I was having lunch with several NP colleagues and as we were lamenting the lack of actual nursing experience in so many of the students we get asked, and refuse, to precept one of them shared something that of course I had always suspected but to know that it is a blatant direction makes me sick. Apparently his university, which is part of a very well known, enormous teaching hospital is pushing the direct entry programs because the philosophy is to keep the money coming in while the student is there rather than take the chance they will graduate and for whatever reason not return to grad school or go to another grad school. No consideration for the value of actually working as a nurse.
Not that I didn't suspect this with the whole push for DNP which is only at this point is only being driven by the universities not my board of nursing. Good business I guess but I'm worried about the quality of NPs going forward.
Your thoughts and experiences with direct entry practitioners?
There are absolutely exceptions to every rule. It is just tough for me to imagine going through the program and staring farther behind than I already was as a fairly new RN. Now I am curious how the RN thing worked. What did yall do before you took the NCLEX? A down and dirty RN program?? I am not trying to be overly critical...just genuinely curious! How far into the program did you take the NCLEX?
What do you mean by a "down and dirty" RN program? Our RN portion of the program was the same as any ADN program (I do not have a BSN). We had to have the basic science pre-reqs (A+P, chemistry, micro, etc) finished before we could even apply to the DE program. We all had at least a Bachelors in another discipline, so we didn't have to take any of the Gen Ed courses. We took Health Assessment, Theory, Patho, Pharm, Ethics, Research, etc. and did the same number of clinical hours and synthesis as the undergrad BSN students. We took NCLEX after all of those requirements were completed, just like any other RN student.
I don't feel like I started "further behind" as an NP because I didn't work as an RN. To be honest, I use very little of what I learned in the RN part of my program. I'm not saying it wasn't valuable and necessary, but most of it isn't relevant to what I do on a daily basis.
I am not the least surprised about this. Back when these direct entry APN programs were brand new, a lot of the students accepted expensive and coveted training from area hospitals. They did this despite knowing full well that they would be leaving after a year or less. This caused a lot of hard feelings among unit managers and their staff. We had several who accepted positions in our critical care nurse residency program. Its an intense 9 month training program that takes news grads and turns them into competent entry level ICU, ER, L&D, PACU, or PICU RN. Initially our managers where excited to hire these direct entry RNs, not understanding that their program would require them to return in 9 to 12 months for the APN portion of their program.
After that experience our managers refused to hire any direct entry new grads. At the time there was confusion about direct entry RN MSN programs and direct entry APN programs.
i completely agree with what you're saying. None of us were looking for hospital positions We were more interested in part time positions in clinics, community health centers, and LTC. I was planning on doing my NP program part time if I was able to get one of those jobs, and then I would have stayed for at least 2-3 years while completing my schooling. That didn't happen, so I continued full time, and was hired as an NP right out of school.
Specializes in Cardiac, Home Health, Primary Care.
What do you mean by a "down and dirty" RN program? Our RN portion of the program was the same as any ADN program (I do not have a BSN). We had to have the basic science pre-reqs (A+P, chemistry, micro, etc) finished before we could even apply to the DE program. We all had at least a Bachelors in another discipline, so we didn't have to take any of the Gen Ed courses. We took Health Assessment, Theory, Patho, Pharm, Ethics, Research, etc. and did the same number of clinical hours and synthesis as the undergrad BSN students. We took NCLEX after all of those requirements were completed, just like any other RN student.
I don't feel like I started "further behind" as an NP because I didn't work as an RN. To be honest, I use very little of what I learned in the RN part of my program. I'm not saying it wasn't valuable and necessary, but most of it isn't relevant to what I do on a daily basis.
That's what I had no idea about. If there was kind of a separate part or what exactly. There aren't really direct entry programs in my state and I didn't look/consider any out of state. Thanks for answering!
EDIT: By "down and dirty" I was wondering if it was kind of an accelerated type program or a full type program or what. Forgot to add that clarification
I don't feel like I started "further behind" as an NP because I didn't work as an RN. To be honest, I use very little of what I learned in the RN part of my program. I'm not saying it wasn't valuable and necessary, but most of it isn't relevant to what I do on a daily basis.
I guess I just wonder why the need for the education of a Registered Nurse if, as you say, you use very little of that education as a Nurse Practitioner. Again, this is merely my opinion, but I can't help but feel like these Direct Entry programs and those who admit nurses who have never practiced as nurses are leaving the Nurse out of Nurse Practitioner.
What do you mean by a "down and dirty" RN program? Our RN portion of the program was the same as any ADN program (I do not have a BSN). We had to have the basic science pre-reqs (A+P, chemistry, micro, etc) finished before we could even apply to the DE program. We all had at least a Bachelors in another discipline, so we didn't have to take any of the Gen Ed courses. We took Health Assessment, Theory, Patho, Pharm, Ethics, Research, etc. and did the same number of clinical hours and synthesis as the undergrad BSN students. We took NCLEX after all of those requirements were completed, just like any other RN student.
I don't feel like I started "further behind" as an NP because I didn't work as an RN. To be honest, I use very little of what I learned in the RN part of my program. I'm not saying it wasn't valuable and necessary, but most of it isn't relevant to what I do on a daily basis.
Thank you for coming and sharing your experience :). It really helps to see the other side of things realistically rather than just talk about it theoretically. I know that DE programs only accept the best of the best and it sounds like your program molded you into a confident and competent NP.
BCgradnurse, MSN, RN, NP
1,678 Posts
What do you mean by a "down and dirty" RN program? Our RN portion of the program was the same as any ADN program (I do not have a BSN). We had to have the basic science pre-reqs (A+P, chemistry, micro, etc) finished before we could even apply to the DE program. We all had at least a Bachelors in another discipline, so we didn't have to take any of the Gen Ed courses. We took Health Assessment, Theory, Patho, Pharm, Ethics, Research, etc. and did the same number of clinical hours and synthesis as the undergrad BSN students. We took NCLEX after all of those requirements were completed, just like any other RN student.
I don't feel like I started "further behind" as an NP because I didn't work as an RN. To be honest, I use very little of what I learned in the RN part of my program. I'm not saying it wasn't valuable and necessary, but most of it isn't relevant to what I do on a daily basis.