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.

[djmatte, ADN, MSN, RN, NP]

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.

I don't disagree that the NP level should have more training, but as a trained pediatric NP, I could see how you feel FNP training lacks in pediatrics. A lot of it comes down to what the student plans to get out of it. Two of my weakest areas in FNP school was peds and women's health. I knew this going into those sections and to better prep me for those classes and courses, I actually bought pediatric and WH np board study guides to better expand where I needed to focus. I went into my peds rotation terrified as I have no kids and the few kids I treated were in a PACU waking up from a range of surgeries. Not exactly the environment to truly understand pediatric care. I literally walked out of my pediatric rotation feeling a whole new respect for PNPs (not that I didn't before) and with a new idea that I actually loved seeing them in clinic.

I will grant that RN's aren't prepped to easily diagnose OM because simply put...they aren't trained to diagnose. I never toughed an otoscope until NP school and more specifically right before clinical. But I learned and while I probably didn't quite see things like OM by the end of peds, my final adult clinical I was seeing it clearly. But much like I wouldn't expect an RN from a med-surg unit to walk into my PACU and appropriately be able to identify when and how often to provide pain medications and when to opt to hold them, it is something that can be taught with the right training.

What I think is unfortunate is that people are forgetting they are advance practice REGISTERED NURSES. You are someone who has been equipped with the ability to care for patients in a capacity that requires a license that many people cannot obtain. That means to me delegating authority, administering IV medications and drips, understanding at a more advance level how medications affect the human body and have the assessment skills to recognize when there's a problem. Advance practice doesn't minimize take away from the original very important authority granted. Your certification is exactly that and not *better* or *more profound* than your original license. You simply decided there is an aspect of nursing you want to expand your knowledge base and practice level towards.

[Oldmahubbard]

I'll never forget, back in the 90's, 4 years after graduating from an Associate's RN program, going to an Urgent Care and seeing one of my former classmates there as a provider.

I can clearly remember thinking I wouldn't have the nerve to do it. In those days, you worked as an RN for 10 years before you even considered being an NP.

Could be some of us are just jealous? Including me?

Twenty years ago there was virtually no money in it. You did it because you didn't like being an RN, or you really wanted advanced practice. Nobody did it for the money.

Now, a few of us make real money. Nowhere near enough of us though!

In reading some of the posts about people still working for 80 grand, I feel a little sick.

The one thing I do find, is that there are a few NPs who don't know what they don't know.

I worked with an RN at a mental health facility for a year or two. He then became an FNP, and he seems to think he knows a great deal about mental health just because his body was in that building for a bit. No.

[Dodongo, APRN, NP]

The one thing I do find, is that there are a few NPs who don't know what they don't know.

I worked with an RN at a mental health facility for a year or two. He then became an FNP, and he seems to think he knows a great deal about mental health just because his body was in that building for a bit. No.

I think this is extraordinarily prevalent in FNP programs in particular. It has been said by many posters on this forum, that many FNPs think they can practice anywhere. They think any area of medicine is fair game. They want to specialize in peds, women's health, psych, and work inpatient. They don't realize what they don't know in those areas. And what's worse, is that state boards of nursing have no oversight.

So you have providers who *think* they know a lot practicing in areas where they know very little. FNPs are great for what they are trained to do - primary care. But it reflects poorly on all NPs when they try to practice outside of their training.

[Dodongo, APRN, NP]

And to drive my point home, everyone here is saying FNPs and AGNPs don't need RN experience because they're primary care.

Except, how many FNP and AGNP graduates go to work in an inpatient specialty, rather than primary care. A lot. So not only are they practicing outside of their scope and training as a NP, but they don't even have a bit of RN experience to fall back on.

So that argument doesn't sit well with me.

[guest769224]

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?

I actually didn't say anything even remotely similar to what you are suggesting. Next time try using reading comprehension. It will help you as a practitioner.

[guest769224]

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 did not say RN or ER experience replaces NP competency. I said it may familiarize the RN to certain situations.

Interesting how some posters purposely misread comments to cover up their defensiveness.

[FullGlass, BSN, MSN, 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!

ER nursing is acute care. I was talking about primary care.

[guest769224]

ER nursing is acute care. I was talking about primary care.

So am I.

If you were to spend some time in an ER, you may find many conditions and diagnosis are similar to what's seen in a primary care clinic. And some are not, it is the ER afterall.

i.e. stubbed toe, tooth ache, allergies, fever, headache, nasusea/vomiting, constipation, UTI, etc.

[FullGlass, BSN, MSN, NP]

I don't disagree that the NP level should have more training, but as a trained pediatric NP, I could see how you feel FNP training lacks in pediatrics. A lot of it comes down to what the student plans to get out of it. Two of my weakest areas in FNP school was peds and women's health. I knew this going into those sections and to better prep me for those classes and courses, I actually bought pediatric and WH np board study guides to better expand where I needed to focus. I went into my peds rotation terrified as I have no kids and the few kids I treated were in a PACU waking up from a range of surgeries. Not exactly the environment to truly understand pediatric care. I literally walked out of my pediatric rotation feeling a whole new respect for PNPs (not that I didn't before) and with a new idea that I actually loved seeing them in clinic.

I will grant that RN's aren't prepped to easily diagnose OM because simply put...they aren't trained to diagnose. I never toughed an otoscope until NP school and more specifically right before clinical. But I learned and while I probably didn't quite see things like OM by the end of peds, my final adult clinical I was seeing it clearly. But much like I wouldn't expect an RN from a med-surg unit to walk into my PACU and appropriately be able to identify when and how often to provide pain medications and when to opt to hold them, it is something that can be taught with the right training.

