As a NP do you miss bedside care?

  1. Hello Everyone,

    I have two questions for anyone who would like to answer:

    (1) If you were a bedside nurse who loved bedside care before you became a nurse practitioner, how much do you miss bedside care now? How do you satisfy your need to scratch your "bedside care" itch... or, during NP school did you somehow loose your "bedside care" itch?

    (2) Are neonatal nurse practitioners "allowed" to take positions (like per-deim or part-time at a hospital other than the one they work as a NNP) as bedside nurses? Does being a Neonatal Nurse Practitioner (NNP) somehow legally make it impossible for you to perform as a bedside nurse anymore?

    I'm seriously contemplating returning to school to become a neonatal nurse practitioner. I must admit that over the past 8 years I've observed our Neonatal Nurse Practitioners (NNP's) and occasionally, secretly, tried to imagine myself in such a role. Recently two of our NNPs have approached me and encouraged me to continue my education. I am in awe of the work they do and wonder what it is they see in me which has caused them to approach me with this idea...

    One of my main concerns is the fact that I love bedside nursing care of these tiny, sick babies. I receive incredible satisfaction doing my absolute best to care for them and also love the interaction with the families. I wonder if I could be as happy as a NNP as I am a bedside nurse... I realize that as a NNP I would have the ability to affect the care of the little ones to some extent which is a great benefit. One of our NNPs says she gets her "cuddle time" in with one-on-one care while doing transports.

    Any input you have will be very much appreciated!!! Thanks in advance!!!
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  2. 14 Comments

  3. by   boysinfirm
    I love being a NP. I am a hospital diploma/university bachelors/masters/post masters Nurse Practitioner. I do not miss the endless documentation,never need to see a bed full of poop,the suction catheter full of pseudomonas snot. I can still smell ETOH on breath,do do rectals for prostate/well women exams. I love being able to think for myself.The "bedside" IS next to the patient. When I check out a breast lump or listen to an irregular heart rythym it does not matter if I am in an office or in a hospital. NO I do not miss being in the hospital and I love being at the PATIENT'S side
  4. by   TRAUMARN96
    I'm not an NP, but I'm toying with the idea. I do, however, work (or have worked in the past) with NP's working as staff RN's. You're still an RN, right?? So I don't think there would be too many hospitals not willing to hire a per diem RN due to being 'overqualified'. Good luck!!
  5. by   Love_2_Learn
    Thank you both, TRAUMARN96 and boysinfirm, for you responses to my post.

    I'm glad to know that Nurse Practitioners are able to be regular bedside RNs. I guess I was concerned that once a RN became a NP that their advanced education would hold them to a higher standard that for some reason would make it difficult for them to be hired as bedside nurses... I don't know what I was thinking because to me their advanced education should only be a plus at the bedside. (One of the reasons I've considered learning to be a NP is because I want to have their knowledge in my head which I feel would make me a better bedside caregiver...) I also was concerned that the hospital/facility would feel some need to pay the NP-bedside RN a higher salary than the regular bedside nurse salary due to their higher education and for that reason they might not want to hire NPs as bedside nurses. Again... I don't know what I was thinking...
    :smackingf


    As far as missing the difficult parts of bedside care such as the endless charting and hectic shifts where one never seems to be able to catch their tail so to speak, I am sure that would be a plus. As a NICU nurse, my little patients have tiny, cute poops and thankfully don't have many of the irritating things that adult patients bring to the environment. Some of our more difficult situations involve family dynamics; as you know, pediatric/neonatal patient care involves the family just as much as the patient...


