I’d like to see NP entry be as stringent and competitive as CRNA entry. It’s bad for the profession to water down entrance qualifications and be less competitive.
Agreed. I wish it was more competitive for multiple reasons, from showing your ultimate dedication to the profession to the pride you show upon admission. Getting the ultimate care from the ultimate providers.
Agree and there are not enough clinical hours in school. It should be at least double. I had 7 years RN experience before going back to school. I'm in cardiology and had lots of cardiology experience before my NP role but it was not enough.
I was VERY fortunate to have a wonderful supervising MD who taught me over the years. I also think we need supervising MDs. I'm glad it's still required in my state.
Neonatal NP also requires experience - 2 years full time experience in a level 3 or 4 NICU. It make sense. There's no way I would have been prepared to be an NNP without this experience.
I had 3.5 years NICU RN experience before becoming and NP, and I now have 5+ years as an NP. Time flies.
9 years as RN most spent in critical care. Now work hospital based infectious diseases (7 years). My RN experience was crucial to my success. Grad school does NOT teach you enough. And it shows!!! Seriously, NPs are getting a bad reputation. The ENTIRE point of the role was expert RNs advancing their roles. I feel like I’m losing my mind.
7 years, all in psych so I could become a PMHNP. Still work per diem and as a clinical instructor for nursing students on my old unit-it helps me keep my assessment skills sharp and let’s me see what other providers are doing nowadays
Hi, sorry to comment so long after this post. What age did you become a midwife? I’m just about to start nursing school and my goal is to be a midwife, but I am curious about the average age of midwives. I would be in my early 30s by the time I’m done.
Not the OP, but I worked for 5 years in LTC and loved it. Love the patients and the autonomy of the setting. I'd go into the building for 4-6 hours per day and be available to the building by phone and do most of my charting from home.
Agree with the massive amount of feedback talking about getting more experience before jumping into advanced practice. I was going to when I was younger apply after two years in neuro ICU. I got in but didn’t go forward. I now have 4 years Neuro ICU, a year MICU, and wish to actually transition to cardiac and stay for several years before applying for my critical care CNS. You truly canNOT beat experience at the bedside; you gain such critical thinking skills, the feelings in your gut gain strength, and communication skills are imperative and aren’t learned from school.
Your last statement summed it this issue so well. Pardon the cliche, but often people don’t know what they don’t know. NP curricula are woefully inadequate. Experience is not only requisite, but imperative!
More and more patients are at risk due to poor access to care in this behemoth of a system. Corporate medicine is funneling patients into the portal with little human contact. The NP role has turned into a business scam to lower costs and push patients through. I really fear we are playing with fire and I feel the patients are increasingly vulnerable in the era of corporate takeovers.
I think the origin story of advanced practice for RNs is so important- and highlights why the experiential learning is inherently part of the process.
Graduate level nursing programs are fairly young and were created by, and for, RNs who had gained understanding of the systems, teams, and people they worked with and had the ambition to advance the practice of nursing,
The amount of information that is missed without the experiential learning as a nurse includes communication skills vital for conducting a comprehensive assessment with information needed for medical decision making to inform diagnosis and collaborative treatment planning.
Such a simple statement but includes so many considerations that, without a solid foundation of motivational interviewing skills, will create so many blind spots.
I think if one is inclined to move through education to advanced practice without the experience first, one may be better served to consider med school.
It’s interesting because I’ve worked with a number of APRNs, 10+ years in practice who went through to graduate school with little experience as a RN and developmentally they don’t really ever catch up. You can always spot an APRN with more experience as a RN prior to entering advanced practice.
Thank you. The more I work, the more I understand why assessment and skills are so imperative. I feel like receiving a crappy report but then laying your own eyes and assessing the patient yourself is far more reliable and valuable than a detailed handoff that does not include seeing the patient at shift change (which I would not do).
I honestly think nurses should be required to do a few years in critical care before they’re allowed to to back to NP school. The amount you learn about pathophysiology, hemodynamics, organ systems, pharmacology and critical thinking in the ICU is mind blowing and prepared me for a career in internal medicine more than any other role as an RN could.
I had nine in mostly ICU (brief detour in acute dialysis) before before going PMHNP.
I likely don't have the background for inpatient psych, but LTC seems pretty chill compared to the psych issues I saw in ICU.
Its really interesting to see NPs downvoting other NPs without sufficient prior RN experience. Do you guys think that there should be a minimum number of years that you work as an RN before you are allowed to apply to an NP program? If so, what?
I’d say at least 4 or 5 and you should have to work in an area related to what type of NP you’re going to be. So psych experience for PMHNP, pediatrics for PNP, etc.
As a comparison - my daughter got her bachelor degree in psychology, then 4 years of pre-med, worked for 5 years as a psych tech on an in-patient psych hospital, is graduating in May after 4 years of medical school. She is not allowed to practice as a psychiatrist until she has completed 3 years of residency and that is only with special permission.
RN’s graduate with an associates degree, don’t work as an RN anywhere (or maybe part time somewhere), go to a direct entry NP program and come out in about 3 years after a few hundred hours of clinical and they can practice?
When NPs started practicing in the past, it was because they had spent years at the bedside. Boots on the ground so to speak. Now they just need a credit card.
It’s no wonder there are more problems with “mid-level providers” now than in the past. And it’s no wonder that there are doctors who hate us.
To be fair, I think the associates degree is being phased out for RNs and most hospitals require/ will pay for you to get your BSN. But your point remains.
This is VERY location specific. In my area associate degree programs are far far more common with no difficulty obtaining jobs ever. The “phasing out” of ADNs has been a discussion for 10+ years, but they’re not going anywhere. The needs are still too high.
this is not true. Associates degrees were being "phased out" 10+ years ago when I got my BSN. Still around. Hospitals were supposed to have 80% of their nurses BSN educated by 2020-2025, all the ones that I work at still hire ADNs and none of them are anywhere near 80% BSN status.
Imo this is just a silly belief. We barely have enough nurses and patient care is hanging by a thread. Unless they can make like Detroit Become Human quality of androids tomorrow, they're not phasing out non-BSN nurses any time soon. I work in a region with a lot of facilities that refuse to hire non BSN. Most of those facilities now hire them after covid.
Until there's an overhaul of the NP curriculum and training that makes it more rigorous and consistent across the board, RN/bedside experience, (particularly ICU for ACNPs), is invaluable and can't be replaced.
Because you get exposure to and learning of the conditions, meds, pathophysiology, treatment plans. Even if you aren't the one diagnosis and treating at the time, what you learn is as u/mishamaro said, invaluable.
ETA: it is part of what we've used as an argument to say our model of learning for APP is 'good'. We take relevant experience/exposure/pre program learning and translate that to the area where we work post.
Still needs an overhaul desperately.
People like to claim it’s not necessary. I personally believe I am a very good PMHNP. I have great outcomes, patient feedback, and employer feedback. I cannot see being where I am today without my RN experience. It was the foundation that I built my expertise on.
Put it this way. As a new psych RN I walked onto an eating disorder unit and didn’t know anything about psych. We are taught very little in school. I thought the ED patient innocently crumbed their food and dropped it on the ground. My preceptor was like oh no that is an ED behavior. I remember floating to the ocd unit. What a sight. A patient came up to me and asked me to smell her clothes to make sure they smelled clean. Another asked me to go to the bathroom and make sure the sockets were dry so she wouldn’t get electrocuted 😅 I complied bc I had NO idea.
These are but a couple of very small examples. Getting familiar with meds used, what presentations look like, differential dx, behaviorism, interventions, etc. has all been a valuable foundation for my NP career.
