Nurse Practitioner Route: No RN Experience?

[meganec17]

Hi! I am getting way ahead of myself, but here goes nothing. I am currently a second year BSN student, with TONS to learn. My goal has always been to become a nurse practitioner in a primary care setting (either FNP or Pediatrics). I also would like to do primary care because of a pre-existing back injury.

I was wondering if I will be able to enter NP school directly after I (hopefully) recieve my RN licenses? Do I need experiece for all programs, or is it just recommended? I would like to do it directly after I get my bachelors for a few reasons: I am a bit worried about bedside nursing with my back (clinicals are going ok right now). I also worry that I will not want to go back to school when I am a bit older, I would rather finish it sooner rather than later.

Any advice and/or personal experience would be greatly appreciated! Thanks! :)

[Mavrick, BSN, RN]

Huh?

Apparently, a lot of people. See the OP and allnurses for more examples.

The NP education, as it is, expects the nurse to come in with a notable amount of experience. The scant amount of clinical hours in most NP programs is laughable in comparison to PA/MD schools.

OOps, Sorry PB. I was quoting you to AGREE that it is ridiculous to practice advanced without the basics.

The "you" I was referring to was the OP who wanted to become a Nurse Practitioner without having any experience as a nurse because it was inconvenient.

She is pretty young in the field and was just asking but it really shows how little people know about Nurse Practioners.

[OliverElio87, BSN, RN]

I am hoping to be an NP also, but to compare clinical hours of NP to PA/MD is worthless. I feel that NP's should have more clinical hours (if you do not have a certain amount of RN experience). PA's have more than triple the amount of clinical hours and MD's have god-knows how many.

It is scary to think that some NP's, with no health-care experience, can be an NP and practice autonomously in some states is SCARY.

[BostonFNP, APRN]

This question has been asked and debated many, many times. If you are interested, OP, do a quick search and you can get all sorts of information for both sides of the issue.

My two cents having worked as a NP and having precepted and taught many student NPs (and medical students): it is very much based on the individual. I have had student NPs with no RN experience perform very well and I have had students that couldn't pass; likewise I have had nurses with more than 20 years experience that couldn't pass clinically (honest truth my most challenging student ever was an ICU nurse of 27 years who just couldn't adjust to the provider role and clinic setting enough be safe to pass).

Most of the students I have taught have been in the middle; they could benefit or did benefit from some RN experience. My opinion is that RN experience is most helpful in navigating the healthcare system and being comfortable/confident in interviewing/assessing patients. It has been my experience that some aspects of RN experience can actually be a double-edged sword in NP preparation.

I think RN experience is very helpful in the specialty settings (provided that the RN experience and NP position are in the same specialty).

I also feel that direct-entry students bring some bright motivated people to nursing that might have ended up in another branch of healthcare if not for the DE programs. The DE program at the school I am involved with has admission selectivity that is more than double that of their RN or MSN programs.

FWIW I also don't think any novice provider (NP, MD, DO, PA) should be entering into independent practice; everyone needs collaboration, at least in their first years, and hopefully though their whole career.

Best of luck!

Also remember that PA and MD clinical training is also not 1:1 like NP training is, and it is spread out across specialties that may or may not be relevant to the ultimate practice role (i.e a psych PA may only have 100 hours in psych training where a PMHNP has 600-1000).

[KatieMI, BSN, MSN, RN]

In all honesty, when you hear that MDs spend like 120 hours every week working during their residency training, you need to divide that by 3.

Medical residency is awfully ineffective because teaching facility receives "x"% of $$$ given by Medicare for the fact of a future doctor being trained there. Therefore, residents function as cheap workhorses at least 2/3 of their training time. They do insane amount of paperwork, "call consults", hunt attendings and each other, "round" forever listening to everything from old "war stories" to personal opinions, do admissions/discharges (important but one needs to be a clinical idiot in order not to learn how to do that in one year), do everything nurses "are not comfortable with" (blood draws on aggressive patients, for example). I'd seen them doing online shopping for attendings and one time a whole bunch of them was sent, after a night on call, to a LTC 50 miles away with the mission of finding the tip of a PICC line which was pulled out a week before. Guess the attending supposed that that thing was kept as a precious keepsake.

The fact that quite many PAs get to the level of independently running a medical floor in just one year or so post school speaks volumes about "best training in tge world" American doctors supposedly receive.

