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.
Specializes in Psychiatric and Mental Health NP (PMHNP).
HRSA released a report in Nov 2016 regarding the supply and demand levels of primary care providers by state.
In 2013, some states still had a deficit of providers (such as California), but many, such as TN, had a surplus. TN already had 1000 too many FTE NPs.
By 2025 it is expected that NO state will have a deficit. In fact, 13 states are expected to have a surplus of 1000 or more FTE NPs. One state, TX, is expected to have a surplus of more than 5000 FTE NPs.
The report also discusses PAs and docs. PAs will also impact the number of jobs available to NPs.
This is specific to PCPs. It is important info.
I provided that study in my article. Guess what? The sun is going to go supernova and destroy the earth at some point. There is a supervolcano under Yellowstone Park that is going to explode and destroy most of North America at some point. We are going to have a recession again at some point and lots of people won't be able to find jobs. Robots are going to be doing most work soon, putting everyone out of work, including doctors and nurses We are overdue for a flu pandemic. California is overdue for another killer earthquake. We are all going to die at some point. In the mean time, the rest of us have to get on with living in the here and now.
What is your point? Most moms are familiar with those things, too. So what? We're talking about whether RN experience is necessary to be a primary care NP. It is not necessary.
Perhaps you two are arguing two different arguments. There are lots of things that aren't *necessary* for someone to succeed at something. But they may be helpful. My years spent as an acute/chronic pain nurse will be exceptionally helpful in guiding that patient that shows up to my clinic complaining of a recent injury. I won't be doing nerve blocks and injections, but I can guide them on a well-balanced therapy and medication regimen that reduces the use of opiates and improves outcomes.
What nurses see in their duties are important parts of learning a host of medical conditions that they would never really understand if they were lay-persons and minimizes orientation when they see them in person as clinicians. That is why I tend to argue for some form of nursing practice before advance practice. Certainly as you point out, it isn't the only way. But to me it is what separates the new MD from the new-grad NP with seasoned clinical experience.
I provided that study in my article. Guess what? The sun is going to go supernova and destroy the earth at some point. There is a supervolcano under Yellowstone Park that is going to explode and destroy most of North America at some point. We are going to have a recession again at some point and lots of people won't be able to find jobs. Robots are going to be doing most work soon, putting everyone out of work, including doctors and nurses We are overdue for a flu pandemic. California is overdue for another killer earthquake. We are all going to die at some point. In the mean time, the rest of us have to get on with living in the here and now.
There is no need for this sort of response. I did read your article and in fact referenced your point about moving. I think it's important for us to all know the facts (er, projections), don't you?
I think people who can move should consider it. It will offer more opportunities, money, and open up jobs for those that can't or won't. That's why I said the market must (and will) self-correct. There are many ways the market will do so.
I am working towards becoming an NP with full knowledge of the market, because it is a long-held goal and desire, because I believe it is what I am supposed to do, and because I know I will serve my patients well. I am hopeful those are the kinds of people who will persist. But I think it's very important we are not ignorant as we proceed. I imagine you agree.
What is your point? Most moms are familiar with those things, too. So what? We're talking about whether RN experience is necessary to be a primary care NP. It is not necessary.
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.
Unfortunately the thread has descended into the sarcastic, as many do.
I worked with a woman whose nursing experience was mainly in public health. She got her Master's, became an NP, and worked in an ENT office for 5 years. She then came to our facility (a forensic setting) to work as a PCP in her mid 40's.
She was there more than 10 years, and never earned general respect in that time. She didn't earn my respect when she misspelled Oxycontin, but prescribed it. OK, I am not the spelling or grammar police, but Oxycotton? Does she even know the drug?
People like this are scary.
She always complained of being overwhelmed, but as you might guess, many inmate health complaints are minor. Stuffy nose, etc. But you also need to be able to manage serious chronic disease.
I think she was bogged down, and couldn't see the forest for the trees. The physicians never respected her, which was sad.
I think she did not have the intellectual capacity for the job. She used to come to work in skimpy outfits.
I would say it is smart for those who know that they want to be a Primary Care NP to go directly through school if they can. This is what I recommend the to college and high school students that I mentor. And to go to the best school that they can get accepted to and afford.
Nurse practitioners should be smart. There is nothing wrong with others saying so. Again, it's a self depreciating of nurses. Our profession is moving forward only to be sabatoged by ourselves. It's an attitude of "who do you think you are going to grad school before you put your time in like the rest of us?" We will never move forward with this mentality.
