What do you think about...

bluesky, BSN, RN · Jan 15, 2005

... but for some people, I believe they can develop that perspective through coursework and supervised clinical practice as a student. I guess it depends upon the quality of the educational program.
llg

Well, I guess a great program can create an environment in which a student learns the fundamental values of nursing. But then you're left with the clinical question. It is very doubtful that even the greatest nursing undergraduate program could provide the necessary breadth of experience necessary to recognize and/or resolve complexe clinical situations. While it is true that in the real world there are other clinicians available for consult and opinion, often early recognition is key_ understanding the subtle, early signals is instinctive when you have practiced at the bedside for years and watched your patients progress into sepsis or get an illeus or start to show early signs of losing reserve or whatever. Whereas Doctors have years and years of supervised training AFTER school, NPs only have clinicals and a paltry mentorship. This is why practice as an RN is so heavily valued when assessing the CV of an NP.

I have not met a single NP or MD for that matter who have found it to be a wise decision to progress immediately from BSN to NP. I myself am debating medical school vs. CRNA right now and feel guilty about only doing 2 yrs in SICU as an RN. I may go for longer because there is so much that I'm learning that will be of value, besides I really enjoy being a shop steward for my union which I would have to give up. :)

LilPeanut, MSN, RN, NP · Jan 15, 2005

I'm in a direct entry NP program. For those that don't know, it's an accelerated program designed for people with non-nursing/medical degrees to come back to graduate school and become RNs and NPs.

MOST of the tracks do not require any working time as an RN prior to the NP clinicals and other advanced classes. But, most of those tracks are office care focused. I guess it's not as big of a deal there potentially.

My track (NNP) requires two years in the NICU before you can do any of your advance practice coursework. (I think that may be a national requirement) I am consistently surprised by the number of people who are put off by that, but I'm thrilled - this program was actually the way for me to get my RN the fastest, and the opportunity to become an NNP is icing - nursing is my first goal.

I would think that especially in any high acuity setting, there would be a benefit to having hands on experience as a nurse prior to taking the NP coursework.

cgfnp · Jan 15, 2005

Every one has their opinions about nursing and reasons for going into nursing. No offense taken on my part. One last question...if you don't mind. Are you satisfied now in your field? Was all the nausea worth it?

I love it now... and yes it was worth it, but it certainly was a miserable experience.

cgfnp · Jan 15, 2005

You wanted to learn more about ekg's, xrays and surgery:rotfl: Nursing stuff is crap????? So you are a N.P.?????

Yes. Yes. Yes.

bluesky, BSN, RN · Jan 15, 2005

Yes. Yes. Yes.

So why didn't you just go to Med school, then?

*PICURN* · Jan 16, 2005

The entire reason I became an RN was to become an NP

I personally don't think that there is anything wrong with wanting to be an advanced practice nurse from the getgo. So what? Some people know what they want early on.

At the same time, I do enjoy the role of the RN, I just always knew I would never stop there (not that there is ANYTHING wrong without getting your MSN)

cgfnp · Jan 16, 2005

So why didn't you just go to Med school, then?

Several reasons.

1. malpractice insurance (850/yr compared to tens of thousands a year).

2. No long, moneyless, work-your-a$$-off-for-pennies residency.

3. Started practicing as NP 6 years before I would've started as MD out of residency (get to start living normal life much earlier).

4. Saved about $900,000 in lost income/tuition/interest between now and the time that I would've got out of residency.

5. In primary care, I would've made the same amount of money I'm making now (especially as an employee). Soon, I'll make more than average PCP doc makes.

6. I have a baby girl, and don't want anything (including career) to come between us.

7. As NP (in my particular situation) I have no call, no weekends, no holidays, 40 hours/week.

Those reasons above made it an easy choice for me. Now, I'm fresh out of school and loving every minute of it. No regrets.

