Too soon to become an NP?

DayDreamin ER CRNP · Aug 12, 2016

your post comes across to me as it is too soon for you. You mention "getting the minimum hours" needed. Will your patients appreciate that you just did the minimum?

I tell people to get at least 3 years experience before attending school. Of course, everyone is different, but the more quality experience you can get, the better off you will be at school AND in helping people. I would urge you to get some urgent care or emergency room / ICU experience. Med-surg can be good experience but you haven't seen fast paced until you work in an ER or ICU. Every pt in the ER/ICU is YOUR patient and you often have to work autonomously to care for your patients. You don't have that so much on the floor at most hospitals.

Not trying to discourage you but I can always tell the NPs that had no or very little RN experience before becoming an NP. Even the new RN in NP school struggles at times.

Take some time to really get some great experience if you can. It will be a benefit to you and your patients AND your MD you are working with.

Daryl_G · Aug 12, 2016

Readiness based on time and floor experience is difficult to assess on a forum. Things I look for when an RN ask me this question in person:

1. Do you show leadership in the area you work in?

2. Do you fully grasp what is going on with the patients your managing on the floor?

3. Do I see others coming to you for help or support?

4. Do you exhibit critical decision making on the floor?

5. Do you have the communication skills necessary to convey information on a professional level and patient level

6. Do you seek new information to better your practice or do you need to be spoon fed.

If it is NO to any of these question then wait. If it's a yes to all then I say maybe depending on what you want to do FNP, ACNP, ect.

There is no hand holding at the ARNP level and that is what make it difficult. Many of us hit the ground running, no 8 week orientations and have to work with staff that look to us for leadership and answers.

matthdrn · Aug 12, 2016

I started my NP pathway at about the 6 month mark of being an RN. I don't regret it at all. To me keeping the ball rolling on education and not putting it off made it easier for me transition into school again. I ended up finishing my Master's degree in 3 years and successfully passed the ANCC certification exam on the first attempt.

I do agree with the poster above. I had a two day orientation. You are expected to be autonomous and independent on day 1. I found that assuming the most responsibility you can safely handle in your clinical experience in graduate school will help you prepare for this. For example; in my last clinical semester I was seeing all the patients and my preceptor was just in the room observing. I did everything including the billing paperwork. This has proved invaluable to me. I know some of the other students did not take such an active role and are having trouble handling the patient volume and pace seems to be the biggest corner of my former classmates.

YoutubeTheNP · Aug 13, 2016

I would say no one is ever really 'ready' to be an NP. What quantifies being 'ready'? Is someone who has 10 years working in a nursing home more 'ready' than a 2-3 yr nurse in a busy ICU? Or is the 3 year RN in the innercity trauma ER more ready than the 3 year suburban ER nurse?

I think it comes down to this; if you want to take the challenge of going back to school and learning new things than go for it. If you want to advance your career and take on the challenges of being the decision maker than go for it. I've been an NP for almost 4 years now and I can tell you everyday I learn something new. Medicine is so vast that you will never be able to learn it all, thus my argument of how can you define being 'ready'. If you want the responsibility of diagnosing patients, ordering/interpreting studies and labs, prescribing medications and creating a plan of care than go for it. You may not know now, but that's why you go to school. It takes a lot of time and sacrifice to complete so I would advise you once you go back to put your whole heart into it.

Ill leave you with a great quote:

You do not go to school and study to pass a test. You go to school to study so that when the only thing between a patient's life is you and death, you will know what to do.

Ryan

Malenurse1235954 · Aug 16, 2016

I started a DNP program today, with zero previous RN experence. Before doing so, I read everything I could to see if any research was done on years of RN experence and proficiency as a NP.

The literature I read found either no corrulation or suggested little to no RN experence is best. Academically speaking, the most reliable predictor of success (by far) is previous coursework GPA.

There was a quote from class today that seems fitting: "Practice needs to be evidence-based rather than 'how we always did it.'"

There are plenty of people online that will tell you dont do it because you need to get more exp, then cite they "always" can tell a NP with no/little RN experence. Personal experences are so vunerable to bias. It erks me everytime someone discourages someone with this rationale.

I see you have two very small children, if you start NP school would you have enough time to study? I would make sure you can devote enough time to success or someone is gonna say "its because she didnt work enough as a RN..."

