Too Soon to Start MSN for NNP?

babyNP., APRN · Sep 10, 2014

I just finished my NNP degree awhile ago, thought I would give you my perspective:

To be eligible to take the NCC board exam, you don't need any NICU RN experience (this is fairly recent; it used to be at least 2 years). However, virtually all the programs (I haven't looked recently, but doubt they have changed) require at least 2 years of experience in a Level III. Many of the programs have the caveat that you may begin the program as long as you keep working in a NICU so that you have 2 years experience by the time you start your clinical rotation. When I was first looking at NNP programs, I created a spreadsheet of all known ones I could find and they all said this. This was about maybe 4 years ago? but I don't think much will have changed for a couple of reasons:

You probably know that many new grad RNs go straight into getting their adult NP license. This is more appropriate than NNP because nursing school is largely tailored to the adult population. Nearly nothing towards the NICU, although I was fortunate enough to get my senior practicum in the NICU.

NICU, as you know by now, is nothing like adult nursing. You even have to re-learn what a normal vital sign is for you patient. They are so different and so complex, not to mention the fact that they are an ICU patient. The learning curve, as you know, is very steep. I waited 4 years before starting my program, partly due to my wanting to wait and partly due to my family situation at the time. I ended up taking the RNC-NIC, which gave me a lot of confidence to apply.

That being said, I think 1-2 years is fine, but if you are continued to be employed in a NICU. Not only for your own experience, but I found that it really helped me put the principles I was learning in school into practice in what I saw as a RN. There were some challenges...going back and forth between the provider role and the RN role made things interesting, but it really enhanced my education.

If you go back with just 1-2 years, expect school to be very hard. It was clear that some people in my class that had less experience had more trouble grasping the concepts and just "knowing" things innately. But everyone brings their strengths and weaknesses to the table. I was very concerned about going to school because I had no delivery room experience (I worked at a children's hospital). The first semester learning all the antepartum and delivery and run of the mill stuff that we never really dealt with was a bit challenging, but I was able to pick it up fairly quickly. I found my strengths during my clinical rotation when I really had to guide the nurses on what to signs/symptoms to look out for on a very sick patient and impressed my preceptor on my knowledge.

PA's are trained as generalists and if they are hired into a NICU, they usually need more guidance and a longer orientation as compared to a NNP. There are actually a few NICU residencies that are popping up around the country in order to help them be more attractive to employers. There are some NICUs that refuse to hire them but there are others that hire them regularly. I've worked with several PA's in my home facility and most of have them have been excellent (however, they were experienced). We did have one person that switched to NICU from a different service and this person really struggled to grasp how to take care of the neonates.

In conclusion, I would definitely recommend that you apply to school. Whether it's next year or the year after...I would recommend that you have at least 2 years experience, but you could gain this while still going to school part-time. I would also recommend taking the RNC (well, I think you need at least 2 years experience) or the CCRN (I think this is just one year required). Just keep in mind that the learning curve will be just as steep or more with less years of experience, so school will be challenging.

If you do a search on this forum, you can find the thread I made that listed the current as of then schools that offered the program. Oh! and also either a) make sure you go to a school that sets up your clinical sites or b) if you have to set up your own, make sure you have agreements with other hospitals that will take you on. I think it's absolutely criminal that many programs require you to find your own clinical sites and if you can't find them, tough luck.

There is a NNP shortage and the average age of a NNP is something like 48. With health care changes and pediatric residents no longer required to do 2 months in the NICU (just 1), we need more NNPs. Best of luck...let us know how your journey goes and let me know if you have any other questions.

anh06005, MSN, APRN, NP · Sep 10, 2014

Well I'm finishing my FNP program and the NNP program is much like mine you usually have book work for the first several semesters before you actually start clinicals. I have been going part time (so 1-2 classes per semester) so I could also work full time. By the time I started clinicals I had about 2.5 years of RN experience so I felt MUCH better about things.

Oh and I graduated in May 2010 and started my MSN program August 2010.

