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.

[christvs, DNP, RN, NP]

Im not enrolled yet but I will be going to Viterbo's BSN/MSN program and doing the NP probably in family practice. I work in neurology and I do mostly phone work, refills, deal with insurance. I do alot of IV therapies, but this is the one of the only nursing skills I seem to use on a regular basis. Im not sure where I want to work when I have my NP, Im really not sure of all the options. I really enjoyed working at the nursing home, and I did work on a med/surg floor for a couple of months right out of school (22 y/o preceptor wasnt very happy to have an "older lady" for a preceptee. I was told that the first older lady they had didnt work out so I should just keep my mouth shut and do what I was told). I feel that working in a hospital will give me better skills and knowledge to fall back on.

Do you work as an NP? Which field?

Thank for the feedback!

I am a new NP (graduated from my acute care NP program in June). I am working in Hospital medicine. I like it so far, although since I just started everything is so new and a bit scary still. lol I enjoy working in the hospital setting, and before I graduated as an NP I worked in med/surg/tele as an RN for 3 years. I do feel those 3 years gave me a good background for what to expect to be the patient care issues for my current job. Once you are in your program and start clinicals, I bet you will have a better sense of what you like.

[Pester1]

I am a new NP (graduated from my acute care NP program in June). I am working in Hospital medicine. I like it so far, although since I just started everything is so new and a bit scary still. lol I enjoy working in the hospital setting, and before I graduated as an NP I worked in med/surg/tele as an RN for 3 years. I do feel those 3 years gave me a good background for what to expect to be the patient care issues for my current job. Once you are in your program and start clinicals, I bet you will have a better sense of what you like.

Congratulations!!! Thanks for all of your input/feedback. I have a few applications out for hospital nurse positions. So, hopefully.......

[christvs, DNP, RN, NP]

I am a new NP (graduated from my acute care NP program in June). I am working in Hospital medicine. I like it so far, although since I just started everything is so new and a bit scary still. lol I enjoy working in the hospital setting, and before I graduated as an NP I worked in med/surg/tele as an RN for 3 years. I do feel those 3 years gave me a good background for what to expect to be the patient care issues for my current job. Once you are in your program and start clinicals, I bet you will have a better sense of what you like.

Congratulations!!! Thanks for all of your input/feedback. I have a few applications out for hospital nurse positions. So, hopefully.......

Good luck with the job search. We'll keep our fingers crossed for you!

[markEmark]

i want to be a nurse practitioner too. they said NP's are more independent than regular nurses. and they earn more. but you have to study for 2 years more to get the certification/license.

[abnerfnp]

Go for it!!!

NP job is a different ball game than RN.

NP has more responsibility, autonomy, respect and stress. Your neurons will fire 24/7.

RN is stressfull, but is more lay back. Basically, you put your brain under cruise control for 12 hours until you clock out.

After graduating from the University of Memphis, I worked as a Cardiovascular Surgical ICU RN traveler for 8 years. Pretty much, cruise control!

Then, I became a Critical Care Transport RN for American Medical Response in the Greater Los Angeles area. I had the opportunity to work side by side with firefighters, paramedics and EMTs. It was like taking a brake for two years in the back of an ambulance!

Finally, the last 3 years, I have been working as a Family Nurse Practitioner after attending the UCLA FNP program.

NP work is more stressful! But, I feel butterflies in my stomach after I help out a patient and make a diffence!

Sometimes I miss my old RN jobs.

One must do the NP job for passion and dedication to the profession and NOT FOR THE MONEY!

It will be a bumpy ride to go straight into the NP program at first, but eventually with will pick up speed man!!!

Good Luck!!!

[jelly2008]

Hi Mission,

I am actually applying to the ETP program at Columbia. I would love to talk to you about it, if you have time. But, I'm knew to the site and don't know what "PM" is? How can I contact you?

[sirI, MSN, APRN, NP]

Hi Mission,

I am actually applying to the ETP program at Columbia. I would love to talk to you about it, if you have time. But, I'm knew to the site and don't know what "PM" is? How can I contact you?

