NPs with no RN experience: How'd you do?

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Just curious how NP's with little/no experience as a bedside RN felt upon graduation from NP school, and in your first job. Tell me a little about it. Do you feel you would have done better with more bedside experience? Did you sometimes feel behind the curve a little? Or did you feel equally competent as those with years of experience. I know the roles are different, but I wonder what effect it has.

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While I worked as an RN for a while, my classmates that did not were significantly more nervous about starting their new advanced practice nurse role. Really, I think the most important aspect of working as an RN however is not the clinical experience, but rather knowing how to work with patients. In reality, that's what gives me an edge in working with patients over that of the MD's and DO's in my practice...is my ability to work with patients. If you don't get that experience as an RN, you have similar experience as the typical MD or DO student and struggle likewise with communication and general knowledge of what it takes to be a patient.

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I began working as an FNP without any RN experience. My first job was in a walk-in/ family practice clinic. I certainly had a steep learning curve when I graduated but quickly caught up. I working as an NP without any RN experience is totally do-able, especially in the clinic setting.

That being said, it is important to have a supportive work environment with an MD or other NPs/ PAs who are aware you may need some help. Having others around you to help you continue learning is key.

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Specializes in Pediatric Pulmonology and Allergy.

I am an NP who had no RN experience when I graduated. It was not by choice. I went back for my master's only after spending six months fruitlessly searching for an RN job. I know (in retrospect) that six months is not a long time in the scheme of things, and maybe if I had been a bit more patient an RN job would have opened up for me somewhere.

In any event, the area that I feel I'm most lacking is knowing what to do if something "bad" should happen. I can handle routine things, but I have seen very few things that can really go wrong in an office setting and I fear not knowing what to do in an emergency. The advantage of having worked bedside is that you have seen patients who are very sick and you know what "sick" looks like. Sure, I know it by the book but not from first hand experience. I did rotations as an NP student in many different specialty clinics and saw a wide range of conditions, but I have no acute care experience except for my RN rotations.

I also feel I'm circumscribed in what I can do. An NP with acute care RN experience can work in primary care or in patient (separating primary from acute care programs is a relatively recent development, and many jobs will take either degree). I cannot apply for any inpatient job. On the other hand I'm happy with where I am now and feel I'm on track to have a satisfying career. So what if I don't get to do every single thing I ever hoped to do as a nurse.

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Specializes in allergy and asthma, urgent care.
I began working as an FNP without any RN experience. My first job was in a walk-in/ family practice clinic. I certainly had a steep learning curve when I graduated but quickly caught up. I working as an NP without any RN experience is totally do-able, especially in the clinic setting.

That being said, it is important to have a supportive work environment with an MD or other NPs/ PAs who are aware you may need some help. Having others around you to help you continue learning is key.

This^^^. I also had no RN experience when I started as an NP. I think everything erin has said is true. Having a supportive work environment with other clinicians willing to help is really the key to any new NP's success.

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I feel very relieved just reading all of the posts above.

I have a very non-acute care setting RN experience, and have only been a RN 1.5 yrs before getting admitted to the FNP program part time.

Finding a job, and even just receiving a call for an interview at a hospital never happened for me after receiving my license.

Took me a month of daily search, and feared not getting any job at all to pay for my loan back -- and finally found a home health agency who was super short staffed at the time, and took a chance on me... and that's how my nursing career started.

My background include: home health, SNF with some subacute, Public Health, and back to SNF/Rehab as per diem to accommodate school scheduling.

Anyway, all of my classmates have very impressive backgrounds in acute care, and I feel very left out a lot, and at the same time I feel very disadvantaged because I can tell, majority of my classmates make the classes look like cake walk.

I put so much time and effort studying, and trying to keep up, and understand what most of my classmates already know in the back of their hands. I got in the program after all, so I guess I belong in the group, otherwise, I would have been turned away from the program all together.

It is tough. Very tough. And being in the FNP program takes a lot of dedication, and hard, hard work.

Sometimes, I feel I should take a break from school for a year to find (more like desperately find, and beg for) a job that equate to "acute care" so I'd have a more solid knowledge base, instead of just reading about it.

