The raw truth about what NPs really do

  1. I am a new RN working L&D at the bedside. Honestly nursing is no where near what I expected it to be. I come home every day crying. I feel stressed, overwhelmed, and exhausted all of the time. I am VERY interested in continuing my education and becoming an ARNP. This time I want to be sure I know what I'm getting myself into before getting neck deep in school debt. So I want to know what are the pro's and con's of the job? If you could do it all over again what would you do? What area is the lowest stress? The lowest risk? Which area has the lowest rate of lawsuits? I want to know all of the complaints and all of the perks of being an NP. I just want to be prepared for reality because being a bedside RN slapped me in the face... HARD.
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    About ccuevas12

    Joined: Jun '13; Posts: 1


  3. by   Psychcns
    Besides researching APRN roles you may want to look over the All Nurses forum 'Career advice' and the section 'First year of nursing after licensure.'
    Floor nursing is very hard. And you can learn a lot. Maybe tell us whAt you find the most stressful--the workload, the other nurses, organizing your time, etc. and maybe we can help you with some strategies.
  4. by   jamonit
    Get into a NP program as soon as possible. Life will improve, and I think a big part of the improvement is feeling you have options. The expanded scope and autonomy (and being outside of the hospital) will feel great. Look at University of Cincinnati online. I had friends that did that MSN/FNP and said it was a great program. Start looking around, just seeing what is out there will give you new hope. Good luck.
  5. by   carachel2
    The millions of alarm bells ringing, new patients whizzing in, current patients crashing, doctors dropping by adding a million orders, CNA staff to supervise.......I don't miss any of it. Don't get me wrong, I LOVED my patients. Loved pulling up a chair and talking to them about life after a heart attack,how to catch early CHF, etc. etc. But I hated the craziness of the day. I know there are some who absolutely thrive on the chaos but that was not me.

    As an FNP, I STILL have stress. I STILL do have some very sick patients in the office and it's my job to quickly figure out what to do and order, etc. But it is a much more predictable form of chaos and usually mixed in with people coming for WELL visit or medicine follow up visits. Still with lots of paperwork, but nothing critical that MUST be done in like the next 5 minutes all day long.
  6. by   ice2015
    Don't wait to go back to school. I love being an ARNP!!!!! It is completely different from bedside nursing.
  7. by   Multicollinearity
    I got a night-shift slacker job on an easy hospital unit while I do my DNP program. Nursing can be very sucky at times, but honestly I find my hospital job to be much easier than my previous non-acute care job. Point being - unit characteristics and shifts very greatly.

    I think staff nursing is hard because there is so much responsibility with so little power. I think it makes sense to become an NP if you strongly desire that knowledge base and role - while acknowledging you will be answering to a different pimp - keeping your billing numbers high and profitable for your practice.
  8. by   NPAlby
    You said you were a new nurse. Not to discount what you are feeling but it's pretty normal to feel ***** slapped the first year of nursing. Its not like school at all. Most of us doubted why we got into nursing and if we could truly handle it that first year. i know I did. It does get easier.
    As for being an NP it give you more options and more control, generally speaking. Yes you have to worry about getting sued and harming a patient because you missed something or prescribed the wrong thing. And yes the buck stops with you so you need to be ready to make the tough decisions. But like nursing you get the hang of it and it becomes easier in time. I would check out NP jobs in your area or the area you would want to live in when you are done with school. NP practice, pay and job prospects vary from state to state. So before you make that investment see whats out there and see if its something you would like to do. Sorry cant give you a more black and white answer of lawsuits, lowest stress, lowest liability. For myself I know my first year as an RN was a lot tougher than the first year as an NP. Yes I worried as a new NP but I had no where near the self doubt that I did as a RN. I think its because of my RN experience that I felt more comfortable.
    Last edit by Esme12 on Jun 26, '13 : Reason: TOS
  9. by   NPAlby
    "you will be answering to a different pimp - keeping your billing numbers high and profitable for your practice.[/QUOTE]"

    Ha! I love that! I know it1 Sometimes I liken my job to pole dancing.
  10. by   Annaiya
    I think you really need to look at what it is about your current job that you dislike so much. It actually surprises me that so many people here have said that being an NP opens up more doors, because I see it as the opposite. Once you are an NP you are committed to one specialty, your hours and places you can work are far less. The number of jobs are significantly fewer (with fewer overall applicants) so depending on what area of the country you're in, it can be nearly impossible to get a job or you can have people pounding down your door to hire you, it just depends.

    As an RN your first year is rough and then it starts to get exponentially better. Everyone keeps telling me to expect my first 2 years as an NP to be like that. The amount of responsibility is a lot more, you are salaried, so you leave when the work is done, not when your shift is over (and you don't get overtime for staying late), school is hard and expensive. I feel that by pure percentages there are more downsides to being an NP than an RN, however, for me, the things that are good about being an NP far outweigh the bad. But that will be different for everyone.

