RN With Limited Bedside Experience - Having Trouble Getting in FNP Program

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Dear Nurse Beth,

Career decisions

I worked for a FQHC Practice for 11yrs. 8yrs as a CMA, 3yrs as a RN. I obtained my ADN because I was functioning too similar to an office nurse and was responsible for training the nurses coming in, the only difference was the pay. I continued to worked in practice as a nurse due to tuition reimbursement requirements.

I had no intentions on leaving but was laid off due to the financial crisis. I took a job as a nurse at a hospital based CAC. Went back to school, obtained my BSN. I love my current job, however I want to go for my FNP.

I've applied to multiple schools and have been denied due to "no bedside experience." I have 3.8 GPA. I was accepted to two online schools but not sure if that's my learning style. I am wondering if going to the bedside would assist me professionally even though I plan to work in family practice.

It seems as though I am not considered a nurse because I am not a floor nurse. Is it too late in my career to switch up? I haven't been at the bedside since clinicals 4yrs ago. Will not having that experience hinder potential employment opportunities after I graduate?

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15 Answers

Specializes in Tele, ICU, Staff Development.

Dear Wants to Be FNP,

What a great goal!

You are wondering about eligibility for an FNP program, and and also future employment as an FNP.

You're having trouble getting into an FNP program because you don't have enough hospital experience. There are many good FNP programs that are direct entry. What I don't know is if they accept RNs, but there are many NPs here on site who I'm sure do know. Have you tried that route?

If you are eligible for direct entry, then I would not spend the next couple of years working as a bedside nurse if your goal is to be an FNP.

My belief is you can be an outstanding FNP without RN bedside experience. Just my opinion.

A future employer is most likely not going to scrutinize your resume to see how much bedside nursing practice you had before obtaining your FNP. I wouldn't spend the next 2 years in bedside nursing on the chance that a future employer will see you as less marketable if you don't have hospital bedside experience. Are you planning to practice in a primary setting?

Either way, you will still have to decide whether you will attend an online program or not. There are some very knowledgeable APRNs here on site who I hope will share their insights with you.

Here's the link to the APRN forum also the link to the student forum: Student FNP. There are some great folks over there with lots of tips for you.

Specializes in Oncology, Med-Surg.

I have heard many FNP's struggle with onine learning and those with limited bedside nursing struggle as FNP's. Med-Surg or clinic work is enormously helpful for being an FNP. Md's complain that FNP's without clinical experience and online training have very poor assessment skills. One of my friends just experienced a huge paycut because of this, as the MD has to scrutinize her assesments, which takes up too much of his time and exposes him to liability. Another nurse I just hired at a home health agency is an FNP working as a staff RN because she felt inadequately prepared to perform as an FNP and is gaining experience in home health. She was a direct-entry having a Biology degree and went for the FNP-DNP route. She couldn't use the DNP for teaching, as in my area they wanted PHD's for this. I am in Milwaukee, however, and we have a ton of brick-and-mortar colleges in the area that are top-notch. So in my area, online FNP's are looked down upon somewhat because employer can pick and choose.

Also, as an person in administration, I have to tell you, those who choose the direct-entry and online FNP's have this fact exploited and are paid substantially less and scrutinized more.

It seems your FQHC background would be adequate, but you may be able to transfer to a position of Urgent Care or triage, which would boost your skills and your confidence.

Don't underestimate your confidence level as a big factor in your early success.

The reason I think many of those who took this route wish they would have went to med school is because they would have been more adequately prepared and better compensated for their time and financial commitment, which is often similar to a FP MD.

Being an NP seems to confer all the disadvantages of an RN and an MD, without the benefits of either. .

Specializes in Family Practice, Med-Surg.

I always felt like I didn't know enough, even after all the experience I had. I became an excellent clinician with great assessment skills, sort of felt like a hit a glass ceiling. I have 2 sons who are physicians, so I am not unrealistic about the educational requirements. In my organization I was required to put in 36 patient contact hours a week, the family practice docs, 24. The docs were entitled to wind down when they neared retirement, NP's no. I was never paid what I was worth. After working there for 17 1/2 years there were times when I needed help I felt the docs were thinking "Why can't she do that yet". Like why does she need help admitting a patient with an abcessed diverticula on Friday night after hours? Because they don't give hospital privileges to NP's.

I started NP school when I was 41, had a husband and 3 school aged kids. Med school would not have been realistic for me at that time.

i think if you are young and have no family, I think med school should be weighed carefully.

There are some college which have online platforms which are identical to the classroom and technology had made this easier than ever. I am currently a student at Simmons College and we have actual online classes which meet once a week, with webcams so you can see your instructors and fellow students. It's set up such that we can also have study groups. I met with other students from all over to study. Just make sure you explore all the options about online schools.

Also, one of my study partners just graduated and is a new RN and is super smart. I think that she might have felt some of the same things about experience.

Not saying you need it but having bedside experience helped me immensely in my NP program. You need a basic knowledge of chronic diseases. I felt like it helped with critical thinking because of my bedside experience.

I do highly recommend getting the bedside experience .... it's invaluable down the line. It's what makes NPs different from PAs is our time spent at the bedside. If you are set on not getting the bedside experience, perhaps look at going the PA route.

Specializes in ER/Tele, Med-Surg, Faculty, Urgent Care.

Please explain what an FQHC practice is, also what is a hospital based CAC. I'm not familiar with those 2 acronyms.

I don't know CAC, but FQHC is Federally Qualified Health Center -- I can't speak to the rest of the country, but in my area the designation covers mostly urgent cares and primary health clinics in inner-city and rural areas.

FQHC = Federally Qualified Health Center

CAC has a bunch of medical-associated meanings, including Children's Acute Care, Children's Asthma Care, Child Advocacy Centers, and Computer Assisted Coding. OP will have to clarify.

Specializes in Pediatrics, Forensic Nursing.

FQHC: Federally Qualified Health Clinic.(Most patients are non-insured, under insured, homeless, undocumented. Majority of funding is provided by the government, 2009 recession hampered government funding, in turn caused large scale layoffs. CAC: Child Advocacy Center, examination of children who may have been the victims of physical or sexaul abuse, neglect and non-accidental trauma.

Specializes in Pediatrics, Forensic Nursing.

I'm in Pittsburgh Pa. All of the local NP programs require at least one yr bedside. I applied to all of them anyway and still turned down or asked to obtain the experience during first semester. I ended up choosing to start at Maryville University Online though I would have preferred a face to face class situation. I didn't want to wait any longer. (Most schools begin cohorts only in the fall). Thank you all for your advice.

You could just do a year at the bedside to meet the requirements. ...or what about the going the PA route? OR you could try the online school and see how it works for you. I was apprehensive about online school as well but so far so good!

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