Is it necessary to get experience as a Rn before NP?

Nursing Students NP Students

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I will be going to an absn program and was wondering if it is necessary to get RN experience before NP? Two schools of thoughts:

1) get rn experience pay down my loans, makes me more employable from what I have been told

2) go straight to NP program that means more years of experience at the job, the two jobs between RN and NP are completely different. I have more interests in working in specialties like Derm or psych.

What is the general consensus?

necessary? no, a lot of NP schools allow you to enter without EXPERIENCE as an RN.

Why might that be?

Maybe because schools have caught on that admitting anybody who applies gets them as much tuition money as possible?

That's why admission standards are low/lacking.

Specializes in Psychiatric and Mental Health NP (PMHNP).
Why might that be?

Maybe because schools have caught on that admitting anybody who applies gets them as much tuition money as possible?

That's why admission standards are low/lacking.

You do know the difference between primary care and acute care, don't you?

The FACT is that most primary care NP programs do not require RN work experience in order to be admitted. That is true of the BEST schools such as Hopkins, Yale, UCLA, etc. Another FACT is that getting an NP job in primary care does not require RN work experience.

As you well know, this topic has been discussed ad nauseum on this forum. While many feel RN experience should be a requirement, and recommend future NPs get this, that is a matter of opinion, not fact. In addition, as has been pointed out many, many times, there is no evidence to support that NPs with RN experience are superior to NPs w/o RN experience. Personal anecdotes are not evidence and are subject to confirmation bias anyway.

And yes, you are big on ICU. Good for you. Most RNs don't work in the ICU, and neither do most NPs.

Why might that be?

Maybe because schools have caught on that admitting anybody who applies gets them as much tuition money as possible?

That's why admission standards are low/lacking.

LOL oh so you caught that huh? yeah.... more students, more money, lower standards... :/ which means the NP profession gets looked at in an even WORSE light by other health care providers (and many patients as well). But it's all good because money.

Specializes in Psychiatric and Mental Health NP (PMHNP).
LOL oh so you caught that huh? yeah.... more students, more money, lower standards... :/ which means the NP profession gets looked at in an even WORSE light by other health care providers (and many patients as well). But it's all good because money.

Are you an expert on NP admissions standards? Low standards - that's rich, from someone who can't write properly. Are you really claiming that schools like Yale, Hopkins, U Penn, UCLA, UCSF, and so forth, have low admissions standards? Do you think you could get into one of those schools? Can you produce any evidence to support your view? If so, then let's see it.

Are you aware that in healthcare, we now practice evidence-based medicine? The evidence does NOT support that NPs with RN experience are superior. In fact, the evidence that exists indicates that NPs without RN experience perform better academically and have better physical exam skills. Granted, this is a area requiring additional study.

LOL oh so you caught that huh? yeah.... more students, more money, lower standards... :/ which means the NP profession gets looked at in an even WORSE light by other health care providers (and many patients as well). But it's all good because money.

I agree. It is disappointing to realize. If there were tighter regulations on admissions this wouldn't happen.

Are you an expert on NP admissions standards? Low standards - that's rich, from someone who can't write properly. Are you really claiming that schools like Yale, Hopkins, U Penn, UCLA, UCSF, and so forth, have low admissions standards? Do you think you could get into one of those schools? Can you produce any evidence to support your view? If so, then let's see it.

Are you aware that in healthcare, we now practice evidence-based medicine? The evidence does NOT support that NPs with RN experience are superior. In fact, the evidence that exists indicates that NPs without RN experience perform better academically and have better physical exam skills. Granted, this is a area requiring additional study.

So, I was going to unsubscribe from the thread and just ignore your reply.

Yes, there may be schools that are highly respected and have wonderful programs that produce top notch, highly qualified NPs that don't require experience. But even you have to admit that for every one of those schools, there are other schools that don't live up to that bar.

And there may be studies showing one thing, but the problem with studies is that we can always find other studies to contradict the others.

Again, I'm not saying that you're destined to be a crappy NP if you don't have any experience as an RN, just that maybe it's not a bad idea and that there are schools out there who have less than scrupulous intents when it comes to their admission.

