do you think your school prepared you or

ArmaniX, MSN, APRN · Mar 3, 2019

I'd say 75% NP program/clinical... but definitely my RN experience has assisted. My first job also provided a orientation period of roughly 2-3 months. On my own now I feel quite capable, I also know my resources.

Advanced Practice Columnist / Guide · Mar 3, 2019

I would consider the sources of those articles. Those comments seem par for the course at SDN and in articles that want to slow down the pace of full practice independence for all NP's. My program was over 10 years ago...much of what I know now are no longer because of that program.

When I was a new NP, I felt like an intern. I knew how to assess a patient, write an H&P and progress note, and present my plan to a physician. However, my plan was never final, needed some tweaking, and additional questions answered by the physician I was working with. But I certainly wasn't viewed by the practice as inept.

My RN experience helped as far as modeling provider behavior and critical thinking process. As a bedside nurse, I often asked the providers about the rationale for their actions as a way to learn. I think letting go of the RN mentality can be hard when you're in a provider role.

Oldmahubbard · Mar 3, 2019

Psych is a completely different animal. Several years of inpatient psych RN experience are needed to smell the difference between major mental illness and personality disorders.

If you can't smell it in a few minutes, you don't belong there. My opinion.

You can't get it out of a book or a few hundred clinical hours.

No my program didn't prepare me, but I didn't expect it to. I had seen other people in different walks of life with phony degrees. French teachers who didn't speak French. They didn't really have the goods. That wasn't going to happen to me as an NP.

All that being said, since I graduated 15 years ago I have run circles around most Psychiatrists, largely because I actually show up for work, and these entitled morons don't.

FullGlass, BSN, MSN, NP · Mar 4, 2019

I'm in primary care and did not work as an RN. I work in a busy rural clinic. Of course, I was very stressed out and felt woefully ignorant my first 6 months , then I gradually gained confidence, which is what my NP program had told us.

The Medical Director, other doctors, and my NP peers at this clinic have been happy with my performance. They didn't expect me to know much and wanted me to ask a lot of questions. This clinic also has a good ramping up system for new grad NPs.

Contrary to what online articles say, the MDs I talk to in real life don't care if an NP has RN experience for a primary care NP. Some have even said they don't want anyone with the acute care mindset. In primary care, it is all about the H&P, knowing how to work up a patient, and developing a plan. We don't have any equipment or IVs beyond an EKG machine. A primary care NP has to learn to work independently very quickly.

Our clinic had to fire an experienced NP who also had 10 years experience as an RN, including ICU and ER, because this person was woefully incompetent as an NP and was either unable or unwilling to do thorough physical assessments, refused to treat pain patients (even if they were dying of cancer), was prejudiced against certain ethnic groups, endlessly lectured everyone on being a vegan, and generally had poor interactions with patients. So this person's RN experience was of absolutely no benefit.

Personally, I can only speak for primary care and I think the 1st year will be a bit harder for an NP w/o RN experience. After the first year and certainly after 2 years, it won't matter and no one will care.

Most Acute Care NP programs do require RN experience, as well as some specialties like Oncology, which is understandable.

Trauma Columnist · Mar 5, 2019

I came into being an APRN after 12 years as an RN so yes, like some others I did count on some of my assessment skills as I transitioned. I had no issues with the physicians thinking I didn't know enough...