MSN for Non-nurses, your opinion...

Chris-FNP · Mar 24, 2001

wildtime88,

I hear what you say and I want to clarify some things. This thread is getting out of control and the way I replied in some of my posts can be interpreted in ways that make me sound like I am putting down RNs...THAT IS NOT THE CASE!!!

I spent 1 1/2 years on hospital floors as an RN student and almost a year as a working RN. I know the role after almost 2 1/2 years. What is the amount of RN experience required before one is able (in your eyes) to be an NP?

"Bridge" programs do not ignore traditional RN duties or experience. The time spent as an RN is obviously less, but, we learn the role and take the NCLEX. A lot of us, I hope, then work as RNs while we finish our education. By the time we actually get our first NP job, we probably have 2-3 years under our belt as an RN student and practicing RN.

Chris-FNP

Chris-FNP · Mar 24, 2001

SeasonedRN,

You sound angry. Anger is such a useless emotion. You should try being more open-minded to "bridge" NPs. Most of us, if you gave us a chance, would probably suprise you. We're a lot better nurses than you give us credit for.

Chris-RN-FNP (There, is that better?)

MollyJ · Mar 24, 2001

Originally posted by RHinesRN:
I have read most of these postings and what I find most ironic is that its NURSE practitioner. This is just another example of how the nursing profession continues to pull itself down. If you look in any nursing magazine you will find numerous listing and programs on how to advance your "nursing" career. From LPN to RN, From RN to BSN, from RN to MSN, and from "do it by mail", to "do it on line." If I keep looking I'm afraid I will find an UAP to RN program and probably it can be completed as a correspondence course with a weekend clinical. Where will it end, probably when they certify any college graduate that knows what the initials RN stand for as a NP. I can say I am certainly biased as I have come from a traditional 4 yr. BSN program, but I give you this thought. Logic would say that before you become an Advanced practice nurse (NPs,CNMs, CNAs), you should be a nurse, and not just by initials but by experience gained in the trenches. How can we promote our profession when there are so many inconsistencies across the Nursing field. I have met and worked with many competent and professional nurses that came to our profession from various communities using the back roads and two lane highways and I have no problem with that, but I sure would like to see them leaving on the same interstate. This road would have many off-ramps (NP, CNM, CS) but no on-ramp other than the one coming from the community of REGISTERED NURSE.

I have a MFT (marriage and family therapist) friend who contemplated in a playful way going to PA school so that she could prescribe anti-depressants. I was stunned. Why would you do a lot of things you didn't care about (learn to do medical H & P's, take a peds rotation, take a ob rotation) if you wanted to do one discreet thing--Prescribe psychotropics. But it dawned on me that people who go for these MSN entry level programs likely have a different set of motives than I did when I entered my diploma program 24 years ago.

I guess I want to say that perhaps these entry level programs have a place for people who know they want an advanced practice role. But I share some of RHinesRN's concerns. I think these folks with previous BA's and BSN's do bring some legitimate life experiences to our profession and we need to provide them mutliple ways to get where they are going, including accelerated MSN access BUT I worry about what I read in nursing magazines. Professions SHOULD guard their entry into practice and nursing has got to be the only profession who keeps building more and different shaped gates into the profession. I worry about the RN's I know who were EMICT's and took a correspondence course and did observation clinicals to get the title. These are NLN accredited courses of studies. This is nursing being very cavalier with how they allow our credential to be obtained. I don't think this person knows squat about nursing process. (He probably does understand the business end of a bed pan, but I am not so worried about that skill....)

Anyhow, I wish nursing would think more carefully about this issue. One thing a profession does is guard access to ability to use the professional title and I think we've gotten sloppy about that.

Just a thought.

Amygdala18 · Mar 28, 2001

Hi everyone,

I'm reading these posts and honestly don't know what to think. I have a bachelors in Bio. and Chem. I am going into a 4 year ND program which will give me my RN degree in 2 years, then a MSN, then finally a ND degree. It's been explained to me that this is an intensive program. It's never occurred to me that people would have a problem with this because I have no nursing experience. MD's and vets don't need prior experience to pursue their fields; I think just the fact that you are willing to go through that much schooling, achieve good grades, and pursue the profession you have chosen implies the dedication underlying your choice. After 8 years of school, I will be 36 years old--I am positive that I will do whatever it takes to excel in my field. I hope I don't encounter this type of negative attitude once I do get into my field of being a NP--but if I do, I will succeed in spite of it.

Chris-FNP · Mar 28, 2001

Great response Amygdala18!!! That's kind of what I've been trying to say, but I've spent so much darn time defending myself here that I could never really get it out. You will find that a lot of RNs tend to have a big chip on their shoulder when it comes to these types of NP "bridge" programs.

I have 7 years of higher education from two very good schools (Providence College and MGH-IHP at Massachusetts General Hospital) and yet I still get harassed here about being an NP. You know what, just ignore it. If you have the passion and desire to be an NP, go for it. You will succeed and become a great NP, regardless of what others may say.

Intelligence, passion, and desire is all you need to accomplish anything. Best of luck!!!

Chris-FNP

Q. · Mar 28, 2001

I'm reading these posts and I sympathize with Chris.

