Do you feel more people are entering nursing only to become APRN's?

Nurses General Nursing

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I am not a nurse yet, but I'm an EMT, have worked in and around the hospital, and I am currently finishing my last two prerequisite courses before applying for ABSN programs. It seems like 90% of my current classmates in nursing prerequisite courses, along with other prospective nurses I've worked with, are entering the nursing profession with the goal of become a Nurse Practitioner or CRNA.

Do you, especially those already working as nurses, feel a lot of new graduate nurses are entering nursing for the sole purpose of becoming an APRN? I feel like since APRN's are gaining more popularity, people are entering the nursing field to become an APRN and not a "nurse", in lieu of becoming an MD/DO or PA. I'm not saying more education is bad, but it seems like people want to be an NP, not a nurse, if that makes sense. Which leads me to believe (and I know it's been discussed before) a huge over saturation of APRN's is in the near future.

Thoughts? Again, I'm not a nurse yet, so I could be completely off base.

Specializes in Psych/Mental Health.

Students don't even need to be the "best & the brightest" to get into NP programs. As long as you have a 2.7 GPA, a pulse, and can find your own preceptors, you can become NP.

RNs with associate degree tend to stay in bedside longer. Perhaps these BSN-only research hospitals should start hiring ADNs again.

Specializes in Adult Internal Medicine.
Not only is this likely to be problematic for the future of nursing AND Advance Practice Nursing, it's a problem NOW. All of these future NPs and CRNAs aren't really interested in the job they've been hired to do right now, and the patients get short shrift.

This is a huge problem.

These novice RNs are trying to learn an RN role without their complete attention while also trying to go to didactic graduate classes and learn the NP role in clinic without complete attention. It is not a good model for the novice nurse, the employer, or patients.

Believe me, it has nothing to do with treating new grads better. These folks are boasting that they're applying to an NP program or only looking for ICU experience to get into anesthesia school before they've spent even a single day on the unit.

But that is not a blanket excuse to be treated poorly, or worse, unsafely. I am not saying you personally, just in general.

Specializes in ICU.
Students don't even need to be the "best & the brightest" to get into NP programs. As long as you have a 2.7 GPA, a pulse, and can find your own preceptors, you can become NP.

RNs with associate degree tend to stay in bedside longer. Perhaps these BSN-only research hospitals should start hiring ADNs again.

Due to magnet status, it's next to impossible to get a nursing job as a new grad in Southern California unless you have a BSN or will complete your BSN soon.

Specializes in Adult Internal Medicine.

Even when we treat such people well, it doesn't change their underlying motivation and plans. As a profession, we need to map out different career paths for such people to avoid wasting the resources they consume during that mandatory 1-2 years of hospital experience.

I think Katie's point is (maybe not, but I've seen this happen many times) is that often times novice RNs that do have plants for APRN roles don't get treated well on the floor. I understand why the experienced RNs on floors are pissed, it's a bad situation, but I don't think that's a reason to treat people poorly.

Sorry, Katie, but you missed my point. This has nothing/little to do with how we treat them. They have no intention of working in a hospital even before they enter school. I've talked with high school students who tell me their plan is to get "1 year of experience in a hospital" and then go to grad school and do ....

Even when we treat such people well, it doesn't change their underlying motivation and plans. As a profession, we need to map out different career paths for such people to avoid wasting the resources they consume during that mandatory 1-2 years of hospital experience.

It wasn't always this way. What do you think has changed?

I will reluctantly engage in this conversation again because I think there has been a blatantly obvious negative change - and it pre-dated the situation in which we now find ourselves by a long shot.

I very honestly and sincerely believe your basic premise is wrong. You are focusing on the fact that it may not matter as much now what we offer newer nurses - that no matter what we "invest" in them we can't get them to stay. That is because the tide has turned and the word has spread.

Nurses have already spent the better part of a decade or so (more or less depending on location) hearing things like, "The need to think critically is where errors happen. We must reduce this need. We are looking at all possible areas where we can eliminate your need to employ critical thinking." Yes, I have sat in group upon group where non-nurses told us this very thing and much more. Our nursing leaders went along with it. The direct result of this is that anyone who wanted to be a nurse for the art (heart) and science (mind) of it now finds this situation intolerable and unethical. It certainly doesn't compel anyone to aim for being an acute care bedside nurse.

The "best and brightest" nursing has to offer do not enjoy entertaining crazy ideas like scripting. An intelligent person does not find such ideas acceptable, generally-speaking. Do you think new and experienced nurses, alike, enjoy being told point blank that no one here wants them to employ critical thinking? What about any of the other countless bad or even unethical ways we are told to perform our jobs these days? What about "improvements" (barriers) that are thrown down just for the sake of "change" or "optimizing our value stream?"

