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.
If they're new, how "good" should they be? And would it not be helpful to strengthen the NP program rather than increase RN experience? What you learn as a provider is different to what you learn as an RN. Provider role training is more important in building knowledge and confidence. I'm saying this as an NP with many years of nursing experience.
But here's the other thing. I must have my head in the sand somewhere, because, in real life, I have not engage in or overheard this conversation (and my hearing is good). The only way I know about the possibility of no bedside experience is by how young they are.
This truly is one of the most sensible comments I've seen as it relates to the RN experience vs DE debate. I know it's been said in a variety of ways that NP education needs to be shored up and standardized. But we constantly compare our own education to that of PAs and claim that they require "thousands of hours" of healthcare experience prior to admittance PLUS 2000 or more hours of clinicals (compared to our paltry 600 or so), but one thing they do NOT standardize is the actual healthcare experience. They will take a variety of patient care experience, including pharm techs; a local program here requires just 250 hours.
Where the major difference is in the program itself...the training...the hours of clinicals. I do think we could only benefit from more hours in the program. I will point out, though, that PAs are trained to be generalists, and NPs must get another certification to practice in a different area, so it is not totally apples to apples.
I don't agree entirely with this article. For example the author states that this is not about a turf war or economics. However, one of his main points is that NPs are starting to have the nerve for asking for equal pay for doing the same job. I'm sorry but that is about turf and money.
However, I am not without my criticism of NP education. My DNP program could use much more focus. Classes tend to try to cover too much ground in too much detail leading to a process of cramming information into your brain for comprehensive exams designed by nurses with lots of gotcha ya questions on relatively minor points. How much of this crammed knowledge is retained? Who knows. We spend in an inordinate amount of time on a CAPSTONE project that has nothing at all to do with being a care provider. Quality hands on clinical experience should drive these programs. I went to a traditional, well established bricks and mortar school with 1700 clinical hours. I think these experiences are what should drive the program. Not cramming for tests and certainly not data collection, statistical analysis and poster creation (it wouldn't be nursing if arts & crafts didn't rear its ugly head). I also agree with some posters who state that these programs should be more specialized and focused on what role the provider will be engaged in upon graduation. A formal residency period wouldn't be the worst idea in the world either.
What I don't have a problem with is DE programs. If think if these providers are given a quality education they can certainly grow into a role of being a great contributor to the profession. I've been a ER Nurse for the better part of 2 decades and don't think that experience is directly applicable to being a provider. People of good will can disagree but that's my opinion. Further, these programs are a reality and not going anywhere so nurses can cast all the dispersions they want but at the end of the day we all have a job to so & we need to accept the reality of what is and move on with life
I don't agree entirely with this article. For example the author states that this is not about a turf war or economics. However, one of his main points is that NPs are starting to have the nerve for asking for equal pay for doing the same job. I'm sorry but that is about turf and money.
However, I am not without my criticism of NP education. My DNP program could use much more focus. Classes tend to try to cover too much ground in too much detail leading to a process of cramming information into your brain for comprehensive exams designed by nurses with lots of gotcha ya questions on relatively minor points. How much of this crammed knowledge is retained? Who knows. We spend in an inordinate amount of time on a CAPSTONE project that has nothing at all to do with being a care provider. Quality hands on clinical experience should drive these programs. I went to a traditional, well established bricks and mortar school with 1700 clinical hours. I think these experiences are what should drive the program. Not cramming for tests and certainly not data collection, statistical analysis and poster creation (it wouldn't be nursing if arts & crafts didn't rear its ugly head). I also agree with some posters who state that these programs should be more specialized and focused on what role the provider will be engaged in upon graduation. A formal residency period wouldn't be the worst idea in the world either.
What I don't have a problem with is DE programs. If think if these providers are given a quality education they can certainly grow into a role of being a great contributor to the profession. I've been a ER Nurse for the better part of 2 decades and don't think that experience is directly applicable to being a provider. People of good will can disagree but that's my opinion. Further, these programs are a reality and not going anywhere so nurses can cast all the dispersions they want but at the end of the day we all have a job to so & we need to accept the reality of what is and move on with life
Refreshing way to start my long weekend! I happily join you in supporting a moratorium on APRN 801 Arts and Crafts. For other DNP students perhaps the capstone thing is valuable but for NPs it is, in my opinion, time that could be better spent elsewhere.
I am surprised you don't feel your ED experience was valuable, again perhaps I was in need of remediation because I still go back to floor RN experiences, but I appreciate your opinion and agree with most of the other points. Obviously some of the author's concern is the turf issue but that isn't their only focus and their viewpoint wouldn't be worth a damn if our education wasn't such an easy target. I mean that for all flavors of NP education, although I can't speak for CRNAs if if fact they consider themselves NPs.
