NP w/no desire for RN?

Well, not so much NO desire...but are there any NP's out there that wanted to become (and had their sights set on being an NP from day 1) an NP with no real 'drive' to be an RN first? My cousin is finishing up her RN-MSN program and never really wanted to become an RN, but she really wanted to become an NP, so she went the RN route to become an NP (which I know you have to do).

I know this is somewhat rare, but wondering are there any other NP's out there that looked at RN as kinda pre-NP school/clinical stuff in order to become an NP? Like, they may not be real thrilled with what they are doing (RN) but they know they have to do it in order to become an NP. Keep in mind I'm not saying you would hate being an RN or hate RN's or anything to that affect, but you dream has been to become an NP and RN school/work is a sort of necessary 'not the most enthusiastic' hurdle?

[zenman]

So, if this diploma was such a wonderful, varied and in-depth form of education, why has it gone by the wayside?

Here you go: http://www.aacn.nche.edu/EdImpact/

[elkpark]

So, if this diploma was such a wonderful, varied and in-depth form of education, why has it gone by the wayside?

"Death by political correctness" -- the ANA and the other PTB in nursing made a big push, starting in the '60s (starting, specifically, with a 1965 ANA position statement on differentiated levels of practice), to move all nursing education into academic settings instead of hospital settings. I have no disagreement with that principle at all -- I just dislike how it's been implemented. I'm shocked at how little new grads know about nursing today compared with what my peers and I knew (and knew how to do) when we graduated.

The irony, to me, is that, in the big push to "professionalize" nursing education and try to make it an academic pursuit, we're going back more and more to "on the job training" (which is what nursing fought so hard to get away from a century ago!) -- all the extended "new grad" orientation programs, "externships," "preceptorships," etc.; hospitals now assume that new grads don't know how to do anything and they're going to have to teach them everything practical they need to know.

[ECMOismygame]

Depending on the setting, there isn't much difference in the roles of NPs and PAs. If you do a web search for jobs, you will find many that advertise "PA/NP wanted," and there is no difference listed in the job or pay based on the educational background. My personal experience has been the same. I've seen PAs & NPs who work in specialty practices where a physician sees every pt behind them. I also know PAs who own their practices, something that NPs are able to do.

I think your best bet will be to explore both professions, the educational processes, and the job settings you are interested in. Then chose the path that speaks most to you.

true. when used in the same setting the NP and PA will most always have the same responsibilities and pay. and yes there are a *few* PAs that own their practices. they hire a supervising MD to do chart review. this is something a NP practice could do also with a collaborating physician, if state law requires.

shadow both and see where you might fit in better. :)

[jhoonk]

[...read everything I could get my hands on...even outside my scope of practice, such as interpretation of xrays, etc.. I'd try to second guess what was going to be done on every patient and why. Couple of my friends did the same thing and the trauma chief asked them to stop ordering labs and tests so his residents could learn something, lol! ]

Thank you, Zenman,

That's exactly what I intend to do and the reason for

getting this job before I start nursing school.

CTs and X-rays can be accessed from computers now

and so cool to look at. Just by standing there and listening to

what Docs and nurses say, I learn new stuff almost

every day. So, it would help whatever I do, RN or NP.

Amitai.

[scooterRN52]

PAs have much more clinical time than NPs, 2,000 hrs plus compared to 600 hrs or so so there is not quite an even comparison.

When I was in the ARMY in 1970,the best officers and leaders were the ones who had the most experience. So who would you want in this life or death situation, a newbie right out of school or someone who had experience under their belt?

If you go straight into NP school WITHOUT any experience, you're just plain dumb no matter how smart you are. You certainly don't have to have 31 years of experience like me, however, consider that I was "learning" along the way. I really don't consider it "punishment" but "educational moments" that others might love to have.

I agree w/ you, how can anyone understand and assess a patients needs w/o

having the experience of an RN, how can they possibly understand what is really going on. I knew one NP that had only nursing home experience, and she ended up doing staff developement in a nursing home. That is pretty sad, don't you think?

[scooterRN52]

"Death by political correctness" -- the ANA and the other PTB in nursing made a big push, starting in the '60s (starting, specifically, with a 1965 ANA position statement on differentiated levels of practice), to move all nursing education into academic settings instead of hospital settings. I have no disagreement with that principle at all -- I just dislike how it's been implemented. I'm shocked at how little new grads know about nursing today compared with what my peers and I knew (and knew how to do) when we graduated.

