Becoming an NP with little to no nursing experience??

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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.

I'd be very curious to see what kind of practice direct entry NPs originally are planning for and then also what they end up working in. If I hadn't been exposed to this board and to a few NPs in a nursing home I had a short stint at, I wouldn't even know that there were advanced practice nursing roles beyond primary care, midwifery, and CRNA.

I don't know when exactly "advanced practice nursing" became more common, but it's title does imply that it's an advancement in one's nursing practice - building upon prior education and experience. Thus, it would make sense that the nurse have several years of experience in a field before "advancing" their practice in that field. Otherwise, they have only the bare bones of a general RN education to build upon. Perhaps that is enough of a foundation for advanced practice roles but in that case I can't really see it as "advanced" nursing practice as opposed to a DIFFERENT kind of nursing practice - similar to the differences between med-surg nursing, ICU nursing, school health nursing, public health nursing and the like.

I'm sure the term "advanced" is meant to refer the expanded ability to diagnose and prescribe... however as others have pointed out, the skills involved in being a good NP are not necessarily the skills involved in being a good acute care nurse or occupational health nurse or whatever. Thus, it can cause confusion and resentment within the ranks of nurses that people can essentially bypass being a *regular* nurse in order to practice "advanced nursing."

Meanwhile, someone who is working as a nurse can't just up and "advance" their practice without having to go back and take a bunch of courses that aren't directly related to nursing practice. It could easily take a practicing nurse longer to qualify as a NP than someone without any nursing background. Of course, part of that relates back to the whole ADN-BSN dilemma.

And while DE NP programs may require at least six months of part-time work as an RN, that's not much time. It certainly isn't time and experience enough for most to really nail down their knowledge and skills. So experience as an RN either is or isn't fundamental to NP practice (or certain kinds of NPs). Of course there are always those few exceptional folks who will succeed no matter what kind of program they attend but curriculum shouldn't be based upon catering to the strongest of the stong students.

I just help but ramble on about these issues... :lol2::rolleyes::smilecoffeecup:

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Specializes in ED, Cardiac-step down, tele, med surg.

So, what particular skills are honed as an RN that would make someone a better primary care NP? Is it more medically based or is it more psychologically based?

J

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Specializes in Nephrology, Cardiology, ER, ICU.

jzzy88 - I'll take a stab at this question. Particular skills honed as an RN that would make someone a better primary care NP?

1. Assessment is the first thing that comes to mind. Nowadays, people are sicker and sicker being handled totally as outpatients. For instance, I work in nephrology - knowing the difference types and reasons for renal failure, insufficiency is extremely important when dosing meds. It is also important that the primary care NP understand how the different disciplines work for the one goal of health.

2. Awareness of resources in the community. For instance, what insurance plan will cover which med. How to word a script in order to get what you want as an off-label.

3. The abilty to work within the medical system. With years of experience, you know who you can go to. Not everyone wants APNs to succeed. It is important that the new APN know who they can rely on and who might sabotage their efforts. This comes from knowing the hx and experiencing the medical system first hand.

4. Without experience as an RN, you are an untried resource. Physicians have a built-in system of med student, intern, residency, fellowship. We in nursing think we can take shortcuts and get as much respect as those that "have paid their dues." Medicine is still a good old boys network. You are respected for your experience, your publications, your experience (did I just say that)?

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Specializes in Education, FP, LNC, Forensics, ED, OB.

  1. Learn how to identify facts relating to the case and evaluate their reliability and relevance to reach a diagnosis and prescribe and implement treatment.
  2. Observation of the PCP in troubleshooting the provisional and differential dx
  3. Reading and interpreting dx studies as they apply to the pt. dx and how the results direct the PCP in the tx
  4. Recognizing subtle s/s that indicate change in dz process warranting need for further dx studies
  5. Rationale behind rx drugs ordered
  6. Rationale behind why certain dx studies are ordered
  7. Professional interaction with not only PCP, but fellow colleagues, and other healthcare workers
  8. Hone the ability to properly educate the patient in preventive health maintenance
  9. Learn how to be a leader
  10. Learn how to deal with uncertainty and make the best possible decision for the well-being of the patient
  11. Learn to recognize and appreciate ones limitations as they apply to the role of the APN
  12. Know how to utilize all resources available in treating the patient and coordinate the interdisciplinary care team and specialists
  13. Know when to refer

Just a few off the top of my head. The nurse wishing to advance his/her nursing career as APN will take the time with the above. And, this takes experience.

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jzzy88 - I'll take a stab at this question. Particular skills honed as an RN that would make someone a better primary care NP?

