The nurse practitioner role was built on a fundamental premise: advanced practice nursing should be advanced nursing practice.

Historically, nurses entering advanced practice brought years of bedside assessment, clinical judgment, patient advocacy, and direct patient care with them. Graduate education built upon that nursing foundation.

That expectation has changed.

Today, some educational pathways allow students with little or no prior nursing experience to progress rapidly from a non-nursing bachelor’s degree to RN preparation and then toward advanced practice. At the same time, many traditional NP programs do not require meaningful RN experience before admission or progression. It’s terrifying that someone with a bachelors in IT can gain direct entry to a MSN/DNP NP program 

Time to protect the profession and the patients who trust us.

What needs to change:

• Require meaningful and related RN experience before entry into nurse practitioner clinical preparation.

• Establish minimum direct patient care requirements for advanced practice nursing programs.

• End direct-entry MSN and DNP pathways that allow students to progress toward advanced practice without first developing substantial experience as registered nurses. 

• Require accrediting organizations, boards of nursing, certifying bodies, and educational institutions to establish clear and enforceable standards for prior nursing experience.

• Stop treating RN experience as optional when preparing nurses for roles that require independent assessment, diagnosis, prescribing, and management of complex conditions. 

Why this matters:

• Passing the NCLEX establishes entry-level RN competency. It does not create an experienced nurse.

• Graduate clinical hours cannot fully replace the repeated assessment, pattern recognition, communication, prioritization, and clinical decision-making developed through sustained nursing practice.

• Advanced practice education should build upon nursing expertise, not attempt to create foundational nursing experience at the same time it teaches advanced practice.

• Patients deserve clinicians who have had adequate time to develop the nursing judgment upon which advanced nursing practice was intended to be built

This is also about protecting nursing as a profession.

If prior nursing practice is unnecessary to become an advanced practice nurse, we need to ask what makes the role advanced nursing practice at all.

We are asking nursing education programs, accrediting organizations, certifying bodies, and state boards of nursing to establish meaningful minimum RN experience requirements before a nurse can progress into advanced practice preparation and practice.

There can be reasonable differences in what experience should be required for different specialties. What should not be acceptable is zero. 

Advanced practice nursing should require nursing practice first.

If you believe patients deserve adequately prepared advanced practice nurses and that nursing experience should remain foundational to the NP profession, please sign and share this petition.