Direct entry NP, switch to bedside RN?

  1. This might be a bit of a unique situation, but I'm hoping for some advice or personal anecdotes of similar situations.

    I graduated from a direct entry NP program (biology BS degree -> RN -> MSN) 6.5y ago. In other words, I only have RN experience from my clinicals, not from working as an RN. BTW, I'm not asking for any judgment on that piece.

    I have been quite successfully working as a family nurse practitioner in a busy family practice clinic for the past 6y. I really enjoy my patients, but I am SO. BURNED. OUT. I work all day, and then go home and work on charting, refills, etc paperwork in the evening and on weekends. I'm a bit of a perfectionist, and it is a tendency I haven't been able to break, and it is ruining me in this career. I have a few nights per month on call. I never feel like I am "off of work," EVER.
    About 6mo ago I added a per diem job as a SANE RN (sexual assault nurse examiner). Despite the unfortunate circumstances that bring these patients in to the hospital, I really enjoy that job.

    Recently I've been considering the idea of giving up my NP career (as I am getting somewhat closer to paying off my 6-figure loan) in favor of becoming a bedside nurse. In particular, I really think I would enjoy L&D nursing. I don't see any way of getting into it though, since I don't have floor experience as an RN. There are some local hospitals that have specialty residency programs, but they will only take RN's who graduated within the past year. I definitely need more teaching/experience before I could do the work.

    And yes, I've considered going back for midwifery degree. Just don't have tens of thousands more dollars to do it!

    Any advice? Am I just crazy?
    Thank you reading my long post, and for any and all advice!
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  2. 12 Comments

  3. by   NurseLaura2244
    Hi! You are definitely not crazy and I feel like this is a great question! I have been a floor nurse on a medical surgical unit for about 3 years now and am currently enrolled in NP school. I have to say I truly think you made the best decision going straight through. Although the experience I have earned as a floor nurse is invaluable, you have already reached the NP goal. Although labor and delivery may be different and I cannot speak for that area of nursing, I learned very quickly that bedside nursing is a thankless job the majority of the time. I consider myself somewhat of a perfectionist too and that is a tough trait to take to floor nursing. Things are constantly not going according to plan and with 5-6 patients in this type of environment, the stress is unlike anything I can describe. Patients do not understand this and often times expect things to be done immediately. I cannot even being to count the amount of times I have been yelled at by patients or family members for things that are completely out of my control. When something goes wrong, the floor nurse is the one who takes the frustration and anger associated with this. All I can say is that floor nursing just makes me feel sad and horrible at the end of the day, and I do not encourage going back to that once you have reached NP status. I think you would notice a lot less respect for much less pay. Of course there are patients that praise you and are so thankful for your care, but this does not overshadow the other cases. Keep looking for PRN jobs in labor and delivery though, like I said I can't speak for that area. However, I would switch NP jobs first before ever going back to be an RN.
  4. by   missdeevah
    I'm in an NP program, graduating at the end if this year. I have been an RN for 6 years, and an LVN for 2 years prior to that. Honestly it sounds to me like you are burned out with your job, and not necessarily with the profession. Before making such a drastic change, why don't you consider looking for another job that does not require you to take a bunch of work home every day, and be on call? I know that these positions exist. I think it would be a mistake to just up and quit the profession because you have one job that is draining you. You might even be able to work in women's health if you are an FNP. You have experience, and therefore at an advantage in a job search, compared to say,...well, me-when I graduate.

    Floor work is not easy, especially if you are a perfectionist, because more often than not you will not achieve that. If you want to test the waters, you could get a PRN job at say, a nursing home, or LTAC, and start to get an idea of what bedside nursing is like. But if I were you, I would simply look for another job. You can turn your lemons (a job that is burning you out) into lemonade (experience, which is a plus in a job hunt). Good luck, and I'd be interested to know what you end up doing.
  5. by   traumaRUs
    I too loved being an RN more than an APN!

    However, I agree that since you have no RN experience its going to be an uphill battle. I would look for another job.
  6. by   SopranoKris
    Quote from traumaRUs
    I too loved being an RN more than an APN!

    However, I agree that since you have no RN experience its going to be an uphill battle. I would look for another job.
    To add to this, most facilities aren't going to hire you as an RN when you have your NP because you are "over-qualified" and they'd have to pay you more (unless they work on union scale).

    Sounds like you have a job that is just piling on the work. Now that you have NP experience, test the waters and see what else is available in your area.
  7. by   LSNP
    Thank you all so much for the input! You are giving voice to the little bit of reason that is in the back of my head telling me I am just burned out.
    And thanks for the perspective on floor nursing. The grass just always seems a little greener, right? I still really think I would like L&D, but am sure I am just seeing the positive parts of the job.
    You're exactly right @missdeevah that I could get a Women's Health job. I already do pretty full practice women's care in my primary care office. I think I need a break from so many responsibilities.

    Thanks again everyone, I am so grateful for your input!!
  8. by   msufan3710
    Ever consider going into women's health as a NP? Many places I know of prefer the WHNP but since the area of medicine and nursing seems underserved in some areas you may get the opportunity?
  9. by   AZ-RN
    Yeah I have to agree with some of the other commentators, just switch to a job that is a 'clock-in, clock-out' sort of job that doesn't require you to take work home. Many of those out there; working for specialists, ED, urgent care, exc.
  10. by   LibraSunCNM
    No, you don't sound crazy, just burned out, to echo the others! As an FNP, you can absolutely work in women's health, opportunities abound in that area. If you can find a new job where you can get a little experience doing it, plenty of OB, midwifery, and family planning clinics would love to have you.
  11. by   JellyDonut
    That may be the difference from direct entry vs years of bedside nursing. I spent ages at the bedside and honestly do not see anything that I could gain from ever returning to the bedside. It was dull and routine and I grew tired of idiot residents and new PAs trying to "teach me" areas I knew way more than they did. Now as an NP I have an eternity to go before I reach the point where I will feel like an expert plus I work with specialists so the distance is that much farther.

    Maybe the humdrum of family practice is wearing you down. how many times can you give the hypertension/diabetes/cholesterol/weight-loss/exercise talk before you feel like you want to drink on the job? I agree with some of the comments regarding finding a different job. Maybe try a specialty or something that makes you learn and think differently.

    That is just my two cents.
  12. by   Bayechri
    I hear you! I would say I have thought about returning to rn role also. I was a nurse for 9 yrs before I became an np. The role of np in clinic does feel like a never ending job. There are constantly in basket tasks and lots of charting. But I would say it's worth trying something else before switching to an rn role. Hospital based positions have the advantage that when you are done for the day you are done. No labs or other forms to fill out at home. Good luck!
  13. by   Calalilynurse
    Stay an np. I think looking for women's health jobs is a good suggestion.
  14. by   Calalilynurse
    I'm not 100 percent but I think if you are sued you are held to your highest liscense. So if anything happens at the bedside they can say you should have known because your a licensed np.
    Last edit by Calalilynurse on May 15 : Reason: Typos

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