    From your post, it sounds like you're considering being an NP as a way out of being a bedside nurse, and I don't think that's a good enough reason. You need to do it, because you want to be an NP, not because you don't want to be an RN. Otherwise, you run the risk of getting another degree that doesn't provide you with any greater job satisfaction. I agree with PsychCNS, go spend some time reading the "first year after licensure" forums. That might help you get better clarity of why your struggling so much with your current job. Once you have more insight into that, come back here and ask for advice again. You'll get answers that are better tailored to what you're looking for in a "perfect" job.
  11. by   Dixiecup
    I refuse to work for salary. I get paid an hourly wage and time and a half for every hour over that.
  12. by   Annaiya
    Quote from Dixiecup
    I refuse to work for salary. I get paid an hourly wage and time and a half for every hour over that.
    I think this attitude is very hurtful of the professional image of nurse practitioners. When you look at the wage and hour laws with regard to exempt and non-exempt employees, we are definitely in the exempt category. We are professionals and should not have the mentality of "I punch a clock and should get paid for every last minute of work I do." It makes us look bad. We should have a salary that adequately compensates us for the work and actual hours we spend, but demanding hourly wage and overtime makes us look like we don't take our jobs and our responsibilities seriously. Being an NP is not just a job that we show up to. It should be part of our lives and who we are, we should be the leaders of a strong work ethic and do what we need to in order to provide the best care to our patients. If you just want to punch a clock and get hourly wages and overtime, then you should stay as a staff nurse.
  13. by   reddgirl
    Well said!!! I sure don't wanna clock in either! I come in and see my patients and when I'm done I go home. I don't need a time clock to show my worth. That's staff nurse mentality and ARNPs are well beyond that phase of our careers.
  14. by   BlueDevil,DNP
    Agree with above. Professionals do not punch time clocks, lol.

    I LOL'd about working for a different pimp. Very true. As a NP you will have to worry about money/billing, I don't have any NP colleagues who don't except those in free clinics, and they have a different set of money problems. Grant writing is a pain in the patoot, and there is never enough money to go around! It is different being a provider than being a nurse. You don't get to mitch and boan about not having supplies while "the man" gets his bonus, because you will be the one, while still needing supplies, wanting your own bonus, lol. It is a different view of providing care: conserving/allocating resources, earning money- issues that probably don't affect the day to day practice of most RNs very much, but that direct the practice of most APNs, and it can be frustrating. There is no getting away from it. A very little bit in the University systems, but even there money is going to be at issue as departments fight over budgets. One department will argue that their Charlson, Higashi, or Total Illness Burden Index score is higher than another's, and the other department will argue that that metric shouldn't be used because blah blah blah. They will fight tooth and nail for peanuts, becuase ther isn't enough to go around. The department that publishes the best research will get the most in the end, because most of the money comes from grants and donors. So just being out of for profit health care won't save you. And that is my least favorite reality of my job, and it is never going to go away.

    I have never given much thought to being sued, probably because I never have been. Once it happens (not if, when) I'll worry about it more. I try to document well and hope for the best. I have a colleague who was told by a patient recently, "Gee doc, I really like you, and I hate to do this to you, but I need a new roof, and my son is going to college soon, so, sorry man."

    I get crazy sometimes. I go off on tangents when I just flat out refuse to indulge people for weeks at a time because I get so irritated at the lack of accountability and intrinsic motivation. During that time I don't always like my job or all of my patients. I lose faith in human nature. It happens if I just see too many people taking advantage of the system, too many people refusing to make any effort at all, too many abused children, too many neglected elders, too many narcotic seekers, too many liars, too many demanding jerks, too many whiners, too many entitled losers, too many know-it-alls, too many prior authorizations, too many charts back from medical records for review, too many forms to complete, coupled with too few pleasant patients for respite in between, all within a short span of time. I'm human, it happens.
    I have these mini freakouts about 1-2x a year, and they last about a week or two. It means I need a vacation, or some validation, small reminder that what I am doing does matter. I get one or the other and I usually all right again.

    What I love about my job- I do what I want to, for whom I want, when I want, how I want, if I want to. I make my own schedule, can come and go when I please. If I decide to have breakfast with my son, I call and say, cancel the 9:00, I won't be in until 10, or I can not call and just saunter in at 10:00 if I want to, lol. I wouldn't do that because I think it rude, but if I did that, no one would say boo to me about it. I have office mates who do, our practice manager makes petty remarks to the other providers about them behind their backs, but she doesn't say anything directly to them, she is not big on confrontation, lol. My point is, if something important comes up and I need to change my schedule, I have the freedom to do it on a moment's notice and I answer to no one but my own conscience. Now, do it too often and the money issue will come up again, lol.

    I love that I get to choose how I practice. No one tells me how to provide care, what kind of patients to see/not see. I was free to determine how to shape my business and if I decide to change it, that too is up to me. If I decide tomorrow I don't want to see females, or anyone under age 14, or over 65, etc, fine. If I decide I want to do some cosmetic derm, I could do that. I decided last year to stop doing IUDs, for instance. Takes too long, I need a chaperone, and they are expensive devices I have to order and have lying around. Not worth it, I'd rather refer that out. I like that I get to decide that on my own. No one tells me "you have to do this," "you can't do that." To me, that is an extremely valuable aspect of independent practice.

    I control my day. I control my career. It is up to me. All of it. I never enjoyed that kind of autonomy as a Nurse and I relish it now. Of course, it is tremendous responsibility as well, and not everyone would find it worth it. Some people just want a job they can go to, "clock in" and go home. I wanted a real profession I could steer myself, so this is an ideal fit for me. I wouldn't change a thing.