Straight to FNP or work full-time first?

[Matt799]

Hello everyone!I am graduating from Thomas Jefferson with a BSN in 2 months. This is my 2nd degree (first was a BA in English), so I did the accelerated 1-year program and as a part of my admission I have the opportunity to go directly in to a 15-month FNP program. Here's my dilemma:Nurses are having a hard time getting hired all over the country and it really helps to have experience. With that in mind, do you think going straight in to an NP program is going to hurt me because I will only have clinical experience? Do you think I would be better off doing the non-accelerated program, which is 24 months that would allow me to work at least part time as an RN so I have more experience when I graduate?Are there any FNP's here who went directly from BSN graduation, to boards, and then directly in to an NP degree? Thanks so much, I'm having a hard time figuring out the best plan of action.

[BlueDevil,DNP, DNP, RN]

I practiced critical care and emergency nursing in high acuity major med centers and trauma centers for just short of 20 years before becoming an NP. I had the CCRN, CEN, CFRN, MICN, TNCC certs, and was truly expert at my job. And it has not made one iota of difference in my NP practice. I work in primary care and have yet to have a trauma out in my waiting room. I did have a kid with a BB in his ear this week, but that was a far cry from the kind of gunshot wound I'm used to.

Treating exacerbation of chronic conditions as an outpatient is entirely different in most cases than treating them as an inpatient. And it goes without saying that none of my experience has been helpful with the critical piece of developing the differential diagnosis. That kind of learning only comes from NP experience.

I have observed that like myself, many of my colleagues were "in the trenches" so to speak for at least a decade, and many are resentful that NP candidates no longer have to "pay their dues." Well, that's just the way it is, so all of us old farts are just going to have to get over our bad selves. Our life and work experience is valuable because it helped make us who we are. I am a better person now than I was 20 years ago. I have lived and learned. If I am a better NP today than I might have been 20 years ago, I attribute that to life experience, not nursing experience.

Young people, new nurses- do not be intimidated by this mantra of having to work in a job you don't want in order to be worthy to pursue what you do want. Just go for it. Best of luck!

[BostonFNP, APRN]

We are in the middle of a research study on this topic, and will hopefully

have it ready to publish prior to the end of the year. The project is looking to identify the factors of RN experience, pre-licensure clinical experience, and graduate clinic experience that facilitate the role socialization of new graduate FNP in the first year of practice as well as how to include those factors in the graduate education. It's nice to hear that people are interested in the topic.

[BlueDevil,DNP, DNP, RN]

Looking forward to reading your paper.

[donutsfordinner]

As an RN coming on five years of experience at the bedside preparing for an NP program, I can understand both sides of the issue. I understand how experienced nurses can feel defensive with many NPs going straight from BSN. We have 'paid our dues' and the first years as a nurse are incredibly challenging and really mold who you are, even if the area is different, and I also think there is a sort of 'magic' to nursing that those of us who love it have a passion for. The intuition you develop that belies interpreting ecgs or changes in vital signs or how you find yourself problem solving and expertly caring for patients and families.

I don't feel that bedside experience directly correlates with being a great NP at all, but I can understand how long time nurses feel resentful of people whose attitude is "I didn't go to school to wash patients" or are disrespectful and demeaning of what we do every day but are supposed to be allies. That said, I think that the same kind of people that are passionate about nursing are passionate about advanced practice nursing! There are enough obstacles to patient care, let's give each other the mutual respect that we deserve and work together!!

[Ruby Vee, BSN]

two-thirds of the nps with whom i work are pompous, all-knowing and non-listening people who are all too impressed with their own initials and not at all interested in someone else's experience. not just one. it seems to be a very common phenomenon among brand new nps with little or no bedside experience. you just don't know what you don't know. an np who has had a few of years of bedside experience before starting their np program and continued to work while going to school has a much better idea of the magnitude of things that they don't know. the more experience you get, the more you realize you don't know and the safer practitioner you are.

