This is a long post, but I'm really looking for input from nurses, NPs, or any other providers. I'm a couple months into my nursing career and have just been accepted into an NP Program, and am wondering if I am making a mistake. I feel ready, but others have told me I shouldn't.
For a little background, I went to a second degree BSN program, and got my first degree in biomedical neuroscience. I graduated my BSN with a 4.0, tutored all med-surg and critical care classes in my program, spent a year working in an ED during school, and currently am in orientation as a nurse in a level 1 trauma ED at a big university health center. I got into adult-acute care NP school in the same university that I work at. It has a great reputation consistently ranking in the top 5 for NP schools in my specialty and was ranked #1 this year for AGACNP. I was approved to attend on a part time basis so I can hold full time work through the program, and get to spend the first year attending non-clinical foundational classes (physiology/pathophysiology, healthcare economics, introduction to practice, etc) then start my core classes the second year. I'll be starting the program as a new grad, but by the time I ever see a patient in school as a NP or take clinical classes I'll have nearly 1.5 year of experience (nearly 3 years by the time I graduate). In my limited time so far as a nurse, I am definitely humbled by how much I don't know in the realm of nursing, but still feel as confident as ever in my understanding of fundamental sciences (Patho/pharm/physiology) so I still just feel ready to move onto further education. I've gotten pushback from a lot of nurses, but encouragement from my professors, preceptors, and my nurse educator in my previous ED job.
I am wondering if I am just being too naive in thinking I am ready for this. I want to go on to NP solely because I really enjoy diving deeper into diseases and their treatment. I want to go onto outpatient cardiology after school and attend a cardiology fellowship to get a more structured and hands on patient care at the NP level. I think my first undergrad degree prepared me to take on the graduate classes quicker, as I got a lot more exposed to organic chemistry/biochem/physiology, but am wondering if this is too quick, even attending part time. In no way do I want to cut corners to becoming a provider and would never want to jeopardize patient safety, but I just feel ready to take on the additional responsibilities.
Is there a big advantage having NP's making home visits over visiting nurse services? I think the preferred model for NP's is working as a money machine for someone else....at least in their employers' eyes.
Can't like this enough. We are a commodity like a chair, table. If we can't make money, we are not gonna make it. IMHO, there should be far more business classes in any and all APRN degrees. We need to know what we are worth.
That said, I had 12 years experience when I became an APRN: 10 in a level one ED, 2 years in adult ICU. I was hired because I could tell sick from not sick which was gained from my years of acute care.
However, times change - you are very smart and I think you can do it.
Can't like this enough. We are a commodity like a chair, table. If we can't make money, we are not gonna make it. IMHO, there should be far more business classes in any and all APRN degrees. We need to know what we are worth.
That said, I had 12 years experience when I became an APRN: 10 in a level one ED, 2 years in adult ICU. I was hired because I could tell sick from not sick which was gained from my years of acute care.
However, times change - you are very smart and I think you can do it.
I'm not the one doing anything- I am retired:) But I worked 41 years in nursing and over 30 of them in anesthesia as a corporate widget. I understand billing:( I also understand the instinctual learning we get with nursing experience, as you said, recognizing who is on the cusp of danger. It's so easy for the inexperienced practitioner to not pick up a young healthy person is going septic or anyone else, for that matter. You can't teach it either. You just have to pay attention to a series of patients with the same diagnosis to learn the subtle signs. I guess if every NP only saw healthy people, it would be nearly impossible to do any damage . But we can't educate NP's like that since they can't cherry pick their working circumstances. Some of these NP programs are appalling so we need to have to have experienced nurses only entering NP programs since they will certainly have to teach themselves.
Thank you for the response! And I didn't mean to minimize the need for RN experience, I picked the part time program specifically to get experience. But for critical care experience, the ER I work in is a level 1 trauma center. I haven't had experiences other than an ER, so would a level 1 center be adequate for critical care, or is there stuff seen in an ICU that isn't seen in an ER?