Good luck! Also some programs say you need so many RN hours before your start the CLINICAL portion of the program.

cmary · Sep 10, 2014

In conclusion, I would definitely recommend that you apply to school. Whether it's next year or the year after...I would recommend that you have at least 2 years experience, but you could gain this while still going to school part-time. I would also recommend taking the RNC (well, I think you need at least 2 years experience) or the CCRN (I think this is just one year required). Just keep in mind that the learning curve will be just as steep or more with less years of experience, so school will be challenging.
If you do a search on this forum, you can find the thread I made that listed the current as of then schools that offered the program. Oh! and also either a) make sure you go to a school that sets up your clinical sites or b) if you have to set up your own, make sure you have agreements with other hospitals that will take you on. I think it's absolutely criminal that many programs require you to find your own clinical sites and if you can't find them, tough luck.
There is a NNP shortage and the average age of a NNP is something like 48. With health care changes and pediatric residents no longer required to do 2 months in the NICU (just 1), we need more NNPs. Best of luck...let us know how your journey goes and let me know if you have any other questions.

Wow, thank you! I'm looking to apply in the Philadelphia area, so right now I am looking at Thomas Jefferson and UPenn. I believe those are the only two schools in that area that offer the specialized Neonatal Nurse Practitioner. UPenn seems to have a shorter program that I could complete in a little over a year (full time) or in 2 years part time. I assume that UPenn would be very challenging to get into, though I graduated with my BSN with a 3.78 and would have level III NICU experience too (hoping that will help!). I will be contacting admissions soon. Do you have any thoughts on either of these programs?

I absolutely do not want to stop working, and would hopefully be able to go part time or casual once school starts in the fall. Still not sure about full or part time school, thought I do like the idea of getting through the program as soon as possible. Any thoughts about full or part time?

Thank you SO much for your insight.

vumblevee · Sep 10, 2014

I feel the same way too. I have 9 months of NICU experience here in Texas. I had 2 years NICU experience outside the country but that was years ago. I really am interested in taking masters but I'm wondering if I should take the RNC first. RNC requires 2 years NICU experience in the US I believe.

I was looking at the UTMB and Vanderbilt programs. I haven't really looked into UPenn yet.

I'm worried about the future of NNPs. I hope it is true that there will be a shortage of NNPs in the future. I think I've read somewhere that no one really likes to hire NNPs because they're expensive and they'd rather have neonatologists. I hope that's not true in most of the hospitals.

I subscribed to this post because I'm definitely interested in what others comments are.

I wish the OP best of luck!

babyNP., APRN · Sep 10, 2014

cmary: For your situation of having less experience, I would do part-time. It'll allow you a greater understanding of being able to apply what you learn in school into what you see at the bedside. It really helped me out. I did a program over a couple of years while working full-time and then dropping down to part-time and I credit my simultaneous school and working to really helping my education.

vumblebee: The RNC requires 2 years of experience, but the CCRN only requires 1 year of experience. I took it after 3 years of NICU nursing just to build confidence in myself, but it's not necessary for any admission. Of any university you choose, be wary if they tell you to find your own clinical. You need to delineate exactly what it means because some places have multiple contracts and others don't and you're not allowed to graduate if you can't find a clinical.

Don't be worries about the future of NNPs. Where did you read that? NNPs are in demand and are very cost-effective. One neo can't run an entire unit, depending on the size. My home facility had three teams and about 60 patients, each team taking 20 patients. One neo taking care of 20 patients that were all medically complex is pretty impossible when you think about family meetings, writing orders, being present for bedside surgeries, completing discharge summaries, doing procedures, and making care plans. Each NNP/PA member on the team took anywhere from 4-6 patients, I believe, discussed the case on rounds with the neo, but then pretty much ran the show afterwards (having the ability to continue consult the neo as needed). There was no neo in-house at night, although they did come in if there were night admission ECMO patients.

cmary · Sep 13, 2014

Thanks again for the advice, BabyRN. I am trying to message you privately, but I am new and do not have 15 posts yet and so I'm not able to use this function! How frustrating!

babyNP., APRN · Sep 13, 2014

Just sent you a PM :)

NNP-2018 · Sep 14, 2014

I am interested in the same question. I transferred to a level IV NICU 6 months ago after working in a level III labor and delivery for 5 years. I was looking into Duke's online NNP program and was thinking of applying for next fall admission. I would have about 1.5 years NICU experience at that time and would have 2+ by the time clinical would start.

babyNP., APRN · Sep 16, 2014

Well, if anyone has any questions, feel free to post them here and I will answer them as best I can. I know that there is one NNP on here named SteveNNP121 (or something like that), but he hasn't been to AN in awhile. I'm not board certified yet, but just finished my program a few months ago.

artipatel18 · Mar 17, 2015

Hey everyone! What did you guys think of online NNP programs? I live in NH and am looking at Thomas Jefferson Univ. which seems to be a perfect fit for me. There arent many NNP programs up here.