Need Advice from working NPs

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Hello,

I am currently enrolled in a Direct Entry NP program that will award a BSN this May. I have heard from many of my clinical instructors and nurses at clinical that it would not be a good idea to become an NP without nursing experience. They said that as a direct entry grad I will not be taken seriously, and will not succeed. I just got a job as a nursing assistant as a local hospital that likes to hire new grad BSNs, so I think I may have the opportunity to work there after I get my BSN if I would want to. Would you advise leaving the program and working for a year full time before returning to NP school, or sticking it out in the NP program I am in. If this helps, I am very dissatisfied with the program, the program does not find preceptors for NP students, and is VERY expensive. However, the NP portion is just one additional year, whereas if I went back for my NP later it would be 2-3 years, depending on the program. I would greatly appreciate any advice.

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Specializes in Adult Internal Medicine.

If you do a quick search through the forum you will find a myriad of answers to this question. The truth is that we all have different opinions on the topic based on our personal and professional experiences. There is some research available on the topic if you are looking for less anecdotal advice.

My two cents:

1. Experience: Those that have RN experience tend to value that experience. This is even more true of specialty practice. Having RN experience will likely improve your practice as a novice NP and is unlikely to hurt your practice, where as not having RN experience may or may not hurt your practice.

2. Job Market: Having RN experience may make you a better candidate for some jobs, it depends on who is hiring and in what type of practice; I do think that students often here an exaggerated side of this story though as many jobs care far more about provider-level experience than RN experience.

3. Individual: The greatest factor in this issue is the individual. There are individuals that absolutely do not need RN experience to be competent NPs; there are individuals that have oodles of RN experience and still won't make a competent NP. Most individuals fall somewhere in the middle.

4. Program/preceptor Quality: The more hours you spend with quality education and precepting at the provider level the better a novice provider you will be. The worse your program and preceptors the more RN experience will help you.

Good luck.

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Specializes in allergy and asthma, urgent care.

Hi knlake,

I'm a Direct Entry grad, and I heard a lot of the same things you are now hearing before I graduated. I ended up going straight through to my MSN and NP, and have not worked as an RN. I don't feel it was a hindrance to me. I had no trouble getting a job as an NP, and I have been successful in my career. The same goes for my entire cohort, only a few of whom did the MSN portion part time and worked part time as RNs prior to becoming an NP. We all worked our butts off, as we had to meet extremely high standards to stay in the program. Believe me, we were taken seriously by prospective employers. I went to a very reputable school with stringent admission standards, and they may have been part of the reason why we had no trouble finding jobs. I thought the program was good, but not great. As Boston FNP said, it really is up to the individual. You can be a very competent novice NP with zero bedside experience, or a crappy NP with 30 years of bedside experience. The reverse also holds true. I personally feel that nursing experience is valuable, but not essential. Many would disagree with me. You have to weigh how much you'll really gain by working as an RN for a year or so versus postponing your education.

I'm sorry you have to find your own preceptors. I think that's unacceptable. They should at least be able to offer you contacts, practices that have taken students in the past, former students, etc.

I wish you the best of luck. Please let me know if you have any more questions.

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Specializes in ER.

I think it would be hard for most people to do as well as a nurse practitioner without having had any nursing experience. Remember, a nurse practitioner is an advanced practice registered nurse - it's all based on a foundation of nursing. I would hope a direct entry program would require a lot more hours than a traditional one. For example, mine required 705 clinical hours (500 is the minimum for any program) and most voluntarily went over, but I don't think anyone could come out of the program I graduated from ready to practice as an NP if they weren't a RN first since so much knowledge was assumed and then built on. As far as getting a job, I think if you're in a competitive area, not having any prior nursing experience will definitely set you behind other new grads. I know in my job search no one has cared about my 4.0 or honors in NP school and have just wanted to know what kind of RN experience I have and how that will help me in xyz setting as a NP. I would at least try to find a part-time or PRN RN job while you're still in school!

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Quality experience can never hurt and with that I mean the working nurse who always strive to learn and self improve. The nurse who just pushes meds and does the minimum to get through - that experience holds no value. I was preceptor by nurses with less experience and it did show, but I did not need them to teach me disease process but rather how to handle the NP role which they demonstrated very well.

Bottom line it matters more what you put into it and everyone is different and everyone has the potential to be excellent at what they do.

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Hi knlake,

I got your PM, but unfortunately I cannot respond to it directly. If you want, PM me your email address and I can answer some of your questions.

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This is not true. I was told this during my NP school by one of my preceptors because my clinical experience was minimal. She was also mean about it and I had self doubts because of her. My university however was wonderful in encouraging me to press on. Working as a NP is totally different from working as a bedside nurse. The approach is quite different.

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I forgot to add, when I was looking for a job and even now that I am looking into changing specialties, NO ONE was/is interested in my nursing experience. The recruiters and potential employers want NP experience.

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Totally apart from the RN experience/no RN experience question, what really leapt out of your OP to me was your statement that you're "very dissatisfied with the program." I have to ask, if that's the case, why are you even thinking about hanging around to finish? Why throw good money after bad? I'm always shocked at the number of people who post here about what awful programs they went to and what awful educations they got in their nursing programs, and I always wonder, then why did you keep attending and paying them tuition? Don't attend a program you're unhappy with and then complain about it -- cut your losses and move on.

One option, as you note, is to finish the BSN portion of the program and get out. You could get licensed and work as an RN, make some money, and "shop around" (maybe shop more carefully, armed with what you now know from this experience) for a better (and less expensive) NP program and still end up an NP, just take a little longer getting there. Over the course of your career, another year or two (or three) won't make much difference, it will jut be a minor "speed bump" that you vaguely remember.

The reason poor quality nursing programs are able to keep operating is because people keep attending them and putting up with them. If people would be more selective about choosing a program in the first place, or leave if they found they weren't satisfied with what they were getting, those schools would have to make changes or close down, which would benefit all of nursing. I can't imagine continuing to pay tuition to a school if I was significantly dissatisfied with the education I was getting.

Best wishes for your journey!

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Actually, it does make a difference. A year or 2 of NP experience is totally different with a year of 2 of nursing experience.

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