I appreciate the fact that the few journal references in that article were actually current and not the tattered references from over a decade ago that are often posted in support of NP outcomes. Times have changed, our numbers have increased, so it makes sense our malpractice payouts will rise but the prescribing data is something that is a slam dunk if they are performing valid studies. Hopefully nursing will be mindful of more than our sheer numbers and the universitys' love of the bottom line and adjust our education prn.
Just to be clear the op-ed is written by Rebekah Bernard MD and although I'm not entirely sure, I believe I've read articles by her before that bashed regular old bedside nurses pretty badly. As I recall her overall opinion is that we should go back to knowing our place because we've become uppity. I'm going to try to verify this.
That doesn't surprise me at all. However, I don't think you should throw the baby out with the bath water. Take the valid criticisms and leave the "I'm pissed because I'm a Doc & you didn't bow before me stuff" behind
That doesn't surprise me at all. However, I don't think you should throw the baby out with the bath water. Take the valid criticisms and leave the "I'm pissed because I'm a Doc & you didn't bow before me stuff" behind
Totally agree. And I might add that if that's what she wants she better be prepared to have more patients die, longer patient stays, increased complications (for which they won't be reimbursed) and a lot less sleep because would be getting phone calls every 5 minutes.
Good for you for getting an ?oncology NP job. You must be very smart! I am sure the doctors were impressed by your fancy degree.
I'm an oncology NP with oncology RN experience. In my opinion, if you were to have interviewed against any new grad NP with RN oncology experience (or one with any good, solid RN hospital experience for that matter), it is unlikely you would have gotten an oncology position.
(Then again, you don't state the quality of position you landed. Hospital-clinic based? For profit? It could be a nightmare where you're seeing 20+ patients, plus walk-ins, a day, without so much break as teaching rounds once a week.)
When my hospital has an open position we RARELY interview new NPs anymore unless they have oncology experience or solid hospital RN experience. Why?
We feel our patients are far too sick to be safely cared for by a new grad. If the NP has several years of experience as an OCN-certified RN and the role of an oncology NP is why he/she went back to school to be an NP? Bring it on. That's a perfect example of a new grad NP who will be way ahead of the others.
In short--readers, please excuse this over-confident, original poster-- ONCOLOGY IS NOT A SAFE PLACE FOR MOST NEW GRADS!!!
RN experience might be helpful, sure. Or it might not. My point is that it is not necessary to get an NP job. The trend is to direct-entry MSN and even DNP programs. Respectfully, unless you are making hiring decisions about NPs in primary care settings, your opinion is irrelevant.
I have had experience with direct entry NP's and I found the experience concerning. While textbook smart this is person had no practical knowledge or skills. From general pt contact/interaction skills on up. One vivid memory I have is over insulin. We were in a clinic setting. She wrote a prescription for 2 ml vials of insulin. I went to clarify the order ( I hadn't heard of 2 ml vials , per her that is what hospitals use))..do you mean 1 vial? It will last 3 days or do you mean do you mean 10 ml vials or 10 2 ml vials. She said there was no such thing as a 10 ml vial. She wouldn't believe me until I was able to show her in print.
Her thinking was so black and white and so concrete and she had difficulty individualizing care.. I have 20 + years of nursing experience as an RN .. and she sometimes had the attitude of my degree makes me more knowledgeable than you..so everything had to be proven and justified. Not to say, she didn't have knowledge I didn't as far as advanced practice. She just didn't really get that there was so much more.
I really think "stepping up" ADN- BSN-MSN working between programs each step builds on the last. You practice and solidify skills and knowledge and then add on. But then again this is just my opinion and experience..
I do appreciate your concern. I am very humble about being a new NP. And I am open to, and grateful for, constructive guidance from anyone who can provide it. In addition, I am carefully selecting my first position based on where I can get the best training and ramping up support.
Perhaps you are unaware, but the post listing all of your achievements and accomplishments did sound egotistical and self-important, not self confident. Attitude is important when dealing with staff who will essentially be working for you. You will come to value the respect of the bedside caregiver, whatever their title or position.
Polly Peptide, BSN, MSN, RN, APRN
221 Posts
This truly is one of the most sensible comments I've seen as it relates to the RN experience vs DE debate. I know it's been said in a variety of ways that NP education needs to be shored up and standardized. But we constantly compare our own education to that of PAs and claim that they require "thousands of hours" of healthcare experience prior to admittance PLUS 2000 or more hours of clinicals (compared to our paltry 600 or so), but one thing they do NOT standardize is the actual healthcare experience. They will take a variety of patient care experience, including pharm techs; a local program here requires just 250 hours.
Where the major difference is in the program itself...the training...the hours of clinicals. I do think we could only benefit from more hours in the program. I will point out, though, that PAs are trained to be generalists, and NPs must get another certification to practice in a different area, so it is not totally apples to apples.