JVanRN · Jan 16, 2005

Thanks for your honest posts cgfnp...I don't think that make you anyless caring. IMO alot of the stuff they teach in nursing school IS crap. I don't think nursing is crap but there is alot of emphasis on the "touch feely, I love you, you love me" aspect of it and not as much on the scientific. Nurses...have to be very up on the "medicine" aspect of things as well. I think that is why when the general public thinks of nurse they think mostly of hand holding and hugs...I don't think the general public is truly aware of what nurses actually do and are responisble for...sorry for the rambling

cgfnp · Jan 16, 2005

Thanks for your honest posts cgfnp...I don't think that make you anyless caring. IMO alot of the stuff they teach in nursing school IS crap. I don't think nursing is crap but there is alot of emphasis on the "touch feely, I love you, you love me" aspect of it and not as much on the scientific. Nurses...have to be very up on the "medicine" aspect of things as well. I think that is why when the general public thinks of nurse they think mostly of hand holding and hugs...I don't think the general public is truly aware of what nurses actually do and are responisble for...sorry for the rambling

very true... I think the term "nursing" should be thrown out and RNs should be titled "Physician Guards".

Kabin · Jan 17, 2005

There may be several benefits if the profession changed its name. I was driving one day and saw a car with a vanity plate that said "I LV 2 TCH." This was obviously a proud teacher and that made me imagine how I could do the same thing with the nursing profession, but I envisioned the wrong first image: "I LV 2 NURS." :)

np2b · Jan 17, 2005

Hi...I haven't read the replys to this posting in detail, but I wanted to give you the perspective of someone who started in an accelerated program, but stepped back a bit.

I started in a masters-entry program for the FNP. I did my research, and really thought that I would be sucessful as an FNP even if I had minimal RN experience (I planned to work as an RN while I studied the masters-level stuff.)

However, as things progressed, I ended up practically begging my institution to give me a BSN and allow me to take some time off from school to pursue to the RN aspect of nursing (which they did). There were a few reasons why this occured, but the biggest was that I fell in love with emergency nursing and, at the same time, felt so utterly clueless about nursing and health care in general that I decided that I wanted to get some experience under my belt. (The fact that every hospital in the area wouldn't hire me in the ER if I were to continue school was the final kick in the butt in that direction.) I've been working in an ER for the last four months and love it.

I still plan to go back to FNP stuff, but I'm in much less of a hurry. Even though I was prepared to do the FNP program, I really do think that I will be much much more confident and qualified to tackle primary care after my experience in the ED. And I think that this confidence is going to make me a lot more happier in the long term. I hate to admit it, but I do feel now that the learning curve might have been a little too steep for me if I had done the program straight through. (These feelings come from someone who considers herself pretty intelligent, but also someone who is deathly afraid of screwing things up--especially when people's lives are at stake.)

So, this is just a few things for you to think about. Personally, I still think it's possible to do the direct-entry stuff, but it didn't sit particularly well with my perfectionist personality. Life and my own personality has steered my career in an unexpected, but welcome, direction. I'm extremely happy, even if things aren't going quite as planned.

Good luck!

llg, PhD, RN · Jan 17, 2005

Well, I guess a great program can create an environment in which a student learns the fundamental values of nursing. But then you're left with the clinical question. ........ Whereas Doctors have years and years of supervised training AFTER school, NPs only have clinicals and a paltry mentorship. This is why practice as an RN is so heavily valued when assessing the CV of an NP.
:)

Very good point. Only an educational program that provided sufficient clinical education could do the job well -- and most do not. Either that or the employers should take the lack of clinical experience into consideration when developing positions, planning orienation and staff development programs, etc. The vast majority assume an NP has the experience and are not prepared to provide that much nurturing of a new grad with so little experience.

I know someone who did a direct enty Neonatal NP program. She chose to practice as a staff nurse for a couple of years before taking the NNP exam and actually practicing as an NNP. I respect her for that. She was very honest and realistic about what she could and could not do well.

llg