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.
That's why I feel they need to change it. Nothing in the DNP improve our clinical abilities. At most it's a glorified PhD. It's the difference of an ADN vs bsn. Both can effectively care for patients with the same license... One has a bunch of extra courses on research and nursing theory.
I wouldn't say "nothing". It hasn't been studied enough to give us any real data, but I think we can be rather confident about the fact that if you get "nothing" from any experience than it is your own fault. There are always primary and secondary benefits to experiences, whether they are significant in aggregate I don't know. I can list a number of personal/professional benefits I found with MSN to DNP. I am not as confident about the RN to dnp programs, for instance one of our local programs simply added 8 credits to the MSN program and called it a DNP.
This is absolutely not the same as the ADN vs BSN issue. There is a large amount of data to support that there is a difference in aggregate with degree in that role. If there were, I think more of us cold get on-board with transitioning MSN to DNP entry.
I think we have a couple different conversations going on her & both are good. First, the educational value and standards of NP programs. I personally think that clinical experience should replace the CAPSTONE in DNP studies as I don't feel the studies have any application to the roles that NPs will face in a clinical setting. Nor do I think any academic is going to confuse a DNP study with a PhD dissertation.
Second, the economics of the NP field. Another very interesting conversation. I think this is an area that each individual nurse needs to look at before making the leap into a new role after a major investment of time and money. Simply put, is it worth it? Only the individual nurse can answer that. For me it is. My employer paid my tuition & my pension is based upon my highest three earning years. So economically it's worth it for me. I think the nurse has to determine if the return on investment is worth for them on an individual basis. If the job market changes and we experience a depression in wages then it won't be worth it. However, most of my colleagues already have well-paying jobs lined up months before graduation. Of course that's only a piece of the puzzle. If you are going into a job just for the money misery will follow. The nurse has to decide if they really want to fill this role and contribute to the healthcare team in a new way. These are tough individual decisions.
Specializes in Psychiatric and Mental Health NP (PMHNP).
Overall, this thread has been quite enlightening. Here is what I have learned about most of the participants:
1. You all gave a great demonstration of "nursing eats its young" in a manner akin to fraternity and sorority hazing. "I did x, so everyone should have to do x for all eternity."
2. Many of you are very resistant to change
3. Many of you are very insecure, as evidenced by your terror of having to compete for jobs if there is an NP surplus
4. The collective hive mind here functions at a middle school level in terms of emotional IQ. Many of you seem to think your opinion of me matters. Ridiculous.
5. It was fascinating to watch: as I refused to kowtow to you all, you started attacking me personally, yet when I defended myself, I became boastful, etc. Don't dish it out if you can't take it. Many of you all also resort to "double binding."
6. Many of you like to tear down others to feel better about yourselves
7. Some of you look down on clinicians that choose to practice in medically underserved and less desirable areas, assuming they must be subpar clinicians. Honestly, that is just plain disgusting and shameful. Talk about discrediting the nursing profession.
8. You all need to take responsibility for your reactions. You choose to be offended or not. That is your own responsibility. But, responsibility can be very scary.
9. Many of you seem to suffer from cognitive dissonance. Fact: I got multiple job good offers w/o RN experience. All your collective cluck-clucking and tsk tsking disapproval does not change that fact.
10. Most of you do not have any sense of humor and cannot engage in any sort of debate w/o getting angry or having hurt feelings. Have you all ever watched political debates? A great example of this is the British Commons Question Time, with a lot of insults hurled back and forth, but of course, those are adults who can engage in a spirited debate. I confess, at first this thread made me feel a bit frustrated, but I quickly got over it. Just so you know, I was laughing most of the time when responding, being as obnoxious as possible, because it was so easy to push buttons here that I couldn't resist the temptation. The only time I really got angry was the insinuation that anyone who chooses to practice in a remote rural area must be subpar.