Hello, jelly2008

pm=private message

General members must have 15 meaningful public board posts prior to sending private messages and/or sending emails from the allnurses.com profiles. We look forward to seeing more of your posts.

Good luck with your nursing career plans.

[subee, MSN, CRNA]

Go for it!!!

NP job is a different ball game than RN.

NP has more responsibility, autonomy, respect and stress. Your neurons will fire 24/7.

RN is stressfull, but is more lay back. Basically, you put your brain under cruise control for 12 hours until you clock out.

After graduating from the University of Memphis, I worked as a Cardiovascular Surgical ICU RN traveler for 8 years. Pretty much, cruise control!

Then, I became a Critical Care Transport RN for American Medical Response in the Greater Los Angeles area. I had the opportunity to work side by side with firefighters, paramedics and EMTs. It was like taking a brake for two years in the back of an ambulance!

Finally, the last 3 years, I have been working as a Family Nurse Practitioner after attending the UCLA FNP program.

NP work is more stressful! But, I feel butterflies in my stomach after I help out a patient and make a diffence!

Sometimes I miss my old RN jobs.

One must do the NP job for passion and dedication to the profession and NOT FOR THE MONEY!

It will be a bumpy ride to go straight into the NP program at first, but eventually with will pick up speed man!!!

Good Luck!!!

EXCUSE ME, but if you were on "cruise control" for 8 years, you must have been missing a few screws. Families of ICU patients need a more creativity and insight than someone just going through the motions of the job. I'm so glad you enjoyed your brake on the ambulance. Congratulations on insulting an entire profession in your first post. I was with an old friend this weekend who is an MD family practice doc and she was complaining about her two NP's (no nursing experience) who are way, way too fluffy-headed to take call and are basically pretty useless except for seeing patients with hypertension. Being an advanced practice nurse myself, I was very embarrassed for a profession that sends out nurses who are supposed to be "advanced" practitioners who are really only beginners.

[amzyRN]

As I'm doing my senior preceptorship, I am unable to figure out how skills like starting and hanging IVs, monitoring patient care, and running around like a chicken with it's head cut off aid in NP training. I can understand why seeing different clients with different diseases and possible assessment skills (though very rudimentary as an RN) apply to advance practice nursing. NPs are going to be taking over stuff done by physicians from a nursing perspective, they aren't going to be doing stuff staff RNs do, so how would this experience help. I'm not trying to ruffel feathers or disrespect anyone, I just want to know how staff RN skills apply to NP practice or even PA practice for that matter, since many RNs go on to practice as PAs. Please explain how, thanks much,

J

[core0]

As I'm doing my senior preceptorship, I am unable to figure out how skills like starting and hanging IVs, monitoring patient care, and running around like a chicken with it's head cut off aid in NP training. I can understand why seeing different clients with different diseases and possible assessment skills (though very rudimentary as an RN) apply to advance practice nursing. NPs are going to be taking over stuff done by physicians from a nursing perspective, they aren't going to be doing stuff staff RNs do, so how would this experience help. I'm not trying to ruffel feathers or disrespect anyone, I just want to know how staff RN skills apply to NP practice or even PA practice for that matter, since many RNs go on to practice as PAs. Please explain how, thanks much,

J

I'll give the PA point of view (actually my point of view). Technical skills (ie IV starts or running pumps) don't give anyone a leg up on PA practice.

Some technical or professional skills can be considered value added for a PA practice. A surgical tech will have better scrub skills than most PAs can get in school. An athletic trainer brings extra value to an ortho practice. A pharmacist gives extra value for specialties that have drugs that have a lot of interactions for example. Some nursing specialties will give added value for example a CVICU RN working for a cardiology group. None of these will overcome poor personality but would be considered as part of the hiring assessment for a new grad PA. Once a PA gets 1-2 years of experience what you did before becoming a PA doesn't really matter.

Outside of this there are three advantages that an RN will gain as a PA applicant:

1. Access to those schools which require healthcare experience (about 1/3 of programs).

2. Knowledge of how health care works. There is a ebb and flow in how a patient moves through a hospital or other healthcare system. Knowing that IR does a liver biopsy for example or that you need to talk to GI for melena. Working as an RN gives insight into how the patient interacts with this health care environment.

