You don't need RN experience to get an NP job

[FullGlass]

I'm a new grad Adult and Geri Primary Care NP. I do not have RN experience. Since I started seriously pounding the pavement in my job search, I have had numerous phone and in person interviews. I've also received multiple job offers.

Has anyone asked me if I had RN experience? Yes. When I answer that I have none, here are the 2 responses I've received:

"Good for you!"

"You must be very smart."

This will probably upset some readers, but it's the truth.

There are some job postings for new grad NPs for outpatient specialty positions that do require RN experience - oncology is one.

Conclusion: if you want to be a Primary Care NP, you are fine going straight from BSN to MSN. There are plenty of employers that will be happy to have you, at least in the Western U.S.

[Oldmahubbard]

There will be some DE grads that will swim, and some that will sink. It may have more to do with personal factors, ie nothing to do with experience. Some people are much more comfortable in new situations than others. Some people can bluff their way through, and some will be able to distill the knowledge but be able to refer when their scope of knowledge and practice is exceeded.

Some practice settings will support a new grad much more than others.

I would imagine that the first couple of years are a huge eye opener for the DE grad. Too bad we don't hear more from them, and about them.

I know in Psych, I could not have managed without significant RN experience. I would have had no clue.

[BostonFNP, APRN]

There will be some DE grads that will swim, and some that will sink. It may have more to do with personal factors, ie nothing to do with experience. Some people are much more comfortable in new situations than others. Some people can bluff their way through, and some will be able to distill the knowledge but be able to refer when their scope of knowledge and practice is exceeded.

I have talked about this many times before, but I think that anyone that has precepted APRN students would more-or-less agree that individual variability is far larger than other factors like RN experience. When we think about this from a profession perspective those individual variances should balance out and leave just the variability of other factors (basic research 101) but we don't have a lot of good research going on about this topic.

Some practice settings will support a new grad much more than others.

The effect of employer orientation and support has been demonstrated consistently in the extant literature as a independent factor in role socialization.

I would imagine that the first couple of years are a huge eye opener for the DE grad. Too bad we don't hear more from them, and about them.

Isn't this true of any novice NP? We do have some posters that are DE grads but the meet so much negativity that its not surprising they often don't speak up.

I know in Psych, I could not have managed without significant RN experience. I would have had no clue.

Did you have psych RN experience? Specialties are really a different story vs primary care and, though I don't have research to support it, I feel like APRNs do need some sort of formal experience outside of their graduate preparation.

[BostonFNP, APRN]

Very Very Good points Boston!!! The "measured" response is probably gonna be "but we don't approve". Do yourself a favor and stop caring. Many in nursing think they are owed an explanation by others for all sundry things that really are not within their control. IE "why did you do DE NP?" Real answer is "because I could" followed by closely by "Its none of your business and nobody did or will seek your approval".

But we need to do whatever we can to change this dynamic. Nursing is stronger together in the end. I hate the notion that one of the major obstacles novice NPs face is other nurses. There is some irony to the fact that experienced RNs don't want non-experienced NPs telling them how to do their bedside job but also have no problem trying to tell the novice NP how to do their provider job without any education/experience. It reminds me a bit of the scene from Scrubs (by far the most realistic medical show there is) when Dorian finally stands up to Carla on a medical decision.

[FullGlass, BSN, MSN, NP]

If you are smart enough to pass an NP program, you are smart enough to read. I've stated my point 3 times. I won't restate it when you purposely choose to be ignorant.

RN experience absolutely is beneficial to becoming a primary care NP and I am forever in favor that every NP should be required to have it before practicing. But tuition money talks louder than experience, we know that won't happen.

Perhaps I do have a cognitive issue. Are you an NP? No, you are not. Are you working in a primary care environment? No, you state you are an ER RN. Are you in a position to hire Primary Care NPs? No, you are not. So, please help us all understand why your opinion of what experience primary care NPs should have is relevant to NP job seekers? Despite your disapproval, I got SEVEN job offers.

I do not presume to weigh in on what education, training, and experience ER and ICU nurses should have. Nor do I weigh in on what education, training, and experience Acute Care NPs should have. My opinion on those matters is irrelevant because I have not been, nor will I ever be, acting in those roles.

