A male Nurse Practitioner: What are your thoughts? - page 2

by indomie23 13,282 Views | 18 Comments

I am debating on whether I should become a NP or a PA. I've been researching on both professions on the Internet and elsewhere all summer, and I look forward to finally being able to job shadow these two positions as they will... Read More


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    Hello:

    I am a male RN. I have been practicing nursing in Telemetry--Cardiac--for 6 years. I am in my completion of my MSN--Adult-Gerontological NP--studies, which I will complete after two more semesters--August 2013 graduation.

    NP VS. PA: NPs are more autonomous than PAs. PAs by definition are assistants. NPs are gaining much more autonomy, very quickly these days.

    DNP VS. MSN--in relation to after 2015: The Consensus Model is what guides nursing now. It stipulates a DNP will be the minimum requirement to gain NP licensure, starting implementation by 2013, fully integrated by 2015. NPs currently have certificates, i.e., are certified NPs, with STATE licensure as an RN, and they practice under their RN license. The difference is that, in the very near future, NPs will have a separate license from their RN license, and it will be the same nation-wide. Nursing schools across the country have already started phasing out the MSN. One example is Temple University, which no longer has an MSN--NP program. Schools would not be doing away with money-making MSN--NP programs, if there was not a reason!! So, yes, the DNP is going to be a requirement, and yes there is a specific policy, etc. about such.

    Education--other: If one is already an RN with a BSN, it will be easier to get the MSN--NP, but with the DNP requirement, it will still take one an additional 4 years, in some advanced cases only 3 years, to complete the DNP, after the BSN. If one does not have any RN degree or license, it will be a lot easier to gain PA Master degree and go the PA route.

    Male: I do believe that our arrogant society still has this belief that nurses are female and physicians are male. And, there is actually good reason. Although medical students, starting after around the 1960s, became about 50% female and 50% male, today 95%+ nursing students are female, and 95%+ NP students are also female. International honor societies for nursing tend to be about 97% female, even if the society members are invited!! This shows that, since membership is by invitation only, these societies are excluding men. In fact, I am sure one could open a legal case against these such nursing societies. However, in practice I believe being a male is much better than being a female, whether floor RN or male NP. Males, in my experience, are treated better, with more respect, and have a different work ethic that is liked. There are exceptions on both sides--female and male--but this is my generalization to answer the question above.
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    Quote from rxh027
    DNP VS. MSN--in relation to after 2015: The Consensus Model is what guides nursing now. It stipulates a DNP will be the minimum requirement to gain NP licensure, starting implementation by 2013, fully integrated by 2015. NPs currently have certificates, i.e., are certified NPs, with STATE licensure as an RN, and they practice under their RN license. The difference is that, in the very near future, NPs will have a separate license from their RN license, and it will be the same nation-wide. Nursing schools across the country have already started phasing out the MSN. One example is Temple University, which no longer has an MSN--NP program. Schools would not be doing away with money-making MSN--NP programs, if there was not a reason!! So, yes, the DNP is going to be a requirement, and yes there is a specific policy, etc. about such.
    This post is not correct and once again makes it seem like this is a done deal and a finalized issue when it's not at all.

    Please take a look at this post from one of the AllNurses site guides that provides what I believe to be a more accurate analysis of the "DNP for NP recommendation" issue:

    Quote from juan de la cruz
    Speaking from the NP perspective, it is still a recommendation and not an official mandate. That's just how it's going to unfold regardless of where you stand on the issue because as we all know, NP practice is regulated by the individual state boards as well as the multiple national specialty certification boards so change has to come from a collective effort from these entities. It is easier for other APN groups to set a deadline (such as CRNA's, for example) because their practice is more uniform and their training programs and certification are governed by a streamlined and unified entity unlike us NP's who seem to be more scattered (i.e., no formal accreditation specific to NP programs by a single entity and no unified national certification body).

    The optimists feel that the speed at which DNP programs emerged is promising and the natural progression is that the DNP programs will outnumber the MS/MSN programs which may lead to the phasing out of the master's degree eventually regardless of a formal mandate. They compare it to the time when master's degrees for APN's started to pick up and the certificate programs naturally died out even though some states were still granting NP licenses to those trained at the certificate level. The pessimists feel that this is just a flashback of the "BSN-as-entry-to-nursing practice" issue and will never happen. I don't have an opinion as I'm happy with my current degree and have no immediate plans to return to school.
    Here are some additional threads on the issue:
    http://allnurses.com/doctor-nursing-...np-529004.html
    http://allnurses.com/doctor-nursing-...-a-505362.html
    http://allnurses.com/doctor-nursing-...al-511344.html

    I don't understand how so many people can be so unclear about the factual nature of this issue. Especially folks who are already in the field.
    MUUGUZI, elkpark, ChristineN, and 1 other like this.
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    I am looking at retirement in about 5-6 years. If the DNP had been on the table many years ago I would not be doing what I am doing today. I had considered a Phd years ago but it came down to that old benefit ration thing. The cost and effort was not worth it. Right now I am in a happy place.
  4. 0
    …missed a few additional gems from this post…


    Quote from rxh027
    Schools would not be doing away with money-making MSN--NP programs, if there was not a reason!!