The irony, to me, is that, in the big push to "professionalize" nursing education and try to make it an academic pursuit, we're going back more and more to "on the job training" (which is what nursing fought so hard to get away from a century ago!) -- all the extended "new grad" orientation programs, "externships," "preceptorships," etc.; hospitals now assume that new grads don't know how to do anything and they're going to have to teach them everything practical they need to know.

You are so right!!! I see new grads every year in the hospital I work in and I

wonder what they teach them, I went to an LPN hospital program and then 2

years later I graduated from an ADN program. To be honest I learned more in the hospital program as far as skills went. The 2 year college program

evened things out w/ the chemistry, A&P, and micro biology classes.

These new nurses don't even know where to give an IM injection and why to give it there, among the other many things an RN needs to know.

I think the orientation time and preceptorship time is too long, but considering how little they know coming out f school, I guess they need it.:rotfl:

[krisssy]

You are so right!!! I see new grads every year in the hospital I work in and I

wonder what they teach them, I went to an LPN hospital program and then 2

years later I graduated from an ADN program. To be honest I learned more in the hospital program as far as skills went. The 2 year college program

evened things out w/ the chemistry, A&P, and micro biology classes.

These new nurses don't even know where to give an IM injection and why to give it there, among the other many things an RN needs to know.

I think the orientation time and preceptorship time is too long, but considering how little they know coming out f school, I guess they need it.:rotfl:

Firstly, sorry to repeat certain things for those who have heard my story over and over !!!!!! As I keep repeating it and getting more and more feedback, it helps me a lot.

When I graduated from college with a BSN in 1969, I DID NOT feel qualified to work in a hospital. So I took the easy way out and worked as a school nurse teacher for 2 years. I was then offered a teaching job and took it. I was a fabulous teacher . Although I did get my MA in ed. , I learned everything on the job. Upon retiring, I became very ill with PTSD and was hospitalized. At that time, I decided that I wanted to be a psychiatric nurse. I took an acute med surg refresher course with clinicals, and I loved it. I am starting NP school for my psych nurse practitioner degree in Jan. I have been actively taking part in this discussion thread, and I really see both points of view. Although I loved teaching at the time, there is a part of me that wishes I had gone to the diploma hospital based nursing school that I was originally planning on going to. I think I would have learned great skills there, and then I could have gone for my BSN. My upcoming program involves 42-45 theory credits and 500 hours in a supervised clinical practicuum. If I can find a manager that will hire me to work on a psych unit as a staff psych RN, I will do that part time while I am going to school. It is hard to get a job WITHOUT EXPERIENCE. At least in my clinicals, i will get EXPERIENCE. I did what I did, and I can't turn back the clocks. But right now I am doing what I really want to do, and I will never take a job that I am not qualified for. If I go all through this and don't feel qualified, I will be happy to be a staff psych nurse until I feel qualified to work as a NP. I want to help people with mental illness and chemical dependency and alcoholism, and that goal makes me very happy. Personally, I cannot get the experience first as I have just explained. Anyway, starting in Jan., and I am open to all suggestions. I think there is a grey area here, and as I have matured I do think in less black and white terms. There are two sides to this discussion and individual differences that need to be taken into consideration. These differences include goals, personality, type of NP you are looking to be, age, experiences, motivations etc. As I have already stated, we can help eachother by giving supportive advice and suggestions.

[Jayla]

You are so right!!! I see new grads every year in the hospital I work in and I

wonder what they teach them, I went to an LPN hospital program and then 2

years later I graduated from an ADN program. To be honest I learned more in the hospital program as far as skills went. The 2 year college program

evened things out w/ the chemistry, A&P, and micro biology classes.

These new nurses don't even know where to give an IM injection and why to give it there, among the other many things an RN needs to know.

I think the orientation time and preceptorship time is too long, but considering how little they know coming out f school, I guess they need it.:rotfl:

Just graduated inn 2004 from a BSN program and I actually do know where to give IM injections (among many other things). Besides, this thread is not about BSN vs. Associates degree vs. Dimploma nurses. It's about RN experience prior to starting an FNP program.

