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

  1. 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?
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  3. by   FullGlass
    If you are going to be a primary care NP, you don't need RN experience. If you want to be an acute care NP, then you need RN experience. Go to some nursing school websites and check out their admissions requirements for different NP tracks. I'm a new grad adult/geri primary care NP and had nine job offers within 2 months of starting my job search.
  4. by   Oldmahubbard
    The topic has been done, but I will just emphasize the necessity of substantial RN experience in the field for future Psych NPs. My opinion only.

    If you don't have it, you are likely to fall into really bad prescribing traps, due to the highly subjective nature of the field. And the large number of malingerers, drug seekers, and disability wanna-haves.

    Really bad prescribing, like the large doses of adderall plus ativan prescribed together, which I encountered yesterday. They both start with A, don't they?

    But the patient took an online test that said she has ADHD!

    Have they noticed any of her symptoms at the methadone clinic she attends every day?

    Do you see the irony here?

    Second hint: bipolar disorder is not diagnosed by asking the patient if they have mood swings.

    But that is what you'll be doing without experience.

    With regards to inexperienced advanced practice clinicians working in Derm, check the NY Times for articles on the big medicare scams that have started going on in that field.

    I have said my piece.
  5. by   ICUman
    Quote from FullGlass
    If you are going to be a primary care NP, you don't need RN experience. If you want to be an acute care NP, then you need RN experience. .
    This is only an opinion, not an across the board fact.

    A counter opinion is that yes, RN experience can be very beneficial and advantageous in terms of familiarity to situations, medication uses and dosing, protocols, networking, paying down loans/receiving tuition reimbursement, etc.

    There are many advantages to working as an RN while completing an NP program.
  6. by   Oldmahubbard
    I am a PMHNP.

    That being said, I can see how a very intelligent, motivated person could succeed as an outpatient primary care provider, without significant RN experience.

    The diseases are mostly stable and chronic. They are usually objectively verifiable. Labs, x-rays, physical exam, etc.

    Yes, there will be drug seekers.

    No one should be walking in your door half dead, and you should call 911, if that is the case.

    You will have a physician colleague to talk over difficult cases and refer to.

    I can see how lack of familiarity with the medical system overall may present a problem at times, because all of the cases will not be totally straightforward.

    Still, it is hard for me to picture how years of working at the inpatient oncology unit (where I was first employed) would have helped me very much become a PCP.

    However, I find it very unlikely that people will succeed in some advanced practice roles without significant RN experience. To include Nurse midwife.

    Are you kidding?

    Acute care and Psych.

    Unfortunately the definition of "success" in Psych now is that a gluteus maximus sits on a chair, and signs the prescriptions for whatever the patient wants.

    I know several examples of this.
  7. by   FullGlass
    This topic has been beaten to death here. I suggest the OP look up previous discussions on this topic.

    The facts, without an opinion:

    1. RN experience is NOT required to get into most primary care NP programs. That is true for the top rated primary care NP programs like Hopkins, Yale, UCLA, etc. I did not have RN experience and was accepted by Hopkins, UCLA, and Univ of San Diego Hahn School of Nursing.

    2. RN experience IS required to get into most acute care NP programs.

    3. RN experience is NOT required to get into a lot of PMHP programs, including top schools.

    4. RN experience is NOT required for a new grad NP to get a job as a primary care NP.

    5. RN experience IS required for a lot of acute care NP jobs.

    6. If you are interested in oncology, even if it is outpatient, these jobs NP usually require RN experience.

    A debate has raged here about whether NPs should be required to have RN experience. People here make a good case for both sides. However, the limited research that has been done on this does not support that RN experience is required. So there is no evidence to support that RN experience should be required for NPs, other than personal anecdotes.

    The best source for school requirements are school websites. The best source for job requirements are job listings.
  8. by   Oldmahubbard
    OK, you may be right about the Psych NPs not needing experience, but that is only because we, as a society, don't give a rat's arse about this population.

    I know a couple of these non experienced Psych NPs, and they are just horrid.

    They often become mules for various street drugs, to include seroquel, the poor man's heroin, and of course all the benzo's and stimulants.

    There was a lawsuit some 10 years ago against a Psych NP at an Ivy League school, after an 18 y/o there committed suicide.

    The young man had never been diagnosed with ADHD as a child, and he was valedictorian of his small town class.

    He got to college, and suddenly started worrying about his ability to compete as a small fish in a big pond. It was easy to read about ADHD online to know the symptoms to endorse.

    He went to the clinic, and the NP gave him the stimulant he wanted. If she had bothered to read any of the literature, she would have known half (or more) of these drugs are diverted on such high pressure campuses.

    Apparently it wasn't enough. Within a few months, she gave him 2 more stimulating antidepressant drugs.

    Of course, all the details were not released, but as an experienced NP, I would never have prescribed the first drug, let alone 2 more.

    It was said she wasn't properly supervised by the MD , but nothing was proven. She still has her license.

    I just think it is very, very sad.

    Come to think of it, my brick and mortar school 20 years ago required some RN experience, but nothing Psych specific.

    However, my cohorts generally had extensive experience, as I recall.

    I worked inpatient for many years, and an RN there who was widely considered to be just barely functional got his Psych NP degree.

    The last I knew, one of the physicians rolled his eyes and told me the guy has a good job in a nearby city.

    The doctor said "don't worry, all he does is renew scripts for a real psychiatrist".

    That is not all he does, I can assure you.

    Rant over.
  9. by   ICUman
    The OP did not inquire about whether RN experience was required.

    The bottom line is, RN experience can be very advantageous and helpful; during school, and upon completion.

    Is it necessary? Depends. Obviously there are successful nurse practitioners on this site without that experience.
  10. by   RobotechTD
    Many of the NP online schools will have discussions that will require you to talk about some of your experiences as an RN. For example, in one of my discussions they asked if I made any major ethical decisions that affected a patient's care.
  11. by   FullGlass
    Quote from ICUman
    The OP did not inquire about whether RN experience was required.

    The bottom line is, RN experience can be very advantageous and helpful; during school, and upon completion.

    Is it necessary? Depends. Obviously there are successful nurse practitioners on this site without that experience.
    You're playing with semantics. Necessary can be viewed as synonymous with required. There is a difference between what is necessary or required and what some people view as advisable.
  12. by   db2xs
    The only other thing I could think of that previous RN experience might help (but is not necessary) is if you're interested in getting into a specialty. For example, I work in heme/onc as an RN and many of the oncology NP job postings state they prefer someone with previous heme/onc experience (bedside experience, not NP experience, necessarily). Not that someone who hasn't had heme/onc would be excluded, but since there is such a steep learning curve, I can see why they would prefer an NP with previous heme/onc exposure.
  13. by   thatgirl2478
    necessary? no, a lot of NP schools allow you to enter without EXPERIENCE as an RN.

    is it a good idea? Yeah, probably. as other's have pointed out some specialties require it.
  14. by   ICUman
    Quote from thatgirl2478
    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.

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