DayDreamin ER CRNP · Aug 16, 2016

I started a DNP program today, with zero previous RN experence. Before doing so, I read everything I could to see if any research was done on years of RN experence and proficiency as a NP.
The literature I read found either no corrulation or suggested little to no RN experence is best. Academically speaking, the most reliable predictor of success (by far) is previous coursework GPA.
There was a quote from class today that seems fitting: "Practice needs to be evidence-based rather than 'how we always did it.'"
There are plenty of people online that will tell you dont do it because you need to get more exp, then cite they "always" can tell a NP with no/little RN experence. Personal experences are so vunerable to bias. It erks me everytime someone discourages someone with this rationale.
I see you have two very small children, if you start NP school would you have enough time to study? I would make sure you can devote enough time to success or someone is gonna say "its because she didnt work enough as a RN..."

I respectfully disagree. Especially about the "academically speaking" part. As a patient, I'd rather have an RN with a wealth of patient care experience vs an NP that made straight As through school.

As a co-woker, I'd rather have the experienced RN on my side, too. I've worked with a lot of NPs that have never once been an RN and they have very limited, if not absent, recognition of clinically ill and declining patients. No book on the planet can teach you clinical judgement.

By the way, "The way we always do it," does have clinical basis. Don't discount it.

Everyone is different in their career / school path but the NP with a good foundation as an RN, makes a better clinician and coworker.

kobra357 · Aug 16, 2016

I agree with keeper mom . I have worked with many NPs that have never been a nurse and not one has been worth a crud. The lack of experience is obvious. All the NPs who say they are good and never did any nursing cant have an opinion, I would have to talk with their patients and co workers and I bet I would get a different answer. This goes for all the Master and Dr programs who get their degree and run a hospital or clinic etc.. They have no idea what its like to be on the floor and doing the job they direct us to do. Experience is key and the more the better and the more ICU/ER experience makes you more rounded for the job. I cant believe they let non experienced noobs go into NP school with no experience. Do it for your patients coworkers and yourself to be the best and not just a title for the $$.

ritit123 · Aug 17, 2016

As a second year Primary care NP student with and 4 years of experience as an RN in acute rehab I decided to go back to school when I felt confident in my skills and understanding of the patient population I was working with. I would say it also depends on where you want to work after you graduate. My ICU experienced counter parts who decided to go for primary care at times struggle because they lack the experience working with patients in an out patient setting and by experience I mean the timeline of events and plan of care which happens in outpatient setting. I, on the other hand would probably struggle in the acute care track as I know little about that setting. All in all, I can recall wanting to be an NP about 2 years into my career but felt that I had more to learn. As some folks above mentioned, it's not so much the details of medical facts but the experience of seeing the "big picture", taking on leadership roles and working independently.

Malenurse1235954 · Aug 21, 2016

the NP with a good foundation as an RN, makes a better clinician and coworker.

Does RN experience relate to NP clinical skills? - PubMed - NCBI

Exploring the Factors that Influence Nurse Practitioner Role Transition. - PubMed - NCBI

Does Prior RN Clinical Experience Predict Academic Success in Graduate Nurse Practitioner Programs? - PubMed - NCBI

This is a bold statement and I would love to read any literature you can find that supports it. However, as far as I can tell there is none. Above is a brief literature review on the subject. It does not appear much of a correlation can be found between years of experence as a RN and proficiency as a NP can be found. If anything there seems to be slight favor for less RN experence.

I am certain there are many that have a story of a NP that did a bad job and happened to be low on years of RN experence, then make a (biased) conclusion based on a small set of encounters that they generalise to all in the demographic. Same can be said about some physicians vs NPs in general. In both cases there is rarely data to support the assertion.

kobra357 · Aug 21, 2016

Well nurseshawn1234. Your articles prove NOTHING. How long have you been a nurse? Also are you one of the many who come out of school thinking they know it all right off the get go? Heading to a masters program to tell the many minions how to do their job better? Just wondering how many years experience you have to contribute. Real world experience proves you wrong. Are there nurses who have been one for 20 years that still dont get it and go on? Yes. Are they not so great NPs. Yes. But expeience and knowledge for the majority not the minority is best for patient outcomes and coworker confidence.

applesxoranges, BSN, RN · Aug 31, 2016

My advice is to get some experience working in a different setting or hospital too. I think having some knowledge of how different providers and hospitals do things help me a lot. I like to compare different approaches and events. Technically I am in one company but the different jobs help a lot.