Now, I am going to decide which of my 9 excellent job offers to accept. I decided to cancel an interview for a great cardiology NP position this week, because 9 offers is enough. I'll make a decision by the end of the week.
Overall, this thread has been quite enlightening. Here is what I have learned about most of the participants:
1. You all gave a great demonstration of "nursing eats its young" in a manner akin to fraternity and sorority hazing. "I did x, so everyone should have to do x for all eternity."
2. Many of you are very resistant to change
3. Many of you are very insecure, as evidenced by your terror of having to compete for jobs if there is an NP surplus
4. The collective hive mind here functions at a middle school level in terms of emotional IQ.
5. It was fascinating to watch: as I refused to kowtow to you all, you started attacking me personally, yet when I defended myself, I became boastful, etc. Don't dish it out if you can't take it. Many of you all also resort to "double binding."
6. Many of you like to tear down others to feel better about yourselves
7. Some of you look down on clinicians that choose to practice in medically underserved and less desirable areas, assuming they must be subpar clinicians. Honestly, that is just plain disgusting and shameful.
8. You all need to take responsibility for your reactions. You choose to be offended or not. That is your own responsibility. But, responsibility can be very scary.
9. Many of you seem to suffer from cognitive dissonance. Fact: I got multiple job good offers w/o RN experience. All your collective cluck-clucking and tsk tsking disapproval does not change that fact.
10. Most of you do not have any sense of humor and cannot engage in any sort of debate w/o getting angry or having hurt feelings. Have you all ever watched political debates? A great example of this is the British Commons Question Time, with a lot of insults hurled back and forth, but of course, those are adults. I confess, at first this thread made me feel a bit frustrated, but I quickly got over it. Just so you know, I was laughing most of the time when responding, being as obnoxious as possible, because it was so easy to push buttons here that I couldn't resist the temptation. The only time I really got angry was the insinuation that anyone who chooses to practice in a remote rural area must be subpar.
Now, I am going to decide which of my 9 job offers to accept. I'll make a decision by the end of the week.
You've never worked as a nurse. So you have absolutely no qualifications to speak to nurses eating anything. Regardless of what you think you know.
For someone who "quickly got over it", somehow you are still here throwing insults back. Go on and tackle that new job "provider".... Because you'll never be a nurse in my book.
Some of you look down on clinicians that choose to practice in medically underserved and less desirable areas, assuming they must be subpar clinicians. Honestly, that is just plain disgusting and shameful. Talk about discrediting the nursing profession.
Did I miss something? I never saw anyone post about only subpar clinicians that choose to practice in that environment. The only post I saw was one stating that perhaps some of those positions are less desirable to many clinicians given their locale, workflow, and compensation.
Why don't you be honest with us and yourself and explain why you chose to work in a medically underserved area: is it because you "won" a scholarship which requires to you do so or because that is really what your end goal was meaning you plan to stay working in an underserved area your whole career not just two years?
You all need to take responsibility for your reactions. You choose to be offended or not. That is your own responsibility. But, responsibility can be very scary.
Can you turn your own advice on yourself, after all I am sure you already know the importance of self-reflective practice.
Many of you seem to suffer from cognitive dissonance. Fact: I got multiple job good offers w/o RN experience. All your collective cluck-clucking and tsk tsking disapproval does not change that fact.
You got multiple job offers without RN experience: this is not a new thing. Every year thousands of new-grad DE-NP students get job offers and enter practice without much fan-fare.
This thread has gone on to discuss many issues outside of this fact. From my read, most people opposing the notion of DE programs have concerns about novice NP competency in clinical practice not the ability to get a job (though I do think that nurses say "you need RN experience to get a job" frequently and often to dissuade more novice RNs then themselves from seeking APRN practice).
Most of you do not have any sense of humor and cannot engage in any sort of debate w/o getting angry or having hurt feelings.
What do you feel your most important contributions to this debate were?
Excuse me, that is just one example I chose to share. How many examples do I need to be considered valid and not anecdotal?
