kadphilly

I agree we need to have stricter criteria from our accrediting bodies, however I don't necessarily believe the RN experience translates well to a better prepared NP, especially in primary care. We recently hired a brand new NP, no RN experience, attended one of the top programs in the country, and her clinical skills and knowledge are stellar. In my experience in precepting, RN experience transfers few skills to NP I propose the following to further our profession. 1) Longer more stringent education, with a "residency-like"program. I think we should be considered "advanced education" nurses, not necessarily "advanced practice." 2) Programs should have strict academic requirements to be admitted. Candidates should be academically advanced. 3) Programs should be required to find appropriate clinical placements for NP students. No more finding placements on your own. Overall, there are far too may programs that accept anyone and everyone. We need to have stricter academic requirements, and attract young, bright individuals into our profession.

It might familarize you with some clinical situations, however, there is a compete different skill set that NP's required to have. For example, I am a PNP primary care. I diagnose otitis media all day long. I have yet to see an NP student yet who could diagnose an Otitis based on RN experience. It's a skill that needs to be developed and can take a considerable amount of time. I precept FNP students also, and in my experience SOME of them are terrified of young infants. Some of them might work inpatient with adults, so how would they feel comfortable? Their RN experience in an inpatient adult cardiac unit has not provided many skills to care for a 2 month old with RSV. Or to help diagnose an 18 month old with autism. My last FNP students flat out told her clinical site visitor that she was never going to take care of infants in anyway, so she really didn't see the point of seeing them in clinical. Except, that's your degree??? You chose to be an FNP. Part of the issue is that the pediatric clinical requirement for FNP students is far too short. I never feel like they have enough of a grasp in peds at the end of the rotation. There needs to be more trainging at the NP level instead of focusing on RN experience.

There is a brick and mortar school near me with a great reputation, however a few years ago, they started an almost completely online NP program. I know a faculty member from this school. She has 2 years experience as an NP and is already grading papers. They do not vet clinical sites, and they don't even do clinical site visits. So they are graduating students that they have never seen examine a real live patient. I see that as severely lacking in adequacy.

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.

Not childish, just a fact. I have plenty of children on my panel, including the children of physicians. I honestly do not want to see anyone who doesn't want to see me. I have said that from the get go.

Don't worry, we don't want to see you either. I already have a 2,000 patient following.

Yes! The culture of nurses eating their young, and the jealousy and pecking order is holding us back. We can do better in supporting our profession.

I would agree with this statement. I have been shocked over the past few years at the quality of some of the FNP students that I have been asked to precept. Some programs seem to accept anyone and everyone, without consideration of their suitability to be an NP. I have refused students from all but two universities because of the incredibly low standards of not only the students but the curriculum itself. Back when I went to NP school about 20 years ago, only those who would consider themselves strong academically would consider even applying. Now, it's just open access. It should still be rigorously competitive to be accepted to NP school.

Yes, self-deprecation is what I meant. Lol. I'll correct the typo. I agree, I don't think that bedside nursing experience has no value, however, I do think that there needs to be more of a focus on actual NP education rather than RN experience. The roles are very different, especially in primary care. And you can assume some level of intelligence based on perhaps where they went to school, but not necessarily by just taking the DE route. I can agree with that. We just hired a DE NP who attended an IVY league school for both undergrad and grad school and graduated with an excellent GPA. She is intelligent. We knew that on paper and it was confirmed by her interview. I have precepted for this school for years and their program is stellar and well deserved of it's top tier ranking. Will it guarantee that she will be a fantastic clinician? No, but it's a good start.

I do not think that inpatient RN experience makes a difference for primary care though. Maybe they should increase the credit hours and clinical hours in NP school. I am a fan of he DNP track, but believe it should be far more clinical based, and that should be the entry level for primary care NPs. Not expecting years of working as an RN, but more training in actual primary care. And I have precepted students from probably 19 different universities, and the quality of the program absolutely makes a difference in the preparedness of the student, without or without RN experience.

Not the OP, but we just specifically hired a brand new NP without experience as an RN because the medical director and physician wanted myself and the other NP/MD staff to train and "mold" them from the get go. And they wanted someone who graduated from a top tier school. They actively sought out someone who was brand new.

I would say it is smart for those who know that they want to be a Primary Care NP to go directly through school if they can. This is what I recommend the to college and high school students that I mentor. And to go to the best school that they can get accepted to and afford. Nurse practitioners should be smart. There is nothing wrong with others saying so. Again, it's a self depreciating of nurses. Our profession is moving forward only to be sabatoged by ourselves. It's an attitude of "who do you think you are going to grad school before you put your time in like the rest of us?" We will never move forward with this mentality.

I think that there is an unfortunate culture in nursing that implies the requirement of "putting your time in." We are really one of the only professions that does so. PT's, PA's, Speech Therapists don't require one to work in the profession prior to continuing on in their professions. Many go straight through to their masters or doctorate level. Sure they might have jobs to pay bills while in school, but not necessarily in their professions. As I have previously stated, I do not believe that for the role of a primary care NP that you need acute care experience. I have precepted for close to 20 years and I have not found that hospital experience necessarily equates to strong primary care skills. If anything, that longer they have been a nurse, I have seen a correlation with having greater difficulty with the autonomy of nurse practitioners. I am far more concerned about the number of programs popping up, especially those that are predominantly online and have a near 100 acceptance rate. Nurse practitioner programs should be very selective, and require high academic and cognitive standards, in additional to strong social and interpersonal skills. And there are far too many programs that require students to find their own preceptors. It makes us look comepletely unorganized and unprofessional. We as a profession should be far more concerned about these issues than direct entry.

We just hired a brand new NP without RN experience. And she was offered the job out of about 6-7 candidates who had experience. She interviewed well and went to a top program undergrad and grad. Ultimately, the MD's at my practice wanted a new grad that they could mold, and someone who went to a strong school. I do t think having RN experience matters in the primary car role.

My contract is up for renewal next year, and I have been told that on-call duties will now be expected for myself and the other 2 NP's in my primary care peds office. The call will be every 6th weekend, with the expectation to see patients on that Saturday for 4 hours, and one weeknight every 2 weeks. Its not a lot, but I have taken call at my first job and I know how disruptive it can be to your life. Can anyone share their experiences on how a salary should be structured with the addition of call?