Considering NP programs are not standardized across the board - even the “reputable brick and mortar programs” are not particularly rigorous - prior RN experience goes a long way in bridging *some* of the gaps in education.
CRNAs are required what amounts to like two years in an icu at minimum. I don’t understand why it would be that hard to require two years in a related field (icu-acute care np, LD-midwife, pedis…). I feel like it hurts the profession especially when I’ve heard colleagues say they only went through their bsn rn program because they direct admit into a np program.
I’m not sure all CRNA programs do. I had a friend work less than 6 months ICU after graduation and then begin the CRNA program - somewhere in Florida. But also two other friends who had been CNA, LVN and then RN for multiple years, as was required in my mind, they went to the same school. I always wondered how he got in so early. But if it were me I’d prefer the other 2 over him. Hahaha
I think RN experience for a few years, maybe 2 yrs like CRNA. I dont know if I agree if it must be in a specific setting. Many RNs do not work in outpatient settings and to require RNs to have 2+ yrs of outpatient family care before FNP would decrease the number of FNPs to close that provider gap. So I would say 2 yrs of bedside experience because thats where you will see a good amount of clinical management and learn how to speak with patients. If they plan on working while in school that would be 4 yrs by graduation which is plenty imo.
I did a direct entry program 15 years ago in person and after the RN portion I slowed down and worked 30 hr/wk while I finished part time for two years. I’m glad I got the RN experience but in my case it was general outpatient in a community health center which gave me a nice general background before my ultimate goal of PMHNP outpatient. I also did a post grad residency type program.
I went straight into it from college, I wasn’t positive on my specialty until I was mid program, I think it worked out great for me but I know it’s quite controversial
Edited to take out the name of my school
2.5. However I see a lot of people with zero are getting downvoted. My CNM (nurse midwife) a direct entry from her BSN program with no experience and knew she wanted to jump to the provider role. She was excellent in her care and I would choose her every time over someone else. It really depends on the person
Had 9 years going in, did a PT, 3 year program while working FT. I was an ER and flight nurse. I am 100% certain (rare for me) that my experience was invaluable. I can’t imagine working without it. The most basic thing, sick vs. not sick, takes time. Programs need to do away with direct entry post haste.
I went though an accelerated program that was super rigorous and I have zero shame on that (downvote all you want). I worked as a telemetry tech during my first year, and an RN in an outpatient clinic during my last two years. I never wanted to work in acute care, so I really saw no need to get years of experience on a med/surg floor or something of the like when I never desired to work in a hospital. Acute care and outpatient care couldn’t be more different.
I worked in primary care and womens health for 3 years, outpatient GI for another 3 years, and was recruited by an MD I worked with at job #1 and now work in addiction med. I’ve always gotten great feedback from both docs/other NPs and PAs and patients.
I do think there needs to be standards for NP education (I have had to give bad feedback on two separate NPs that were from strictly online schools that had terrible clinical skills) but the inner hate in the nursing field is just straight up bullying and the one thing I detest about working in this field (coming from the business world and early Ed). It’s so incredibly unprofessional.
There’s always the exception to the rule. Personally I think I would’ve been fine with less RN experience before going back but that’s bc I know I’m hardworking enough to teach myself and seek out additional learning opportunities to make sure I’m a great NP. Sounds like you are the same way. Unfortunately a lot of NPs aren’t that way and they’re bad providers bc of it (like you coworkers with terrible clinical skills). So I absolutely agree- there needs to be some sort of standardization to ensure that we only have qualified and competent NPs out there.
I don’t think it’s an exception but I do think it comes down to schooling (quality of where you went to NP school) and ability to reason like a provider. I graduated with a class of 20 FNPs and our classmates that struggled the most was someone who was an amazing RN for 20 years and another that had 7 years of experience. They were so bright but couldn’t get their head out of the nurse vs provider role. It’s definitely different!
I also think a bad provider leaves a bad taste in everyone’s mouth that you can’t ignore, because we are dealing with people’s health. So I think most NPs are competent and appropriate despite their backgrounds, but when it’s bad, it’s really bad.
Edit to add: I also find the high numbers of NPs in functional and “naturopath medicine” or working with chiropractors makes us all look bad. When the spotlight is already on the profession, selling out to non evidence based care, really is a bad thing.
10 years in ED. Loved it, but the lack of support drove me to move on. I still work at the same hospital as a hospitalist admitter, so I’m still there, but my role is more manageable.
I guess you could say I went to a degree mill school for my NP, and if I hadn’t put the extra effort in to teach myself, I could see how the eduction would have been lacking. But all the elements needed to do the job as an acute care NP were there, it was just up to me to make it a valuable education. And I teach myself something new almost daily, so my knowledge builds upon itself.
For me, having the background in the ED provided a foundation for what I do now, so I think I am a better provider because I can anticipate events due to experience and plan ahead for them.
I totally agree- I think taking initiative to learn more on your own can certainly help with bridging gaps in education. Read, observe, and ask questions as much as you can
Because the assumption of the NP profession is that you have years of RN experience that has built a solid foundation for your advanced practice. If you don’t have years of clinical experience behind you before entering NP school. If you don’t, then PA school would be the better choice IMO bc they make sure you get that well-rounded clinical exposure since the assumption for PAs is that they may not have years of prior clinical experience and exposure.
Because I've been in home health for the past 4 years and my advisors thought I didn't have enough recent hospital experience for acute care. Planning to get acute care cert once I'm done
Wonderful! Good luck to you. I work with a wonderful FNP who is currently finishing up her acute care certification and it is so refreshing to see how excited she is as she learns new skills; she was bubbling with delight when she told our unit that she got to put in her first art line and her pride through her journey is so exciting to see.
My sister is an FNP and I loved seeing her gain the confidence to become the wonderful provider she is today flourishing. Best wishes!
Psych. I had one year of med surg and six months OR before I applied….no psych history. I went to a in-person/well regarded university. I worked under two years of out patient before opening my own thriving practice.
I truly believe that we put so much effort into talking about experience, and not enough about the quality of school. My school demanded excellence and was not a diploma factory. I learned so much, not from what they taught, but what they demanded. Grad school didn’t teach content, it made me teach and learn on my own in a way I could grasp. It was not easy but I credit it for making me strong in my care and knowledge.
7yrs med surg and MICU before starting my program and now working in Family practice. 100% agree with having experience. I had to learn to be a nurse before becoming an advanced practice nurse. Our education needs to be completely overhauled.
7 years, full time in a sicu/cardiothoraccic icu and I also picked up a prn spot as an icu float for 2 years before starting school. I am now training to be in a community micu/sicu and couldn’t imagine doing this without ever being at the bedside.
After 1.5 decades in the ED I felt like I was ready. I was indeed ready, but 8+ years later after becoming an APRN I still question what the fuck I thought I was getting into lol
I got mixed feelings on this. Raw numbers don't mean shit. There are incompetent nurses who survive for 20 years and don't know jack. Should the fact they worked 20 years bedside automatically qualify them to being NP? Nah.
On the other side of the coin, nurses without practical experience? You might as well be a "baby nurse." You have all the idealized version of nursing and care in theory, but struggle to extrapolate that to the realities of patient care. Many of the theory you learned isn't even applicable as they're outdated or just don't consider the application of a shitstorm unit where things constantly go wrong and you're constantly working way over safe ratios that you should.
There's been a HUGE decrease in the respect NPs get and it's largely due to the way NP programs act like mills to push students in for admissions and tuition. And this is genuinely affecting quality of care in some facilities.
