NP w/no desire for RN?

Specialties NP Nursing Q/A

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?

Specializes in CTICU.
Bridge program:

RN---licencse---MSN---boards--NP

only clinical is academic.

No non acadmeic nursing required prior to obtaining np.

Get done with school...pooof... you're an NP.

Well, as long as there's a poof :chuckle

Ok, I'll try to avoid my probably misunderstood sense of humor and get to my point (and it's long). What really happens in during the master's portion of the program is that everybody works (usually full time) as an RN. So really, they have more experience than just clinicals. All the advanced practice programs at my school (save CNM and CRNA) also enroll RNs who took the traditional route. There's no way they are going to stop working. So lectures are usually smashed into one day a week and then 2 days of clinical leaving 4 days free to work. The CNM and CRNA programs have constant clinicals which is why they don't work, however they are getting WAY MORE than 680 clinical hours. (There may be people who don't work but they are definintely few and far between)

Now everyone is welcome to argue that 2 years in not enough experience, but you can no longer argue that these students have no experience and are therefore inadequately prepared. That argument is based on a fallacy and therefore invalid. Furthermore I am tired of this being said by people who have clearly not researched what actually goes on in these programs. I'm still getting over someone being surprized at a specialty having more than the minimum # of clinical hours. It's a minimum, not a maximum. This demonstrates to me that most people just hear about this and don't bother to look into what is actually involved in these programs.

Somewhere someone mentioned that even with 2000 clinical hours you still won't be prepared and need experience (I believe the response was "so what"). Well, you are welcome to that opinion but you can no longer make the comparison between PA clinical hours and NP clinical hours as a reason nursing experience is needed, since the amount of hours would be the same. That's basically saying I don't care if you address my concerns (about limited NP clinical hours) or not, I don't like these programs just because. Unless, of course, you are arguing that everyone (including PA's) needs prior nursing experience despite a large number of clinical hours.

Finally, I really wish everyone could just get along. All the DE students in my program are highly intelligent, hard-working, caring, and motivated people. I would think these people would be welcomed with open arms into the profession of nursing. It's really a shame that they aren't.

What really happens in during the master's portion of the program is that everybody works (usually full time) as an RN. So really, they have more experience than just clinicals. All the advanced practice programs at my school (save CNM and CRNA) also enroll RNs who took the traditional route. There's no way they are going to stop working. So lectures are usually smashed into one day a week and then 2 days of clinical leaving 4 days free to work. The CNM and CRNA programs have constant clinicals which is why they don't work, however they are getting WAY MORE than 680 clinical hours. (There may be people who don't work but they are definintely few and far between)

Now everyone is welcome to argue that 2 years in not enough experience, but you can no longer argue that these students have no experience and are therefore inadequately prepared. That argument is based on a fallacy and therefore invalid.

I'm not trying to throw fuel on the fire here, but I also attended a graduate program which mixed direct entry students and traditional students (I was a traditional, experienced-RN student), and just wanted to make the point that your observations do not apply to ALL direct-entry programs. In my program, the DE students were not even eligible to sit the NCLEX and become licensed as RNs until they completed the second of their three years, and the program was so intense and demanding that only a very few students worked at all, traditional or DE (I worked one shift a week when classes were in session, and full-time during the school breaks/vacations -- anything more than that would have been putting my grades (not to mention my physical and mental health!) at risk -- none of the DE students I knew had any kind of employment at all, in or out of healthcare, and none of the traditional RN students worked more than a few prn shifts here and there). We had two full days of lecture and two days of clinical a week, and plenty of studying & writing to do the other three days.

So, in the case of my alma mater specifically, most (if not all) of the DE students do graduate without having a single day of nursing experience outside their school clinical hours.

Again, I'm not arguing with you, just pointing out that your experience in your program does not apply to all programs.

Specializes in CTICU.
In my program, the DE students were not even eligible to sit the NCLEX and become licensed as RNs until they completed the second of their three years

I'm curious, how do they do NP clinicals without an RN license? I was under the impression that wasn't allowed.

I'm curious, how do they do NP clinicals without an RN license? I was under the impression that wasn't allowed.

I guess that is like doing clinicals to be an RN-you are under the license of your instructor????????? I am in NP school with an RN, but that is the only thing that I can think of Krisssy

.... In my program, the DE students were not even eligible to sit the NCLEX and become licensed as RNs until they completed the second of their three years, and the program was so intense and demanding that only a very few students worked at all, traditional or DE (I worked one shift a week when classes were in session, and full-time during the school breaks/vacations -- anything more than that would have been putting my grades (not to mention my physical and mental health!) at risk -- none of the DE students I knew had any kind of employment at all, in or out of healthcare, and none of the traditional RN students worked more than a few prn shifts here and there). We had two full days of lecture and two days of clinical a week, and plenty of studying & writing to do the other three days.....

