New grad to NP. Is it a mistake?

Nurses General Nursing

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New Grad: Should I go straight to NP program?

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. 

Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.
Tweety said:

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.   

Med and PA school are generally a lot more rigorous than many NP programs nowadays.

4 Votes
Specializes in CRNA, Finally retired.
Tweety said:

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.   

Then let's not call it advanced practice nursing.  With so many suspect NP programs available today, perhaps they should all just become PA's.  I think when the public hears "advanced practice nursing", they expect that the person has experience in the ranks.  Yes, I agree that this OP has it together.

1 Votes
Specializes in Emergency.
barcode120x said:

The NP can diagnose and prescribe on the spot, whereas an RN cannot. As we know, information takes time to communicate. I do agree with your second comment though haha. We still make good money nonetheless and it's way more non-physical labor which is one of things I was looking forward to when I got my NP. I wish I went for my NP sooner rather than breaking my back on the floor for 7 years.

@ OP
I won't say it's a mistake, but I would still recommend (to my former self and others) to at least get like 1 or 2 years of experience first before going for your NP. One can argue that by the time you finish your NP school, you will be at least 2 years experienced as an RN already. This is true, but in NP school, you will likely be starting clinical rotations very quickly. While there is huge amount of information to learn as a new RN, a new ED employee, and the world of healthcare, your preceptor will already be expecting you to provide some sort of plan of care including diagnosing and treatment. It's also important to note that why nursing and medicine can overlap, acute care/ED is very different that primary care (assuming your program is an FNP program as most are). Providing a treatment plan was my initial struggle because as a telemetry nurse, I had been program to fix this now/asap, but primary care, that's far from the truth (unless it's an emergency of course). I had to separate my knowledge from acute care and primary care. If you think you are able to do all this, then more power to you. There are many stories I've had from both the floor and in clinical where I was glad to have the # of RN years behind my back. Experience will help you in the long run, what's the rush? 

The program I'm going into is an AGAC-NP Program, I just say outpatient cardiology because my school offers sub-specialty education (which would involve an additional 3 credit course on cardiology with an associated clinical). The part time program is also set up really nicely for my situation, as the first year is strictly foundational classes (physiology/pathophysiology/healthcare economics) and health assessment, advance practice classes, and clinical all happen the second year

Specializes in RN, BSN, MA, CLNC, HC/LC.

I've been a BSN RN for over 45 years in a variety of settings and roles. (20+ years OR, level one trauma+outpt. Case manager,  then became certified oncology nurse to give chemo infusions when Dad and dear friend faught cancer. Clinic was grossly understaffed.   I have been seen by NPx1 and DNP because my MD PCP was over booked. NOT impressed. Inexperienced lack of follow up and work product/care/notes not reviewed by PCP. Referrals not coordinated/reviewed/followed up by PCP. 

This may be because the number of providers is at critical low to serve demand but I will never submit to NP care again. 

The future is frightening. I know the level of education and experience I have and the lengths I've gone through to ensure I  gave competent effective care within my skillset and NOT let the system jeopardize my reputation or patient care. 

I'm struggling with health issues that could have been avoided.

Please be honest with yourself, really look at the venues you work in and seek out supervision and collaboration with your peers and supervising Provider.

Good luck whatever decision you make. We old gals do need you to step up. I will keep you in my prayers.

3 Votes
Specializes in Cardiac.
Nursenick123 said:

The program I'm going into is an AGAC-NP Program, I just say outpatient cardiology because my school offers sub-specialty education (which would involve an additional 3 credit course on cardiology with an associated clinical). The part time program is also set up really nicely for my situation, as the first year is strictly foundational classes (physiology/pathophysiology/healthcare economics) and health assessment, advance practice classes, and clinical all happen the second year

I guess the real question is, will any of these responses/advice offered change your acceptance or start to AGACNP this fall. It seems that you have made your decision to go back for acute care NP which is great because so am I.  Just try to get the best experience you can possibly get out of your work experience during graduate studies. The question is never if it's achievable but whether it is recommended, whether you graduate from your profession and gain the respect and knowledge expected out of an advanced nursing practitioner. 

 

Specializes in Physical Medicine & Rehabilitation.
Nursenick123 said:

The program I'm going into is an AGAC-NP Program, I just say outpatient cardiology because my school offers sub-specialty education (which would involve an additional 3 credit course on cardiology with an associated clinical). The part time program is also set up really nicely for my situation, as the first year is strictly foundational classes (physiology/pathophysiology/healthcare economics) and health assessment, advance practice classes, and clinical all happen the second year

I see. Regardless of the NP Program specialty, I still stand by my recommendation on getting more RN experience first before pursuing your NP. The information to learn, to retain, and to critically think for the past, present, and future of the patients is too vast for a new grad. But as some have said, based on your previous responses to others, it seems you are committed to going through with the program. I wish you the best.

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