While you sounded earnest and sincere when this thread started you now sound defensive, rude and arrogant. Obviously people may have been more kind and supportive if you hadn't kicked into ***** turbo mode.
I have absolutely no problem with anyone regardless of title or degree or experience if they can deliver.. it's a team effort and no one likes picking up after someone who talks the talk but fails miserably at walking the walk.
I really hope you bring a little less arrogance and a lot more compassion to the patients you treat. Because THEY are your success or failure and they do not care about your previous successes. They care are about here and now. So the sooner you realize you can't ride on your previous laurels and sit down and commit to amazing care for your patients the happier you will be.
Specializes in Hospital medicine; NP precepting; staff education.
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Thank you very much. You are helping my literature review. I had some of these already, actually.
Specializes in ICU, Telemetry, Cardiac/Renal, Ortho,FNP.
Wow. All I can say is "Wow". You are happy you don't need RN experience to be called an "Advanced Practice RN" like it's totally removed from being an RN. I'm happy you have a job offer. I'm disappointed this profession is failing patients by providing inexperienced practitioners to take care of the public. I could have gone straight into the APRN role also but I was tired of being a pseudo healthcare provider and there was NO WAY I wanted to be an APRN w/o real, boots on the floor and hands on the bedpan, real RN experience. I even delayed getting an NP job until I had more RN experience for almost a year. I can tell you that as a graduate APRN you do not have the background to fully understand "why" you are doing "what" you are doing. And time will tell you that without that exposure to other medical providers you will lack the basic science background to understand pharmacodynamics, pharmacokinetics, and pharmacology. NP's struggle with this and differential diagnosis to begin with compared to PA's and physicians, add to it no experience at all being a registered nurse makes the whole profession at risk. This is not good. It may be reality, but it's not good.
I could have gone straight into the APRN role also but I was tired of being a pseudo healthcare provider and there was NO WAY I wanted to be an APRN w/o real, boots on the floor and hands on the bedpan, real RN experience.
And as someone wanting to get out of the pseudoscience bit, what did you base this important decision on?
I even delayed getting an NP job until I had more RN experience for almost a year. I can tell you that as a graduate APRN you do not have the background to fully understand "why" you are doing "what" you are doing. And time will tell you that without that exposure to other medical providers you will lack the basic science background to understand pharmacodynamics, pharmacokinetics, and pharmacology. NP's struggle with this and differential diagnosis to begin with compared to PA's and physicians, add to it no experience at all being a registered nurse makes the whole profession at risk. This is not good. It may be reality, but it's not good.
Did "almost a year" of RN experience fill all these gaps in your knowledge base or did you work for longer than that just added a year to the end (was hard to tewll from post)? What did you think of your RN role? Did you develop expertise in that role? Could/did you do that while also going to school full time? How long was your orientation, how long did you work on your own prior to leaving? What was the most important thing the experience gave you in your new APRN role?
Having worked with student NP students along side medical students and ddx is a struggle for all of them and I have never noticed a significant difference between SNP and M3 or M4s in this. Novice practicing NPs still struggle as do novice physicians even after residency. Actually, even experts still are developing their ddx skills while others are effectively losing their skills.
BostonFNP, APRN
2 Articles; 5,584 Posts
I wouldn't say "nothing". It hasn't been studied enough to give us any real data, but I think we can be rather confident about the fact that if you get "nothing" from any experience than it is your own fault. There are always primary and secondary benefits to experiences, whether they are significant in aggregate I don't know. I can list a number of personal/professional benefits I found with MSN to DNP. I am not as confident about the RN to dnp programs, for instance one of our local programs simply added 8 credits to the MSN program and called it a DNP.
This is absolutely not the same as the ADN vs BSN issue. There is a large amount of data to support that there is a difference in aggregate with degree in that role. If there were, I think more of us cold get on-board with transitioning MSN to DNP entry.