I will forgive the personal attack on my writing style as it was sarcastic & flippant in response to another poster.

While the trend has been to admit into NP programs directly from undergrad, because, well, the money that schools make is huge. But I will tell you that those accepted into the PMHNP program that I attended that had no experience were unable to find preceptors. No experienced NP wants to take the time to precept a student with zero experience; the community centers that we once contracted with now also ask for the students experience, and half of those in my class were unable to graduate on time due to NO EXPERIENCE, and therefore, no preceptors. And quite frankly, it is somewhat insulting to think that a new grad, or even a nurse with no psych experience, would expect to be successful in a graduate program that is a specialty. I like babies, but to think that I should be accepted into a Midwife program in which i have no experience is entitlement at it's finest.

Specializes in Psych/Mental Health.

If you are not in a rush, getting a little bit of RN experience is beneficial especially because you sound like you aren't sure what specialty you like (derm and psych are so different).

At the end of the day, having intellectual rigor and drive is far more essential. Experience alone doesn't mean jack. I know people (in nursing and in my old career) with years of experience and are totally clueless. This is why there is no black and white answer to this question. It comes down to the individual. Evaluate your own situation and go with it.

Specializes in Nephrology, Cardiology, ER, ICU.

STAFF NOTE: hot topic guys. Please be polite and mindful of the terms of the service

Specializes in Psychiatric and Mental Health NP (PMHNP).
So, I was going to unsubscribe from the thread and just ignore your reply.

Yes, there may be schools that are highly respected and have wonderful programs that produce top notch, highly qualified NPs that don't require experience. But even you have to admit that for every one of those schools, there are other schools that don't live up to that bar.

And there may be studies showing one thing, but the problem with studies is that we can always find other studies to contradict the others.

Again, I'm not saying that you're destined to be a crappy NP if you don't have any experience as an RN, just that maybe it's not a bad idea and that there are schools out there who have less than scrupulous intents when it comes to their admission.

I will forgive the personal attack on my writing style as it was sarcastic & flippant in response to another poster.

What you are really saying is that there should be more rigorous and uniform requirements for NP program admissions. That is a separate topic from whether RN work experience should be required. In addition, you admitted that the top schools do a good job. Whether or not RN work experience should be required for NPs is a matter of opinion, not fact, for primary care.

In addition, primary care is very different from acute care. Very few RNs work in primary care - most work in hospitals. Most NP acute care programs DO require RN work experience.

Since some on this forum are convinced anecdotes are evidence, I have some anecdotes of my own. In my NP program, we had health assessment class for learning physical exam skills. Some of the students had RN experience and were currently working as RNs. I assumed this class would be easy for them. To my surprise, many of them struggled and I ended up coaching them! (I have no RN work experience). The one study that was done on this found that MDs evaluating new NP grads scored those with RN work experience lower on physical exam skills than those w/o RN experience.

And no, there are NO studies that support RNs with work experience are better NPs. So it's not a matter of a different study, it's that NO studies support your opinion.

Rich, E. R. (2005). Does RN experience relate to NP clinical skills?. The Nurse Practitioner, 30(12), 53-56.

Barnes, H. (2015). Exploring the factors that influence nurse practitioner role transition. The Journal for Nurse Practitioners, 11(2), 178-183.

Pellico, L. H., Terrill, E., White, P., & Rico, J. (2012). Integrative review of graduate entry programs in nursing. Journal of Nursing Education, 51(1), 29-37.

Hart, A. M., & Bowen, A. (2016). New nurse practitioners' perceptions of preparedness for and transition into practice. The Journal for Nurse Practitioners, 12(8), 545-552.

Faraz, A. (2017). Novice nurse practitioner workforce transition and turnover intention in primary care. Journal of the American Association of Nurse Practitioners, 29(1), 26-34.

