I'm an NP student - How did you choose your specialty?

**NICU Guy, BSN, RN** · Mar 27, 2018

This proves the point of many members on here and bedside nurses I work with. New grad nurses (BSN) that aren't even out of orientation and applying to NP schools. I am lumping in the Direct Entry MSN students also into this group. You need a base of nursing knowledge and experience to be a competent NP. Your nursing school will not teach you everything that you need to know to be a good provider. NP programs should require a minimum of 5 yrs nursing experience before applying. That way you actually have a good base of knowledge and experience to have an informed decision on their route to take in NP school. It is a scary thought that patients go to the doctor's office for a problem and they are treated by a fresh New Grad NP that has zero nursing experience prior to being an NP.

{Getting off my soapbox}

Oldmahubbard · Mar 27, 2018

As I worked as an an RN, over a period of years, Psych repeatedly spoke my name.

Over and over. I had a calling.

Some days, still do.

abc616 · Mar 27, 2018

Though I appreciate you taking the time out of your day to respond to my post, I wish you had shared why you love your job in the NICU, as your signature states, rather than telling me why I am an invalid candidate for the career I am working toward. These programs would not exist if they were so radically unsafe.

As a direct entry student (thanks for lumping me in there) and an adult learner, I've been shocked over and over again at how brutal nurses are on students and new nurses. For being one of the most compassionate groups of people out there, it's amazing how nurses truly eat their young. Rather than tearing me down, give me the advice or help I'm asking for, because I could very well be your colleague one day.

djmatte, ADN, MSN, RN, NP · Mar 27, 2018

For being one of the most compassionate groups of people out there, it's amazing how nurses truly eat their young. Rather than tearing me down, give me the advice or help I'm asking for, because I could very well be your colleague one day.

Just some early advice, you are in no position to comment on who/what nurses do and don't eat. You are pursuing a career path that actually bypasses the nursing profession and have no grounds to throw around such accusatory terms you hear in passing.

Bumex, DNP, NP · Mar 28, 2018

To go off what the OP said, these programs are facing huge opposition on many terms. There are two programs in my region alone that have abdandoned these types of programs due to criticism and failure to actually prove that they are indeed safe.

To answer your original question, I found my specialty through my experience as a RN as to what my clinical strong suits are and ultimately used the connections to secure a good job. I would've never thought of myself as a nephro and internal med NP.

I also find it amazing that whenever a nursing student has criticism they immediately revert to "nurses eating their young." It shows mental and professional immaturity. That fact alone, nullifies your original question. Get through the RN component and gain experience, simple as that.

**NICU Guy, BSN, RN** · Mar 28, 2018

I've been shocked over and over again at how brutal nurses are on students and new nurses. For being one of the most compassionate groups of people out there, it's amazing how nurses truly eat their young. Rather than tearing me down, give me the advice or help I'm asking for, because I could very well be your colleague one day.

No, we are not brutal on students and new grads, we actually care that they learn what they need to know to be a safe bedside nurse because they WILL be my colleague. We are very supportive of them and there is definitely no "eating our young". NICU is definitely a team sport and we depend on our co-workers daily.

Fortunately, NNP programs require 2 yrs as a NICU nurse to apply for their programs. NICU nurses are very protective of their patients and new NPs/MD Residents need to earn their stripes before they are completely trusted.

To answer your question: I am blessed to be in a unit that the nurses are highly respected by the medical staff. As a result, the parents are reassured that their baby is in capable hands. Some of our patients (24 weekers) are on our unit for months and you get to watch them grow and get to know the parents. It is rewarding to know that you had a part in their ability to take home a healthy baby.

allnurses Guide · Mar 28, 2018

Hey abc616-

Welcome to the world of Direct Entry haters. You get to be torn down for not doing things the "right" way and "bypassing the entire nursing profession", while those that think that their way is the only way shout out their righteous indignation and beat their breasts at the thought of someone who-gasp!-doesn't want to "pay their dues" as a bedside RN. Some of these people aren't even NPs, yet profess to be subject matter experts on what makes a good NP. Oh, the humanity!!!

Actually, I'm exaggerating here, but the underlying premise holds true. DE NPS can be, and are, competent and successful. Nursing experience can be valuable and beneficial, but does not necessarily affect the success of NPs and patient outcomes. This topic has been beaten to death on this forum. A good DE program can and does turn out excellent NPs. There are some bad programs, just as there are bad traditional NP programs. Make sure you're in a good, reputable program.

