Working as a bedside RN after getting NP....

Trauma Columnist · Dec 8, 2010

There is a huge liability working as a bedside RN when you are an APN. You are held to the highest education/standard level.

That said, when I graduated (2006), there were no jobs in my area so I continued to work in the ER as a staff nurse for 3 months. However, since then, no I haven't worked as a bedside RN.

Yes, I do miss it and yes, if circumstances were different, I would (in a heartbeat) go back.

linearthinker, DNP, RN · Dec 8, 2010

There used to be 2 NPs working in this area as staff nurses. One did w/e but stopped when her kid graduated from college. Now she just runs a coumadin clinic. The other is a CNM who works FT in a OB prac all week, and in L&D as a staff RN prn. She does a day or so a month. She says it keeps her close to the staff, and she donates 100% of that income to her church. I just quit my RN job, and no, under no circumstances will I go back. If I don't get a job by the end of 2011, I might take a teaching position, but I am moving on from staff nursing. My back hurts.

shannons1 · Dec 8, 2010

Well, I am a FNP with lots of peds experience as a RN and NP. I briefly did pick up some RN time at a local community hospital about a year ago but I will not donthat again for two reasons that may be more specific to my situation. First I realized that I really like large, teaching institutions-around here they treat their nurses and NPs better(in a nutshell). Secondly, the majority of the docs I worked with acted really weird with me once the other nurses told them I was a NP and where I worked in the past. One of them in particular kept asking me what to do to great certain patients and I just wasn't comfortable with it. I generally liked the nursing staff and the PA was nice but overall I decided never again.

Also, I know this wasn't really your question but I would strongly encourage u to pursue

FNP. I really don't like adult, love peds but u never know what life will throw your way. Currently, I work in the ED at my favorite hospital. I still seel lots of peds but have to see adults too. The schedule works well for my family and I am waiting for a part time/prn position to open up again in the peds department. So having the FNP really helped me

out!! Best of luck!!

HappyBunnyNurse · Dec 8, 2010

I think it would depend on your NP speciality. For example if you were a NNP working on an adult unit or an adult nurse practitioner working in a NICU you would surely only be held to an RN's standard as those patients would be outside your practitioner scope. Things get a bit hairy if you are functioning as an RN in an area you are also where certified as an NP. However, I have known FNPs to do it for financial reasons. Which makes me nervous about getting a NP. This is a question for me too as I am debating between FNP and NNP. I'd love to practice as a FNP in my rural area but my heart breaks at the thought of leaving the NICU! If I do FNP, I'd love to work as a RN occasionally in the NICU. This actually sounds like a question for the board of nursing in our particular states. Good luck with your decision.

Spacklehead, MSN, NP · Dec 8, 2010

If you are not sure if you would like to work as an NP yet and you would prefer to work as an RN for a while, then I would honestly hold off on going back to school until you are ready to make that switch. Reason being, the more time you spend as a non-practicing NP, the harder it gets to find an NP position. Plus, it would make re-certification in your NP specialty that much more of a PITA.

WoosahRN, MSN, RN · Dec 9, 2010

Thanks everyone! I definitely was having confusion when I hear that people are working bedside while trying to find a job. I can see the lines being muddled if coworkers know you as an NP or if the person steps beyond their role that night and starts treating their patient as an NP (writing their own orders).

I imagine working acute care peds, either in the PICU or as a hospitalist. I'm afraid I would get terribly bored in a peds clinic. But like I said I also am getting into diabetic education and can imagine working in an endo office doing that as well as consulting in a hospital.

It seems that the majority of those that say they love NP and would never go back to bedside are those that started out hating bedside. I work in an environment where I feel like the hands on is rewarding. I am the one interpreting VS, labs, assessments and trouble shooting what the problem is. Then applying an intervention and seeing the results. I fear I will lose that contact and satisfaction with NP but I'm also interested in advancing my roles and responsibilities.

Trauma, thank you for your honesty. It's refreshing to hear all sides of it. What is it about NP or your circumstances that has you regretting the decision? Can you let your NP lapse to go back into bedside?

WoosahRN, MSN, RN · Dec 9, 2010

I am taking education slow, or rather not the direct route. Plan on getting MSN and then when I'm really ready I can do a post-Master's. Figure that's still a way to get me into different roles and get as much school done until I'm really certain.

Trauma Columnist · Dec 9, 2010

Like some other posters, I liked the bedside - I worked in a level one ER and loved the chaos, the pts, the staff, etc..

As an NP, I'm becoming way more concerned with paperwork than I want to be.

shannons1 · Dec 9, 2010

Had a thought after reading part of your response about wanting to work in the PICU or more acute setting. I may be possibly starting back very part time for a post masters ACPNP. Depends on finances and scheduling at this point, but just a thought. Could do a FNP with a post masters?

Best of luck!!

MC1906 · Dec 11, 2010

Some nurses that I know are APNs at a hospital/clinic and then work as a staff nurse at a hospital. I think you should read your nurse practice act to determine this and also speak with the HR department. My understanding is that, if you are hired as a staff RN, then that is your role, despite your education and training. To work as an APN, you have to be credentialed to do so within that hospital (might be stated like that in their medical by-laws). Now if you plan on picking up shifts at a hospital that you would also be an APN in, I would re-think that. That might create a lot of role confusion for you, staff, physicians and patients. I would just work at a different facility to pick up the hours if you want to keep your hands in bedside nursing.

ARNPCD · Dec 13, 2010

I have kept the thought of working as a bedside RN in the back of my mind..... If I ever needed to just work part time, and NP jobs were not meeting my flexibility needs, I would probably work per-diem as an RN. However, I would try to find an NP job first. I hesitate dealing with other RNs, like any other person, some nurses can be brutal to another person they are jealous of. Myself and other classmates dealt with many snide comments from co-workers. I just wanted to say "YOU can be an ARNP too, just get off your big #*@!!