Several others have already emphasized the advantages of ICU experience and I agree. I spent 6 months in ICU before I decided it wasn't for me, then worked 10+ years in the ER and it's a different animal altogether. "Is there stuff seen in an ICU that isn't in an ER?” Yes and no. ER nurses will care for the critical patient initially, but the amount of time spent with them is very little compared to the ICU nurse. The ER is all about stabilizing and moving patients as quickly as possible, so you won't gain the depth of knowledge for treating patients that you would in ICU. You won't even see the same volume of critical patients in the ER because most of your patients will far less ill, not to mention all of the complaints that should have been seen by PCPs instead.
Some of these NP programs are appalling so we need to have to have experienced nurses only entering NP programs since they will certainly have to teach themselves.
Can you answer the question of the OP of how much experience is enough? The poster will have over two years when they graduate but not when they enter. Two years is enough to go to anesthesia school. Is it enough to become a NP? Or would you say the OP should have a certain set of time, then start school, and then come out with say 4 or 5 years at the bedside?
Doctors get to go straight to medical school after a Bachelors Degree, as do pharmacists and physical therapists, and graduate and practice medicine or their speciality. Granted they aren't alone and there's a long residency for doctors, and an orientation for the rest of advanced practitioners. This poster will be in clinicals in school with an MD or another NP, while working at the bedside as an RN, and obviously is very intelligent.
Experience does indeed matter and that should be respected. I can think of dozens of times I've suggested things to doctors or NPs that have helped patients because I'm right there and they haven't seen, or they haven't been there during a change in condition. But I wouldn't say to a doctor, "you should have more experience at the bedside before becoming a doctor". They get their experience the same way I did. With time.
Can you answer the question of the OP of how much experience is enough? The poster will have over two years when they graduate but not when they enter. Two years is enough to go to anesthesia school. Is it enough to become a NP? Or would you say the OP should have a certain set of time, then start school, and then come out with say 4 or 5 years at the bedside?
Doctors get to go straight to medical school after a Bachelors Degree, as do pharmacists and physical therapists, and graduate and practice medicine or their speciality. Granted they aren't alone and there's a long residency for doctors, and an orientation for the rest of advanced practitioners. This poster will be in clinicals in school with an MD or another NP, while working at the bedside as an RN, and obviously is very intelligent.
Experience does indeed matter and that should be respected. I can think of dozens of times I've suggested things to doctors or NPs that have helped patients because I'm right there and they haven't seen, or they haven't been there during a change in condition. But I wouldn't say to a doctor, "you should have more experience at the bedside before becoming a doctor". They get their experience the same way I did. With time.
I agree with the OP that two years is enough! I don't agree that nurses should be accepted into NP programs straight out of undergrad with no experience.
I don't agree that nurses should be accepted into NP programs straight out of undergrad with no experience.
From what I understand, this is what the OP is doing, but by the time finishes will have two years because they intend on working while in the program.
So what you're saying is if they are accepted into the program straight out and don't work and have clinical only, that's not good enough?
From what I understand, this is what the OP is doing, but by the time finishes will have two years because they intend on working while in the program.
So what you're saying is if they are accepted into the program straight out and don't work and have clinical only, that's not good enough?
I don't understand your question. The OP has been working as a nurse. What does "don't work and have clinicals only mean?" Do you mean people who only get their nursing experience during their graduate student clinicals? Hell yes that's what I mean:) They don't even have the basics down. What a waste of graduate school time. If people are signing for NP specialty programs with no experience, is that a wise financial decision? IMHO it is a bad for the student and ultimately not advantageous for patients. The OP in question will have cardiac skills in place before moving into more advamced material. No NP school should have to teach a cardiac nurse how to read a 12 lead EGK. It should be assumed they already have that skill and move on from there. Time is valuable and there is so much to learn.