    The Neonatal Nurse Practitioners I've worked with generally don't do much hands on care unless we present them with a concern they need to check out. Of course, they help the Neonatologists with rounds and do assessments on certain babies and write orders/progress notes, attend high risk deliveries/cesarean sections, order ventillator changes, write admission orders, putting in umbilical catheters & PICCs, reviewing x-rays, etc., etc., etc... but as far as spending oodles of time with a baby, they simply do not have that as a part of their role. They do spend a good deal of time talking with parents and helping them understand their baby's plan of care and treatments, etc. To me it seems they spend most of their time "putting out fires" and working on discharge summaries in addition to their rounds on a few babies. Where I work now our NNPs mostly provide coverage from 7 pm to 7 am and the Neonatologists come in the morning. Our NNPs do rounds on the less critical babies when we have a high census, otherwise, they go home in the morning. At my previous job, we had NNPs around the clock who took more of a role in doing rounds with writing orders on the less critical patients, doing discharge summaries, and some were responsible for attending to babies in the follow-up clinic (where NICU graduates are followed at regular intervals for problems until they are about 3 years old).


    I'm learning that there is a big difference in the everyday activities of NPs in different areas of nursing, which only makes sense. Again I thank you both for your posts, it means quite a bit to me to hear your perspectives.
  6. by   shelq56
    Hi,
    I am a family nurse practitioner student. My advanced practice roles instructor, also an NNP, told us that as NPs we are indeed held to a higher standard and that it would be very difficult, if not impossible to function as a bedside nurse because of this. I am in Colorado in case that makes a difference. I will try to get some more info for you and re-post.
    Vickie
  7. by   Love_2_Learn
    Thank you shelq56 for your post. I look forward to hearing any more you can find out about NNPs being hired as bedside RNs. Maybe it has to do with certain state laws or board of nursing regulations... or maybe it has to do with the type of Nurse Practitioner Specialty area a person is trained in...

    I happened to ask one of my favorite NNPs at work last night if she misses bedside care now that she is a NNP and she said, "Not as much as I thought I would." That was comforting to hear.

    It kind of looks like I may need to make a heartfelt decision about the possibility of not being able to do routine bedside RN care anymore if I should (by a major miracle :chuckle ) actually become a Neonatal Nurse Practitioner someday.

    Thanks again for your post!
  8. by   shelq56
    Hello again,
    I wanted to mention that your being encouraged by the NNPs you work with is a huge vote of confidence in your ability, your style,your intelligence, and your personality. You must stand out in some positive ways or they wouldn't be encouraging you. I wish you the best in whatever you decide. Continuing your education won't be easy, but I bet you won't regret it.
    Vickie
    PS I will be 50yrs old when I graduate with my MSN in May and sit for FNP boards. I have loved the challange and look forward to the new opportunities that await. I'm a late bloomer!
  9. by   Love_2_Learn
    Hi Vickie,

    I'm tickled pink for you! I too may be a late bloomer; I didn't go to nursing school until my late 20's and I am now 45 years old. A part of me was wondering if my occasional lack of memory lately (most likely due to perimenopause symptoms I assume) would make returning to the world of academia even more difficult than I found it when I went to college 12 years after finishing high school. (I however did very well in nursing school much to my surprise.) I expect the education for a master's degree will be much more intense than for my first nursing degree, but I must say, your situation gives me hope!

    My husband recently bought the book "The Richest Man Who Ever Lived: King Solomon's Secrets to Success, Wealth, and Happiness" by Steven K. Scott. I'm not looking into the Nurse Practitioner role for the salary, I'm wanting to grow professionally more than anything else. Anyway, this book speaks more about wisdom and applying knowledge to a person's life. Concrete examples are given to help a person recognize their dreams and desires along with a well defined plan to implement which, if applied consistently, will increase the chances of achieving the dream/goal. It's a small book full of true wisdom and reading it has added kindling to the little fire in my heart that burns for professional growth. My parents weren't the greatest role models for helping with goal setting so this book is helping me in this area. (Of course my parents encouraged me and wanted the best for me... they just weren't that helpful in teaching me how to get from point A to point B if you know what I mean.)

    I talk too much. Thanks again for your insight about the NNPs I work with encouraging me to further my education. And, big thanks for sharing your experience of returning to school as an "old dog" who has truly enjoyed learning "new tricks". Your post has inspired me, made me smile, and given me a glimmer of hope.

