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?
Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.
How do I know their background? That sure isn't all that hard. I know who they are and what their background is. I chose my health care provider based on experience and background. I am lucky in that I have a choice. I have no desire to have a no-experience NP taking care of me or my family.
Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.
Jules, I like you more and more as I read your posts. Just wanted you to know. :-)
Embarrassingly enough before I received my PsychNP I had 1 general pharmacology course with all NPs and one psych pharm course. I also had 1 general patho course and 1 on neuropath so in that area it wasn't bad but the pharmacology was pitiful, imo.
Thankfully and here is where I think you are selling yourself short, I was familiar with almost all the psych meds and many of the somatic meds thanks to as you said med passing. The fact that you can get a patient stable enough to transfer, know when they need to stay for more close monitoring etc. will be invaluable to your patients as a general practitioner. Look its not the ear infections or viral vs bacterial flu that I care about it is Grandmom who comes in with a DVT that gets treated as arthritis pain or a PE that gets written of as anxiety that your assessment skills will make the difference. I can spot potential etoh w/d in a patient with no know history of alcohol simply because I have seen it so many times. Will your skills make a huge difference every day? Maybe not but in the moments when you need it I'd rather have you assessing me than a brand new person who hasn't ever seen the above presentations.
On a side note what is interesting to me is that I normally love your posts and think you are extremely sharp but you repeatedly discount the experience, skills and gut instincts of working as a nurse. Seriously, you have intuition and skills that you aren't giving yourself credit for.
An excellent education might soften the learning curve but I'm a big believer and follower of gut instincts with something as specific as prescribing or patient care instincts and intuition are largely the result of experience. My gut instincts although always good in a general sense when it comes to nursing they improve with every patient interaction and have served me well time and time again.
Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.
I disagree. The right education does.
When you are a nurse a while, a long while, like 10 or more years, get back to me. Education is HUGELY important but will NEVER EVER replace or make up for experience. I will take the BSN/ADN/LPN with experience EVERY TIME over the one who lacks any. The most talented nurse I work with is a 45 year LPN, not a BSN or MSN even. I would trust her skills and knowledge and *experience* over the latter and my own------every. single. time. She is like a gold mine for me. Her experience, shared with me, has been invaluable. She is the most trusted professional on our unit and even the doctors defer to her word when making decisions on their patients' care. That how valuable she is.
Experience is the teacher that hones our talents, skills, abilities and intuition. You won't convince me classroom education makes up for it or can replace it. No, it does not; formal education simply compliments. I am all for nurses getting more education---- ( I am doing so as we speak)------- as their careers go forward, but will not discount solid patient care experience----comparing experience to an an MSN with none; there is no comparison between the two.
I will take the BSN/ADN or LPN with many years first, every time...... They don't stack up. Nothing teaches like experience with real, live patients.
Specializes in ICU, SICU, Burns, ED, Cath lab, and EMS.
Unfortunately, many schools are trying to keep the money coming in without much regard to the product. They are focusing on board pass rates. Seen other graduate schools discounting experience and student newly out of school. Definitely not confidence building trend for patients.
Specializes in Cardiac, Home Health, Primary Care.
I think prior experience helps. I worked as an aide and student tech during my BSN. I feel like this helped me feel more comfortable in clinicals, know more of what to do, etc. After I graduated I think it made me value the aides more because I knew what all they did. I also think RN experience is important before becoming an advanced practice RN (as we are called in my state...APRN). I did go straight into my MSN program after my BSN BUT by the time I started clinicals I had a couple of years of RN experience under my belt. It took me 4.5 years to get my MSN. I worked 30-40 hours per week the entire way through. I think getting my RN experience helped me in my clinicals. It helped me develop those "gut feelings." I also think working my way through school was nice because I was able to incorporate some of my MSN course work into my RN role. As an RN I was able to learn normal from abnormal, I knew what orders to expect for common complaints, I learned how to deal with patients and families and educate.
I have only been in my NP job about 3 months now but I cannot imagine doing it without the RN background. I am still learning stuff everyday and it's an entirely new job. I am surviving though and when somebody asks how it's going I usually respond with "Well I haven't killed anybody yet."
I know there are some direct entry NP's without the RN experience who do great. In general, though, and logically it seems that you would need the RN experience before become advanced at it in the NP role.
I have only been in my NP job about 3 months now but I cannot imagine doing it without the RN background. I am still learning stuff everyday and it's an entirely new job. I am surviving though and when somebody asks how it's going I usually respond with "Well I haven't killed anybody yet."
There are still days when I feel that way! Hang in there. For those of us with insight into the gravity of what we are undertaking, that first six months is brutal. But awesome also. :)
Ever hear of Patricia Benner? Education and experience provide different experiences for the learner. As an old lady of 50, 28 years of which has been as an RN, I will tell you with all honestly that I learned many important things as a junior volunteer at age 16 which still serve me well today. Many of the meds and procedures I learned about in school are no longer in use. I have long forgotten things I had to memorize. Experiences with patients who have displayed subtle and atypical symptoms: the colour of the skin, the smells, the things they said or their tone of voice, watching how more experienced nurses solved problems, talking down the anxious... has stayed with me much more. Don't get me wrong, I can recite volumes of facts about OB nursing, NRP, etc. but as a thinker, it is experience which has nurtured my expertise the most.
SmilingBluEyes
20,964 Posts
How do I know their background? That sure isn't all that hard. I know who they are and what their background is. I chose my health care provider based on experience and background. I am lucky in that I have a choice. I have no desire to have a no-experience NP taking care of me or my family.