People who think they know everything -- or who are not secure enough to admit that they don't -- are a problem in any setting or profession, regardless of the initials they have after their name or how many years of experience they have under their belts. These characteristics are hardly limited to freshly minted NPs.
That said, an NP is not an NP is not an NP. Just like RNs, they have their specialties and education to support them. The problem is, we've got NPs practicing beyond their educational backgrounds. Should an FNP with no experience as a practitioner be able to go to work in an ICU? No. He or she has been educated for primary care, not acute care. Yet we see hospitals across the country putting NPs to work in settings for which they have not been educated.
Nowhere on this thread -- and forgive me if I missed it -- do I see reference to the APRN consensus model for self-regulation or the statement issued in 2010 by LACE. As I understand it, these statements are essentially closing the window on FNPs working in most acute care settings by 2015 unless grandfathered. That will be restricted to NPs specifically educated in acute care. FNPs will still be allowed to work in ED settings when under the direct supervision of an MD. At least, that's how it was explained to me by the head of the NP program in which I am enrolled. (Any clarification or correction is appreciated.) So, as I understand it, part of the problem identified by the OP -- the NP who has neither the education nor the experience to recognize a particular issue, apparently -- is going away.
The other major theme here is how much bedside experience an RN should have before starting the process of becoming an NP. I'm going to risk the same "perfect storm of feces" that Ruby Vee took in her original post and say: none.
I am in my third year as a hospital RN. I completed an accelerated BSN for second-degree students because, though recruited for a three-year entry-to-practice NP program, I agreed with my adviser, who told me no hospital would hire me as an NP without hospital experience. With two years of hospital experience under my belt, I started going to school part-time for my master's degree. By the time I'm finished, I'll have five years of RN experience.
Will that bedside experience be valuable? Absolutely. Is it, however, essential? I don't think so. Without question, experience helps the practitioner to recognize the varying trajectories of illness. But as an NP student, I see that a significant portion of my BSN education, though valuable in itself, is not relevant to learning to diagnose, recognize differentials, and prescribe drugs (and I don't mean to reduce the role of NP solely to those tasks). The RN and the NP play very important roles. But those roles are very different, and they require very different skill sets, something I didn't fully appreciate until I was well into my NP program.
As for listening and learning from others, I'm all for it, no matter what your job or title.
