Maybe an ignorant question, but I'm asking it anyway....

SteveNNP, MSN, NP · Mar 21, 2009

Steve-
What are some of the things that might be sorely needed, in regards to lack of experience, specifically to the NNP?

+ Solid NEONATAL assessment skills, both in the sick and well, term and preterm neonate. This comes with experience.

+ Solid delivery room and resuscitation skill and experience

+ Solid IV and venipuncture skills. YOU will be called when the most skilled RN can't get the IV. And you have to be able to get it.

+ I am a firm believer that certification as a NICU RN, such as CCRN or RNC is very helpful.

+ Lab interpretation skills

+ Knowledge of common NICU diagnoses. As an NNP, YOU will be the one diagnosing, and basing treatment on assessment skills.

+ Knowledge of ventilators and their management. Vents, CPAP and HFNC are bread and butter in NICU. In this age of gentle-ventilation strategies, knowledge of how to operate, wean and adjust ventilation is critical. As an NNP, you need to be able to look at a ventilator loop hysterogram and know what that lung is doing, and what the next move is.

+ Critical thinking and time management. Instead of having 1-4 pts as an RN, you will have anywhere from a few, up to every kid in the unit, especially if you are doing night coverage. You have to be able to prioritize, so that when they call for a stat 23 weeker abruption, and you are in the middle of a crash intubation in the unit you can cope with the situation.

I hope I don't sound discouraging. I am simply trying to convey the importance of not simply taking the shortest path to your goal of an NNP. I went on for my NNP after practicing for 3 years as an RN in various roles, from preceptor, to charge, to transport, etc...I still shake in my shoes when they hand me a blade and tell me to intubate the crashing 500 gram-er in front of me.... but I can tell you that taking one step at a time, and getting as much experience as you can, will help you tremendously as a NNP.

greenfiremajick · Mar 21, 2009

This is the description for what I was looking at:

The pre-MSN phase includes 52 credits of undergraduate nursing theory and practice as well as 9 graduate credits. At the completion of the 59 credits students are eligible to complete the NCLEX.

Students then complete the MSN requirements in a specialty area.

Now, are some of the issues and concerns about becoming an NNP, going to be the same for a peds NP?

Also, the beginning and end of the education will take approximately 15 months plus the 42 credits worth of MSN and specialty of choosing. I give this information, because several have indicated it seems I am trying to take shortcuts but this is not the case. If I were to try and attempt this, I would be going backwards in regards to education since I am 1 semester away from starting my PhD….I was trying to ensure that none of my previous education, time, and energy were not wasted by starting on an associate’s degree and then moving forward. Does that make sense? I am asking all these questions to ensure that I am making the right decisions and choosing the best path to take.

I also think that with all you guy’s advice, I am armed with a few more intelligent questions to ask of the University, so that I will know how much actual experience I will get, before I would take an NP cert test and be let free to wander and roam a department I have no experience in! (yes, I know that was a runon sentence but there was just no way I could contain the damn thing….)

I am wondering if, during the 52 credits worth of BSN requirements and obtaining my RN, I would be allowed to gain a lot of experience in NICU or PEDS? Probably not, huh?

Another question to ask them: If after I choose my specialty, would I then be allowed to do all my clinicals and "experience" times, in the NICU or PEDS?

greenfiremajick · Mar 21, 2009

And no, Steve you do not sound discouraging. I am wanting real word, realistic advice so that I am not setting myself up for failure, or screwing up other people's lives.

greenfiremajick · Mar 21, 2009

"+ Knowledge of ventilators and their management. Vents, CPAP and HFNC are bread and butter in NICU. In this age of gentle-ventilation strategies, knowledge of how to operate, wean and adjust ventilation is critical. As an NNP, you need to be able to look at a ventilator loop hysterogram and know what that lung is doing, and what the next move is."

This is the part that makes me the most nervous............

SteveNNP, MSN, NP · Mar 22, 2009

Now, are some of the issues and concerns about becoming an NNP, going to be the same for a peds NP?

Not necessarily. NNPs can really only work in a hospital setting, either a NICU or followup clinic. Or as part of a neonatal transport team. PNPs usually work in a primary care, outpatient setting, such as a pediatrician office or clinic. They can also work in a hospital setting as part of a pediatric group, such as peds GI, GU, neuro, cardiology, etc.

I am wondering if, during the 52 credits worth of BSN requirements and obtaining my RN, I would be allowed to gain a lot of experience in NICU or PEDS? Probably not, huh?

Probably not. Most nursing programs have just one course for pediatrics/OB. I had to beg to get a few days of clinicals in a NICU. Most of your clinical time in NS is going to be in adult acute care, such as med/surg, tele, ICU, etc.

Another question to ask them: If after I choose my specialty, would I then be allowed to do all my clinicals and "experience" times, in the NICU or PEDS?

Probably not. You need to sit for the NCLEX, which is a general knowledge exam. Your program may have a practicum or integration semester at the end of the program, in which you can choose a specialty to finish your clinical hours in. You might get into a peds or NICU setting at that point.

LoveTheNICU · Mar 23, 2009

All the way back to your original question-

I think the reason you may see NNP positions listed as "MSN preferred" is because not so long ago, you could become an NNP as a certificate-type program if you were a BSN prepared RN. There was definitely advanced education, but simply not within the confines of an MSN program. When the newer national guidelines required an MSN, these NNPs were "grandfathered in". Since some of them had been practicing for 20 years or more, it would have been quite the hardship to ask them all to return to school to obtain an MSN. However, any new NNP is required to have an MSN. The BSN/certificate prepared NNP could still apply for an NNP position, on the basis of experience and prior education, but most hospitals prefer their NNPs have a MSN, and encourage them to return to school to obtain one. I personally ran into this issue, as I am almost finished with my NNP degree. When I was doing precepted clinical hours in the NICU, I could only be there if there was an MSN NNP on staff that day, due to my university's requirements. We still have 3-4 (out of 12) NNPs that have their certificate only, so I had to make sure to schedule around them. I was kind of disappointed, as I felt these practitioners would have a significant amount to teach me, given that they have worked there since the 70s! However, they have often mentioned the difficulty they would have getting a position elsewhere without their MSN.

Hope this helps! :nurse:

BittyBabyGrower, MSN, RN · Mar 24, 2009

You also have to have an MSN for prescriptive privleges. I think that the bottom line is that you should have experience in the area you are going into. You can't go from working at Wendys to brain surgery, so you can't just go from nursing school to being a practitioner in a super specialized area.

NurseDawg06 · Mar 24, 2009

Agreed