Little experience as an RN

BlueDevil,DNP, DNP, RN · Nov 11, 2013

I find it interesting that you have repeatedly implied there is a chasm between acute and primary care with regard to the challenges of patient management. It tells me you do not understand very much about either domain. My advice to you is to stop talking so much about things you do not understand and listen more. You have much to learn, young padawan. Best of luck.

Mark Hill BSN · Nov 11, 2013

I find it interesting that you have repeatedly implied there is a chasm between acute and primary care with regard to the challenges of patient management. It tells me you do not understand very much about either domain. My advice to you is to stop talking so much about things you do not understand and listen more. You have much to learn, young padawan. Best of luck.

I suggest that you stop insinuating that NO ONE EVER knows as much about anything as YOU! You have no idea where I have been, and what I know! Your statement is ridiculous, and your assumed sense of superiority is laughable. You have turned this into a personal attack, because you dislike my opinion on the subject, and you have NOTHING that proves my opinion wrong. So instead, you blurt out ignorant comments that make you look foolish. You try to make it look as if you are so much smarter than everyone else, and you just look arrogant, and assumptive. If that is your goal, then you have reached it! My advice to you, is that you stop assuming you are the smartest person in the room (or chat board), because your not (in case there was that lingering question in your mind)! Don't tell me how smart you are, prove it by saying something smart now and then! Surprise me!.... WOW!

allnurses Guide · Nov 11, 2013

It is one of the unintended consequences of NPs coming out of school with little or no real world experience, then giving orders to expert nurses who, in many cases, have worked in trauma ERs, and ICU for 20 and 30 years. Often these nurses are old battle axes anyway, very jaded, aggressive, opinionated, but also very good at what they do. It can be a nightmare for the inexperienced provider.

Is this supposed to demonstrate a problem with inexperienced providers or the "aggressive" and "jaded" nurses who make doing their job a "nightmare" for inexperienced providers? From my experience, these individuals make a providers job difficult regardless of experience because they always seem to know best, which in the end are why there are "orders" that are to be followed. You may find that some of these very same individuals will make your life as an APN difficult even though you have 30 years experience.

Ultimately, this argument will continue for many years to come, and regardless of the studies done there will always be those of us who will believe that more experience is better, as with most things in life.

Argument will continue regardless of studies done. That about sums up the issue: opinion > fact.

Now, I will say that experience is probably less important in the primary care setting, but I still don't see how it can hurt.

The majority of NPs do work in a primary care or out-patient setting.

Trauma Columnist · Nov 11, 2013

Hey guys - lets keep it civil and debat the topic, not the poster. Thanks....

BlueDevil,DNP, DNP, RN · Nov 12, 2013

:wideyed:

I say again, best of luck to you young man.

Mark Hill BSN · Nov 12, 2013

I say again, best of luck to you young man.

Its funny how when arrogance, and assumed superiority get called out the only response is "crickets", and Have a nice day. Just for the record, LUCK is a fallback strategy for the unprepared, which I am certain you are intimately familiar with. You have a nice day as well "old man".

Mark Hill BSN · Nov 12, 2013

Is this supposed to demonstrate a problem with inexperienced providers or the "aggressive" and "jaded" nurses who make doing their job a "nightmare" for inexperienced providers? From my experience, these individuals make a providers job difficult regardless of experience because they always seem to know best, which in the end are why there are "orders" that are to be followed. You may find that some of these very same individuals will make your life as an APN difficult even though you have 30 years experience.
Argument will continue regardless of studies done. That about sums up the issue: opinion > fact.
The majority of NPs do work in a primary care or out-patient setting.

As I said before, it is a unintended consequence of the inexperienced provider. I have also seen it happen with residents, and brand new MDs. Part of having experience will be learning how to handle ones self in theses situations, which exist in many ERs ad ICUs everywhere. To act as if they don't exist is ludicrous, or a lack of having worked in these environments.

I agree that most NPs will work in primary, so I don't get your point.

I have no doubt that some of these same people will "try" and make my professional life miserable, but with 23 years experience working in these environments.....I like my chances over an NP without experience.

Trauma Columnist · Nov 12, 2013

Sometimes we have to agree to disagree. Let's move on...

Riburn3, BSN, MSN, APRN, NP · Nov 12, 2013

Wow, this is a fun conversation. Everyone is right in this one, I don't really understand why it's so heated.

As a nurse with extensive experience in critical care, I feel like that experience has helped me tremendously in FNP school and in clinicals, especially with understanding varied diseases in numerous states. In my humble opinion, experience is important, but so too is the quality of experience. There are vast differences in nurses that work in a floor setting compared to those that have spent their careers in critical care or an ED. At my program, classmates with a similar length of experience doing floor nursing with worse patient ratios struggle a bit more compared to those of us with higher acuity backgrounds that get more time with their patients.

In the end though, it largely boils down to the individual and their own personal experiences. All of us can sling anecdotes in one direction or another, but the reality is everyone is right. Telling people there is research supporting their claims and then not citing it is just bad form.

Mark Hill BSN · Nov 13, 2013

Due to my interest in in this subject, I spoke to one of my instructors about it. --------has been a nurse for 30 years, and a DNP for 20 years, she has also been an NP instructor since 1999. She has also been a department head for a major state university nursing program (I failed to ask which one). Her position is that “practical experience makes a world of difference in, not only the practicing NP, but also during the preparation of NP students”. She also told me, that she has read the qualitative studies as well and, does not believe the conclusions that have been reached…..I think I’ll go with that. Now I'm sure that there are going to be those who will scream "evidence based research says". Well these statements were made by a published evidence based Researcher!

Mark Hill BSN · Nov 13, 2013

Wow, this is a fun conversation. Everyone is right in this one, I don't really understand why it's so heated.
It should not have gotten so heated, but the initial response to my initial "opinion" was condescending and assumptive, and it progressed from there. Intellectual, and academic bullies cant tolerate alternate view points without attempting to tear the holder of that alternate view point down. Ultimately, when they cant "out debate you" they attack you personally... Typical!

Guests · Nov 13, 2013

Is it feasible to get a job as a FNP in an office/ clinic setting with only one year hospital experience?

Oh, I certainly hope not.

I don't get how you're supposed to be an 'Advanced Practice Nurse' when you haven't even become a 'Basic Practice Nurse.'

With a nod toward BlueDevil, Juan, and the other rocking NPs I come across here, the FNP thing becomes more and more a joke every year.

I almost wonder if it's not some MD conspiracy... dilute the competency and expertise of NPs so much that the whole thing implodes.