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?
I have to agree. My son sees an NP at his allergist's office. She is fantastic. We have talked about her background and she has never done bedside. She knew going into nursing that she wanted to be an NP.
She graduated from NP school and she worked a few MD practices until she found allergy [her niche]...now she has been there many years.
My guess would be that she actually found one of the rare practices that was willing to train and support a new NP.
I agree, but this is SO new that I don't know if there has been enough time to do a longitudinal study to look at outcomes. I may be a non-issue. I just feel better when I have an NP/PA to work with that has more experience than I do
I was going to say something similar and I do worry that NP outcomes vs. physicians will start to slide based on the new grads without any nursing experience. I definitely could be wrong but based on what I have seen while caring for the hospitalized patients of area NPs I can *usually* tell who had no experience in their specialty prior to becoming a NP.
Lemme clarify, no doubt a seasoned nurse brings a lot to the table, iI was thinking of the year or two of nursing experience that really just gets you going.
I would think solid relevant nurse experience or a residency would be essential.
Lemme clarify, no doubt a seasoned nurse brings a lot to the table, i would feel I was thinking of the year or two of nursing experience that really just gets you going.
I would think solid relevant nurse experience or a residency would be essential.
Gottcha and I agree I would be very happy with a minimum requirement of 2 years experience to hone assessment skills and the even more important gut feelings. Although I'm glad I was able to get away without one I think a fellowship situation would be appropriate and likely even necessary as we move forward.
I'm an RN and I will be graduating with my BSN on Saturday. A lot of my classmates are already applying to NP programs (we all graduated together from the same CC last May). They are currently working as nurses, but they don't even have a year of experience yet, since we just passed our boards last summer and many of them didn't get jobs until the fall. Listening to them talk about applying to NP schools always made me feel like a slacker not wanting to further my education right away. I personally feel the best way I can further my education past graduation is to get out into the field and get some experience under my belt.
I think that it is borderline irresponsible to go into NP school minimal or no experience. Personally, I would want at least 2 or 3 years of working at the beside before I would even consider something like NP school. I'm glad I'm not the only one that feels this way.
I think that it is borderline irresponsible to go into NP school minimal or no experience. Personally, I would want at least 2 or 3 years of working at the beside before I would even consider something like NP school. I'm glad I'm not the only one that feels this way.
Why is it irresponsible? Again, I see a whole lot of people wanting change for something that's not even a problem. If patient safety was an issue, those direct entry programs would be shut down. I'm sorry, but I have to play devil's advocate here. You can't effect change based on what you personally think or feel, because it's nothing more than an opinion (not just you, I'm talking in general). I see a whole lot of cries with no supporting evidence to back up with you and other posters are claiming as problematic for the NP profession.
Why is it irresponsible? Again, I see a whole lot of people wanting change for something that's not even a problem. If patient safety was an issue, those direct entry programs would be shut down. I'm sorry, but I have to play devil's advocate here. You can't effect change based on what you personally think or feel, because it's nothing more than an opinion (not just you, I'm talking in general). I see a whole lot of cries with no supporting evidence to back up with you and other posters are claiming as problematic for the NP profession.
It's good to know because I really didn't, now it will be something I will ask when/if I'm shopping for a provider.
Why is it irresponsible? Again, I see a whole lot of people wanting change for something that's not even a problem. If patient safety was an issue, those direct entry programs would be shut down. I'm sorry, but I have to play devil's advocate here. You can't effect change based on what you personally think or feel, because it's nothing more than an opinion (not just you, I'm talking in general). I see a whole lot of cries with no supporting evidence to back up with you and other posters are claiming as problematic for the NP profession.
I suppose I should have explained myself better. I would feel as though I was acting irresponsibly by entering into an NP program as a new grad RN with no experience. The NCLEX is just a minimum competency exam. Nurses that pass the NCLEX still have A LOT to learn once they get their first nursing job. I'm not an NP, but I'm willing to bet that a lot of that on the job nursing experience that they would gain as a bedside nurse is still pretty darn important to know as an NP.
I just think that there are some things that cannot be taught in a classroom. But that's just my opinion so take it with a grain of salt.
I suppose I should have explained myself better. I would feel as though I was acting irresponsibly by entering into an NP program as a new grad RN with no experience. The NCLEX is just a minimum competency exam. Nurses that pass the NCLEX still have A LOT to learn once they get their first nursing job. I'm not an NP, but I'm willing to bet that a lot of that on the job nursing experience that they would gain as a bedside nurse is still pretty darn important to know as an NP.
I just think that there are some things that cannot be taught in a classroom. But that's just my opinion so take it with a grain of salt.
Experience is invaluable, but I wouldn't say direct entry NPs are unsafe or bad practitioners because they lack RN experience. Are nurses who were never CNAs, techs, or medical assistants irresponsible for going straight into nursing without those prior experiences?
While I do agree that the NCLEX is just a minimum competency exam, ALL NP students must take a competency based exam to become certified. I respect your opinion, though.
I do wish some direct entry NPs would chime in and discuss their experiences.
A new RN with no experience becoming an NP immediately lacks some fundamental theory in practice points. And theory based practice is why one is an NP, No?
Physician's assistants have to have a kabillion hours of clinical under their belt BEFORE even applying to PA school. (and I believe a degree)
In any event, NP's do have clinical rotations, however, in some states LPN's have more.
If one has never practiced as a nurse, how can one be a nurse who practices at a provider level?
Book smart practioners with little common or nursing judgment/sense...
Master's degrees will not detect subtle patient presentation that requires treatment.
I feel an NP glut in the future. NO RN I work with has plans to stay at the bedside for more than 2-3 years. Most have their sites on NP school. It will be interesting to see how the market adapts.
Jules A, MSN
8,864 Posts
My guess would be that she actually found one of the rare practices that was willing to train and support a new NP.