[rnmaven]

I am in NP school right now. I worked as an RN first and loved it, but grew tired of not having any autonomy. It is my understanding that most schools require at least 2 years of ER or critical care experience before you apply. I may be wrong though. Another tidbit, several nursing organizations are pushing for the NP degree to be a Doctorate. It would be a Doctorate of clinical practice. They are pushing for this by the year 2015. Won' t the MDs be happy!

I agree that in order to enter a NP school the RN should have a good solid foundation in experience at the bedside. That experience is invaluable in creating a foundation upon which an advanced practice is built. You will be a better autonomous clinician and more secure in your individual decision making abilities.

Re: the doctorate degree. I agree that this should be the way to go. Look at Physical Therapy........also now a DPT for practice. If the profession's goal is autonomy and direct access then the clinical doctorate is the way to go. I'm all for advancing the profession and I believe that life experience (clinical) combined with education is the way to go! I've practiced at the bedside (in varying degrees) for 28 years. Just finished my MSN and am considering taking post masters courses for Geriatric NP. I would have no problem if someone encouraged me to also have a Doctorate. The more education I cram into my brain, the less room there is for Alzheimers to develop!:wink2:

[rnmaven]

So, if this diploma was such a wonderful, varied and in-depth form of education, why has it gone by the wayside?

I don't know the exact numbers, but diploma schools do still exist in the US. My almamater, Muhlenberg Hospital School of Nursing is still alive and well. Back in 1974 they had the vision to collaborate with an associate degree program and at least give you some credits to apply towards your BSN.

The program has evolved and certainly meets the needs of the community it serves. Times have changed and there aren't as many HS graduates moving into the dorms and spending 3 (full) years "training". I believe that as parents' educational levels have increased over the years, more and more parents encourage their children to go straight to a BSN route for their education.

I believe that most diploma schools that have survived have found their niche in serving the adult learner who needs a bridge into nursing. Either they are changing careers, or perhaps and LPN who wants to become an RN but can't afford the full time commitment or dollars a university setting involves. Additionally, not ALL students of nursing aspire to "beyond the bedside." Certainly, when I graduated HS, I thought that I wanted to be a nurse and nursing to me was a career caring for patients in a hospital setting.

Diploma schools have not gone by the wayside entirely......the strongest ones will most likely continue to survive.

[ECMOismygame]

to all the NPs who say previous experience is essential.......i beg of you to talk some sense into anyone you know who wants to be a PA.

both PAs and NPs go through accelerated programs in order to be health care providers, this assuming that they have SIGNIFICANT medical experience, RN, RT, Paramedic, etc. (this is why NP and PA programs arent 4 years long and dont require residency, the residency is the first few yrs of practice)

all non-MD providers should have a good foundation in the medical field, no matter what arena they come from.

that is the reason why the NP is first a RN, in order to obtain that experience. otherwise NP would be a direct entry and one would not have to be a RN right?

i only wish MORE PA programs would see how valuble prior experience is, and take NP programs as an example. they should learn from NP programs which all require at least RN licensure. even a green RN entering NP school is better than a bio major w/o exp entering PA school, b/c they know how to take a BP, start an IV, know basic pharm, feel comfortable with pts, etc, etc. plz try to convince any pre-PA to obtain medical experience or instead convince them to go to nursing school. this is where the NPs have the upper hand and i hope they continue to demand at least 1 yr of experience. this country needs competent health care providers, not watered down providers.

b4 flaming, i do believe that some people can make good health care providers w/o previous experience, but that is not the norm, and also there is a greater learning curve.

[elkpark]

that is the reason why the NP is first a RN, in order to obtain that experience. otherwise NP would be a direct entry and one would not have to be a RN right?

But there are plenty of direct-entry NP programs, which take people who aren't nurses but have baccalaureate degrees in something else, people who have no healthcare experience at all ...

Another tidbit, several nursing organizations are pushing for the NP degree to be a Doctorate. It would be a Doctorate of clinical practice. They are pushing for this by the year 2015. Won' t the MDs be happy!

I am willing to bet a great deal of money that the docs couldn't care less -- nor will anyone else outside of nursing. The MD is the entry into practicing medicine, not a terminal degree that only a tiny percentage of practitioners ever achieve ... They will certainly still not consider any nurses to be their equals or equivalents. (Even) a clinical doctorate in nursing still represents just a fraction of the time, effort, and study that docs put into becoming MDs. And (as I've said before), as long as you can become a Registered Nurse with (just) an Associate's degree, we will never really be taken seriously as professionals by any of the real professions.