I will assume you have seen the post here on one of the subforums where a non-nurse "guru" has come asking how he can make our lives easier and "reduce nurses' stress" by using technology to help us recognize which patient we are caring for and what room we're in and what kind of isolation precautions are needed, and inquiring about problems we might have with isolation signs. This sort of "thing" is going on everywhere now. But...nurses are intelligent people of ethics. I believe the crowd has spoken and they/we aren't buying it. In fact, nurses are fed up with it and done. As you are seeing. They now want to work at the bedside only as a means to get somewhere else. I think that's a pretty logical and expected reaction.

llg, with all due respect, I will implore you once more to see that you have this backwards. You are looking at the fall out of some very bad decisions and (I believe) coming to incorrect conclusions.

This doesn't matter for argument's sake, it matters because no correct interventions can be deployed without considering this angle/premise. Acute care units, generally-speaking, serve the sickest patients in the country. It behooves all of us to be painfully honest about this situation. Nurses' intelligence has competence has been completely de-valued.

Specializes in Psych/Mental Health.
Due to magnet status, it's next to impossible to get a nursing job as a new grad in Southern California unless you have a BSN or will complete your BSN soon.

Yes, and these hospitals end up with BSNs who are usually highly academically motivated and they want to pursue masters (this is the same in other good-paying industries).

I work in a hospital in the suburb where ADNs are still hired and these RNs tend to have young kids. None of my coworkers talk about going back to school. They don't want the responsibility nor to put in the time and money. They get paid well as RN already. When I worked in a large research hospital as a tech, >90% of the techs are pursuing pre-nursing, pre-med, pre-PA, or pre-NP.

Don't take what people say in your pre-req courses too seriously. People talk big, but few follow through. At least in my pre-req courses, most couldn't even make it into nursing school.

Specializes in CVICU, MICU, Burn ICU.
It wasn't always this way. What do you think has changed?

I will reluctantly engage in this conversation again because I think there has been a blatantly obvious negative change - and it pre-dated the situation in which we now find ourselves by a long shot.

I very honestly and sincerely believe your basic premise is wrong. You are focusing on the fact that it may not matter as much now what we offer newer nurses - that no matter what we "invest" in them we can't get them to stay. That is because the tide has turned and the word has spread.

Nurses have already spent the better part of a decade or so (more or less depending on location) hearing things like, "The need to think critically is where errors happen. We must reduce this need. We are looking at all possible areas where we can eliminate your need to employ critical thinking." Yes, I have sat in group upon group where non-nurses told us this very thing and much more. Our nursing leaders went along with it. The direct result of this is that anyone who wanted to be a nurse for the art (heart) and science (mind) of it now finds this situation intolerable and unethical. It certainly doesn't compel anyone to aim for being an acute care bedside nurse.

The "best and brightest" nursing has to offer do not enjoy entertaining crazy ideas like scripting. An intelligent person does not find such ideas acceptable, generally-speaking. Do you think new and experienced nurses, alike, enjoy being told point blank that no one here wants them to employ critical thinking? What about any of the other countless bad or even unethical ways we are told to perform our jobs these days? What about "improvements" (barriers) that are thrown down just for the sake of "change" or "optimizing our value stream?"

I will assume you have seen the post here on one of the subforums where a non-nurse "guru" has come asking how he can make our lives easier and "reduce nurses' stress" by using technology to help us recognize which patient we are caring for and what room we're in and what kind of isolation precautions are needed, and inquiring about problems we might have with isolation signs. This sort of "thing" is going on everywhere now. But...nurses are intelligent people of ethics. I believe the crowd has spoken and they/we aren't buying it. In fact, nurses are fed up with it and done. As you are seeing. They now want to work at the bedside only as a means to get somewhere else. I think that's a pretty logical and expected reaction.

llg, with all due respect, I will implore you once more to see that you have this backwards. You are looking at the fall out of some very bad decisions and (I believe) coming to incorrect conclusions.

This doesn't matter for argument's sake, it matters because no correct interventions can be deployed without considering this angle/premise. Acute care units, generally-speaking, serve the sickest patients in the country. It behooves all of us to be painfully honest about this situation. Nurses' intelligence has competence has been completely de-valued.

I think you're both right. And I think the answer lies in solutions that speak to all the angles.

