No RN experence NP "non-nurse"

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So the other day I came across an article explaining a term non-nurse nurse practitioner. This refers to nurse practitioners that didnt stop to be RNs before going to NP school. As an aspiring "non-nurse" nurse practitioner, I found this humorous and comforting. Humerous because I could argure for and against. Comforting because there are enough of us for someone to assign us a nickname.

Are there any other non-nurse nurse practitioners out there? How did you do in school and transitioning to practice? How many clinical hours did you get in school? What do you think of NP residencies/fellowships?

Or maybe people should just go to medical school instead of becoming NPs ... If, as many people here advocate, NP programs are going to become v. similar to medical school and residency, why not just do the real thing?

I think this is just a hurtfull thing to say about the NP profession and excludes the possibility of advancement of NP schools

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The qualification for admission to the program, AFAIK, was RN licensure and nursing experience. So, yes, diploma nurses were just as qualified as any other RN. I wouldn't refer to a diploma grad as "sub associate's." Graduates of diploma schools got much better nursing educations than those in associate degree programs. The programs were longer and much more in-depth.

I admit I have no experrnce with diploma/hospital trained RNs. I base this solely on info recieved from my BSN classes that said diploma nurses were regularly pulled from instruction to meet hospital shortages. I suppose a BSN class teaching BSN trained RNs are better than diploma trained RNs has a high possibility for bias.

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I would like to see evidence that supports the quality of care of NPs with no working experience. This may be too new for real evidence to be available but I feel we will see the negative effects of the relaxed schooling in the upcoming decade.

From 2005

Does RN experience relate to NP clinical skills? - PubMed - NCBI

There are more recent studies showing the same thing if you are intrested. I'm sure this is as hard for experenced RNs going to NP, since it breaks the paradigm and common sense knowledge of the last 50+ years. However, MDs are in the same boat looking at studies showing comperable care from their APRNs counterparts.

Other more recent studies look at academic performance of exp vs non-exp RNs. They suggest the longer students are out of school (i.e. More experenced RNs) the harder it is to go back to their previous successful study habits.

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I admit I have no experrnce with diploma/hospital trained RNs. I base this solely on info recieved from my BSN classes that said diploma nurses were regularly pulled from instruction to meet hospital shortages.

Yes, that probably used to happen -- back before, and maybe during, WWII. When I was a student in a diploma school in the early 1980s, we were clearly identified as students. We did clinical rotations in the hospital supervised by our instructors, the same as students in any other kind of nursing program (only several times as many hours as most nursing students get) and were not counted toward staffing on the units. We weren't pulled out of class for anything other than fire drills.

I'm always amused when BSN-prepared nurses with no actual experience, like your instructor, criticize diploma schools on the basis of how they've heard the schools operated generations ago, as if nothing could have changed since then. :rolleyes:

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Specializes in Hospitalist Medicine.
To be honest - what I have seen in reality / practice is that the NPs that never worked as a regular RN or only very limited hours to fulfill BON criteria and instead went straight into the advanced practice role are often not prepared for the advanced role. Some NPs somehow make it but I can see the difference. I have rejected NPs for my children based on the fact that they were incompetent and most of those were very young or very not experienced as a nurse.

But how is this any different than those who go to PA school? They have little to no health care experience (some programs require less than 500 hours HCE and they count working in a lab as HCE), yet they don't have the bad rap about no experience compared to the NPs.

I do agree that NPs need to have some prior nursing experience before going to NP school, but you do need to take in to account the type of experience. Someone who's been an ICU or ED nurse is going to have a whole heck of a lot more knowledge than someone who's been an office nurse.

What I find frustrating is that there are so many paths to NP that it's confusing. MSN or BSN-to-DNP? Direct-entry programs for those who aren't RNs. Full time, part-time, etc. There aren't any part-time PA programs. There's one way to get in and nearly most schools have the same pre-reqs.

ETA: I took all the pre-reqs that would qualify me for med school or a PA program. Organic Chem, Physics, Calculus, etc. Do I think I'll be a better NP because of it? I think Orgo will be helpful for higher level Pharmacology. I don't think Calculus & Physics were as helpful (had 2 semesters each). I chose not to go to med school because at my age, I'd never recoup the investment (over $250K). I can't quit my job to go to PA school (no part-time options and you can't work while in PA school), so that leaves NP as my only option. I became a nurse to be an NP. This is what I want to do. I've been on a critical care unit for a year and now I'm moving to ICU in a few weeks. By the time I start NP school, I'll have 3 years under my belt as a critical care/ICU nurse. I think that's better HCE than most PAs have before they start their programs.