3. For me the most important. This undefineable quality to look at a patient and quickly determine that the person is seriously ill. This is an aquired skill and not everyone gets it (whether an RN or practitioner). The ability to work with hundreds or thousands of patients in various states of health gives RNs an advantage in gaining this knowledge. This is same reason that many PA programs value Paramedic skills, the ability to rapidly evaluate a patient and determine how sick they are.

For PAs those that don't have health care experience the second two can be gained in training or in practice. To some extent this is why on the average non-HCE programs are longer than HCE programs (both clinically and didactically).

The other advantage that HCE gives a PA student (not just RNs) is that they are less likely to be affected by the impostor phenomenon. There is emerging data that non-HCE students are more likely to go into primary care as opposed to specialty care. This is probably a phenomenon of having more confidence in their primary care skills (where the majority of training is spent in most programs).

Hope this helps

David Carpenter, PA-C

[jjjoy, LPN]

I'd agree with you that running around calculating I&Os, hanging IVs, checking blood sugars, making sure folks are using their incentive spirometer, etc aren't going to give a leg up to someone who wants to go into advanced practice.

I think it is that staff RNs eventually learn a lot on the job about different treatments, drug interactions, symptomatology, and complications. Traditionally, this is the knowledge and experience nurses would bring to the advanced practice role, thus they wouldn't require as much instruction and practice as someone without that experience. For my data collection job, I've been reviewing medical records for cardiac cases and now can fairly accurately predict, just by quickly eyeballing the drugs prescribed or cluster of symptoms notes what the diagnoses likely are. Last year, though, I had to more carefully comb through the charts before I felt I had a grasp of what was going on with any particular case. Floor RNs should also be able to quickly assess patient status already being familiar with the various presentations of symptoms and clustering of symptoms.

A floor nurse after several years should be able to often predict how various cases will be treated and traditionally becoming an advanced practice nurse only formalized and reinforced and filled in the gaps of what they already knew.

Like new nurses are still often expected to be able to "hit the ground running", I imagine advanced practice nursing grad are expected by potential employers to have a level of confidence in their skills and knowledge that only experience can impart.

I think in reality there is a disconnect between the training nursing schools offer to students and what level of competence employers expect from both RNs and advanced practice nurses. Many nursing schools encourage students to go straight through to becoming an NP, or perhaps just work part-time for a year, and that previous experience need not be directly related to the specialty one is preparing for. The big question is whether or not NP programs adequately prepare their students for their role as NPs or if they have them jump through some hoops, give them a license/certification, and then leave them to sink or swim professionally.

[core0]

snip

I think in reality there is a disconnect between the training nursing schools offer to students and what level of competence employers expect from both RNs and advanced practice nurses. Many nursing schools encourage students to go straight through to becoming an NP, or perhaps just work part-time for a year, and that previous experience need not be directly related to the specialty one is preparing for. The big question is whether or not NP programs adequately prepare their students for their role as NPs or if they have them jump through some hoops, give them a license/certification, and then leave them to sink or swim professionally.

I think that in a large sense the market place does this. I work in a large university system which has an MEPN program. However, those same NP students cannot get hired by the system since the system requires a minimum of 2 years full time work as an RN to be hired as an NP. "Traditional" NP students do get hired. Also I don't think that the MEPN students are allowed to do clinicals as NPs (at least at the mother ship). While the nursing faculty has one idea, the market has another.

There has been anectdotal discussion here that many MEPN students end up working as RNs. Ultimately this probably effects long term prospects. If you have a choice between an NP that had RN experience then got their NP or one who got their NP and then worked as a nurse you have to consider how stale the advanced practice skills are. On the other hand we have also heard anectdotal discussion of MEPNs not having any problem finding APN jobs. YMMV.

I think that as in many other issues (DNP:cool:) nursing academia is at odds with the nursing market. In the long run these things will probably sort themselves out.

David Carpenter, PA-C