Specializes in Emergency.
Yep. That is what I am seeing. Most of the students and new grads that I work with are using their BSN's and hospital staff nursing jobs as quick stepping stones to a grad school for an APRN role. It's contributing to my hospital's turnover problem and making us question whether we really want to hire the "best and the brightest" new grads anymore -- because most of them have no intention of doing hospital nursing for more than 1-3 years.

Hey hiring managers with high turnover--hire people like me! This is my second career, I have an ADN and I plan to stay in one place until I'm at least 65--that's fifteen years. I want to be "only a bedside nurse", no aspirations for advancement.

Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
This is a huge problem.

But that is not a blanket excuse to be treated poorly, or worse, unsafely. I am not saying you personally, just in general.

I don't know of any place that routinely treats new grads either poorly or unsafely. In fact, the core of new grad orientation programs seems to operate on the idea of "Treat them well and they will stay." To the point where RNs with hard-won seniority have been asked to give up many of the percs they achieved only through seniority (choice of holidays off, first dibs on vacation time, seniority as criteria for bidding into more desired shifts or rotations schedules, etc.) in favor of new grads who were just hired. "If we don't let them have some of those percs right now, they will leave." And they leave anyway.

New grads aren't poorly treated. Many of them are just too special to realize that working nights, weekends and holidays isn't evidence of poor treatment, it's just part of the job.

Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
I think Katie's point is (maybe not, but I've seen this happen many times) is that often times novice RNs that do have plants for APRN roles don't get treated well on the floor. I understand why the experienced RNs on floors are pissed, it's a bad situation, but I don't think that's a reason to treat people poorly.

And I don't think people are treated poorly on the floor. I think many of those new grads aren't used to a situation in which they aren't coddled. Asking a new grad to work nights, weekends or holidays is not poor treatment, yet I've been on the receiving end of phone calls from their parents demanding that they be given "better schedules" because "working nights is cruel and inhuman treatment." Being corrected when you goof up is not poor treatment. Yet I've had orientees who will not accept ANY negative feedback as anything other than "bullying."

People who go looking for poor treatment, bullying or NETY will always find it -- even if it isn't there. Nursing schools and even forums like this one prime new grads to go looking for it.

Specializes in ICU.
And I don't think people are treated poorly on the floor. I think many of those new grads aren't used to a situation in which they aren't coddled. Asking a new grad to work nights, weekends or holidays is not poor treatment, yet I've been on the receiving end of phone calls from their parents demanding that they be given "better schedules" because "working nights is cruel and inhuman treatment." Being corrected when you goof up is not poor treatment. Yet I've had orientees who will not accept ANY negative feedback as anything other than "bullying."

People who go looking for poor treatment, bullying or NETY will always find it -- even if it isn't there. Nursing schools and even forums like this one prime new grads to go looking for it.

You've had parents call....you're kidding me, right? Aye....

Specializes in ICU, LTACH, Internal Medicine.
Sorry, Katie, but you missed my point. This has nothing/little to do with how we treat them. They have no intention of working in a hospital even before they enter school. I've talked with high school students who tell me their plan is to get "1 year of experience in a hospital" and then go to grad school and do ....

Even when we treat such people well, it doesn't change their underlying motivation and plans. As a profession, we need to map out different career paths for such people to avoid wasting the resources they consume during that mandatory 1-2 years of hospital experience.

We need to preserve those resources for the people who are interested in hospital-based careers. And we need to present attractive images of hospital-based careers (at all levels) so that students can see them and include them in their consideration of their choices. Many nursing school faculty invest a lot of time and energy recruiting students into the APRN graduate programs and academic careers. Because those faculty members have not spent a lot of time in hospital-based roles themselves, they don't always know much about those types of careers.

This is one realm in which the infamous nursing "practice - academia split" hurts the profession as the practice environments and academic environments don't always work well together. Students graduate unprepared to succeed in the world of practice and end up running away to alternative careers because of their lack of preparation.

I would be totally for that. Make separation early, so that those who want it could have science curriculum brought close to one in at least PA (or even MD) level and then go directly to clinical MSN. I am not so sure about Leadership MSN becuase these people are supposed to know how the system works (although the impression is that many of them actually don't).

I am afraid, though, from my own and other "exceptionally academically successful" students experience, that these students should somehow be separated from entry-part of clinical nursing absolutely or have some sort of extremely modified experience. On the one hand, they definitely will need to see "clinical nursing" of some sort and avoid "sheltering" unless we want to lose what makes APRNs unlike any other advanced level health providers. On the other hand, to be "too smart" a nursing student is quite often a very painful and absolutely negative and unnnecessary personal experience.

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