New grad thinking about FNP school

Summers_Off · Nov 9, 2010

I hope a few people answer this because I am very interested in hearing the responses as well! :)

Spacklehead, MSN, NP · Nov 10, 2010

It is definitely a different type of stress. Many times as an NP, you are the one making the ultimate/final decisions. I don't typically turn to somebody else and ask them what I should do about abnormal lab values, EKGs, X-rays, etc. (unless it is beyond what is the obvious correct rationale) - I am the one deciding how to address the problem. Same with meds/treatments - I am no longer questioning someone about if they think a patient needs something; I am ultimately making the decision and ordering it (or not) without anybody else's (meaning another NP's or MD's) input. Sometimes, that type of responsibility can be a little daunting, especially as a new grad NP when you are adjusting to your new role. Even the most experienced, confident RN will probably feel a little overwhelmed/humbled as a new NP.

I will also be completely honest - I did not feel comfortable even thinking about becoming an NP until I had at least 3 years of full-time, bedside, acute-care RN experience under my belt. Then it took me another 5 years before I felt confident enough with my knowledge/skills to make the decision to apply to an NP program. Granted, this will vary greatly depending upon who you talk to, but I am always thankful that I waited as long as I did and gained the experience I did as an RN because my assessment skills and cumulative RN bedside experience has probably saved my orifice more times than not, especially since people don't typically present with the "textbook" symptoms for their disease processes.

linearthinker, DNP, RN · Nov 10, 2010

ITA w/ spacklehead. I am an expert RN, and the transition is very humbling indeed. I admit to being thoroughly biased against NPs that don't have at least 5 years of RN experience before school, so take my opinion with a grain of salt. I personally think it takes most nurses 5 years just to be competent RNs, lol. I have loved NP school, and I'm sad and scared that it's over. I have one clinical day left! I'm supposed to be able to this myself at this point, and if I didn't have 20 years CCU experience, I'd never make it.

I'm dreading looking fro a job, and I'm tempted to stay right where I am and go back for a post grad certificate and delay the inevitable. I have 30,000 RN patient care hours and had 1200 NP clinical hours and it doesn't feel like nearly enough.

ILoveIceCream · Nov 11, 2010

I totally respect the above points-of-view, but I'd like to offer an alternative perspective. I'm a new grad RN now in FNP school and I'm doing great and feeling relatively comfortable with the transitioning role. I went through nursing school knowing I wanted to go straight to NP school, so I kind of tried to soak up as many extra tidbits as possible. I think it really depends on the person. If you want to be an NP, go for it! :)

Trauma Columnist · Nov 11, 2010

No offense to those who did go straight from NS to APN school. School is so waaayyy different than actual practice.

I have 14 years as a nurse (2 years LPN and 12 years RN) with my RN years being ICU and level one trauma center.

To have the decision-making on YOUR head is extremely humbling. And...I'm not known for my tact so here goes - if you are NOT humbled, you WILL make mistakes and mistakes in prescribing, assessments, interpretation of tests can kill pts.

VivaRN · Nov 11, 2010

I didn't have a ton of RN experience before going back to school. I'm another one of those who knew I wanted to be an NP and that's partly why I chose nursing. Haven't had issues. Though I have known people who went straight through who were scary, and also experienced nurses who had a hard time with critical thinking at the provider level. IMHO, it depends more on the person than their years of experience (or lack thereof).

About the stress... it's a different kind of stress. The buck stops with you and you have to make judgment calls with wider implications, often when you're pressed for time. I still ask a lot of questions. Though I have to say I enjoy my job more than I feel stressed. I love interacting with patients as their PCP.

Christen, ANP · Nov 11, 2010

I agree with most of the above. It's a different type of stress. The RN is mandated to do the tasks / therapies / watching out for the pt / etc as ordered. The NP is the one ordering, which is (as stated above) a very humbling and serious job. I went to nursing school with the plan to become a NP, so I took jobs along the way that I thought would help me with that. I started out in critical care with a goal that I would learn a lot quickly and become independent quickly. I took a senior staffing job to learn about leadership and managing a team. By the time I entered NP school, I'd been out 3 - 4 years and was getting bored in my job, and was very ready to go back to school. Getting out of NP school has been humbling - I didn't like feeling like a "new grad" when I was one - and then I got to do it again as a NP! Being the one ordering the therapies, counseling the patients, making sure you don't miss anything or kill anyone is a very different type of feeling / responsibility than that of an RN. You'll know what we mean when you get out. :)

Spacklehead, MSN, NP · Nov 12, 2010

While there may be a few exceptional RN's out there who have gone through their NP programs as new grads and have been successful in their NP careers, I think they are the exception more than the rule.

Not too far into the recent past, reputable NP programs wouldn't even consider a new grad RN for entrance into their progams; however, it seems to be more and more common these days. I also wonder if this is why we are seeing more questioning of our credibility as advanced practice nurses?

firstyearRN · Nov 16, 2010

I would think it would depend on the area you go into? Any truth to this? I just stared NP school after almost a year on the floor and have my sights set on a minute clinic or preferably a relatively low stress environment. Do these exist? Or is it constant doubting and stress from here on out? Thank you in advance for your thoughtful responses. I too am trying to escape the constant chaos of a cardiac floor as a floor nurse.

Trauma Columnist · Nov 16, 2010

As an APN in a Minute Clinic - you are your own - no one to ask questions of, no one to bounce ideas off of, you are alone. Definitely not for new grad NP!