:yeahthat:

And if you don't get sufficient financial aid to pay your living expenses (not to mention tuition, &c), or if you don't have a spouse/partner/parent/trust fund paying your way through school, you can't attend this school, or you have to drop from the program when clinical hours, esp. in some of the specialties, become so overwhelming that what with classes, thesis, recovering from call schedules, &c, you simply can't work to support yourself and maintain any kind of decent GPA or sanity. Unless you're one of those rare people who can make it on 4 hours of sleep a night. That is why few RNs apply to this school because they get shorted on aid more than the DE students. Working RNs are working to middle class people without a financial cushion for things like school, yet whose tax returns show them to have an income too large for aid. If you have to work your way through school, forget the luxuries of international health care trips and volunteering with different groups/organizations to pad the resume with and get notice from the faculty (these experiences seem to be the norm these days). Truly a two-tiered system. Which is why state schools are popular with RNs: much cheaper tuition, available federal aid goes much further than with private schools, whoses tuition eats up the $$$$.

Not that it's easy being a DE student, either; I can't imagine doing a basic nursing degree and then jump into a MSN specialty without any real world experience. This takes guts. (Which is probably why I hear anecdotally how many of these grads do work as RNs after graduation, which brings a smile to my face, because I've already put my years into the trenches -- I was ready for advanced practice YEARS ago.)

I'm curious, how do they do NP clinicals without an RN license? I was under the impression that wasn't allowed.

The students are practicing under their preceptor's and the school's licenses and insurance, like when you got your undergraduate nursing experience. The requirements for clinical hours vary by state: in the state this school is in, the students do not get the required hours in during their GEPN year but the state allows them to use their specialty MSN clinical hours towards the BON requirements for taking the NCLEX. Make of this what you will. So they are eligible to take boards in February of their second year (first year specialty).

Other states are different: I hear students in a similar program in NYC can take their boards after the first year and in fact many students will take a leave of absence then in order to work and get a bit of experience under their belt before resuming the program.

And in this state, nurse-midwives don't even have to have a NURSING license. They have to be ELGIBLE for RN licensure: they have to take the NCLEX and pass it but don't need an RN license to be a NURSE midwife. Which probably explains the snotty attitudes of CNMs towards nurses I've encountered in this state on the job, and has greatly contributed to my bad attitude.

Specializes in Education, FP, LNC, Forensics, ED, OB.

And in this state, nurse-midwives don't even have to have a NURSING license. They have to be ELGIBLE for RN licensure: they have to take the NCLEX and pass it but don't need an RN license to be a NURSE midwife. Which probably explains the snotty attitudes of CNMs towards nurses I've encountered in this state on the job, and has greatly contributed to my bad attitude.

Hello, Anon Nurse,

I would love to see the specifics outlined by the state BON regarding a lay midwife sitting for NCLEX. Could you provide that link?

Hello, Anon Nurse,

I would love to see the specifics outlined by the state BON regarding a lay midwife sitting for NCLEX. Could you provide that link?

I should clarify. The term "direct entry" is used in different contexts and is confusing. The students are not lay midwives in a DE/CPM/lay midwifery program (take your pick of nomenclature for non-nurse-midwives) but in a direct-entry 3 year MSN program in which you must have a degree in a non nursing field to enroll. This topic has been debated to death elsewhere on this forum. The students are able to take the NCLEX and obtain nursing licensure in February of the second year of the program -- they get a "certificate" for RN licensure, not a BSN or ADN or diploma, and get an MSN when they finish the program. I think it's strange, too; why not give them a BSN instead of a certificate?

In CT, CNMs don't have to have an actual RN license, but show proof they've passed the NCLEX. I have never heard of this before and do not know of any other states which have this option. This came up in our Professional Issues class.

Here is a URL:

http://64.233.161.104/search?q=cache:szsye9AST4QJ:www.dph.state.ct.us/Licensure/apps/midwife_stats.pdf+cnm+licensure+in+ct&hl=en&gl=us&ct=clnk&cd=1&ie=UTF-8

This entire URL is not showing up in the post. I googled "cnm licensure in connecticut". The first hit is a pdf file of the cnm licensure law which states this.

Have fun in Hawaii!!!

Specializes in Education, FP, LNC, Forensics, ED, OB.
I should clarify. The term "direct entry" is used in different contexts and is confusing. The students are not lay midwives in a DE/CPM/lay midwifery program (take your pick of nomenclature for non-nurse-midwives) but in a direct-entry 3 year MSN program in which you must have a degree in a non nursing field to enroll. This topic has been debated to death elsewhere on this forum. The students are able to take the NCLEX and obtain nursing licensure in February of the second year of the program -- they get a "certificate" for RN licensure, not a BSN or ADN or diploma, and get an MSN when they finish the program. I think it's strange, too; why not give them a BSN instead of a certificate?