1. It is also important that the primary care NP understand how the different disciplines work for the one goal of health.

Would the average acute care nurse really have a good idea of how the health care system works outside of the hospital?

2. Awareness of resources in the community. For instance, what insurance plan will cover which med. How to word a script in order to get what you want as an off-label.

I don't see that experience working in acute care would give nurses any real insight into such issues.

3. The abilty to work within the medical system. With years of experience, you know who you can go to.

This would really only apply to those nurses planning to continue working in a related field after earning their NP. If they move to a completely different field, they still won't have the connections. I don't know how many experienced nurses pursing advanced practice are planning to work in related area or how many might be planning a bigger change or how much weight admissions committees put on having related experience versus not, especially given that DE students are admitted without having any prior related experience.

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Specializes in Nephrology, Cardiology, ER, ICU.

jjjoy I'll try to address this:

1. Yes, the average RN working in acute care had better have some idea of how the healthcare system works outside the hospital. Most care nowadays isn't provided in the hospital, its in the outpatient world.

2. Working in acute care, the RN works in a multidisciplianary environment should know in general what will be covered, and/or how to get things started for the pt.

3. Most NPs and other APNs that I know DO work in the general area of where they have experience. The RN experience gives you the ability to accurately choose where you would fit best. Without the RN experience, you are just shooting in the breeze that you might be happy working in primary care. How do you know that maybe the ER or ICU might not be your forte and love? Answer....without the RN experience, you don't.

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Specializes in ICU,ER,OR.

I have a couple thoughts on the original topic...NP with little or no RN experience.

On one hand:

It requires zero experience to go to Med School. It requires zero experience to go to PA School. Why should it require experience to go to NP school? Are NPs so hard to train that they have to arrive to college "pre-trained"?

On the other hand:

My personal thought are that some people may do well wilth limited RN experience while others may make poor practicioners. 50% of doctors, nurse, and PAs graduated in the bottom half of thier class. I'd be for an RN experience rquirement with certification (ie, acute care NP program could require CEN) prior to acceptance into a NP program. It would just produce high quality, smart, learned people that take very good care of the patient. Money drives that education train, though so don't expect to see my version any time soon.

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Specializes in Education, FP, LNC, Forensics, ED, OB.
why should it require experience...

apn=advanced practice nursing

rns advancing their practice of nursing. period. how can you advance something that does not exist?

why should it require experience to go to np school?

i'd be for an rn experience rquirement with certification prior to acceptance into a np program. it would just produce high quality, smart, learned people that take very good care of the patient.

these quotes are in opposition to the other.

(edited to add: my original post above was made prior to member editing for clarification)

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Specializes in ICU,ER,OR.

sirI,

I thought it might be cumbersome to read intially, but opted to let go "as is". I edited it to show the opposing rationales as natural. Thanks.

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Specializes in Education, FP, LNC, Forensics, ED, OB.

Thank you, peddler. That does make more sense to compare/contrast opposing viewpoints as you have now edited.;)

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Specializes in L&D.
APN=advanced practice nursing

RNs advancing their practice of nursing. Period. How can you advance something that does not exist?

Honestly, I hear this argument on this board frequently, and it doesn't make sense. It is inaccurate.

An advanced degree in nursing does NOT require experience as an entry level nurse. The experience might be helpful, and for some people necessary - but it is not required legally or, for the majority of people who choose a direct-entry option, intellectually.

An "advanced practice nurse" is, by definition, a nurse who holds either a master's or a doctorate. It is not, by definition, someone who has been a nurse for _ years and then got a masters or a doctorate. You are ADVANCING upon your education. You are an ADVANCED practice nurse because you are practicing in a role that is, by definition, advanced beyond the role of an RN.

I have the utmost respect for people working in the nursing field, but the cynical attitudes and downright disrespect for people who are non-nursing DE MSN majors is frustrating. The reason we are able to complete these DE MSN programs in three years is that we possess these skills already in another field, and are able to translate that experience into nursing and adapt quickly.

The fact is, these programs are here, and they aren't going anywhere. The nurses that graduate from these programs are prepared individuals who will, of course, still need on the job training. Just as an NP who was an RN will need. We are all united by the fact that we are nurses (or in the process of becoming nurses).

Bree

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Specializes in Nephrology, Cardiology, ER, ICU.

I respectfully disagree with you Bree - "As nurses move along the

continuum of experience and education, they acquire additional

competencies that are incorporated into their practice." This presumes a basic body of knowledge. While I do agree critical thinking skills are present in many professions nowadays, that is not the end-all of nursing practice.

cna-nurses.ca/CNA/.../pdf/publications/ANP_National_Framework_e.pdf

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