I don't understand your question. The OP has been working as a nurse. What does "don't work and have clinicals only mean?" Do you mean people who only get their nursing experience during their graduate student clinicals? Hell yes that's what I mean:) They don't even have the basics down. What a waste of graduate school time. If people are signing for NP specialty programs with no experience, is that a wise financial decision? IMHO it is a bad for the student and ultimately not advantageous for patients. The OP in question will have cardiac skills in place before moving into more advamced material. No NP school should have to teach a cardiac nurse how to read a 12 lead EGK. It should be assumed they already have that skill and move on from there. Time is valuable and there is so much to learn.
My question is based on the original post " I'll be starting the program as a new grad, but by the time I ever see a patient in school as a NP or take clinical classes I'll have nearly 1.5 year of experience (nearly 3 years by the time I graduate). In my limited time so far as a nurse."
I just wanted to be clear that you're okay with the above starting NP straight out of school with no experience, but will work while in the NP Program and get experience that way, but not okay with someone that goes straight into the program and doesn't work as a floor nurse and becomes a NP.
I just wanted to be clear that you're okay with the above starting NP straight out of school with no experience, but will work while in the NP Program and get experience that way, but not okay with someone that goes straight into the program and doesn't work as a floor nurse and becomes a NP.
In my opinion, " Jane Jones" off the street decides "it would be cool to be an NP and write scrips for my friends is a really bad idea. In my work for the BON ,we saw a lot of that and that is why is most cases I 'm not in favor of no prior experience as a nurse to NP. The OP has a much different situation.
From what I understand, this is what the OP is doing, but by the time finishes will have two years because they intend on working while in the program.
So what you're saying is if they are accepted into the program straight out and don't work and have clinical only, that's not good enough?
Yes that is the case with me! I've opted to attend the program part-time so I can keep full time employment through the program
My question is based on the original post " I'll be starting the program as a new grad, but by the time I ever see a patient in school as a NP or take clinical classes I'll have nearly 1.5 year of experience (nearly 3 years by the time I graduate). In my limited time so far as a nurse."
I just wanted to be clear that you're okay with the above starting NP straight out of school with no experience, but will work while in the NP Program and get experience that way, but not okay with someone that goes straight into the program and doesn't work as a floor nurse and becomes a NP.
THIS OP already has a non-nursing degree. They will be working full-time while in school in a unit that's strong on cardiac skills. That is quite different from someone who as a new grad going to a full time program without any experience and not working at all. The OP is working now but isn't in school yet. We still have direct-entry to MSN programs where non-nurses get their master's with a specialty without any working experience. I had an NP who went to one of those programs who had previous worked in HR. I don't know if she only got the healthy routine physicals or not, but, in my book, that isn't acceptable. At least FNP's aren't working in acute care setting anymore.
THIS OP already has a non-nursing degree. They will be working full-time while in school in a unit that's strong on cardiac skills. That is quite different from someone who as a new grad going to a full time program without any experience and not working at all. The OP is working now but isn't in school yet. We still have direct-entry to MSN programs where non-nurses get their master's with a specialty without any working experience. I had an NP who went to one of those programs who had previous worked in HR. I don't know if she only got the healthy routine physicals or not, but, in my book, that isn't acceptable. At least FNP's aren't working in acute care setting anymore.
Physician's Assistants do this all the time. I know one that went from college to a PA program to work with an ortho doc. Another one was a CNA and then was hired after PA school by the hospital to work with Trauma patients. Someone in PA school was doing a clinical and did my physical and in talking to her she had no medical experience at all but yet was going to be able to graduate and start working right away in a family practice.
Paramedics and Forepersons get out of school and save lives never having had any experience.
It's not an unheard of concept. Why is it not okay for NPs to do the same?
We can disagree and drop it, that's okay. The original poster seems to have thought it out and made up their mind regardless of what we think anyway.
traumaRUs, MSN, APRN
87 Articles; 21,287 Posts
Can't like this enough. We are a commodity like a chair, table. If we can't make money, we are not gonna make it. IMHO, there should be far more business classes in any and all APRN degrees. We need to know what we are worth.
That said, I had 12 years experience when I became an APRN: 10 in a level one ED, 2 years in adult ICU. I was hired because I could tell sick from not sick which was gained from my years of acute care.
However, times change - you are very smart and I think you can do it.