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]

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.

I'm sorry; I was a bit cranky yesterday. However, in my previous career I was quite successful, so based on my experience, people who plan to fail will indeed fail. While it is important to have a realistic view of one's career choice - job market, trends, salary, etc. - people who have a gloom and doom attitude are generally unsuccessful. Successful people are empowered individuals who believe in their own ability to achieve success despite the odds. Individuals who think: "oh, the job market is terrible, so I won't find a job," "oh, i can't work more than a 5 mile radius from my home," "i can't possible move to get a good job," and so forth will indeed fail.

Let's look at acting - certainly a field where there are more hopefuls than there are good jobs. Yet, that doesn't stop people from pursuing an acting career and every year there are new stars who do extremely well. I will say that pursuing acting seriously generally requires moving to LA or NYC and individuals who refuse to do so are putting themselves at a serious disadvantage.

Projections are just estimates. It is very hard to make an accurate projection beyond 5 years. The farther into the future the projection is, the greater the margin of error. At any rate, if there is a surplus of NPs in the future, then the best will still get jobs.

We have a surplus of lawyers, yet the graduates of the top law schools still get hired for big bucks by the top law firms. There is no shortage of aspiring business hopefuls, but graduates of top MBA firms still get hired for big bucks by corporations.

Having a can do attitude, planning for success, and being willing to make some sacrifices in order to achieve one's goals are necessary for NP success, and success in any other field, for that matter.

[SpankedInPittsburgh, DNP, RN]

Thank You FullGlass!!! It's about time somebody said it. Nurses have this peculiar way of judging other nurses. Who really cares what some other nurse thinks about your qualifications to be an NP? The only opinions that really count are the folks who hand out Licenses to practice & they sure as heck aren't on this web site gassing off about an opinion that seems to have no bearing in reality. Like it or not NP's are out there without ever having been a practicing RN. I'm not going to be one of them but if I was I would care less about what some twit from the land of the internet thought. After all I graduated, took my boards and was deemed appropriate to practice by the people who make such laws in my state so whatever amount of sniveling that goes on I'm gonna practice my profession and second-guessing nursey-poo will have to suck it up

[djmatte, ADN, MSN, RN, NP]

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.

"Respectfully", at some point in life, I just might helping with hiring decisions just like right now I participate in the interviewing and hiring of RNs. Working on any team, group interviews are exceptionally common and a major factor for me and evidenced here a few others is experience that you bring to the team. And there's not "might not" help when it comes to rn experience. Any form of clinical patient interaction is infinitely more valuable than none. YOU may think you gain nothing from it, but you went direct entry yourself, so how would you know? You never took the time to work as and actually understand what it means to be an RN. You used the profession to fast track to primary care. Congrats on your ability to sell yourself in an interview and willingness to move anywhere. That's about all you needed to say in the original post.

[WestCoastSunRN, MSN, CNS]

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?

This!!!!! It's not about "paying dues" (I don't think that's what I do when I go to work at the bedside everyday -- it's never been "paying dues" to me. sigh.) So maybe medicine employers shouldn't/wouldn't care about past RN experience. They are hiring a provider, not a nurse. But it's more than OK for nurses to care about the ever-burgeoning amount of advanced practice nurses who go forth in the world representing the profession of Nursing. DE is not the only potential contributor to this issue... I think it's multi-faceted for sure. But it's something to think about.

[BCgradnurse, MSN, RN, NP]

"Respectfully", at some point in life, I just might helping with hiring decisions just like right now I participate in the interviewing and hiring of RNs. Working on any team, group interviews are exceptionally common and a major factor for me and evidenced here a few others is experience that you bring to the team. And there's not "might not" help when it comes to rn experience. Any form of clinical patient interaction is infinitely more valuable than none. YOU may think you gain nothing from it, but you went direct entry yourself, so how would you know? You never took the time to work as and actually understand what it means to be an RN. You used the profession to fast track to primary care. Congrats on your ability to sell yourself in an interview and willingness to move anywhere. That's about all you needed to say in the original post.

And you have never worked worked as a NP, so how can you judge whether RN experience is helpful, necessary, or whatever? You've never done the job, so you have no way to know what's helpful or not. No one is "using" the nursing the profession to fast track. That really sounds like you're taking the whole DE segment as a personal affront. It's a whole lot of feelings and perceptions that are not based on evidence. Are we not supposed to be an evidence based profession?

There is not only one correct pathway to take to a destination. Medicine and health care are constantly evolving, and non-traditional pathways may become more prevalent. Those who cannot accept change and cannot adapt will not survive.

[djmatte, ADN, MSN, RN, NP]

You are correct in that there is no one pathway for everyone. And maybe that is a long term hindrance to the nursing profession. I kind of take thecareer choice personal, but she shared her opinion that based of two praises about not ever working as an RN that it was possible. It sure is. There are sadly no requirements of experience before entering advance practice. But in my opinion DE only diminishes the career and lends credence to MD claims that NP training isn't enough. Because you lost out on years of working with patients experiencing the very ailments you will be charged with preventing. Those choices diminish the value of my profession that I've worked hard at for over ten years and I think it's sad. And while it's easy to take those kind words (one step shy of "bless your heart") and pass them as proof it can be done, I'm fairly certain behind closed doors there will be more people inclined to go with the person who's worked as an RN with a solid track record in healthcare over the new grad who only saw a clinic environment through a few short months of clinical. It's not a matter of paying dues... But a matter of learning your chosen craft of nursing. Because I the end you're a registered nurse first and a certified whatever second.