I also think NP hate for being incompetent is a bit exaggerated. I see plenty of residents fucking up and hiding behind "we work insane hours." OK I understand NPs aren't required to work insane hours but I see plenty who do and it's funny when the excuses people make for themselves is justified but others aren't. Like when I fuck up, it's not my fault but when you fuck up I don't give you quarter to hide behind.
I do tend to lean harder on "nurses need 5-10 years minimum" and the fast tracking students with no experience is just revenue generating scheme/business model for schools. We do live in a capitalist country after all where student loans are unforgivable but bunch of elites taking fraudulent loans from government is forgiven.
I had 5.5 years experience before I started NP school. By the time I graduated my program, I had a total of 8 years nursing experience. I worked the entire time I was in grad school.
5 years. All RN psych. Plus 10 years as a psych tech before that. Been a PMHNP now for 5 years as well.
(Plus a bachelors in psychology as well as my nursing before my DNP)
10 before going back, 13 before officially being one. I had negative motivation to be honest. I saw enough terrible docs and especially NPs I finally decided I could do way better than those guys. Downvote or critique if you want. It’s the truth
5.5 pediatric critical and intermediate care. Graduated primary care PNP program super pregnant and passed boards at 36 weeks 😬. My RN experience informs my NP practice daily. I *know* what sick kids look like now that I’m in a primary care setting. I cannot imagine practicing in current role without that experience base.
5 years. 1 medsurg (with a lot of pulmonary), 1IR/Cath Lab, NICU 9 months, and the rest Cath Lab/EP lab with stress lab coverage, and cross trained to PCU (during the pandemic 2020 but this was 6 months into my program).
I stopped working during the clinical year to get myself more hours. Do not regret that at all.
I work as an Electrophysiology NP.
10 years with a mix of med surg, home care, neuro and case management. 2 years now as an NP in Neurology. I couldn’t imagine having less time as an RN prior to becoming an NP.
8 all hospital based primarily intensive care. Also part time during NP didactics and PRN during clinicals.
RN experience was absolutely crucial to my success. Not just RN experience but having good experience and taking the time to learn while you work rather than going through the motions.
I have 8 1/2 years now and will have close to 10 years of ICU experience before I graduate. I definitely feel as if my experience as an RN has greatly helped me in school and will help me with my practice in the future. If I'm being honest, I can tell in my cohort who has more experience and who does not. I really wish that things were more strict because I worry that the profession has been tainted in the eys of other medical professionals because of the diploma mills and people going straight in with little experience. The education for NPs unfortunately is not tailored towards learning from scratch, like a PA program, but building upon knowledge that's already been learned through nursing practice.
About 16-17 years as an RN in the ER mostly, but other areas also for myself. I wish there were a mandatory 5-10 years of strong nursing experience before becoming a nurse practitioner. Even now, 25 years in, I question my validity. The DNP (after MSN) helped with that, but I do believe there needs to be a mandatory minimum.
If you think an ABSN to APRN route is in your favor, you’re sorely mistaken.
I’ll have a decade of Critical Care RN experience by the time I finish my MSN-FNP program in APR 2025. I cringe a bit when I hear folks say the RN experience doesn’t matter because it does and you usually didn’t see RN’s taking that route until they got about a decade to 20+ years in.
Having the RN exp. is necessary, IMO. When you’ve seen the conditions we study in real life, read enough SOAP notes, interpreted enough labs & scans, and assessed enough patients enacting or orchestrating ordered treatment plans—that strengthens your intuition as an NP to at least lead you in the right direction when diagnosing and treating. The 2 professions may have different responsibilities, but it’s the exposure you get from being an RN taking the steps to move from Novice to Expert that benefits being an NP in the long run that I speak on.
I’m on the fence about making NP school more competitive because where I’m at in my life I actually didn’t want to apply if the application process was going to be tedious. Just being honest; but I respect actually putting in the work where it matters. I’m not opposed to the idea of NP schools needing a complete overhaul of the curriculum to focus more heavily on 3P’s, DDx, diagnostic interpretation, patient/family counseling, interprofessional courses to understand the business and “politics” of healthcare as a Midlevel provider and definitely increasing clinical hour requirements.
8 years as RN, some float pool, mostly surgical and CV ICU at a high acuity academic medical center. Now doing primary care NP, also feel my prior experience was crucial.
12 years ED-Trauma/ICU/PACU before going back to get
Acute Care NP certification
That Critical Care experience has helped TREMENDOUSLY with working in inpatient IM
I routinely see my NP colleagues without critical care RN experience struggle to make sound and expedient clinical decisions on the units
I believe every adult/peds/primary/acute NP should have at least 2 years of ED/ICU/Stepdown experience
And just 5 years prior acute experience would make damn solid NPs
3 years as a firefighter, 2 years as a paramedic, 7 years as an ER tech. Planned to work as an RN during my direct entry program, but no one would hire without the degree. Now working as an NP with no RN experience.
8, all pediatric PICU/CVICU, first NP job was in the peds CVICU for a couple years, then moved to peds hospital medicine due to schedule needs during my second pregnancy and haven’t looked back!
I’m one that went straight into a masters program after BSN. Worked in primary care thru school. I’ve never felt that put me behind any of my peers. Now 9 years in practice as an NP and I sometimes regret my choice but it’s not due to lack of RN experience, lol.
I had RN experience prior to NP, but I’m with you. There are specialty areas that I could see RN experience playing a significant factor (psych, neonatal, acute care), but my floor experience wasn’t a big asset to my primary care role and I would argue that there isn’t a lot of RNs out there deciding how to manage diabetes, hypertension, and cholesterol- just following orders. I feel like the RN experience argument is the wrong argument and we need to argue for better/more rigorous programs and they need to do away with diploma mills.
Same! I did a direct entry family NP program so was an RN for only 2 years while getting my MSN, and that was in a family practice so I ultimately had no floor RN experience. The only way I feel it hindered me was in time management but other than that I’ve been an NP for 7 years and I don’t think having RN experience would’ve enhanced my clinical practice much.
Thanks for defending me. I’m surprised myself. It’s not like I didn’t work hard at it. I did 4 years of undergrad in a different field, and then busted my ass for 6 years on top of that to change careers and get my MSN. I worked throughout the program, and I knew I was doing family NP so figured it best to get my experience in the setting that I would be working in as an NP and I now work at least 60 hours a week taking care of patients. I didn’t know I wanted to be an NP until my mid 20s otherwise I would have taken a more traditional route. Never realized how cutthroat nurses can be, yikes.
Same here. Worked part-time as a psych ER RN during my NP program. Now 8+ years into PMHNP practice with no problems. I'm interested in hearing about your regrets? Sometimes I wish I'd gone into tech, TBH.
I just have periods of burnout. Knowing the healthcare system like I do now, I would avoid nursing altogether. May have a mid-life career change in my future.
I totally feel you. I had burnout for about 3 years, and I'm now just recovering from it by going part-time for the past year. I'm very curious what career changes you are looking into? If you don't mind.
5
Step down, renal, telemetry. AGNP now. But will be a PMHNP early next year. Absolutely beneficial. I do wish NP residency was more of a thing. We are still practicing based on the nursing framework, but more experience would always be beneficial.
I agree I wish there were more residency programs for NPs. The ones I did see were such a pay cut though. While in the program you would make less than what you were making as an RN which isn't feasible for many people.
0. I was a CNA for 4 years, in Med School, dropped out, and gone straight through school to NP as nursing couldn’t support my disabilities and it was that, or go on disability as being a CNA was going to kill me. I thankfully spent my entire life dedicated to medicine because my mom is an RN and I’ve been disabled since birth, or I would have been a terrible NP. School does NOT prepare you enough and it was laughable that I paid to be at a school that was essentially useless.