Steiner, S. H., McLaughlin, D. G., Hyde, R. S., Brown, R. H., & Burman, M. E. (2008). Role transition during RN-to-FNP education. Journal of Nursing Education, 47(10), 441–447

Rich, E. R., Jorden, M. E., & Taylor, C. J. (2001). Assessing successful entry into nurse practitioner practice: a literature review. The Journal of the New York State Nurses' Association, 32(2), 14-18.

Pasarón, R. (2013). Nurse practitioner job satisfaction: looking for successful outcomes. Journal of Clinical Nursing, 22(17-18), 2593-2604.

Brown, M. A., & Olshansky, E. F. (1997). From limbo to legitimacy: A theoretical model of the transition to the primary care nurse practitioner role. Nursing research, 46(1), 46-51.

Cusson, R. M., & Strange, S. N. (2008). Neonatal nurse practitioner role transition: The process of reattaining expert status. Journal of Perinatal and Prenatal Nursing, 22(4), 329–337.

Kelly, N. R., & Mathews, M. (2001). The transition to first position as nurse practitioner. Journal of Nursing Education, 40, 156–162.

But I will tell you that those accepted into the PMHNP program that I attended that had no experience were unable to find preceptors. No experienced NP wants to take the time to precept a student with zero experience; the community centers that we once contracted with now also ask for the students experience, and half of those in my class were unable to graduate on time due to NO EXPERIENCE, and therefore, no preceptors.

Every one of my preceptors wanted my resume. They wanted to know my experience as a RN and where I attended NP school. For at least 3 of my preceptors it was the deciding factor to agree to act as a preceptor.

The surgeon who precepted me went to medical school where I attended ACNP school.

The hospitalist who precepted me did his residency at the hospital system where I worked in the ICU.

The vascular surgery NP who precepted me got his master's degree from the same school that I got my BSN from, and he was impressed with my RN experience.

I think in general you'll have a much easier go of it if you get at least some minimal, applicable RN experience and, more importantly (IMO), attend a reputable NP school.

Specializes in Psychiatric and Mental Health NP (PMHNP).
Every one of my preceptors wanted my resume. They wanted to know my experience as a RN and where I attended NP school. For at least 3 of my preceptors it was the deciding factor to agree to act as a preceptor.

The surgeon who precepted me went to medical school where I attended ACNP school.

The hospitalist who precepted me did his residency at the hospital system where I worked in the ICU.

The vascular surgery NP who precepted me got his master's degree from the same school that I got my BSN from, and he was impressed with my RN experience.

I think in general you'll have a much easier go of it if you get at least some minimal, applicable RN experience and, more importantly (IMO), attend a reputable NP school.

The best NP programs find preceptors for their students. I do not have RN work experience and my preceptors did not have an issue with that. Well, one and it's kind of a funny story:

My preceptor at a long term care facility was awesome. She has over 30 years NP experience, including international. My clinical faculty instructor is also an awesome NP with 30 years NP experience in a really busy and hectic inner city urgent care. Clinical instructor came to rotation site to check up on me.

Clinical instructor to preceptor: "How if FullGlass doing overall?"

Preceptor: "About as expected. I've never had an NP student without RN experience and her lack of RN experience shows."

Clinical instructor: "Can you give me an example?"

Preceptor: "Well, she didn't know what [some acronym] meant."

Clinical instructor: "I see. Anything else?"

Preceptor: "I can't think of anything else."

Clinical instructor: "The evidence demonstrates that primary care NPs without RN work experience do just fine."

As I walked my clinical instructor to her car, she turned and said to me: "I have no idea what that acronym meant!" I laughed and said, "It's just a term they use in this facility."

Next semester, that preceptor accepted another NP student from our school who had no RN work experience and they got along swimmingly.

I did well in all my clinical rotations and my preceptors (NPs, MDs, and DOs) were all happy to be a reference for me.

I also got a great job within 2 months of starting my job search. Oh, and I got NINE job offers, all of them good.

Many of my classmates had no RN work experience and they all got good jobs quickly as well. Most of them received job offers from their clinical rotations. I did too, but could not accept due to Nurse Corps scholarship requirements and family obligations.

So those are more of my anecdotes.

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