You don't need RN experience to get an NP job

Specialties NP

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I'm a new grad Adult and Geri Primary Care NP. I do not have RN experience. Since I started seriously pounding the pavement in my job search, I have had numerous phone and in person interviews. I've also received multiple job offers.

Has anyone asked me if I had RN experience? Yes. When I answer that I have none, here are the 2 responses I've received:

"Good for you!"

"You must be very smart."

This will probably upset some readers, but it's the truth.

There are some job postings for new grad NPs for outpatient specialty positions that do require RN experience - oncology is one.

Conclusion: if you want to be a Primary Care NP, you are fine going straight from BSN to MSN. There are plenty of employers that will be happy to have you, at least in the Western U.S.

Not all programs require it. I've seen a couple ACNP programs that don't require it.

I almost hate to agree, but I have to. As an RN for 13 years who then became an NP, I can't imagine how nursing experience directly effects one's ability to provide primary care. They are two quite different animals, with very little overlap.

Psychiatry is different. I can't imagine starting my first Psych NP job and only having school clinicals under my belt. Ludicrous. There are too many pitfalls, gray areas, judgement calls, drug and disability seekers, and malingerers. One rarely receives previous records or good collateral information. When you do receive records, they are, often as not, inaccurate and incomplete. I cannot tell you how often intellectually disabled people are diagnosed as schizophrenic. The person will come to your office and give their version of a story. You will have 15 minutes to ferret out the truth. Otherwise you will just be handing out drugs without having the slightest idea what you are doing, but if you order benzodiazepenes and Adderall , you'll be popular.

There was a major lawsuit against a top 10 university a few years back. A male student had done well enough in high school to gain admission to such an elite place, but had never been diagnosed with ADHD as a child. When he got to school, he suddenly was a small fish in a big pond, so he went to the Health Center and got a prescription from an NP for Adderall. It was easy to obtain, in most places you only have to rattle off the symptoms, which of course are found on the Internet. A couple of months later, that didn't seem to be enough, so Wellbutrin, a stimulating antidepressant was added without any apparent investigation into the causes of the problem. Perhaps the young man needed counseling to adjust his expectations. That wasn't enough, so Prozac was added on top of it. The young man ended up committing suicide.

Yes there are many unanswered questions here. Did he have an underlying depression? Was the competition of such a school too stressful? Did the prescription of three stimulating drugs have anything to do with his suicide? His parents sued the school. The NP didn't lose her license but no longer works there. They investigated her supervising or collaborative physician and found they were in compliance with state guidelines.

I have had patients die directly from the effects of drugs, so I have some idea of what it feels like, but the treatment I prescribed was completely appropriate. Was hers? I very much doubt it.

I should have been more clear in recent post with respect to programs not requiring experience. Yes, I am referring to the specialty NP areas and yes,there are programs that do require RN experience.

Thank you for your comments. I welcome new grads and even though it was now almost 29 years ago, I remember what it felt like to be new. It is not the new grad I am worried about. It is the new NP who feels they already know it all and don't have a learning spirit. They have to be willing, open and approachable learners who can resist saying "I know". I can tell you these type of new NP's are hard to find. Thank you though for sharing your point of view!!

I merely reported facts. I was very surprised at these comments and I didn't take them so seriously. And these comments occurred multiple times, not just once each. My intent was to provide a realistic picture of the job search market for new grad NPs in the Western US - California, Oregon, Nevada, Arizona, New Mexico, Hawaii, and Montana - all states in which I interviewed. I also stated that my post would probably upset some people, as it clearly has.

Fair enough; not upset. I thought there was something more to the two responses you chose to relay - which were "good for you!" and "you must be very smart" (because you're a DE grad) - but you say your intentions were honorable so we'll leave it at that.

Take care ~

Specializes in Emergency Room.

I have seen graduates from DE online programs receive offers quickly while some high ranking brick and mortar graduates struggled for over a year before finding a position.

Many things factor in such as a good resume, work and volunteer experience as well as networking opportunities. Some new NPs pass over jobs because it doesn't meet their lifestyle needs in terms of work schedule, pay etc.

I don't believe you need extensive RN experience at all to be a good NP. However, I do believe NP experience will always be more favorable. An HR representative told me that the reason why new NPs get overlooked for positions is because they continue to represent themselves as RNs instead of providers and the hiring managers view this as a person that will be difficult to train and not ready for the major responsibility that comes with being a NP.

An HR representative told me that the reason why new NPs get overlooked for positions is because they continue to represent themselves as RNs instead of providers and the hiring managers view this as a person that will be difficult to train and not ready for the major responsibility that comes with being a NP.