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Residents work almost 80 hours a week, have 4 days off every 4 weeks, and do this for 3-7 years depending on their specialty.

This is very misleading. Some specilities can go as long as 7 years but these are not areas NP currently practice.

If we were compare a FNP to their closest counterpart Family Medicine (FM) we are talking a 3 year residency. I know maximum residency hours have come down in the past, but cant quickly find this information to challenge or support the 80 hr work weeks. My wife is FM and has told me her intern year was heavy but PGY 2 and 3 were not as intense.

Still FM to FNP is apples to oranges because FM spends aprox 1/3 of their time in the hospital, which is in the realm of ACNPs not FNPs.

Further FM residency time is split towards several other specilities that are more or less inline with the FNP speciality. This is a curriculum for FM residency at University of Arizona

Curriculum | Family & Community Medicine

With the emergence of yearlong NP residencies we are not far off from our FM counterparts (still some room for growth). Same could be said for ACNP and Internal Medicine counterparts. I have not compared other NP specilities.

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Yes, that probably used to happen -- back before, and maybe during, WWII. When I was a student in a diploma school in the early 1980s, we were clearly identified as students. We did clinical rotations in the hospital supervised by our instructors, the same as students in any other kind of nursing program (only several times as many hours as most nursing students get) and were not counted toward staffing on the units. We weren't pulled out of class for anything other than fire drills.

I'm always amused when BSN-prepared nurses with no actual experience, like your instructor, criticize diploma schools on the basis of how they've heard the schools operated generations ago, as if nothing could have changed since then. :rolleyes:

It was actually Florence Nightingale era, still I think its clear I have a poor understanding of diploma nursing.

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and having a 2.5 GPA leading into NP school. This is complete garbage. Compare this to PAs and MDs.

Assuming one could get into NP school at 2.5 GPA not just meet the minimum requirements. If this is true I think this is more of a supply demand issue. Schools need to pay instructors etc so they need to fill seats or close the program. If they are acceptung the best applicants and have to go that low I would blame NP salaries. How can we ask RNs (especially experenced RNs that earn near NP rates) to accululate more loans, miss work, and family time to have a small pay bump?

Its no wonder new RNs and low GPA students are applying. I just hope academic standards are high enough to weed out those that would be a threat to patient safety.

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Or maybe people should just go to medical school instead of becoming NPs ... If, as many people here advocate, NP programs are going to become v. similar to medical school and residency, why not just do the real thing?

Medical schools can't keep up with demand. Many are reexploring the 3 year med school model from the 70s and 80s.

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But how is this any different than those who go to PA school? They have little to no health care experience (some programs require less than 500 hours HCE and they count working in a lab as HCE), yet they don't have the bad rap about no experience compared to the NPs.

Sure, and some PA programs don't even require HCE. But, to be fair, PA students go through about 2,000 hours of clinical hours during their program compared to only ~700 in NP programs. As someone with a non-nursing bachelor's, I'm cautious about direct-entry programs and if they'd adequately prepare me as a provider. I'm leaning towards getting into an ADN program, get a couple years of RN work experience, and finally bridging to an NP program.

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Specializes in Hospitalist Medicine.
Sure, and some PA programs don't even require HCE. But, to be fair, PA students go through about 2,000 hours of clinical hours during their program compared to only ~700 in NP programs. As someone with a non-nursing bachelor's, I'm cautious about direct-entry programs and if they'd adequately prepare me as a provider. I'm leaning towards getting into an ADN program, get a couple years of RN work experience, and finally bridging to an NP program.

Absolutely, that's why I got my ADN instead of doing the direct entry route, too. I could get the RN the quickest so I could get experience while working on the BSN. If I do the dual FNP/ACNP DNP (which I would need to work in my hospital's ER), it would have the same number of clinical hours at a PA program.

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Absolutely, that's why I got my ADN instead of doing the direct entry route, too. I could get the RN the quickest so I could get experience while working on the BSN. If I do the dual FNP/ACNP DNP (which I would need to work in my hospital's ER), it would have the same number of clinical hours at a PA program.

That is my career goal as well: ER NP or trauma NP. And I've been leaning towards a dual cert FNP/AG-ACNP program too. However, the PA program in my city is soon switching from a bachelor's to master's degree in the next few years...I may just suck it up and continue accruing CNA/tech HCE and apply later on. It would sure cut my overall tuition costs and years of schooling.

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