In CT, CNMs don't have to have an actual RN license, but show proof they've passed the NCLEX. I have never heard of this before and do not know of any other states which have this option. This came up in our Professional Issues class.

Here is a URL:

http://64.233.161.104/search?q=cache:szsye9AST4QJ:www.dph.state.ct.us/Licensure/apps/midwife_stats.pdf+cnm+licensure+in+ct&hl=en&gl=us&ct=clnk&cd=1&ie=UTF-8

This entire URL is not showing up in the post. I googled "cnm licensure in connecticut". The first hit is a pdf file of the cnm licensure law which states this.

Have fun in Hawaii!!!

Some of these programs DO bestow the BSN upon the individual. Depends upon the program.

But, these individuals are nurses; they are RNs. The CNM is an RN with added education to be a midwife.

If you read the statute again, you will see the individual must be an RN and hold certification from the American College of Nurse-Midwives. The certifying bodies will not accept an applicant who is not an RN.

OTOH - the CPM is not an RN. In Connecticut there are CNM (Certified Nurse Midwives) and the CPM. The CPM handles only homebirths. The CPM quite possibly have "other" education, but not as RN. As of now, there is no licensure in Connecticut for this group of practitioners. These individuals are often referred to as lay midwives, too.

But, these individuals are nurses; they are RNs. The CNM is an RN with added education to be a midwife.

If you read the statute again, you will see the individual must be an RN and hold certification from the American College of Nurse-Midwives. The certifying bodies will not accept an applicant who is not an RN.

As someone going through this whole process right now, maybe I can clarify this a little:

Siri is right - you must have an active RN license to sit for the AMCB (nurse-midwifery) boards. You have to send a notarized copy in with the application.

Anon Nurse is also right - in Connecticut, you do not need to have an active RN license to obtain nurse-midwife licensure. Nurse-midwives are not licensed by the Board of Nursing in Connecticut, BTW, but by the Department of Public Health. Along with proof of ACNM certification, you need to submit a list of any and all states that have issued you a RN license and/or evidence of your nursing school education (if you don't have a CT RN license, you have to submit the nursing school stuff).

So if you move to CT and you've already passed AMCB boards and have your CNM, you don't have to get a CT RN license to be a CNM in the state of Connecticut, and you don't have to maintain one in another state if you don't want to. If you are in midwifery school in CT and plan to practice there, you will have to have or get a current RN license to qualify for the AMCB boards. But it wouldn't have to be from CT.

Becki

....

Siri is right - you must have an active RN license to sit for the AMCB (nurse-midwifery) boards. You have to send a notarized copy in with the application.

Anon Nurse is also right - in Connecticut, you do not need to have an active RN license to obtain nurse-midwife licensure. Nurse-midwives are not licensed by the Board of Nursing in Connecticut, BTW, but by the Department of Public Health. Along with proof of ACNM certification, you need to submit a list of any and all states that have issued you a RN license and/or evidence of your nursing school education (if you don't have a CT RN license, you have to submit the nursing school stuff). ....

Thanks for the clarification, but I was repeating what the teacher of this Prof Issues class told us. She did not even mention this requirement of ACNM that one have an active RN license to take boards. I haven't looked at the ACNM requirements for CNM licensure and wasn't even thinking of those -- you're right. So obviously a DE student from my school would have to obtain a CT RN license in order to sit ACMB boards, but would not have to maintain that licensure, unless they were to leave CT. (Always smart to maintain your original state of licensure because you will need it if you move to another state, and I have known more than a few CNMs working as RNs because they couldn't find CNM jobs.)

I wish the requirements for licensure and endorsements of licensure of RNs, CNMs, any APRN, were uniform across all 50 states. Would be much less confusing.

I have applied to an accelerated BA/BS -> BSN program, planning to start in January 07. I'm 47 and male, BTW, and can't wait to get started on the prereqs. I'm also planning to go straight into the MSN program. The school will allow that, but requires 2,000 hours of clinical experience before students are allowed to enter the clinical phase of the MSN. A friend of mine who is a 30-year nurse just happens to be starting an advanced cert program soon, and has been giving me advice on how to proceed. I'm thinking right now that FNP will be my path, with a focus on community health. However, there are other roles about which I have little knowledge, but sound like they would be interesting and fulfilling. My friend says CRNAs are in big demand, but the job is nerve-wracking. Forensic nursing sounds interesting, and my daughter will be pursuing her BS in Forensics at the same school I'll be attending. Questions, questions!!

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