As for robots taking over and throwing many people out of work, this has been extensively written about in the business and technology media. Silicon Valley has made no secret of their plans to write software can diagnose and prescribe treatment, requiring only a trained technician. Robot nurses are already in use in Japan. There are already robot psychotherapists. There are also already robotic surgery machines. It is common knowledge that driverless cars will be here soon. Once that happens, it will only be a matter of time before there are driverless buses and trucks. Transportation is one of the biggest employers in the USA, so driverless vehicles will result in millions of jobs lost.

References

Ford, Martin. (2015). Rise of the Robots: Technology and the Threat of a Jobless Future.

Google these article titles, as allnurses doesn't like links:

A Robot May be Your Next Therapist. Psychology Today, Jan 2017.

The Chat Bot Therapist Will See You Now. Wired. 2017.

Career of the Future: Robot Psychologist. WSJ, 2017.

4 Million Driving Jobs at Risk from Autonomous Vehicles: Report. Insurance Journal, 2017.

Japan Prefers Robot Bears to Foreign Nurses. Foreign Policy, Mar 2017.

Robot Nurses Will Make Shortages Obsolete. The Daily Beast, 2016.

AI vs Doctors

Artificial intelligence is challenging doctors on their home turf. We're keeping score

IEEE

Technology Will Replace Many Doctors, Lawyers, and Other Professionals. Harvard Business Review. 2016.

[Oldmahubbard]

Yes, 4 years of Psych RN experience, during which time I was in NP school, one class at a time, and asking myself every night when I got home : what is this diagnosis, and how should it be managed? What are these drugs, what are the side effects and how do they affect the patient?

Studying independently to understand it on a much deeper level.

Very extensive self preparation. You wouldn't get it just working there.

Watching very closely what the Psychiatrists did, and figuring out why they did it.

I didn't get what I have from an NP program. Our main instructor had no actual prescribing experience, and was Freudian in her perspective.

Nice lady. You know the expression "pretty face?" Right. Nice lady professor and completely ineffective.

[FullGlass, BSN, MSN, NP]

I'm not sure I agree with going into the *best* school though for things like nursing be it an ADN, BSN, or advance practice. At my VA, we have a slew of University of Michigan students there for clinical on our med-surge floors and I shudder to think of the cost that school is costing them. Each of those students are paying upwards of $30,000/year for a degree in nursing. The only edge this will give them IMO is one on an ADN applying for the same position. This will grant them the same going entry rate as any other brand new nurse that hits the job market. And as they progress in their profession/experience, nobody will give two flips where they went. At the end of the day, they will hold the same license and people will only care what their experience is first, followed by do you have a license. I can't imagine it would be any different with an APRN.

Sorry, but I must disagree. Especially for an APRN, the school does matter. Many hiring managers will tell you that they will give first consideration to NPs from good schools. Medicine is the same. There are many good scholarships and loan forgiveness programs to help defray the cost of MSN and DNP programs.

[FullGlass, BSN, MSN, NP]

"Respectfully", at some point in life, I just might helping with hiring decisions just like right now I participate in the interviewing and hiring of RNs. Working on any team, group interviews are exceptionally common and a major factor for me and evidenced here a few others is experience that you bring to the team. And there's not "might not" help when it comes to rn experience. Any form of clinical patient interaction is infinitely more valuable than none. YOU may think you gain nothing from it, but you went direct entry yourself, so how would you know? You never took the time to work as and actually understand what it means to be an RN. You used the profession to fast track to primary care. Congrats on your ability to sell yourself in an interview and willingness to move anywhere. That's about all you needed to say in the original post.

Do you know how many RNs interviewed me during my job search? ZERO. The majority of my interviews were with MDs. A handful were with NPs.

[Jules A, MSN]

Has anyone actually counted the various responses on this and similar threads? It seems there are plenty of NPs who feel their RN experience was necessary. Everyone is entitled to their opinion and RNs are witness to the quality of product that is being produced, probably even more so than someone asserting their entire DE graduating class is skilled and successful. I have no clue how good my former classmates may or may not be except those who's patients I admit on the acute unit with terrible medication regimens.

[WestCoastSunRN, MSN, CNS]

But we need to do whatever we can to change this dynamic. Nursing is stronger together in the end. I hate the notion that one of the major obstacles novice NPs face is other nurses. There is some irony to the fact that experienced RNs don't want non-experienced NPs telling them how to do their bedside job but also have no problem trying to tell the novice NP how to do their provider job without any education/experience. It reminds me a bit of the scene from Scrubs (by far the most realistic medical show there is) when Dorian finally stands up to Carla on a medical decision.

