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.

[FullGlass, BSN, MSN, NP]

Just out of curiosity, which online schools meet that low level criteria? I just graduated from frontier and can say at least from that they seem to have far stricter requirements than what you suggest. Proceed exams, more clinical hours than university of Michigan (680 to u of m 500), and while I had to find my own preceptor, they had to vet every one and see me actually working at my clinical sites.

As someone else noted, everyone here course as path and maybe some have too strong an opinion regarding that path. I do worry that you lose the nurse aspect when you go direct entry. But that doesn't meant they will lose the ability to be a great provider. Primary care will be a whole new world for me given my periop and pain background, but it makes me more motivated to succeed.

Frontier is a good school. There are plenty of good online programs. I think the concern is the for-profit schools that will admit anyone with a pulse.

[BCgradnurse, MSN, RN, NP]

Frontier is a good school. There are plenty of good online programs. I think the concern is the for-profit schools that will admit anyone with a pulse.

Agreed. Frontier is a fine, reputable school, but there are several for profit schools that will admit anyone with a pulse and a checkbook (and that goes for both DE and traditional entry). I also think NP programs should require more clinical hours. I'd also like to see a nationwide formal residency program and a better accrediting process. There's a lot of room for improvement.

[Dodongo, APRN, NP]

Agreed. Frontier is a fine, reputable school, but there are several for profit schools that will admit anyone with a pulse and a checkbook (and that goes for both DE and traditional entry). I also think NP programs should require more clinical hours. I'd also like to see a nationwide formal residency program and a better accrediting process. There's a lot of room for improvement.

I've asked this on here before but how would one go about making improvements? I would love to effect change in NP education but I have no idea where to begin. What entity is ultimately in charge of NP programs and curriculum? CCNE?

[Dodongo, APRN, NP]

And Frontier is not the problem. Online education is not the problem. I actually prefer it now that I have experienced it. (But not everything can be done online). For-profit, 100% online programs are the problem.

[nursekayde1978]

I'm a RN with 9 years experience and I am currently enrolled in a FNP program. I do believe certain diligent people can obtain success as an NP without RN experience. They would enter the field similar to a PA. However both MD and PA school models are built on the medical theory model with extensive chemistry, biology, advanced pharmacology, and assessment built into their program to over come the lack of bedside experience or medical experience prior to practice.

They also have extensive clinical hours to prepare them.

Because NP programs are built using the nursing model that relies heavily on experience that is mostly obtained by only what hands on knowledge can give you, I don't believe an NP without RN experience could be compared skill for skill with a PA if both just stepped out of college. Nevertheless, I think we should be proud of our fellow colleagues who desire to extend their education and practice in nursing.

[serenitylove14]

Interesting thread here...

OP Sometimes i see jobs that say RN experience or NP experience, I figure whichever job will want to mold you into what they want you to be regardless of the background. I wouldnt necessarily say that no RN experience would be beneficial, but I can say that one thing working while in school did for me was keep my total student loans owed down to $4000 lol. Plus it has helped me communicate with a variety of different people, it has also taught me alot about pharmacology. I think it just depends on the person.

[guest769224]

To be fair, I don't see how nursing experience would help an outpatient primary care provider that much.

Ever heard of emergency room nursing?

Many, many of the situations presented in the ER are very similar to what's seen in a clinic.

RN experience can be very helpful there by how familiar one will be.

I am personally not a fan of direct entry programs. It's my opinion that NP's should have RN experience. But programs will take anyone, if they pay. That's business!

[BCgradnurse, MSN, RN, NP]

Ever heard of emergency room nursing?

Many, many of the situations presented in the ER are very similar to what's seen in a clinic.

RN experience can be very helpful there by how familiar one will be.

I am personally not a fan of direct entry programs. It's my opinion that NP's should have RN experience. But programs will take anyone, if they pay. That's business!

Again, I would respectfully say that unless you've worked as a NP, you really have no way of knowing if your RN experience is necessary to be successful as a NP.

I'd also beg to disagree that many ER situations are similar to what you see in primary care or specialty clinic. Urgent Care, maybe, but not most office practices. We don't see a lot of patients in acute distress, not counting URIs, UTIs, or minor injuries. Patients who do show up with chest pain, severe symptomatic hypertension, respiratory distress, acute abdominal pain, etc. are sent to the ER. Outpatient clinics generally don't have the diagnostic resources to handle these patients.

I take issue with your comment about direct entry programs taking anyone who will pay. Some will, but most reputable programs are extremely competitive with stringent admission requirements. The program I graduated from accepts approximately 10% of all applicants. I was blown away by the achievements of many in my program. They (we) didn't enter as RNs, but they were smart as hell and had proven success academically and in their previous careers. Those traits translated well into success as NPs. So, please don't be so quick to characterize all direct entry programs as pay to play.