    Larissa
    :icon_hug:
  10. by   nicolentony
    I live in NY state and we have an RN who became a cardiology PA and still works through an agency per diem as an RN because she loves nursing, too.

    I have worked with an NP in the ICU who took her first job as an NP with the critical care group in our hospital and she didn't like it. She said the pay was not good, and she was bored writing TPN orders all day. Until she finds another NP job that she likes, she is working as a bedside RN through an agency in ICU making (according to her) more money than she would as an NP in our area of the state.
  11. by   traumaRUs
    I am also an APN (CNS). I do miss the ER very much. My current position is more the chronic care. The pace is much slower but I also get more patient interaction.

    However, once an adrenaline junkie, always an adrenaline junkie. I am seriously considering doing prn staff nursing in the ER. However, will need to clarify with the manager/HR about my performance standards.
  12. by   Love_2_Learn
    I'm glad to know that becoming an APN will not "always" place a nurse in a particular peg, if you know what I mean... One of the positive aspects of nursing has, for me, always been that we can move from one area to another without being required to do a 2 year residency/orientation. I loathe the thought of having my options taken away from me... I may never want to exercise my options, but I love knowing I have them.
    :wink2:
  13. by   lannisz
    Quote from Love_2_Learn
    Hi Vickie,

    I'm tickled pink for you! I too may be a late bloomer; I didn't go to nursing school until my late 20's and I am now 45 years old. A part of me was wondering if my occasional lack of memory lately (most likely due to perimenopause symptoms I assume) would make returning to the world of academia even more difficult than I found it when I went to college 12 years after finishing high school. (I however did very well in nursing school much to my surprise.) I expect the education for a master's degree will be much more intense than for my first nursing degree, but I must say, your situation gives me hope!

    My husband recently bought the book "The Richest Man Who Ever Lived: King Solomon's Secrets to Success, Wealth, and Happiness" by Steven K. Scott. I'm not looking into the Nurse Practitioner role for the salary, I'm wanting to grow professionally more than anything else. Anyway, this book speaks more about wisdom and applying knowledge to a person's life. Concrete examples are given to help a person recognize their dreams and desires along with a well defined plan to implement which, if applied consistently, will increase the chances of achieving the dream/goal. It's a small book full of true wisdom and reading it has added kindling to the little fire in my heart that burns for professional growth. My parents weren't the greatest role models for helping with goal setting so this book is helping me in this area. (Of course my parents encouraged me and wanted the best for me... they just weren't that helpful in teaching me how to get from point A to point B if you know what I mean.)

    I talk too much. Thanks again for your insight about the NNPs I work with encouraging me to further my education. And, big thanks for sharing your experience of returning to school as an "old dog" who has truly enjoyed learning "new tricks". Your post has inspired me, made me smile, and given me a glimmer of hope.

    Larissa
    :icon_hug:
    Hi Larissa, "Late Bloomers Unite!".....I am currently in an FNP program and because I am doing it part time it will take me three years instead of 2. So, I will be 45 when I get my FNP. I didn't enter nursing until my late 30's, having been in social work (mom's and babies) for my first career. I JUST got a position in OB/L&D and I am SO excited! This is why I entered nursing in the first place. I have "done my time" the past few years in other areas of nursing like med/surg, which gave me a good base, but was never what I wanted to do in nursing. As far as your worry about how you will do academically now with peri-pause (as I like to call it!), I do feel like I don't have as great a memory as when I was younger...but it's still OK. I think we have a lot more going on in life now with family, work and school all meshed together. One thing about the NP program - it's not like nursing school (thankfully!) My program treats us like professionals and colleagues. It's very nice! Like you, I want to feel that I have choices....good luck on your journey!!
  14. by   Love_2_Learn
    Hi Zias! I'm glad to hear all the good things going on in your life and that the part-time plan is working for you. I also would like to go the part-time route. It sounds like you have a good plan which you will be able to stick with easily. I'm soooo happy for you! Thanks for your post!!!

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