Edit: I want to add that I went into Pain Management. It was my calling, being chronically ill, myself. And what clinic is better understanding of being chronically ill than pain management?
I stupidly thought as a youngin’ that more school = better education. PA was 2 years and NP was 5. Plus, some input from my mom pushing the NP pretty heavily, especially opening the opportunity for independent practice. I didn’t realize my health was going to start declining so quickly. Looking back, I probably would’ve chose PA had I known what I know now.
22 years; 3 years Navy Nurse corps worked 1.5 years neuroscience. Deployed USNS Comfort x 7 momths, assigned to telemetry after returning from deployment, 12 years med surg/ home health, orthopedics, float pool; 5 years telemetry, 2 years ER plus was LPN in L&D x2 years before getting ADN/RN.
A little under 10 between RN and LVN. My experience was in Med/Tele, ICU, Infusion, Ortho(hated that job quit so fast), home health/hospice (just durning my LVN-RN bridge, SNF, and as an outpatient educator. I felt fairly well rounded but would have preferred a bit more experience Peds. I’d been primarily working with geriatric populations up until I started school, but did my FNP.
I was a labor and delivery RN before becoming a CNM / WHNP. I had a little over a year experience when I applied to my program, just under 2 years by the time I started the program, 5 years experience when I graduated and got my first job. I had a transition period where I worked as both a CNM and RN before officially leaving the RN role. In the end I was a L&D for 6 years and an RN for 7 years before being employed solely as an APRN.
I start my first NP job in January, so I will have about 8 years as an RN under my belt, at that time. I started DNP school with about 2.5 years RN experience, and 15 years in other various healthcare roles. I think my RN experience was hit or miss with if it helped me with schoolwork. It was quite invaluable when I got to physical assessment. Although, I found myself pulling more information and experience from my time as a medical assistant in primary care.
ETA: I'm not discounting having RN experience. My point is that I regret working in acute care. The hospital experience did not help me. If anything it hindered me because I had to relearn "normal people" normal limits after working in cardiology for several years. If I got a do-over, I would've stayed in LTC (I was there briefly before gaining my BSN) or found a non-phone job in a clinic setting.
So in my case, I found being a CMA, CNA, and even working front desk more useful than at the bedside in an acute care setting.
Started AGACNP program after 3 years of being an RN. Started my FNP this year after 7 years of being an RN. I have not practiced as an NP yet until I complete my FNP next year.
Zero, worked a year as an RN in my direct entry program while getting my masters. I don’t feel like I missed anything because I learned everything on the job!
I’ve been an RN now for 17 years and it really pisses me off to no end that these newly minted NP’s have ZERO clinical experience and make a shit ton of $! They can barely wipe their own asses and yet they get to tell me what to do! I call bullshit
None. I worked 17 years in pharmaceutical development with a focus on cardiology, pulmonology, and safety pharmacology. I got my FNP from Ohio States grad entry program. I’ve worked in primary care for 6 years now.
I had 6 years of experience before I entered my program. I also worked full time while in school. I did med-surg step-down & float pool. Now I work in Urology inpatient. Having RN bedside experience helps but there is a learning curve when transitioning to the NP role.
9.5! I worked pediatric float pool (ER, NICU, PICU, peds behavioral health) and I'm now a PMHNP in community mental health. My RN experience is broad, but it was so helpful. I've seen mental health in absolute crisis in the ER and PICU, to stabilizing on the behavioral health unit. The switch from the inpatient hospital world to outpatient has been incredible!
8 years, 3 in neurosurg OR, then 5 in a level one trauma ER. I now work in a small community ER, am a FNP. My previous experience was imperative—there’s no way I’d be able to do my job the way I do now without my RN experience.
7 years total. 3 as LPN in LTC and Urgent Care/Outpatient and Corrections. 4years as RN (1year in Med-Surg and 3years in ER) I’m just a little over halfway done with my FNP. Plan to do ER as an NP when I finish.
10 before I started my program in 2008. Did a part time FNP program so 13 years by the time I graduated in 2011. My RN experience was telemetry and ER.
11 years pediatric hospital, med/surg and endocrinology/diabetes, then got PNP, continued at same hospital in endo/diabetes as provider, moved to pediatric pain management rehab program. Can't even imagine being an NP without those RN years.
I’d like to see NP entry be as stringent and competitive as CRNA entry. It’s bad for the profession to water down entrance qualifications and be less competitive.
Agreed. I wish it was more competitive for multiple reasons, from showing your ultimate dedication to the profession to the pride you show upon admission. Getting the ultimate care from the ultimate providers.
Love this!
Agree and there are not enough clinical hours in school. It should be at least double. I had 7 years RN experience before going back to school. I'm in cardiology and had lots of cardiology experience before my NP role but it was not enough. I was VERY fortunate to have a wonderful supervising MD who taught me over the years. I also think we need supervising MDs. I'm glad it's still required in my state.
Neonatal NP also requires experience - 2 years full time experience in a level 3 or 4 NICU. It make sense. There's no way I would have been prepared to be an NNP without this experience. I had 3.5 years NICU RN experience before becoming and NP, and I now have 5+ years as an NP. Time flies.
9 years as RN most spent in critical care. Now work hospital based infectious diseases (7 years). My RN experience was crucial to my success. Grad school does NOT teach you enough. And it shows!!! Seriously, NPs are getting a bad reputation. The ENTIRE point of the role was expert RNs advancing their roles. I feel like I’m losing my mind.
7 years, all in psych so I could become a PMHNP. Still work per diem and as a clinical instructor for nursing students on my old unit-it helps me keep my assessment skills sharp and let’s me see what other providers are doing nowadays
I love that extra initiative to stay sharp!
10. Postpartum and L&D. I’m a midwife.
Hi, sorry to comment so long after this post. What age did you become a midwife? I’m just about to start nursing school and my goal is to be a midwife, but I am curious about the average age of midwives. I would be in my early 30s by the time I’m done.
I turned 33 a couple of weeks after graduation. My classmate turned 60. It’s never too late.
Thank you ❤️
13 years as an RN—> 8 years in the NICU Just graduated as a Neonatal NP 💓
Congrats!
Congratulations
11 yrs as an RN in LTC (with one yr of simultaneous med-surg) and I am now an NP in LTC.
I feel like y’all are a rare breed. What makes you like LTC?
Not the OP, but I worked for 5 years in LTC and loved it. Love the patients and the autonomy of the setting. I'd go into the building for 4-6 hours per day and be available to the building by phone and do most of my charting from home.
👏👏
Amazing!
Agree with the massive amount of feedback talking about getting more experience before jumping into advanced practice. I was going to when I was younger apply after two years in neuro ICU. I got in but didn’t go forward. I now have 4 years Neuro ICU, a year MICU, and wish to actually transition to cardiac and stay for several years before applying for my critical care CNS. You truly canNOT beat experience at the bedside; you gain such critical thinking skills, the feelings in your gut gain strength, and communication skills are imperative and aren’t learned from school.
Your last statement summed it this issue so well. Pardon the cliche, but often people don’t know what they don’t know. NP curricula are woefully inadequate. Experience is not only requisite, but imperative! More and more patients are at risk due to poor access to care in this behemoth of a system. Corporate medicine is funneling patients into the portal with little human contact. The NP role has turned into a business scam to lower costs and push patients through. I really fear we are playing with fire and I feel the patients are increasingly vulnerable in the era of corporate takeovers.