What I think is unfortunate is that people are forgetting they are advance practice REGISTERED NURSES. You are someone who has been equipped with the ability to care for patients in a capacity that requires a license that many people cannot obtain. That means to me delegating authority, administering IV medications and drips, understanding at a more advance level how medications affect the human body and have the assessment skills to recognize when there's a problem. Advance practice doesn't minimize take away from the original very important authority granted. Your certification is exactly that and not *better* or *more profound* than your original license. You simply decided there is an aspect of nursing you want to expand your knowledge base and practice level towards.

My original post made it clear that I am talking about primary care. In primary care, we don't run IVs, except for a few specialties. Primary care NPs are well trained in advanced pharmacology, patho, assessment, and diagnosis. APRN roles are based on the nursing model, yes. No one is disputing that.

[FullGlass, BSN, MSN, NP]

I don't disagree that the NP level should have more training, but as a trained pediatric NP, I could see how you feel FNP training lacks in pediatrics. A lot of it comes down to what the student plans to get out of it. Two of my weakest areas in FNP school was peds and women's health. I knew this going into those sections and to better prep me for those classes and courses, I actually bought pediatric and WH np board study guides to better expand where I needed to focus. I went into my peds rotation terrified as I have no kids and the few kids I treated were in a PACU waking up from a range of surgeries. Not exactly the environment to truly understand pediatric care. I literally walked out of my pediatric rotation feeling a whole new respect for PNPs (not that I didn't before) and with a new idea that I actually loved seeing them in clinic.

I will grant that RN's aren't prepped to easily diagnose OM because simply put...they aren't trained to diagnose. I never toughed an otoscope until NP school and more specifically right before clinical. But I learned and while I probably didn't quite see things like OM by the end of peds, my final adult clinical I was seeing it clearly. But much like I wouldn't expect an RN from a med-surg unit to walk into my PACU and appropriately be able to identify when and how often to provide pain medications and when to opt to hold them, it is something that can be taught with the right training.

What I think is unfortunate is that people are forgetting they are advance practice REGISTERED NURSES. You are someone who has been equipped with the ability to care for patients in a capacity that requires a license that many people cannot obtain. That means to me delegating authority, administering IV medications and drips, understanding at a more advance level how medications affect the human body and have the assessment skills to recognize when there's a problem. Advance practice doesn't minimize take away from the original very important authority granted. Your certification is exactly that and not *better* or *more profound* than your original license. You simply decided there is an aspect of nursing you want to expand your knowledge base and practice level towards.

And to drive my point home, everyone here is saying FNPs and AGNPs don't need RN experience because they're primary care.

Except, how many FNP and AGNP graduates go to work in an inpatient specialty, rather than primary care. A lot. So not only are they practicing outside of their scope and training as a NP, but they don't even have a bit of RN experience to fall back on.

So that argument doesn't sit well with me.

NPs are not supposed to work outside their scope. Credentialing organizations are cracking down on this. And it is also the responsibility of employers to hire people with the right qualifications and skills.

[FullGlass, BSN, MSN, NP]

I don't disagree that the NP level should have more training, but as a trained pediatric NP, I could see how you feel FNP training lacks in pediatrics. A lot of it comes down to what the student plans to get out of it. Two of my weakest areas in FNP school was peds and women's health. I knew this going into those sections and to better prep me for those classes and courses, I actually bought pediatric and WH np board study guides to better expand where I needed to focus. I went into my peds rotation terrified as I have no kids and the few kids I treated were in a PACU waking up from a range of surgeries. Not exactly the environment to truly understand pediatric care. I literally walked out of my pediatric rotation feeling a whole new respect for PNPs (not that I didn't before) and with a new idea that I actually loved seeing them in clinic.

I will grant that RN's aren't prepped to easily diagnose OM because simply put...they aren't trained to diagnose. I never toughed an otoscope until NP school and more specifically right before clinical. But I learned and while I probably didn't quite see things like OM by the end of peds, my final adult clinical I was seeing it clearly. But much like I wouldn't expect an RN from a med-surg unit to walk into my PACU and appropriately be able to identify when and how often to provide pain medications and when to opt to hold them, it is something that can be taught with the right training.

What I think is unfortunate is that people are forgetting they are advance practice REGISTERED NURSES. You are someone who has been equipped with the ability to care for patients in a capacity that requires a license that many people cannot obtain. That means to me delegating authority, administering IV medications and drips, understanding at a more advance level how medications affect the human body and have the assessment skills to recognize when there's a problem. Advance practice doesn't minimize take away from the original very important authority granted. Your certification is exactly that and not *better* or *more profound* than your original license. You simply decided there is an aspect of nursing you want to expand your knowledge base and practice level towards.

So am I.

If you were to spend some time in an ER, you may find many conditions and diagnosis are similar to what's seen in a primary care clinic. And some are not, it is the ER afterall.

i.e. stubbed toe, tooth ache, allergies, fever, headache, nasusea/vomiting, constipation, UTI, etc.

What is your point? This thread is reporting that NPs do not need RN experience to get a job in primary care. And not all RNs have ER or ICU experience.

[guest769224]

What is your point? This thread is reporting that NPs do not need RN experience to get a job in primary care. And not all RNs have ER or ICU experience.

My point is that I stated I believe RN experience should be required before becoming an NP.

And that in some situations it can be very helpful. It's only my opinion.

Some posters suggested what's presented in the ER is far from what's seen in a clinic. I provided examples disputing that, to show a RN can be familiarized before APRN school and thus benefit them.