I think the "those mean ol' bedside nurses" assertion is not generally true or helpful. I don't actually work with any nurses who possess the us v. them attitude with regard to nursing and medicine or nursing and APN. The truth is all newbie providers benefit from guidance/help from experienced nurses. I don't think those providers need worry that those helpful nurses think themselves superior (if that's an issue) or having education equal to a provider. Nurses advocate for their patients, they do what they can to keep them safe -- and my experience has been that they LOVE watching new, passionate, smart, competent providers come up - NPs included. Now are they watching those NPs closely? Sure -- as nurses we ALL are -- because they represent our most advanced practitioners and that speaks something about the WHOLE profession. We have countless threads on AN about NP preparation. All sorts of people are interested and have skin in that game.

So in the words of Spanked .... I am one of those "twits" that care.

[BostonFNP, APRN]

Yes, 4 years of Psych RN experience, during which time I was in NP school, one class at a time, and asking myself every night when I got home : what is this diagnosis, and how should it be managed? What are these drugs, what are the side effects and how do they affect the patient?

So do you think your RN experience would be as valuable if you worked in med-surg or home health or school nursing or in a dermatology office?

I didn't get what I have from an NP program. Our main instructor had no actual prescribing experience, and was Freudian in her perspective.

So your main faculty for a PMHNP program was not a board certified PMHNP? Did you know that going in? Did you do anything about it after graduation?

[BostonFNP, APRN]

Has anyone actually counted the various responses on this and similar threads? It seems there are plenty of NPs who feel their RN experience was necessary. Everyone is entitled to their opinion and RNs are witness to the quality of product that is being produced, probably even more so than someone asserting their entire DE graduating class is skilled and successful. I have no clue how good my former classmates may or may not be except those who's patients I admit on the acute unit with terrible medication regimens.

What good would counting responses be? The plural of anecdote is not evidence. It should be no surprise that people with RN experience find that experience valuable for the most part, it is a natural instinct. Those that don't have prior RN experience have other life experiences they find valuable. This has been shown in the literature as well.

Can you cite/quote a post where anyone on this forum has said their entire DE class was skilled and successful? I've never actually seen that said. What I have seen, time and time again, is people make an assumption that most DEs are somehow inferior, which is as flawed as assuming all are skilled and successful and this is exacerbated by the fact that many of those posts are made by those with a personal vendetta against a group of people that they have never even met. Lets not call the kettle black.

As far as admitting psych patients with terrible medication regimens, isn't this part of the natural course of many mental illnesses. Could the best psych prescriber in the world prevent all acute psych admissions? Do you only admit poorly managed psych patients from DE grad PHNPs or are there some MDs and DOs in the mix too? Do you ever think those patients get discharged from their acute admissions and go back to their community psych prescribers who then grumble about the awful med regimens the hospital pysch team put them on?

[BostonFNP, APRN]

I think the "those mean ol' bedside nurses" assertion is not generally true or helpful. I don't actually work with any nurses who possess the us v. them attitude with regard to nursing and medicine or nursing and APN. The truth is all newbie providers benefit from guidance/help from experienced nurses. I don't think those providers need worry that those helpful nurses think themselves superior (if that's an issue) or having education equal to a provider. Nurses advocate for their patients, they do what they can to keep them safe -- and my experience has been that they LOVE watching new, passionate, smart, competent providers come up - NPs included. Now are they watching those NPs closely? Sure -- as nurses we ALL are -- because they represent our most advanced practitioners and that speaks something about the WHOLE profession. We have countless threads on AN about NP preparation. All sorts of people are interested and have skin in that game.

So in the words of Spanked .... I am one of those "twits" that care.

This isn't a "mean ol' nurse" assertion, I am simply stating what has been demonstrated in the literature. I personally feel it is unfortunate, true. Can you honestly say that the majority or RNs are equally respectful of all novice providers: MD vs NP with extensive experience vs NP with no RN experience? If that's true it's great but honestly after reading enough of these posts I wonder if it's true. I think if a novice NP is "outed" as having no prior RN experience that they would face an uphill battle. Maybe I'm wrong.

I will say, as I alluded to with the Scrubs comment, that there comes a time for all resident physicians to stop hiding behind the nurses and stand up for themselves. This should be true of novice NPs as well, but when that happens it creates a much bigger rift in the nursing community. Being detached does have its benefits in spreading your wings and leaving the nest.