Becoming an NP with little to no nursing experience??

[Blurr156]

Hello to all!!! I have worked as a parmamedic for 20 years, have a B.A. in Economics, and I wanted to advance my career in healthcare. I was originally looking to pursue the PA route, but for certain practical reasons (including my union not helping to pay for it) I have been looking at other options, nursing/NP.

I was very excited to learn of a school near me that has a combined BSN/NP program for people with non-nursing bachelor degrees. I was about to start looking deeper into this program when a good friend of mine who is a member of an interview committee at a nearby hospital told me that I shouldn't do the program because I would have trouble getting a job.

The reason stated was because I wouldn't have been seen as having "paid my dues" as a nurse first.

Is this true?

I could understand why someone might feel that way about someone who went through this type of program never having worked in healthcare before. However, I like to think that to a certain degree I've paid my dues (I know it isn't nursing, but from a time in healthcare perspective).

My friend did say that I might be considered an exception to that rule. The program is at a VERY well known school and I was told by my friend even then it wouldn't matter. I was wondering what people here thought regarding this topic.

Thank you for any guidance you can provide.

[traumaRUs, MSN, APRN]

It's not unfair for employers to choose someone else with experience. This area (direct-entry NP or APN) has not been field-tested. The new grads are just now starting to hit the streets looking for a job.

The one idea to take away from this is that you should do your homework and ensure that the hospitals in your area are open to new-NPs with NO RN experience. In my area (central IL) APN jobs are VERY tight - someone with no RN experience wouldn't even get an interview (this from the HR dept of the biggest hospital system locally).

The schools are selling a product - education. To be honest, they don't care that you can't get a job - they just want you to pass the NCLEX and then the certifying board.

[P_RN, ADN, RN]

While you are waiting and watching out for the perfect unexperienced NP job, you need to be looking for and working in an RN job. You'd be totally surprised at what you don't know. People don't present to the ER or th the office with letter perfect symptoms straight out of Lippencott. After you have seen a few hundred with same sx/different dx you may juxt develop what we call nursing intuition. Is that fever infection? Cardiac? Pulmonary, a clot, atalectasis? metabolic? HUH right off the bat you might guess correctly but don't you want to know HOW you got to the right point?

Keep up the NP license and good luck, BUT squeeze some RN under that cap first.

[2bNPreen]

thanks for the tip. I tried to apply for RN positions with no luck! maybe it is a tight market.. kind of strange because you keep on hearing about all these RN shortages..

[AK556 APRN]

.....Trauma -

Yale has been graduating entry level NPs since the 70's - it is certainly nothing new. Just becoming more available. I have heard from instructors at Yale that in about two years, an entry level grad is at the same level of practice as an RN prepared NP. Sounds like there's been some studies. I did go in as an RN and there were only 11 of us out of about 90. The whole idea scares me to death still - patients should be aware that they may be seeing an NP who has never done an EKG, etc.

[2bNPreen]

I have done EKG during my clincial rotations.

[core0]

.....Trauma -

Yale has been graduating entry level NPs since the 70's - it is certainly nothing new. Just becoming more available. I have heard from instructors at Yale that in about two years, an entry level grad is at the same level of practice as an RN prepared NP. Sounds like there's been some studies. I did go in as an RN and there were only 11 of us out of about 90. The whole idea scares me to death still - patients should be aware that they may be seeing an NP who has never done an EKG, etc.

I think that you have identified the issue. In times of scarcity it may not matter as much, but in a relatively saturated market employers will go with the product that makes the least work for them. That would be the person who doesn't take two years to get to the level they want.

There also may be an early adopter phenomenon here. We have seen this in the PA world. Early adopters of PAs are were willing to take the time to teach PAs and integrate them into the practice because they believed in the concept. Physician now are less willing to do this because they are basing this on a business decision (personal opinion) not because they believe in the concept. This did not happen until there was a relative saturation in the market. You may be seeing the same phenomenon in the NP market now.

David Carpenter, PA-C

[westcoastgirl]

you can always work as an RN while finishing your Master's degree in such a program.

[yellow finch, BSN, RN]

Interestingly enough, some of the NP job prospects I've come across, with a year of NP school left to go, have been on the job as a RN. Physicians see you in practice, and interact with you as a professional. With this, they are able to determine whether you're a good candidate for their group.

[traumaRUs, MSN, APRN]

I stand corrected - thanks for the info.

I do still stand behind my assertion that entry-level NPs or other APNs may have a hard time finding a job. I live far from Yale - but I know that even experienced new grad APNs have it tough finding a job.

[prairienp]

it's not unfair for employers to choose someone else with experience.

the schools are selling a product - education. to be honest, they don't care that you can't get a job - they just want you to pass the nclex and then the certifying board.

i don't think this is a fair generalization. in reality all of the programs i have worked with in the past 20 years do care if you get a job. in fact, so do the accrediting agencies, they want to know where are your graduates. a common driving force of any np program should be the ability of the graduates to be employed.

[2bNPreen]

Let me clarify that I went to 10 interviews for the past 2 weeks (non in hospitals). So yes, I can't find a job in a hospital but I rather work in a primary care setting. NPs with no prior RN experience are pretty well trained to treat and diagnose patients. During my rotations as NP, I did do RN stuffs like injections, EKGs, and wound care.

[HealthyRN]

Thank you for pointing out that this is not a new phenomenon. I have read a few studies that look at entry level NPs, but I believe that more are needed.

I'm not sure why it would scare you to see an NP who has never done an EKG. Most people easily could be taught to perform an EKG. Regardless, the NP role is different from the RN role and I believe that one could be a good NP without knowing how to perform all of the skills utilized by bedside RNs. Now if the NP doesn't know how to interpret an EKG, that is a different story. EKG interpretation is covered in my NP program.

As far as finding NP positions through your role as an RN, that may be the case if you are in an acute care NP program and you work in the hospital. However, it is less likely that you would be able to find a primary care position if you work in the hospital. The NP market seems to be highly variable throughout the country. In my area (and I also live in the midwest), there seems to be plenty of NP jobs and I have not heard of graduates having any trouble obtaining positions.

Yale has been graduating entry level NPs since the 70's - it is certainly nothing new. Just becoming more available. I have heard from instructors at Yale that in about two years, an entry level grad is at the same level of practice as an RN prepared NP. Sounds like there's been some studies. I did go in as an RN and there were only 11 of us out of about 90. The whole idea scares me to death still - patients should be aware that they may be seeing an NP who has never done an EKG, etc.