeared. Now that was neat, but my thought, “neat” (in an unusual way) so I sent him to his doc.

Eventually it was solved. The fellow had “costochondral separation.” He tore the cartilage from the ribs to the breastbone. He had torn several of his ribs right off the breastbone—no games involved, a real injury.

The just out of school ANP had assumed that because the lump had disappeared, he was playing a “get some narcotics” game. There’s a lot of room here for serious injury due to malpractice. I’m no NP but I do know when something is strangely amiss. That inexperienced ANP did not know.

My advice is: Be careful. If you work in an urgent care clinic, which is really, not “acute care,” and have good back-up, fine—but be careful, you will hold the title, and anyone working with you in real acute care has the right to expect that you know quite a lot, experience or not.

I’ve plenty more stories like that one. Get the right job—sure, get the wrong job, good luck with that.

Good for the experienced, "less competent" folks. Guess we aren't moldable enough for the MD's.