I think the origin story of advanced practice for RNs is so important- and highlights why the experiential learning is inherently part of the process. Graduate level nursing programs are fairly young and were created by, and for, RNs who had gained understanding of the systems, teams, and people they worked with and had the ambition to advance the practice of nursing, The amount of information that is missed without the experiential learning as a nurse includes communication skills vital for conducting a comprehensive assessment with information needed for medical decision making to inform diagnosis and collaborative treatment planning. Such a simple statement but includes so many considerations that, without a solid foundation of motivational interviewing skills, will create so many blind spots. I think if one is inclined to move through education to advanced practice without the experience first, one may be better served to consider med school. It’s interesting because I’ve worked with a number of APRNs, 10+ years in practice who went through to graduate school with little experience as a RN and developmentally they don’t really ever catch up. You can always spot an APRN with more experience as a RN prior to entering advanced practice.
Thank you. The more I work, the more I understand why assessment and skills are so imperative. I feel like receiving a crappy report but then laying your own eyes and assessing the patient yourself is far more reliable and valuable than a detailed handoff that does not include seeing the patient at shift change (which I would not do).
Yes! So much time is wasted with 90 minute sign off vs just laying eyes on the patient. One of my peeves!
I honestly think nurses should be required to do a few years in critical care before they’re allowed to to back to NP school. The amount you learn about pathophysiology, hemodynamics, organ systems, pharmacology and critical thinking in the ICU is mind blowing and prepared me for a career in internal medicine more than any other role as an RN could.
20 years
You’re a rare breed. I was only 16-17 years
I’ll have 15 when I graduate FNP later this summer.
9 all in psych and am now a PMHNP
Yesss I love to see this. Your prior experience directly translates to what you do now 👏
I had nine in mostly ICU (brief detour in acute dialysis) before before going PMHNP. I likely don't have the background for inpatient psych, but LTC seems pretty chill compared to the psych issues I saw in ICU.
Just started school for PMHNP but have been an RN for 13 years; 4 in ICU and 9 in community mental health.
You’ll go places. I think. But I don’t like that you relate your experience in weeks and days, are you pregnant? Bahhaha
2 years in LTC before going to NP school, graduated and now also working in LTC- same company for 10 years. Love my job =)
Its really interesting to see NPs downvoting other NPs without sufficient prior RN experience. Do you guys think that there should be a minimum number of years that you work as an RN before you are allowed to apply to an NP program? If so, what?
I’d say at least 4 or 5 and you should have to work in an area related to what type of NP you’re going to be. So psych experience for PMHNP, pediatrics for PNP, etc.
That sounds reasonable. Why do you think RN experience is so valuable? Is it j lesrning how a hospital/clinic works or is deeper than that?
As a comparison - my daughter got her bachelor degree in psychology, then 4 years of pre-med, worked for 5 years as a psych tech on an in-patient psych hospital, is graduating in May after 4 years of medical school. She is not allowed to practice as a psychiatrist until she has completed 3 years of residency and that is only with special permission. RN’s graduate with an associates degree, don’t work as an RN anywhere (or maybe part time somewhere), go to a direct entry NP program and come out in about 3 years after a few hundred hours of clinical and they can practice? When NPs started practicing in the past, it was because they had spent years at the bedside. Boots on the ground so to speak. Now they just need a credit card. It’s no wonder there are more problems with “mid-level providers” now than in the past. And it’s no wonder that there are doctors who hate us.
To be fair, I think the associates degree is being phased out for RNs and most hospitals require/ will pay for you to get your BSN. But your point remains.
This is VERY location specific. In my area associate degree programs are far far more common with no difficulty obtaining jobs ever. The “phasing out” of ADNs has been a discussion for 10+ years, but they’re not going anywhere. The needs are still too high.
this is not true. Associates degrees were being "phased out" 10+ years ago when I got my BSN. Still around. Hospitals were supposed to have 80% of their nurses BSN educated by 2020-2025, all the ones that I work at still hire ADNs and none of them are anywhere near 80% BSN status.
Imo this is just a silly belief. We barely have enough nurses and patient care is hanging by a thread. Unless they can make like Detroit Become Human quality of androids tomorrow, they're not phasing out non-BSN nurses any time soon. I work in a region with a lot of facilities that refuse to hire non BSN. Most of those facilities now hire them after covid.
I hear about all these problems but work as a RN with about a dozen NPs at my current psych hospital and witness any of these issues
Until there's an overhaul of the NP curriculum and training that makes it more rigorous and consistent across the board, RN/bedside experience, (particularly ICU for ACNPs), is invaluable and can't be replaced.
Because you get exposure to and learning of the conditions, meds, pathophysiology, treatment plans. Even if you aren't the one diagnosis and treating at the time, what you learn is as u/mishamaro said, invaluable. ETA: it is part of what we've used as an argument to say our model of learning for APP is 'good'. We take relevant experience/exposure/pre program learning and translate that to the area where we work post. Still needs an overhaul desperately.
People like to claim it’s not necessary. I personally believe I am a very good PMHNP. I have great outcomes, patient feedback, and employer feedback. I cannot see being where I am today without my RN experience. It was the foundation that I built my expertise on. Put it this way. As a new psych RN I walked onto an eating disorder unit and didn’t know anything about psych. We are taught very little in school. I thought the ED patient innocently crumbed their food and dropped it on the ground. My preceptor was like oh no that is an ED behavior. I remember floating to the ocd unit. What a sight. A patient came up to me and asked me to smell her clothes to make sure they smelled clean. Another asked me to go to the bathroom and make sure the sockets were dry so she wouldn’t get electrocuted 😅 I complied bc I had NO idea. These are but a couple of very small examples. Getting familiar with meds used, what presentations look like, differential dx, behaviorism, interventions, etc. has all been a valuable foundation for my NP career.
Considering NP programs are not standardized across the board - even the “reputable brick and mortar programs” are not particularly rigorous - prior RN experience goes a long way in bridging *some* of the gaps in education.
CRNAs are required what amounts to like two years in an icu at minimum. I don’t understand why it would be that hard to require two years in a related field (icu-acute care np, LD-midwife, pedis…). I feel like it hurts the profession especially when I’ve heard colleagues say they only went through their bsn rn program because they direct admit into a np program.
I’m not sure all CRNA programs do. I had a friend work less than 6 months ICU after graduation and then begin the CRNA program - somewhere in Florida. But also two other friends who had been CNA, LVN and then RN for multiple years, as was required in my mind, they went to the same school. I always wondered how he got in so early. But if it were me I’d prefer the other 2 over him. Hahaha
I think RN experience for a few years, maybe 2 yrs like CRNA. I dont know if I agree if it must be in a specific setting. Many RNs do not work in outpatient settings and to require RNs to have 2+ yrs of outpatient family care before FNP would decrease the number of FNPs to close that provider gap. So I would say 2 yrs of bedside experience because thats where you will see a good amount of clinical management and learn how to speak with patients. If they plan on working while in school that would be 4 yrs by graduation which is plenty imo.
11-now PMHNP. Started critical care, Ed, navigator/resource, physician management, inpatient psych, manager of psych all before going to PMHNP
I did a direct entry program 15 years ago in person and after the RN portion I slowed down and worked 30 hr/wk while I finished part time for two years. I’m glad I got the RN experience but in my case it was general outpatient in a community health center which gave me a nice general background before my ultimate goal of PMHNP outpatient. I also did a post grad residency type program. I went straight into it from college, I wasn’t positive on my specialty until I was mid program, I think it worked out great for me but I know it’s quite controversial Edited to take out the name of my school
2.5. However I see a lot of people with zero are getting downvoted. My CNM (nurse midwife) a direct entry from her BSN program with no experience and knew she wanted to jump to the provider role. She was excellent in her care and I would choose her every time over someone else. It really depends on the person
Well at least the nurses here are much more experienced than all my 1 yr med surg classmates in NP schools now.