I am a DE grad who has been practicing for almost 9 years now. I chose to do FNP because I wanted to see patients of all ages, and work in a family medicine practice. I ended up in an adult internal medicine practice for 3 years, and then went into a specialty practice where I could see both kids and adults. I work in allergy and asthma, which was a natural segue for me as my previous work experience and education is in immunology and laboratory medicine. I like having depth of knowledge in a focused area. I will probably stay in this specialty for the remainder of my working years.

Best of luck to you. Work hard, and let your practice speak for itself when you're a NP.

ICU2NP · Mar 28, 2018

I chose my AGNP specialty based on my nursing experience. My BSN clinicals did nothing to help me decide. I have been an ICU RN for 12 years this month, and I can tell you that I have never seen a "nurse eat their young". That is quite the annoying and false phrase. Get some RN experience and you will learn that, and will also be able to figure out your specialty.

djmatte, ADN, MSN, RN, NP · Mar 28, 2018

Hey abc616-
Welcome to the world of Direct Entry haters. You get to be torn down for not doing things the "right" way and "bypassing the entire nursing profession", while those that think that their way is the only way shout out their righteous indignation and beat their breasts at the thought of someone who-gasp!-doesn't want to "pay their dues" as a bedside RN. Some of these people aren't even NPs, yet profess to be subject matter experts on what makes a good NP. Oh, the humanity!!!
Actually, I'm exaggerating here, but the underlying premise holds true. DE NPS can be, and are, competent and successful. Nursing experience can be valuable and beneficial, but does not necessarily affect the success of NPs and patient outcomes. This topic has been beaten to death on this forum. A good DE program can and does turn out excellent NPs. There are some bad programs, just as there are bad traditional NP programs. Make sure you're in a good, reputable program.
I am a DE grad who has been practicing for almost 9 years now. I chose to do FNP because I wanted to see patients of all ages, and work in a family medicine practice. I ended up in an adult internal medicine practice for 3 years, and then went into a specialty practice where I could see both kids and adults. I work in allergy and asthma, which was a natural segue for me as my previous work experience and education is in immunology and laboratory medicine. I like having depth of knowledge in a focused area. I will probably stay in this specialty for the remainder of my working years.
Best of luck to you. Work hard, and let your practice speak for itself when you're a NP.

For the record, there are many who don't get torn down for the specific reason of being DE but more for how they tend to come across. When they try and throw around phrases and criticisms like "nurses eat their young" and they never worked as a nurse and don't have any experience to actually justify that opinion, they put themselves in their own bad light.

To add to the overall theme of the thread, the OP asked the *how* people chose their specialty. Many nurses who go into advance practice have a body of knowledge to justify the direction they chose based on that experience. It absolutely isn't the be-all end-all...but the question wasn't "is DE better or worse"....the question was the how we chose our direction. Followed by the *typical* overreaction from both camps. In reality, it is perfectly understandable and rational that nurses who base their advance practice choices on their experience as a nurse to advocate for nursing experience over DE.

Oldmahubbard · Mar 28, 2018

Some NP roles lend themselves more easily to DE than others.

Psych? No. Not without extensive RN experience.

You will be incompetent, but you'll probably still be able to get a job.

allnurses Guide · Mar 28, 2018

For the record, there are many who don't get torn down for the specific reason of being DE but more for how they tend to come across. When they try and throw around phrases and criticisms like "nurses eat their young" and they never worked as a nurse and don't have any experience to actually justify that opinion, they put themselves in their own bad light.
To add to the overall theme of the thread, the OP asked the *how* people chose their specialty. Many nurses who go into advance practice have a body of knowledge to justify the direction they chose based on that experience. It absolutely isn't the be-all end-all...but the question wasn't "is DE better or worse"....the question was the how we chose our direction. Followed by the *typical* overreaction from both camps. In reality, it is perfectly understandable and rational that nurses who base their advance practice choices on their experience as a nurse to advocate for nursing experience over DE.

You were one who jumped right on the bandwagon of "bypassing the entire nursing profession", so I hope you're including yourself in those that overreacted. I did say I was exaggerating.

It is reasonable for those who have RN experience to base their APRN choices on that experience. That doesn't make it unreasonable for those who have not had RN experience to base their choices on other knowledge and experiences. The two scenarios are not mutually exclusive.

FWIW, it's tough to come on a forum, perhaps being a little naive, and then have people not answer your questions and jump all over you for furthering your education in a non-traditional way. I hate the NETY phrase, but some posters come across as arrogant and a bit cruel at times. I've probably done it myself. DjMatte, I remember the responses you got to a question you recently posted on another thread. You took lot of flak, and while I did not respond, I felt that some of those responses were unnecessarily blunt and not helpful. Same with the constant DE bashing on AN, among other things. Maybe that's why the perception of some is that nurses are nasty and mean to each other. I don't buy into the whole NETY thing, but it's not a stretch to see why some might.