I was wondering Kadphilly what top tier schools you would recommend. I am interested in UTA's online program since it is a brick and mortar school. Would you consider hiring an NP from there?
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.
I don't think it makes absolutely no difference. Working in the ICU as a RN gave me excellent physical exam skills which would be useful in primary care. I do think, a couple years out practicing as a NP, RN experience doesn't matter. It's more useful in school and in the first year or so of practice IMO.
Ultimately, the university/program and the caliber of the individual themselves are the important factors. I have a lot of improvements I'd like to see in NP programs - 1500-2000 hours of clinical, graduate level gross anatomy, required in person/hands on skill labs, etc. All of those things are higher on my list than required RN experience for primary care tracks.
I do firmly believe that PMHNP, ACNP and WHNP/CNM should have RN experience in their chosen concentrations.
I guess the main problem that I have is with a lot of FNP programs. They have abysmally low clinical hours, some accept anyone who can take out a loan, require no experience as a RN, and then, their graduates want to go work in specialty practice that they have no preparation or training in.
NP education needs standardization. Badly.
NPs who are practicing need to precept at the same rate as other health professionals. Then we can talk about increasing the clinical hours. Also, quality preceptors make a difference. Not practicing evidence-based medicine, not performing good exams, not actually teaching the student equals poor practitioners. Standardization is a must. More clinical hours is a must. NPs stepping up to train is a must.
Perhaps you two are arguing two different arguments. There are lots of things that aren't *necessary* for someone to succeed at something. But they may be helpful. My years spent as an acute/chronic pain nurse will be exceptionally helpful in guiding that patient that shows up to my clinic complaining of a recent injury. I won't be doing nerve blocks and injections, but I can guide them on a well-balanced therapy and medication regimen that reduces the use of opiates and improves outcomes.
What nurses see in their duties are important parts of learning a host of medical conditions that they would never really understand if they were lay-persons and minimizes orientation when they see them in person as clinicians. That is why I tend to argue for some form of nursing practice before advance practice. Certainly as you point out, it isn't the only way. But to me it is what separates the new MD from the new-grad NP with seasoned clinical experience.
Personally, I think the sooner you get into the provider role, the better (for primary care). You will have to learn those diseases on a deeper level and take responsibility for managing all aspects of a patient's care. Maybe bedside nursing helps some people, but for many it is actually a hinderance. Just because you think you know something, doesn't mean you actually do. Many a nurse with bedside experience finds out what they don't know when they further their education. I have heard this from RN to NP, RN to MD and NP to MD. It would be much bette to strengthen the NP programs.
There was a similar thread recently titled: "Seeking Advice: Direct Entry Blues." Several people, including myself, pointed out the value of actual bedside nursing experience prior to assuming an advanced practice nursing role, and provided situational examples, which didn't go down too well with some of the "No nursing experience experience necessary for NP folks."
I am so glad that my family sees a highly qualified and experienced Internal Medicine physician for their primary care. We also always state that we want to see a physician and not a NP/PA when we go to the Urgent Care.
I have always preferred my CNP as my PCP. She is phenomenal! She also has an excellent track record as a diagnostition. But she also had years of ICU hospital experiences. She is invaluable to me!!!
Specializes in Psychiatric and Mental Health NP (PMHNP).
Perhaps you two are arguing two different arguments. There are lots of things that aren't *necessary* for someone to succeed at something. But they may be helpful. My years spent as an acute/chronic pain nurse will be exceptionally helpful in guiding that patient that shows up to my clinic complaining of a recent injury. I won't be doing nerve blocks and injections, but I can guide them on a well-balanced therapy and medication regimen that reduces the use of opiates and improves outcomes.
What nurses see in their duties are important parts of learning a host of medical conditions that they would never really understand if they were lay-persons and minimizes orientation when they see them in person as clinicians. That is why I tend to argue for some form of nursing practice before advance practice. Certainly as you point out, it isn't the only way. But to me it is what separates the new MD from the new-grad NP with seasoned clinical experience.
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.
FullGlass, BSN, MSN, NP
2 Articles; 1,942 Posts
I provided that study in my article. Guess what? The sun is going to go supernova and destroy the earth at some point. There is a supervolcano under Yellowstone Park that is going to explode and destroy most of North America at some point. We are going to have a recession again at some point and lots of people won't be able to find jobs. Robots are going to be doing most work soon, putting everyone out of work, including doctors and nurses We are overdue for a flu pandemic. California is overdue for another killer earthquake. We are all going to die at some point. In the mean time, the rest of us have to get on with living in the here and now.