ConscientiousFNP

My viewpoints and comments come from obtaining an education and experience as a nurse as well as that for a nurse practitioner. The offense that I initially spoke of that some nurses take when having this discussion has been made clear as you have chosen to believe one is saying that you are slow and unable to understand the difference. Instead of considering a different viewpoint, you have chosen to take offense. And this action is precisely what fuels the continued dissension between nurses and nurse practitioners. On the other hand, I considered all that was offered through people's opinions and responses to my post. I thought to myself "wow, that is correct. ACNPs are in the hospitals, but most FNPs are in primary care." However, that realization (not offense-taking) did not change my view of what my role is, where I belong, and what experiences will help me to become an efficient health care provider. Why don't we try this? Why don't we learn to support and build each other up in ways that strengthen the field of nursing. Let's face it. There isn't a whole lot of comradery that exists among the nursing profession as a whole....historically and present day. In fact, it was an MD that came up with the idea of having nurse practitioners, but he said when he saw all the bickering and fighting among the nurses with regard to this, he viewed nurses as antagonistic and decided instead to create the physician assistant. And guess what? These nurses he was trying to train to become nurse practitioners had been working as nurses all their lives, so what ever could have been the problem? How about this? Instead of fighting amongst ourselves on the topic of experience, advocate for what you believe in. If you think that nurse practitioners should have nursing experience first and you feel it is better for our patients, then move this conversation from this post and bring it to you legislatures. Until there is evidence-based practice that can supports your views and opinions, NPs will continue to begin practicing as primary care providers regardless of experience because research, statistics and patient satisfaction surveys have shown that it is highly efficient. I am totally open to evidence-based hypotheses and theories that will influence my decision on how and when to practice. Until such a time, I will operate with regard evidence-based practice and research and will continue to practice healthcare with confidence, pride and understanding that I am making a positive impact in the lives of my patients. If I am supported by nurses and nursing-experienced NPs, great. If not, that is fine too because strong opinions not backed by evidence do not carry that much weight.

What should be understood is that FNPs have credibility and reliability in primary care. Most of the responses to this post are related to NPs that work in hospitals. Perhaps with increased knowledge of the field, the distinctions of the two can be better understood and more accurate judgement made. Primary care is where you find your FNPs, PNPs, and WHNPs and hospitals are where you find your ACNPs. There is a special program for that. That being said, NP programs prepare their students rigorously for whichever track the student is taking. As for FNPs, do we have clinicals in hospitals, well, do you provide PRIMARY CARE in hospitals. No and No. It's just that simple. We are in the office doing WELL patient visits, preventative care and referring to specialties as needed. Once one understands this and understands the difference, they might say "hey, yeah, about that nursing experience....maybe not so helpful there." Furthermore, I worked in outpatient as a nurse because of this whole ridiculous and at times ignorant notion of needing experience and the only thing I got from it is difficulty in switching my mind over from carrying out orders as supportive staff to being the final decision-maker as a Primary Care Provider.

This whole argument about new grads without nursing experience practicing is precisely what is dividing nurses from nurse practitioners in the first place. There seems to be this underlying notion that in order to be a good NP, you need to have nursing experience (which ironically no one who says this can agree on a number of years). It really just doesn't make sense. I mean, becoming an NP is not a promotion from being an RN. It's not charge nurse we are talking about her, it is a totally different career. Should MDs and PAs be nurses before practicing? Absolutely not. Certainly any previous patient care is going to make an MD, PA or NP more knowledgeable or "experienced" as the argument goes. So then when do you start? When a kid is 3 years old? Again, an NP is NOT a senior or graduated RN. NPs do not have to "pay their dues" as RNs first and who is to say the "experience" that is said to make an NP better can only come from working as a nurse? There are a multitude of ways that NPs can gain experience and obtaining an advanced NP education is one of them. Once nurses and nurse practitioners can understand this and work together regardless of credentials and "experience", maybe we'll find ways to work better with patients regardless of our credentials. Isn't that what's important anyway???? Furthermore, if NPs could not provide safe and effective practice without becoming RNs first, why would our government allow it and why would MDs agree to "collaborate" with NPs as opposed to "supervise"....just food for thought. Honestly, I believe that if NPs could go by any other name and drop the word Nurse out of the title, the arguing and bickering over this would stop. Maybe the title could be General Practitioner and then everyone would get along.

Wow! Thanks for this info. You know, I don't come from the school of thought that NPs must have RN experience, but in terms of a SPECIALTY...I do think so. Thanks again for this.

Thank you for this info. Only 1 place has given me a written job description and the others all gave verbal descriptions and benefits information. I'll need to ask for descriptions at the other places next time we meet but in a way that is nonoffensive. Out of curiosity, were the interviews you went on private practices or other institutions. Most of the verbal agreements for my colleagues and I have come from private practices. Also, in terms of doing on-call, what kind of experience might that require....my RN experience is slim - a little over 1 year.

So, I've been on a few interviews now for NP positions that except new grads. I swear from all the preparation for interviews to answer all the common questions, the biggest thing these places seem to be concerned about is money and productivity. Whether I have the skills is not a concern. I have to keep reminding myself that while I am eager and anxious to make the transition into practice, I have to be sure it's with a decent company, and how do I tell? It's like these interviewers see New Grad and think "naive and easy-to-get-over on". It's quite disappointing.....but I'm glad I can in some ways pick that up. Any new grads out there having interviews from places that just seem shady? From like, offering salaries much lower than ranges initially quoted to expanding job requirements to greater than what was initially advertised? (including adding an on-call component?) Some of my colleagues have admonished me to get everything in writing because once they started working where they got hired it was a totally different ball game.