[KatieMI, BSN, MSN, RN]

BostonFNP, totally agree.

I have several coworkers who did not succeed in NP programs in spite of nursing since Florence was roaming halls. They are great at where they are, but they seem to be physically unable to think beyond rules, policies, and the holy "we're always do it this way" mantra.

[applesxoranges, BSN, RN]

There are direct entry NP programs. I think it also depends on what experiences you have and how you sell yourself. It also depends on how you learn. However, you have to be able to find clinical sites. A lot of schools that claim they find clinicals do not guarantee clinical sites. At least this is the trend in my area. The main school that has a NP program in a brick-and-mortar does not provide clinicals. I am glad I did not buy into that fear and went there instead of my current school.

Having work experience can only help, however it also depends on where you work.

[BostonFNP, APRN]

A lot of schools that claim they find clinicals do not guarantee clinical sites. At least this is the trend in my area.

Sadly it's a trend everywhere and it needs to be stopped.

[NeldaFNP]

So... Being that PA's and NP's are fairly close in roles.. PA's aren't required to have bedside experiences are they?? Neither are MD's even! But I'm pretty sure Ohio State is one that does not require RN experience to begin NP clinicals

Medical school and PA school require many, many, many more hours. Most NP coursework only requires 500 hours total because they are basing a lot of the experience on previous RN experience. PAs may have 400 hours in just one rotation, so there is a HUGE difference in what they are exposed to in clinical. I think they have closer to 2000 hours total, the equivalent to one year of work, 40 hours a Week.

As as a previous poster noted, you will find Afro profit school that will accept you and your money. But you are not doing yourself nor the profession a favor, so I hope you don't consider it. I will not even give students a recommendation if they are going to a school,like that because I think it is a bad idea for the profession and the person.

[chiromed0]

I don't think that would be a great decision for you unless you have other healthcare experience. I think the comment about PA's/Physicians practicing medicine and NP's practicing advanced nursing is correct. However, most of the time you are practicing medicine, like it or not depending on your work environmnt. Doesn't mean you can't do it, just a suggestion you shouldn't do it but it's your call. You could be just fine-only you will know. Like the others said there probably is a program somewhere. Just look for it, there are a bazillion for now.

[SamanthaKelly]

I went straight from RN tho MSN FNP. YOU DONT NEED BEDSIDE CARE. PA only needs a BS and they do the same thing and they have no experience I have done the South University Online program. Good Luck and go for it

[staphylococci, NP]

As previous posters have already stated, there are programs out there that will accept students without RN experience. I attend a brick-and-mortar school affiliated with a major academic medical center that will accept students into the FNP and AGPCNP programs without previous RN experience. However, applicants with RN experience are preferred over those who do not. The more experience, the more likely to be accepted into program.

I also don't see the rush with every new grad RN wanting to go back to graduate school for one of the APN roles. OP, try to enjoy your first job as an RN and soak up everything you can. There's so much to learn and experience out there! You may discover opportunities away from the bedside as a BSN-prepared RN that you absolutely enjoy. Don't discredit those opportunities just yet! Bedside nursing has taught me a lot about myself, what my strengths and weaknesses are, and where my interests lie. During my BSN program, I was really interested in becoming an AGACNP some day. Working in the MICU and with our AGACNPs, I learned that I wasn't really as passionate about critical care or acute care as I thought I was. I realized that I was more interested in primary care and family medicine as I saw what patients and families went through during their stay in the ICU. Also, some very senior nurses with whom I work greatly encouraged and pushed me to attend graduate school. So, here am I attending a FNP program part time and am absolutely loving it!

[BlackBettyRN,OCN]

Here's my advice, and you can take it for whatever it's worth: do whatever you feel is best for you. If you are a self-motivated student who goes above and beyond to learn, and you know that this is what you want, then just do it.

Because the truth of the matter is, someone out there will always have a negative opinion of your choices. You can't please everyone. You go straight into APN school, and someone will tell you that you are too young and inexperienced to become a provider; you're barely a nurse! If you wait until you are an experienced RN, there will be someone else telling you that you are too set in your ways, you are stuck in "nurse mode", and you can't adapt to the provider role. You can't please everyone. You know what kind of student, learner, and nurse you are, so do what you feel is right.