[djmatte, ADN, MSN, RN, NP]

I think there's some legitimate concern with de programs since in the end, you are forest and foremost still a registered nurse and represent the nursing profession... even if it's in an expanded role. The concern I have is when docs like to point out to how training lacks, it's that experience that can back up np education. Many nurses have years of experience before entering np school and likely have more practical experience at the bedside than most new mds out of med school. This to me is a value that is important in defining advance practice nursing and backing up the aspect we bring to the picture. I don't disagree that many can go straight in and be just a effective. But are you really bringing in a nursing perspective at that point?

[SpankedInPittsburgh, DNP, RN]

Yeah, I'm fairly sure that most people in this forum have heard of ER Nursing. I'm an ER nurse and have been one for over a decade. The notion that ER Nursing makes you more able to be an NP more than anybody else is wrong. If ER Nursing so well prepared Nurses to be Practitioners why have NP Studies at all? All us long-time ER Nurses should be able to simply fulfill this role through osmosis right? Wrong!!! It's not about competence in ER Nursing, experience or even ability. It's about training for a new role as somebody who is responsible for giving orders as opposed to somebody who is responsible for carrying them out. To use a baseball analogy if a person were the catcher for a Cy Young award winning Pitcher for many years one would think he could pitch also. After all he was intimately involved in all the pitches & even help call some of them. Could the catcher win the Cy Young? Heck no!!! Its a different job, from a different perspective with different responsibilities & skill sets. Honestly, I can see why some Docs would prefer a grad with no experience because they don't carry the illusion of already knowing everything they need to know and lack the humlity to learn their new role without the baggage of preconceived notions acquired from role in the treatment team they are no longer filling. This is a trend that is not localized to NP's by the way. The last couple years our ICU has been seeking to hire new nurses utilizing the same logic with apparent success.

[kadphilly]

So that's another problem in and of itself, right? RN training/work absolutely does not substitute for NP training - that should be obvious to everyone. But it's not obvious to everyone. And NP schools do nothing but perpetuate this problem. More time should be required training at the provider level. Some programs require ~500 hours. That's 12 weeks if you did it full time. 3 months. So you receive more clinical training at the RN level than the NP level - where you are expected to work up a patient, make a diagnosis and prescribe treatment. You are expected to lead the healthcare team. Further, so many schools do not vet the preceptors or clinical sites found by the NP student (as they are expected to find these experiences on their own), and the student ends up with essentially a shadowing experience. So you have poor didactic education with 3 months worth of shadowing and the person is let loose. But we want independent practice. Come on.

We need to standardize NP education. One accrediting body. Stricter standards for entry and progression through programs. Shut down the 100% fully online programs with no oversight of their students (i.e. open book testing, no lectures, finding their own preceptors who are not vetted by the school, etc). Flesh out the didactic training and significantly increase required clinical hours.

I think so many candidates from poor schools are forced to rely on RN experience because to highlight their NP education would be disastrous during employment applications.

There is a brick and mortar school near me with a great reputation, however a few years ago, they started an almost completely online NP program. I know a faculty member from this school. She has 2 years experience as an NP and is already grading papers. They do not vet clinical sites, and they don't even do clinical site visits. So they are graduating students that they have never seen examine a real live patient. I see that as severely lacking in adequacy.

[kadphilly]

Ever heard of emergency room nursing?

Many, many of the situations presented in the ER are very similar to what's seen in a clinic.

RN experience can be very helpful there by how familiar one will be.

I am personally not a fan of direct entry programs. It's my opinion that NP's should have RN experience. But programs will take anyone, if they pay. That's business!

It might familarize you with some clinical situations, however, there is a compete different skill set that NP's required to have. For example, I am a PNP primary care. I diagnose otitis media all day long. I have yet to see an NP student yet who could diagnose an Otitis based on RN experience. It's a skill that needs to be developed and can take a considerable amount of time.

I precept FNP students also, and in my experience SOME of them are terrified of young infants. Some of them might work inpatient with adults, so how would they feel comfortable? Their RN experience in an inpatient adult cardiac unit has not provided many skills to care for a 2 month old with RSV. Or to help diagnose an 18 month old with autism. My last FNP students flat out told her clinical site visitor that she was never going to take care of infants in anyway, so she really didn't see the point of seeing them in clinical. Except, that's your degree??? You chose to be an FNP. Part of the issue is that the pediatric clinical requirement for FNP students is far too short. I never feel like they have enough of a grasp in peds at the end of the rotation.

There needs to be more trainging at the NP level instead of focusing on RN experience.