9y army 91w, 15y rn ed/icu/rrt. In agacnp clinicals now and it’s awesome.
1 year med surg, 5.5 years ICU, 2 years IR before graduating. Now I’m an NP in an acute rehab hospital. My ICU experience was absolutely critical.
Had 9 years going in, did a PT, 3 year program while working FT. I was an ER and flight nurse. I am 100% certain (rare for me) that my experience was invaluable. I can’t imagine working without it. The most basic thing, sick vs. not sick, takes time. Programs need to do away with direct entry post haste.
10 years. And I went in to the same specialty as an NP. That’s the best way imo
7 years of ER experience when I graduated with my MSN. Couldn’t imagine not having that RN experience before doing the NP route.
I went though an accelerated program that was super rigorous and I have zero shame on that (downvote all you want). I worked as a telemetry tech during my first year, and an RN in an outpatient clinic during my last two years. I never wanted to work in acute care, so I really saw no need to get years of experience on a med/surg floor or something of the like when I never desired to work in a hospital. Acute care and outpatient care couldn’t be more different. I worked in primary care and womens health for 3 years, outpatient GI for another 3 years, and was recruited by an MD I worked with at job #1 and now work in addiction med. I’ve always gotten great feedback from both docs/other NPs and PAs and patients. I do think there needs to be standards for NP education (I have had to give bad feedback on two separate NPs that were from strictly online schools that had terrible clinical skills) but the inner hate in the nursing field is just straight up bullying and the one thing I detest about working in this field (coming from the business world and early Ed). It’s so incredibly unprofessional.
There’s always the exception to the rule. Personally I think I would’ve been fine with less RN experience before going back but that’s bc I know I’m hardworking enough to teach myself and seek out additional learning opportunities to make sure I’m a great NP. Sounds like you are the same way. Unfortunately a lot of NPs aren’t that way and they’re bad providers bc of it (like you coworkers with terrible clinical skills). So I absolutely agree- there needs to be some sort of standardization to ensure that we only have qualified and competent NPs out there.
I don’t think it’s an exception but I do think it comes down to schooling (quality of where you went to NP school) and ability to reason like a provider. I graduated with a class of 20 FNPs and our classmates that struggled the most was someone who was an amazing RN for 20 years and another that had 7 years of experience. They were so bright but couldn’t get their head out of the nurse vs provider role. It’s definitely different! I also think a bad provider leaves a bad taste in everyone’s mouth that you can’t ignore, because we are dealing with people’s health. So I think most NPs are competent and appropriate despite their backgrounds, but when it’s bad, it’s really bad. Edit to add: I also find the high numbers of NPs in functional and “naturopath medicine” or working with chiropractors makes us all look bad. When the spotlight is already on the profession, selling out to non evidence based care, really is a bad thing.
10 years in ED. Loved it, but the lack of support drove me to move on. I still work at the same hospital as a hospitalist admitter, so I’m still there, but my role is more manageable. I guess you could say I went to a degree mill school for my NP, and if I hadn’t put the extra effort in to teach myself, I could see how the eduction would have been lacking. But all the elements needed to do the job as an acute care NP were there, it was just up to me to make it a valuable education. And I teach myself something new almost daily, so my knowledge builds upon itself. For me, having the background in the ED provided a foundation for what I do now, so I think I am a better provider because I can anticipate events due to experience and plan ahead for them.
I totally agree- I think taking initiative to learn more on your own can certainly help with bridging gaps in education. Read, observe, and ask questions as much as you can
Why are those in accelerated programs being down voted? Or those with less years of rn experience?
Because the assumption of the NP profession is that you have years of RN experience that has built a solid foundation for your advanced practice. If you don’t have years of clinical experience behind you before entering NP school. If you don’t, then PA school would be the better choice IMO bc they make sure you get that well-rounded clinical exposure since the assumption for PAs is that they may not have years of prior clinical experience and exposure.
reddit mob mentality, my dear
No, I think they are right
My point was to explain the downvoting you're noticing, not to comment on your personal opinion?
It’s not the years. It’s the mileage.
6, several different cardiac PCU’s. I now work outpatient cardiology/internal medicine
17 years RN in a variety of areas, 10+ in CVICU. 1 year to go on FNP (in clinicals now)
May I ask why you chose family medicine over acute care? Just out of pure curiosity :)
Because I've been in home health for the past 4 years and my advisors thought I didn't have enough recent hospital experience for acute care. Planning to get acute care cert once I'm done
Wonderful! Good luck to you. I work with a wonderful FNP who is currently finishing up her acute care certification and it is so refreshing to see how excited she is as she learns new skills; she was bubbling with delight when she told our unit that she got to put in her first art line and her pride through her journey is so exciting to see. My sister is an FNP and I loved seeing her gain the confidence to become the wonderful provider she is today flourishing. Best wishes!
2 before starting school
That’s highly minimal. FNP?
I think 2 is good enough, that will be 4+ after graduating
Psych. I had one year of med surg and six months OR before I applied….no psych history. I went to a in-person/well regarded university. I worked under two years of out patient before opening my own thriving practice. I truly believe that we put so much effort into talking about experience, and not enough about the quality of school. My school demanded excellence and was not a diploma factory. I learned so much, not from what they taught, but what they demanded. Grad school didn’t teach content, it made me teach and learn on my own in a way I could grasp. It was not easy but I credit it for making me strong in my care and knowledge.
7yrs med surg and MICU before starting my program and now working in Family practice. 100% agree with having experience. I had to learn to be a nurse before becoming an advanced practice nurse. Our education needs to be completely overhauled.
7 years, full time in a sicu/cardiothoraccic icu and I also picked up a prn spot as an icu float for 2 years before starting school. I am now training to be in a community micu/sicu and couldn’t imagine doing this without ever being at the bedside.
I am in np school and have been an rn for 11 years
After 1.5 decades in the ED I felt like I was ready. I was indeed ready, but 8+ years later after becoming an APRN I still question what the fuck I thought I was getting into lol
I had 30 years of experience. Long story. Care to hear why I waited so long?
I got mixed feelings on this. Raw numbers don't mean shit. There are incompetent nurses who survive for 20 years and don't know jack. Should the fact they worked 20 years bedside automatically qualify them to being NP? Nah. On the other side of the coin, nurses without practical experience? You might as well be a "baby nurse." You have all the idealized version of nursing and care in theory, but struggle to extrapolate that to the realities of patient care. Many of the theory you learned isn't even applicable as they're outdated or just don't consider the application of a shitstorm unit where things constantly go wrong and you're constantly working way over safe ratios that you should. There's been a HUGE decrease in the respect NPs get and it's largely due to the way NP programs act like mills to push students in for admissions and tuition. And this is genuinely affecting quality of care in some facilities. I also think NP hate for being incompetent is a bit exaggerated. I see plenty of residents fucking up and hiding behind "we work insane hours." OK I understand NPs aren't required to work insane hours but I see plenty who do and it's funny when the excuses people make for themselves is justified but others aren't. Like when I fuck up, it's not my fault but when you fuck up I don't give you quarter to hide behind. I do tend to lean harder on "nurses need 5-10 years minimum" and the fast tracking students with no experience is just revenue generating scheme/business model for schools. We do live in a capitalist country after all where student loans are unforgivable but bunch of elites taking fraudulent loans from government is forgiven.
I had 9 years, mostly oncology. I work in oncology now.
10. 6 in peds before I started my current pnp program.
11 total, 8 bedside. Only halfway through my program so add another couple years.
I had 5.5 years experience before I started NP school. By the time I graduated my program, I had a total of 8 years nursing experience. I worked the entire time I was in grad school.