Yes! I have seen a lot of new NP's who highlight their RN experience to perspective employers rather than their NP education and clinical experience.

In my experience in hiring NP's, the strength and prestige of the program and the clinical experience are always more important than RN experience.

Specializes in New Critical care NP, Critical care, Med-surg, LTC.

Just like anything else, there's no one size fits all. For those that are able to go the direct NP route, I'm sure many are successful and some are not. For those that go a more traditional route of returning to school after gaining RN experience, I'm sure that many are successful and some are not. And almost everyone that does something in life finds that it is what worked best for them. I don't make assumptions about someone's intelligence or ability to succeed until I work with them. I've worked with graduates from Harvard and Yale that could barely work with other people and were not successful in their (non-nursing) careers. And I've worked with awesome coworkers that went to community colleges. People make the best of the opportunities they have in life, and you can find success in many ways. I'm not really sure why some people here are so bent on convincing everyone else that their idea of the best way, is everyone's best way.

Specializes in SICU,CTICU,PACU.

i CANNOT imagine being an NP without RN experience. thats all i have to say.

You don't have to imagine it. Its a reality that happens daily. Sometimes to good effect sometimes to bad. For good or bad states grant NP's licenses to practice based upon their list of qualifications. Like it or hate it. It's a reality and hating it is an option & your opinion but it seems that opinion doesn't count for much as the distractors don't get a vote.

Yes! I have seen a lot of new NP's who highlight their RN experience to perspective employers rather than their NP education and clinical experience.

In my experience in hiring NP's, the strength and prestige of the program and the clinical experience are always more important than RN experience.

So that's another problem in and of itself, right? RN training/work absolutely does not substitute for NP training - that should be obvious to everyone. But it's not obvious to everyone. And NP schools do nothing but perpetuate this problem. More time should be required training at the provider level. Some programs require ~500 hours. That's 12 weeks if you did it full time. 3 months. So you receive more clinical training at the RN level than the NP level - where you are expected to work up a patient, make a diagnosis and prescribe treatment. You are expected to lead the healthcare team. Further, so many schools do not vet the preceptors or clinical sites found by the NP student (as they are expected to find these experiences on their own), and the student ends up with essentially a shadowing experience. So you have poor didactic education with 3 months worth of shadowing and the person is let loose. But we want independent practice. Come on.

We need to standardize NP education. One accrediting body. Stricter standards for entry and progression through programs. Shut down the 100% fully online programs with no oversight of their students (i.e. open book testing, no lectures, finding their own preceptors who are not vetted by the school, etc). Flesh out the didactic training and significantly increase required clinical hours.

I think so many candidates from poor schools are forced to rely on RN experience because to highlight their NP education would be disastrous during employment applications.

To be fair, I don't see how nursing experience would help an outpatient primary care provider that much.

So that's another problem in and of itself, right? RN training/work absolutely does not substitute for NP training - that should be obvious to everyone. But it's not obvious to everyone. And NP schools do nothing but perpetuate this problem. More time should be required training at the provider level. Some programs require ~500 hours. That's 12 weeks if you did it full time. 3 months. So you receive more clinical training at the RN level than the NP level - where you are expected to work up a patient, make a diagnosis and prescribe treatment. You are expected to lead the healthcare team. Further, so many schools do not vet the preceptors or clinical sites found by the NP student (as they are expected to find these experiences on their own), and the student ends up with essentially a shadowing experience. So you have poor didactic education with 3 months worth of shadowing and the person is let loose. But we want independent practice. Come on.

We need to standardize NP education. One accrediting body. Stricter standards for entry and progression through programs. Shut down the 100% fully online programs with no oversight of their students (i.e. open book testing, no lectures, finding their own preceptors who are not vetted by the school, etc). Flesh out the didactic training and significantly increase required clinical hours.

I think so many candidates from poor schools are forced to rely on RN experience because to highlight their NP education would be disastrous during employment applications.

Just out of curiosity, which online schools meet that low level criteria? I just graduated from frontier and can say at least from that they seem to have far stricter requirements than what you suggest. Proceed exams, more clinical hours than university of Michigan (680 to u of m 500), and while I had to find my own preceptor, they had to vet every one and see me actually working at my clinical sites.

As someone else noted, everyone here course as path and maybe some have too strong an opinion regarding that path. I do worry that you lose the nurse aspect when you go direct entry. But that doesn't meant they will lose the ability to be a great provider. Primary care will be a whole new world for me given my periop and pain background, but it makes me more motivated to succeed.

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