I am an RN. I am not an NP and have not even shadowed one so I could not even begin to argue what they should/should not do. I think Chris is trying to point out that NPs have a different scope of practice and functioning that non NPs do not understand, and how could we? Yes RNs understand pharm, etc. But I would bet my bottom dollar that the knowledge of that same topic is higher for an NP. It just HAS to be.

For the record, in my area I was researching becoming an WHNP. At the same time I wanted my MSN with it. Well I couldn't get into the program because what it was meant for was NPs who needed a MSN. The guidance counselor told me that the movement is to have all NPs have a MSN, and this program is for all the NPs who don't have one. Incidently, the WHNP required at least one year of OB/GYN experience as an RN or equivalent.

I think we all need to relax and understand that if we haven't gone through the schooling, we really have no idea what it is the other person went through or knows.

Chris-FNP · Mar 28, 2001

Thanks Susy K. I appreciate your response and your absolutely right. I have the highest respect for RNs because I am one!!! I am not the elitist that many here have seemed to make me out to be. I've just tried to provide some insight with regards to how NPs practice today and how well the "bridge" programs prepare non-RNs to be NPs. Somewhere along the line, this thread has turned ugly and I've felt as if my back was against the wall!!!

The comment I made about pharmacology and pathophysiology was not said as an insult. I don't know why it was taken out of context, but the truth of the matter is that we (NPs) do study the subject in greater detail because we have to!!! Sure, as an RN, I gave meds...but now its my responsibility to prescribe them. Its so much different. Giving someone their Glucophage (per an order) is one thing, but actually prescribing it to them by yourself is a whole different ballgame. What if I drop their blood sugar way too low? Its now my fault for prescribing it!!! The intensity level is much higher...that's why we have an entire year of pharmacology. In my school, it was taught by a pharmacist and an NP with a Ph.D. in nursing/pharmacology.

As an RN, I may have seen someone's potassium level drop too low and so I notified the MD/NP. As an NP, its now my responsibility to address the issue myself. Do I do an EKG first? Do I admit them? Do I simply start them on K-Dur 20meq and repeat the potassium level in a week? Again, the intensity level is a lot higher and this is the type of stuff that NPs face on a daily basis.

Yes, I am a nurse. But, all I was trying to get across was that the role of the NP is a lot different from an RN's role. Not in every area, but in most.

Chris-FNP

Q. · Mar 29, 2001

Hi Chris-

I feel your pain - if you've noticed I've been badmouthed lately - check out the thread "NO MORE SUSY K" all over asking the difference between an LPN and an RN. It all started with my post "Why LPN?"

I totally understand what you're up against with the prescribing. If it were that easy, all RNs could do it! I totally agree, it is one thing to administer insulin, etc, but to actually determine the sliding scale?? That is way out of my scope of practice and it should be. We all can't know everything about everything.

I'm fairly new to this board and have seen overwhelming hostility and defensiveness, and it all seems to stem from insecurities, really. I feel almost like walking on eggshells. Several times I've read RNs being put down by LPNs, and I know that the RNs are afraid to respond because they will be branded as being "elitist." This is all just so unfortunate. Like I said, I feel your pain and I'm glad you didn't back down.

BTW not that it matters but I'm usually pretty good at determining someone's gender by the way they write. Are you male?

[This message has been edited by Susy K (edited March 28, 2001).]

Chris-FNP · Mar 29, 2001

Thanks again Susy K. Yes, I am a male...a rare breed in this field!!! I know what you mean about this forum. There is so much anger here. Oh well. I hope others learn to listen more. There is no need for such anger. We're all nurses and we should support each other. I like a good debate, but it can get out of control in this place.

Chris-FNP

fergus51 · Mar 29, 2001

Chris, I just have to point out a lot of the RNs who disagree with this type of program don't have "a chip on their shoulder", they just don't agree with the program for various reasons, a lack of practical experience being one of them. I am not sure what to make of these programs anymore. But I had to respond to the chip on the shoulder comment because to me that implies that RNs don't like their jobs or wish they were NPs or something and that just isn't the case. I definitely agree with you that some of the replies hit under the belt.

Amygdala18 · Mar 29, 2001

No practical experience doesn't seem accurate. While you're in a doctor of nursing program you have to do 1500 hours of clinicals. That's the equivalent of 30 hours a week for a year. That IS some experience--enough to know if you are in the right field for you and definately enough to gain some further knowledge besides sitting in a classroom.

Q. · Mar 29, 2001

I guess in my mind, if a person has gone through the schooling and the required courses and practicums, has taken the tests and gained their certifications and degrees, that that is enough credentials for me.

I guess I view it as the age old argument of always having to start your staff nursing career in a Med-Surg floor. I agree it may be a valuable experience, but I didn't find it necessary for me. I went straight into OB and I wouldn't have it any other way. Some may think that I lack the "basic" nursing skills as a Med-Surg nurse, but really, it's more so that my skills are highly specialized and intensive. I learned how to start IVs on my floor, we do an occaisonally wet to dry dressing change. If we come across something that we haven't done at all or in a long time, we work together to figure it out. We're not idiots - we can usually do a nursing skill even if it's been years or not at all.

Same as with an NP who didn't staff for very long or not at all independently. The NPs skills are highly specialized and intensive; while he may have never administered insulin and had to go through the 5 R's to do it, or do the q shift assessments, their scope of giving the insulin goes waaaayyy beyond just administering and evaluation immediately after.