[BCgradnurse, MSN, RN, NP]

You are correct in that there is no one pathway for everyone. And maybe that is a long term hindrance to the nursing profession. I kind of take thecareer choice personal, but she shared her opinion that based of two praises about not ever working as an RN that it was possible. It sure is. There are sadly no requirements of experience before entering advance practice. But in my opinion DE only diminishes the career and lends credence to MD claims that NP training isn't enough. Because you lost out on years of working with patients experiencing the very ailments you will be charged with preventing. Those choices diminish the value of my profession that I've worked hard at for over ten years and I think it's sad. And while it's easy to take those kind words (one step shy of "bless your heart") and pass them as proof it can be done, I'm fairly certain behind closed doors there will be more people inclined to go with the person who's worked as an RN with a solid track record in healthcare over the new grad who only saw a clinic environment through a few short months of clinical. It's not a matter of paying dues... But a matter of learning your chosen craft of nursing. Because I the end you're a registered nurse first and a certified whatever second.

We will agree to disagree. I see myself as a NP first, and a RN second, because NP is the role I am in everyday. I'm not being disrespectful to RNs. I just don't have any romanticized views of nursing or any other profession. I love what I do, but it's a career, not a calling.

You obviously take a lot of pride in what you do, and I have no doubt you are very good at it. I am also very good at what I do. My patients don't feel I am less competent because of my previous work experience, or lack thereof. At the end of the day, giving my patients excellent care is what really counts, not the opinions of other nurses, providers, or other individuals. My work speaks for itself. I would hazard a guess that if you went into a clinic and observed a number of NPs, you couldn't tell who was a DE grad and who worked as a RN first. Shouldn't patient care and outcomes really be the benchmark, and not opinions, and feelings?

[WestCoastSunRN, MSN, CNS]

And you have never worked worked as a NP, so how can you judge whether RN experience is helpful, necessary, or whatever? You've never done the job, so you have no way to know what's helpful or not. No one is "using" the nursing the profession to fast track. That really sounds like you're taking the whole DE segment as a personal affront. It's a whole lot of feelings and perceptions that are not based on evidence. Are we not supposed to be an evidence based profession?

There is not only one correct pathway to take to a destination. Medicine and health care are constantly evolving, and non-traditional pathways may become more prevalent. Those who cannot accept change and cannot adapt will not survive.

I feel like the point she was making is being missed and also her observation discredited because she is not an NP. I have seen the argument made that if you are not an NP you have no business weighing in on NP education, scope of practice, etc. Bedside RNs are not educated enough in the business of healthcare, academia, and their own profession to weigh in on what their advanced practice peers are up to? Not to mention the public, itself, has a vested interest in understanding how their healthcare providers are prepared to treat them.

Dodongo spoke of the need for standardization. I couldn't agree more. But also, there is a need for unification within nursing. On paper DE doesn't seem to gel, jive or care about cohesiveness in the profession of nursing. Again -- not an accusation towards any individual DE student or NP. I'm not totally against DE programs. As far as I'm concerned the dog in the race here is the nursing profession as a whole. I'm just not convinced DE programs have that same concern.

Now you can dismiss my opinion for any number of reasons you come up with, but chat with an APRN who worked as a nurse before advanced practice and chat with one who went DE. I believe you will find a difference in how they view and relate to the nursing profession, as a whole. I believe you will find a difference in their general interest in the big N nursing profession -- which encompasses ALL their nursing peers, not just APRNs. Just my .02

[BostonFNP, APRN]

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.

Absolutely necessary based on what? We are all scientists here, cite your sources and we can engage on them.

[BostonFNP, APRN]

As far as I'm concerned the dog in the race here is the nursing profession as a whole. I'm just not convinced DE programs have that same concern.

Can you think of and/or see some of the potential benefit DE programs bring to the nursing body as a whole?

[BostonFNP, APRN]

Because you lost out on years of working with patients experiencing the very ailments you will be charged with preventing. Those choices diminish the value of my profession that I've worked hard at for over ten years and I think it's sad.

This really sums up the crux of the issue for most RNs that have a "problem" with DE APRNs.

The major factor when it is all boiled down is that it is a personal issue (which we should all understand because it is such a polarizing issue).

1. Practicing RNs have put years of time and effort and blood and sweat and tears into their practice of nursing, and understandably, they want all that to "mean" something. This is where the first incorrect assumption is made: DE APRNs stand as a monument to that experience/effort not "meaning" anything. It is absolutely wrong. The role and practice and art of being an RN is completely independent of APRN practice. APRNs could go away and the importance of nursing would remain. In this specific case, it seems most RNs opposing DE APRN programs seem to equate "RN experience not necessary" with "RN experience not important". All experience is important and it makes all of us the health care practitioners we are (both nursing and non-nursing).

2. The role of the RN and the role of the primary care APRN is vastly different. While the RN experience with common ailments is valuable (as above) the approach of the APRN to those ailments is (nearly) completely different. In this manner, extensive RN experience can actually be a hindrance to learning the APRN role. In the literature this has been described as "role confusion" and has been identified as a barrier to NP role socialization.

Because I the end you're a registered nurse first and a certified whatever second.

This is the rosey picture that nursing has tried to create but the truth of the matter is the exact opposite: nurses practice by the top of their license. This is how it should be. Each and every nurse should practice to the very top of their license because that is what is best for the nursing profession as a whole.

[SpankedInPittsburgh, DNP, RN]

Very Very Good points Boston!!! The "measured" response is probably gonna be "but we don't approve". Do yourself a favor and stop caring. Many in nursing think they are owed an explanation by others for all sundry things that really are not within their control. IE "why did you do DE NP?" Real answer is "because I could" followed by closely by "Its none of your business and nobody did or will seek your approval".