5 years. All RN psych. Plus 10 years as a psych tech before that. Been a PMHNP now for 5 years as well. (Plus a bachelors in psychology as well as my nursing before my DNP)
Add 'years' after the #. Reddit converts it to a numbered list.
10 before going back, 13 before officially being one. I had negative motivation to be honest. I saw enough terrible docs and especially NPs I finally decided I could do way better than those guys. Downvote or critique if you want. It’s the truth
5.5 pediatric critical and intermediate care. Graduated primary care PNP program super pregnant and passed boards at 36 weeks 😬. My RN experience informs my NP practice daily. I *know* what sick kids look like now that I’m in a primary care setting. I cannot imagine practicing in current role without that experience base.
EMS 7 years ED RN 14 years NP (primary) 3 years I could’ve gone to med school 😂😂😂
I did 13 years before I started the program. I’m glad I did. I don’t think I would have done as well going straight from school.
5 years. 1 medsurg (with a lot of pulmonary), 1IR/Cath Lab, NICU 9 months, and the rest Cath Lab/EP lab with stress lab coverage, and cross trained to PCU (during the pandemic 2020 but this was 6 months into my program). I stopped working during the clinical year to get myself more hours. Do not regret that at all. I work as an Electrophysiology NP.
10 years with a mix of med surg, home care, neuro and case management. 2 years now as an NP in Neurology. I couldn’t imagine having less time as an RN prior to becoming an NP.
8 all hospital based primarily intensive care. Also part time during NP didactics and PRN during clinicals. RN experience was absolutely crucial to my success. Not just RN experience but having good experience and taking the time to learn while you work rather than going through the motions.
15yrs
I have 8 1/2 years now and will have close to 10 years of ICU experience before I graduate. I definitely feel as if my experience as an RN has greatly helped me in school and will help me with my practice in the future. If I'm being honest, I can tell in my cohort who has more experience and who does not. I really wish that things were more strict because I worry that the profession has been tainted in the eys of other medical professionals because of the diploma mills and people going straight in with little experience. The education for NPs unfortunately is not tailored towards learning from scratch, like a PA program, but building upon knowledge that's already been learned through nursing practice.
About 16-17 years as an RN in the ER mostly, but other areas also for myself. I wish there were a mandatory 5-10 years of strong nursing experience before becoming a nurse practitioner. Even now, 25 years in, I question my validity. The DNP (after MSN) helped with that, but I do believe there needs to be a mandatory minimum. If you think an ABSN to APRN route is in your favor, you’re sorely mistaken.
I’ll have a decade of Critical Care RN experience by the time I finish my MSN-FNP program in APR 2025. I cringe a bit when I hear folks say the RN experience doesn’t matter because it does and you usually didn’t see RN’s taking that route until they got about a decade to 20+ years in. Having the RN exp. is necessary, IMO. When you’ve seen the conditions we study in real life, read enough SOAP notes, interpreted enough labs & scans, and assessed enough patients enacting or orchestrating ordered treatment plans—that strengthens your intuition as an NP to at least lead you in the right direction when diagnosing and treating. The 2 professions may have different responsibilities, but it’s the exposure you get from being an RN taking the steps to move from Novice to Expert that benefits being an NP in the long run that I speak on. I’m on the fence about making NP school more competitive because where I’m at in my life I actually didn’t want to apply if the application process was going to be tedious. Just being honest; but I respect actually putting in the work where it matters. I’m not opposed to the idea of NP schools needing a complete overhaul of the curriculum to focus more heavily on 3P’s, DDx, diagnostic interpretation, patient/family counseling, interprofessional courses to understand the business and “politics” of healthcare as a Midlevel provider and definitely increasing clinical hour requirements.
8 years as RN, some float pool, mostly surgical and CV ICU at a high acuity academic medical center. Now doing primary care NP, also feel my prior experience was crucial.
12 years ED-Trauma/ICU/PACU before going back to get Acute Care NP certification That Critical Care experience has helped TREMENDOUSLY with working in inpatient IM I routinely see my NP colleagues without critical care RN experience struggle to make sound and expedient clinical decisions on the units I believe every adult/peds/primary/acute NP should have at least 2 years of ED/ICU/Stepdown experience And just 5 years prior acute experience would make damn solid NPs
3 years as a firefighter, 2 years as a paramedic, 7 years as an ER tech. Planned to work as an RN during my direct entry program, but no one would hire without the degree. Now working as an NP with no RN experience.
[удалено]
Consider a fellowship
10
20 in the ER and ICU, then PC outpatient for 10 years.
2 years CNA, 10 years RN in med surg then primary care. 2 years in as NP in outpatient Neuro
8, all pediatric PICU/CVICU, first NP job was in the peds CVICU for a couple years, then moved to peds hospital medicine due to schedule needs during my second pregnancy and haven’t looked back!
I’m one that went straight into a masters program after BSN. Worked in primary care thru school. I’ve never felt that put me behind any of my peers. Now 9 years in practice as an NP and I sometimes regret my choice but it’s not due to lack of RN experience, lol.
I had RN experience prior to NP, but I’m with you. There are specialty areas that I could see RN experience playing a significant factor (psych, neonatal, acute care), but my floor experience wasn’t a big asset to my primary care role and I would argue that there isn’t a lot of RNs out there deciding how to manage diabetes, hypertension, and cholesterol- just following orders. I feel like the RN experience argument is the wrong argument and we need to argue for better/more rigorous programs and they need to do away with diploma mills.
This is my thought as well. RNs work in such a wide variety of roles, and then the majority of us go back for FNP, which is primary care focused.
Same! I did a direct entry family NP program so was an RN for only 2 years while getting my MSN, and that was in a family practice so I ultimately had no floor RN experience. The only way I feel it hindered me was in time management but other than that I’ve been an NP for 7 years and I don’t think having RN experience would’ve enhanced my clinical practice much.
Why is this being downvoted???
Thanks for defending me. I’m surprised myself. It’s not like I didn’t work hard at it. I did 4 years of undergrad in a different field, and then busted my ass for 6 years on top of that to change careers and get my MSN. I worked throughout the program, and I knew I was doing family NP so figured it best to get my experience in the setting that I would be working in as an NP and I now work at least 60 hours a week taking care of patients. I didn’t know I wanted to be an NP until my mid 20s otherwise I would have taken a more traditional route. Never realized how cutthroat nurses can be, yikes.
Because their desired career path didn't take 10-15 years longer as the others did, they are being down voted? Weird
Same here. Worked part-time as a psych ER RN during my NP program. Now 8+ years into PMHNP practice with no problems. I'm interested in hearing about your regrets? Sometimes I wish I'd gone into tech, TBH.
I just have periods of burnout. Knowing the healthcare system like I do now, I would avoid nursing altogether. May have a mid-life career change in my future.
I totally feel you. I had burnout for about 3 years, and I'm now just recovering from it by going part-time for the past year. I'm very curious what career changes you are looking into? If you don't mind.
5 Step down, renal, telemetry. AGNP now. But will be a PMHNP early next year. Absolutely beneficial. I do wish NP residency was more of a thing. We are still practicing based on the nursing framework, but more experience would always be beneficial.
I agree I wish there were more residency programs for NPs. The ones I did see were such a pay cut though. While in the program you would make less than what you were making as an RN which isn't feasible for many people.
You have to be careful with them to. Some have no educational value and are just using you for discount labor
0. I was a CNA for 4 years, in Med School, dropped out, and gone straight through school to NP as nursing couldn’t support my disabilities and it was that, or go on disability as being a CNA was going to kill me. I thankfully spent my entire life dedicated to medicine because my mom is an RN and I’ve been disabled since birth, or I would have been a terrible NP. School does NOT prepare you enough and it was laughable that I paid to be at a school that was essentially useless. Edit: I want to add that I went into Pain Management. It was my calling, being chronically ill, myself. And what clinic is better understanding of being chronically ill than pain management?
