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 CCU, SICU, CVSICU, Precepting & Teaching.
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.

This is an idea that we've already floated on my unit. I think it's a good one. Unfortunately, I'm at one of those academically inclined magnet teaching hospitals.

Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
You've had parents call....you're kidding me, right? Aye....

Not kidding; not even a little bit. My manager had a call not long ago from an irate father who threatened to "have your job" if Susie wasn't given a pass on working the holidays because it was very important to HIS career to have a hostess for all of his holiday entertaining, and since his divorce, Susie was his hostess.

I believe that "needing to be coddled" and intolerance of even constructive criticism is also part of the problem. I work with a number who are not this way so I don't have a good handle on how big the problem is, but yes, I agree.

Unfortunately, I'm at one of those academically inclined magnet teaching hospitals.

Add this to the list of contributing factors.

Elements of it are great and elements of it have been disastrous. I'd say the disasters outweigh any decent intentions anyone might have had.

Specializes in ICU, LTACH, Internal Medicine.
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.

That sounds very unfair. (and regarding calling parents... there I truly feel sorry for you.)

BTW, it is also not likely to lead to much results. I can only speak from the point of "too smart" person, but what would hold someone like me in place would be chances to develop as a clinician, not working schedule my way. Free subscription for AANC classes for the first year, for example. "Perks" like you describe have little to no attraction for really smart people who know for sure what high-rank nursing grad school entails.

Did anyone of your administration actually try to speak with or poll recent new grads or students in local schools to know what their expectations, beliefs and preferences and make correlations by their experiences and educational achievements? If no, that could be a nice capstone project for some in Ed/Leadership program and results can be used by your facility.

Specializes in Nursing Professional Development.
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. .

You make some good points. There is a, "Which came first, the chicken or the egg?" element in this situation. I believe all "sides" of the situation evolved simultaneously. It's more complicated than "1 aspect caused another."

But ... now that we are in this mess ... we have to consider all of the elements simultaneously in order to move forward. Anyone, looking at any angle is likely to make matters worse by focusing on only 1 aspect of the situation.

1. Yes, some nurses have been treated very badly by the many elements within the health care system. That needs to stop.

2. Some nurses come into hospitals with woefully inadequate preparation for the complexities of the job they have accepted. That also needs to stop.

3. Some schools have the hidden agenda of wanting to recruit their undergraduates into their graduate programs -- and do so at the expense of their preparation for hospital-based careers. I talk to many, many students who have NO knowledge of career pathways "up the ladder" for hospital-based nurses. The only things they have even heard about are the programs offered by the school they attend. We should try to stop that, too.

4. As alternative roles have become more available to nurses, we need to rethink the basic career advice given to students about the necessity of "1-2 years of bedside experience." I have heard many experienced nurses say that -- both hospital-based nurses and faculty members. That philosophy is hurting our hospitals' finances severely and causing more strain on the staff nurses who work at the bedside. New models of education/training are needed. We can't keep counting on the hospitals to provide such education to people who have no interest in working in the hospital.

A lot of work needs to be done and many different fronts to address this problem -- both to make hospital roles more attractive -- and to get those people with no interest in hospital work out of our hospital education programs.

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

I agree. See the post I just made.

Specializes in Nursing Professional Development.
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.

Great. But are you willing to get that BSN? We need nurses with BSN-level knowledge to take care of the complex patients we have at our tertiary care center.

Specializes in Nursing Professional Development.
You've had parents call....you're kidding me, right? Aye....

I've had parents call me because they didn't want their precious babies to have to get immunizations prior to employment.

I've had parents come with their new grads for job interviews and be offended because I wanted to interview their baby privately.

I've had parents call as THEY tried to fill out the employment application for their precious baby.

Such parents are shocked when they are told that we need to deal directly with the RN applicant -- and if their precious baby is interested in the job, she should get in contact with me herself.

Specializes in ICU.

Wow. I'm not really sure what to say about that other than its rediculous.

Specializes in ICU, LTACH, Internal Medicine.
I've had parents call me because they didn't want their precious babies to have to get immunizations prior to employment.

I've had parents come with their new grads for job interviews and be offended because I wanted to interview their baby privately.

I've had parents call as THEY tried to fill out the employment application for their precious baby.

Such parents are shocked when they are told that we need to deal directly with the RN applicant -- and if their precious baby is interested in the job, she should get in contact with me herself.

One word... WOW.

You make some good points. There is a, "Which came first, the chicken or the egg?" element in this situation. I believe all "sides" of the situation evolved simultaneously. It's more complicated than "1 aspect caused another."

But ... now that we are in this mess ... we have to consider all of the elements simultaneously in order to move forward. Anyone, looking at any angle is likely to make matters worse by focusing on only 1 aspect of the situation.

1. Yes, some nurses have been treated very badly by the many elements within the health care system. That needs to stop.

2. Some nurses come into hospitals with woefully inadequate preparation for the complexities of the job they have accepted. That also needs to stop.

3. Some schools have the hidden agenda of wanting to recruit their undergraduates into their graduate programs -- and do so at the expense of their preparation for hospital-based careers. I talk to many, many students who have NO knowledge of career pathways "up the ladder" for hospital-based nurses. The only things they have even heard about are the programs offered by the school they attend. We should try to stop that, too.

4. As alternative roles have become more available to nurses, we need to rethink the basic career advice given to students about the necessity of "1-2 years of bedside experience." I have heard many experienced nurses say that -- both hospital-based nurses and faculty members. That philosophy is hurting our hospitals' finances severely and causing more strain on the staff nurses who work at the bedside. New models of education/training are needed. We can't keep counting on the hospitals to provide such education to people who have no interest in working in the hospital.

A lot of work needs to be done and many different fronts to address this problem -- both to make hospital roles more attractive -- and to get those people with no interest in hospital work out of our hospital education programs.

Good thoughts.

5. We can begin efforts to repair some of the damage done (from within) to the general respect given to the position of bedside nurse. Honestly - - why can't bedside nursing be a well-respected "goal" from within nursing - - at least as respected as other things like Infomatics, Infection Control, Unit Educator, etc. I think something is very wrong when you can't get very far on the "clinical ladder" or enjoy much respect for "merely" being an excellent bedside nurse. I admit it makes me a little flabbergasted (at the world, not at you, llg) because the need for nursing care is THE reason patients are hospitalized - [i'm simplifying but that is generally true] - and they need excellent care! How is Staff RN the lowest possible rung on some ladder?

6. We do need to figure out what happened to experienced bedside nurses - why they chose to go away or why they weren't wanted, however we want to look at it. Their absence affects many things like stability of the unit and especially teaching newer nurses to provide excellent care. The general situation we're discussing is going to grow bigger before we can get a handle on it merely by the fact that advanced intermediates or "competent" new nurses a) cannot adequately teach someone just a little less experienced than they themselves are and b) will have a very hard time trying to survive a "patient load" + precepting obligation. And they are starting to be the only ones left around to precept and orient others. I don't know, but I would think this only accelerates the hemorrhage...

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