But finding an acute care job in a year, with my lack of acute care background -- seems like a dream, and may not happen; so there's no guarantee.

But, I'm glad to have found this post... it makes me feel better to know that there are RN's with limited or no acute care experience who are making it, and surviving the FNP program, and happy about their decisions.

SlyFoxRN -- it is up to you to pursue NP with limited experience. If you do, you have to really prepare your self mentally & emotionally, and totally buckle up because the FNP program is tough.

I wish you the best!!!

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Specializes in Home Health, Podiatry, Neurology, Case Mgmt.

Thinkingpositive, I am in the process of applying to FNP (always have wanted to work in a family care clinic), although I worked as an LPN for 5 yrs, I never worked in a hospital setting. When I received my ASN/RN, I was picked up as a telephonic case manager for a company contracted to do disease case management for their Humana Gold/Medicare patients. I have never set foot in a hospital as an RN and have been an RN for 18mo now. My background has been LTC/SNF, rehab, home health and clinic work. I know I will have to work harder to grasp some of the acute information during school, but like you said I'll just have to buckle down and go! =) I do not think it's that uncommon for some NP students to not have worked at a hospital. I know the ARNP that I work with never did and she is fantastic with her patients!!!! =0

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For those of you working in the outpatient setting already as NPs who did not work as RNs previously, what advice would you give new NP graduates similar to yourself who are currently interviewing? Are there certain things we should ask employers for before taking a position with respect to orientation / supportive environment? Many primary care physicians have never hired an NP before or hired one years ago so it seems they are not sure what you need. Is it wrong to want some on the job training? And how can I tactfully approach this? I don't want to be thrown in to fend for myself.

I had a physician recently look at me confused when I asked about an orientation during an interview. He expected me to just be up and running and attributed this to my lack of experience (indirectly)..yet even an experienced NP who worked as an RN would need time to figure out how an office runs. Any advice from those who posted????????

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Specializes in Pediatric Pulmonology and Allergy.

I was a new grad who started an NP position in a specialty without having RN experience. I am also the first NP to be hired by this doctor. Is it the ideal situation? No. But it's a tight job market and I took what I could get. I am at this job for six months now. It's a learning process for both of us. He did/does give me a lot of training and I was not expected to manage patients independently right off the bat. He has his way of doing things, how to take history, how to examine patients, how to manage their care. As I get more confident and independent I see more patients alone but with him "looking over my shoulder." He still reviews most of my charts especially if he did not see the patient.

as for the rest... negotiating a contract, getting credentialed, etc. etc., everything is much more complicated with both of us being new to this. If you have a choice in the matter I wouldn't recommend taking such a position as your first NP job...

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Thanks Jeanette for your response! I haven't been offered a position yet (still waiting to hear back on that particular one) so I'm remaining cautious but want to be prepared for future interviews with this doc or other practices. I agree it's a tight job market so can't be too choosy...especially for a new grad with limited experience!!! I'm so anxious about the job search and finding/picking the right match. It's a mix of emotions. It's great that your employer has mentored you (they are not all like that) although it seems a bit overkill to be watching over your shoulder constantly after 6 months of working.

I read some of your other posts and have a few questions for you. Since you're part-time without a contract does the doc provide any health insurance or pay your malpractice? Is your per diem salary competitive? It sounds like you are gaining invaluable skills in a field you enjoy although ready for full-time understandably. I'm wondering if I will be offered part-time too. It seems that it may be the trend with practices...a sort of trial period.

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Specializes in Pediatric Pulmonology and Allergy.

Actually as of this month I am full time! Yay!

I wouldn't say he's constantly looking over my shoulder. But he does read my charts and say, "patient X really needs to be on a daily ICS" or something like that, if he feels I overlooked something. I appreciate when he lets me know these things. It's becoming less and less as time goes on. I'm pretty good with "straight" asthma patients at this point but still a bit lost if patients come in with a new diagnosis or more complicated cases.

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That's great! Congrats!!! It sounds like things are really coming together nicely for your new career.

Is your salary / hourly higher now as full-time or equivalent?

During the part-time period did you have to pay for your own malpractice and health insurance? Sorry to bombard you with questions!

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