[Corey Narry, MSN, RN, NP]

Treating exacerbation of chronic conditions as an outpatient is entirely different in most cases than treating them as an inpatient. And it goes without saying that none of my experience has been helpful with the critical piece of developing the differential diagnosis. That kind of learning only comes from NP experience.

Word!

[myelin]

As an RN coming on five years of experience at the bedside preparing for an NP program, I can understand both sides of the issue. I understand how experienced nurses can feel defensive with many NPs going straight from BSN. We have 'paid our dues' and the first years as a nurse are incredibly challenging and really mold who you are, even if the area is different, and I also think there is a sort of 'magic' to nursing that those of us who love it have a passion for. The intuition you develop that belies interpreting ecgs or changes in vital signs or how you find yourself problem solving and expertly caring for patients and families.

I don't feel that bedside experience directly correlates with being a great NP at all, but I can understand how long time nurses feel resentful of people whose attitude is "I didn't go to school to wash patients" or are disrespectful and demeaning of what we do every day but are supposed to be allies. That said, I think that the same kind of people that are passionate about nursing are passionate about advanced practice nursing! There are enough obstacles to patient care, let's give each other the mutual respect that we deserve and work together!!

I'd just like to say that no one in my DE program (at one of the best nursing schools in the country, for what it's worth) feels that way, as far as I know. We were just meeting for beers last night after our second week of clinicals and working with nurses on the floor. We were trading stories and it went something like this:

"I worked with the most amazing nurse who..."

"Wow! I have so much to learn. I'm so glad my nurse preceptor showed me..."

"The doctor/NP missed X and the nurse caught it and..."

"Today my nurse preceptor was really talented and knowledgeable and he let me ..."

In other words, we all have a lot of respect for floor nurses. Some of us are planning on stepping out and working as RNs (and those in the ACNP and Oncology specialties are required to) before continuing on for the MSN. It isn't about a lack of respect for RNs, it's about having different career goals. I want to be a PMHNP. My background is in psych and I went into nursing with an end goal in sight. That doesn't mean I don't respect RNs!

The RNs I work with have been great and I have so much to learn this year (I'm in the accelerated RN portion of my program). I really appreciate the knowledge they have and their willingness to teach. In the end, my goal is NP, but that doesn't mean I don't respect RNs. I just see it as two different paths.

[BostonFNP, APRN]

I will be interesting to see if you feel the same way in two years (you are still very early in your education/experience). I was struck that the majority of girls in my cohort by the end of pre-licensure wouldn't even tell nurses they were DE students because of the response they got. I never felt this way, and it may have had to do with being a male or just personality, but I never had a problem.

I am a big believer that everyone's input, if it can help me better plan for the patient, is important from assistants to RNs to SW to other providers. I treat everyone with respect, and more importantly, I truly respect everyone.

On the other side of the picture, is that I still bring a box of pastries with me when I round on floors with notoriously tough RNs: a little bribe makes my life easier. Should I have to? No.

[Dudenurse73]

I know this doesn't exactly relate to this conversation, but as a nursing student about to finish my BSN I had decisions to make. Most of the people in my area told me to go to PA school because they were looked at with more respect than somebody with the word "nurse" in their title. Obviously these people didnt work in healthcare. But, I see so many people defensive and attacking each other. I am choosing to be NP because of the word "nurse" and at the end of the day I just think more people need to recognize that we are a team and its better to support the profession then tear it down. I know a lot of you old school nurses will just say what does this 22 year old guy know about nursing? Well ill tell you probably not as much as you do, but where I'm from we support each other and maybe as a whole nurses should start doing the same. I'm proud of being a nurse because it takes a pretty special person to do the stuff we do. I wont look badly on somebody because they decided to go straight into extending their education. I will begin to apply to schools when I graduate with my BSN but will only enroll after a year of experience, because that is what I want. If somebody takes the DE route then good luck I wish you the best, but support your other nurses ADN, BSN, MSN, DNP, or PHD.

Just a young pup who hasnt been corrupted yet.