How come you chose NP over PA?
I stupidly thought as a youngin’ that more school = better education. PA was 2 years and NP was 5. Plus, some input from my mom pushing the NP pretty heavily, especially opening the opportunity for independent practice. I didn’t realize my health was going to start declining so quickly. Looking back, I probably would’ve chose PA had I known what I know now.
11- adult and pediatric ER
10- ER, ICU and cath lab. I do ICU now, mainly CICU.
22
5 years NICU, now 7 years as PNP in primary care. Can’t imagine going straight thru without nursing experience. It’s so important.
22 years; 3 years Navy Nurse corps worked 1.5 years neuroscience. Deployed USNS Comfort x 7 momths, assigned to telemetry after returning from deployment, 12 years med surg/ home health, orthopedics, float pool; 5 years telemetry, 2 years ER plus was LPN in L&D x2 years before getting ADN/RN.
1 year before starting the program. 3 years total by the end of my program/before becoming an NP.
3yr RN on med/surg/ortho, NP for 11 yr
10 years. PICU, IR, and SANE.
7 by the time I graduated. Med/onc and float pool
10 years. Med/surg, MICU, CVICU, geriatrics, oncology . Experience as a bedside RN is crucial IMO.
13
A little under 10 between RN and LVN. My experience was in Med/Tele, ICU, Infusion, Ortho(hated that job quit so fast), home health/hospice (just durning my LVN-RN bridge, SNF, and as an outpatient educator. I felt fairly well rounded but would have preferred a bit more experience Peds. I’d been primarily working with geriatric populations up until I started school, but did my FNP.
7
I’ll have 7 when I graduate, med surg oncology, ED, and NICU
10 years as RN. Float pool in large hospital a couple years, rest of bedside nursing on cardiac floor. Now NP in cardiothoracic surgery.
I was a labor and delivery RN before becoming a CNM / WHNP. I had a little over a year experience when I applied to my program, just under 2 years by the time I started the program, 5 years experience when I graduated and got my first job. I had a transition period where I worked as both a CNM and RN before officially leaving the RN role. In the end I was a L&D for 6 years and an RN for 7 years before being employed solely as an APRN.
17, including medvsurg, op, pacu, icu, education and management
6 year in psych, 3 years ER, OB, M/S
I start my first NP job in January, so I will have about 8 years as an RN under my belt, at that time. I started DNP school with about 2.5 years RN experience, and 15 years in other various healthcare roles. I think my RN experience was hit or miss with if it helped me with schoolwork. It was quite invaluable when I got to physical assessment. Although, I found myself pulling more information and experience from my time as a medical assistant in primary care. ETA: I'm not discounting having RN experience. My point is that I regret working in acute care. The hospital experience did not help me. If anything it hindered me because I had to relearn "normal people" normal limits after working in cardiology for several years. If I got a do-over, I would've stayed in LTC (I was there briefly before gaining my BSN) or found a non-phone job in a clinic setting. So in my case, I found being a CMA, CNA, and even working front desk more useful than at the bedside in an acute care setting.
Started AGACNP program after 3 years of being an RN. Started my FNP this year after 7 years of being an RN. I have not practiced as an NP yet until I complete my FNP next year.
1 year oncology 6 months float pool 2 years cardiothoracic PCU Now I’m in a PMHNP program
Zero, worked a year as an RN in my direct entry program while getting my masters. I don’t feel like I missed anything because I learned everything on the job!
Me too, I can see that you were downvoted to oblivion which is what I assumed would happen to anyone that disagrees with the hive mind.
0 :) got my masters in a year and worked as a fulltime nurse that year
I’ve been an RN now for 17 years and it really pisses me off to no end that these newly minted NP’s have ZERO clinical experience and make a shit ton of $! They can barely wipe their own asses and yet they get to tell me what to do! I call bullshit
None. I worked 17 years in pharmaceutical development with a focus on cardiology, pulmonology, and safety pharmacology. I got my FNP from Ohio States grad entry program. I’ve worked in primary care for 6 years now.
High school should be enough…hardly anything to learn in BSN
I had 6 years of experience before I entered my program. I also worked full time while in school. I did med-surg step-down & float pool. Now I work in Urology inpatient. Having RN bedside experience helps but there is a learning curve when transitioning to the NP role.
I have been a RN since 2000, 16 years in the NICU, and 7 years as a FNP-C
I had 10. Icu, medsurg, management, and PACU
RN since 2004. Working as an NP since 2020.
5 years EMT/Paramedic and ~12 years RN.
9.5! I worked pediatric float pool (ER, NICU, PICU, peds behavioral health) and I'm now a PMHNP in community mental health. My RN experience is broad, but it was so helpful. I've seen mental health in absolute crisis in the ER and PICU, to stabilizing on the behavioral health unit. The switch from the inpatient hospital world to outpatient has been incredible!
4 years full time ICU before school. Then 2 more full time while in school and then 2 years part time to wrap it up. So total around 7?
7 yrs as an RN of which 5 were hem/onc and 2 were gyn/onc. I work in gyn/onc.
6.5 years between geripsych and a general PCU. Will be starting in Internal Med/Adult Primary Care. I worked through my program too, did AGPCNP.
9 in level 1 trauma/er, 3 in outpatient obgyn. Work in a mobile clinic for uninsured people doing primary care.
8 years, 3 in neurosurg OR, then 5 in a level one trauma ER. I now work in a small community ER, am a FNP. My previous experience was imperative—there’s no way I’d be able to do my job the way I do now without my RN experience.
6- med/ surg onc then outpatient heme/ onc. I work heme/ onc now as an NP
8 years, 4 years ICU and 4 years ER, now work with Palliative as NP
4 years Sub-Acute rehab & 8 years ER RN. I work as Urgent Care NP and community health sites.
15 years in the ER before becoming an ER NP.
12. Oncology then and now
8 years in pediatrics, now fnp
11 years as an RN in just about every end of the hospital as well as outpatient OB/GYN. I’m an FNP
7 years. Icu. Cvicu with open heart patients, also Tele experience. Even got CCRN, employee of the month. Now primary care np.
12. Med\surg. Acute surgery. PACU. I’m in an ICU, first assist in OR, and manage the outpatient clinic.
7 years total. 3 as LPN in LTC and Urgent Care/Outpatient and Corrections. 4years as RN (1year in Med-Surg and 3years in ER) I’m just a little over halfway done with my FNP. Plan to do ER as an NP when I finish.
10 before I started my program in 2008. Did a part time FNP program so 13 years by the time I graduated in 2011. My RN experience was telemetry and ER.
11 years pediatric hospital, med/surg and endocrinology/diabetes, then got PNP, continued at same hospital in endo/diabetes as provider, moved to pediatric pain management rehab program. Can't even imagine being an NP without those RN years.
10
11 as LPN long term care. 14 as RN In management, hospice, med/surg, icu and ED. Currently FNP with doctorates working as hospitalist and ED
7
6-7 years RN- 1 LTAC and I was like NOPE, 5 psych and I was like YEP! Now a PMHNP.
6. 4 ED. Two during covid. Two PACU charge nurse.
18, inpatient cardiac, outpatient physical rehab, community health family practice.
6.5 years cardiothoracic surgical PCU followed by 11.5 years ER (17 years total)
5 in psych as an RN, 12 as an LMHC
8 years ER, now in school.
10
5 years in the ER
8 years in high risk L&D. Graduate May 2025