    Correct, but not because there is a mandate/requirement for the DNP. Because the DNP is not really a clinical degree, schools can tack on the necessary classes to an MSN program and charge WAY more tuition for essentially the same thing by repackaging an MSN as a DNP.

    Quote from rxh027
    Education--other: If one is already an RN with a BSN, it will be easier to get the MSN--NP, but with the DNP requirement, it will still take one an additional 4 years, in some advanced cases only 3 years, to complete the DNP, after the BSN. If one does not have any RN degree or license, it will be a lot easier to gain PA Master degree and go the PA route.

    This is also wrong because of the false underlying DNP mandate premise. There are still plenty of direct entry programs available for those who do not have a bachelor's degree in nursing. These programs only take 3 years but do have basic science prerequisite classes and can be very competitive. Also, there are some RN-MSN bridge programs available for Associates level RNs who want to become NPs. For example, University of Illinois Chicago has this option. Their program only requires 4 bridge classes for RNs before starting the 2 years of master’s specialty classes.
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    Thank you for each and everyone's help.

    To answer your guys' questions, I am a freshman in college. I'm currently taking nursing prerequisite coursework at the local CC, and I am also working part time as a caregiver at an independent-living senior facility.

    Just a little about my job experience:
    It's simple job (companionship, assisting with daily tasks, MR's, simple shower assists here and there). I work my shift independently. I am realizing that, although I admire the friendships with these great individuals, it is kind of getting mundane to do basically the same task every Sunday night, possibly in part that, with all due respect, they are elderly people, that it's at night (3-10pm), and/or that I work independently, etc...? So am I wanting for a job experience that provides new experiences, or maybe time and experiences will tell.

    I have also never shadowed a professional yet, but hope to soon. I am considering on getting my CNA license sometime this year. I don't think research/policy are areas I want to get into. Then again, I am just starting. For me, teaching may be in consideration someday once I delve into what the nursing field is. Clinical work is what I am more interested in.

    Here's some more personal views and interests that may help one's advice for me:
    I want to be one that can help someone in a more deeper aspect of health, like medicine, and have more closer of relationships with my patients, and not have to go through the process of medical school. That is why I am thinking about going onto to becoming a NP. I notice that they have good autonomy, and can treat patients similarly to a medical doctor in more basic aspects, if i am not mistaken.

    I also have interest in surgery, travelling to third world countries to help those less fortunate, missionary work, the homeless, and just being the one that has the solution to many and common health problems. I am considering the area of Family NP, because it touches a greater range of the lifespan. I am guessing that if is a NP, and wants to get into more medical aspects, then they can take more schooling for that.

    I would greatly appreciate it if someone could give me advice based on what I've mentioned. Thank you!
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    indomie32 hi, I graduated as ACNP after being 5 years as an RN. I think it depends a lot on how you see yourself in a few years and where you want to work. All my training as an ACNP was in the ICU some I know are not ICU based but mine was. I cover the ICU as an ACNP and very independent. Pay is good. I have been debating ACNP and CRNA before I ever started. One thing I can say with ACNP or maybe all advanced practice nurses it's not as easy to find the right job for you. I like ICU but i am not keen to cover days and nights rotation. I struggled with that. I like being able to perform a lot of procedured like central lines, intubations and etc. You cannot also move to different places like obviously pediatric places. We have PAs in our place equally the same autonomy. It depends on your state and hospital policy. Didn't see difference in work between both. One thing i could say with pa their depth in medical knowledge was more that I did start reading more when i started and I still do on every new diagnosis. Anatomy too wasn't as great. There are also some Nps i have worked who couldn't handle the job and we had to let go and I feel bad as an NP for that one of the reasons there should be mandated in person exam if online is a necessity and more clinical hours and definitey the nurse experience should be at least 2 years.( that's just my opinion)

    I worked immediately in the ICU as a new grad NP. I'm very lucky had a very strong intensivist who trained me in clinicals and a very independent acnp. Main difference too with clinicals with acnp in some programs you can choose your own clinicals and some are not sufficient.

    Pa schools the good one at least have it set up already that i know off and also they had same didactic as medical students but no residency but more clinical hours than np.

    SO i guess bottom line it will vary. Are you a good nurse in your area? and do you want to stay in that area? three Work hard on your master's whatever you choose. I always thought when i was doing clinicals one day I will be managing patients on my own and hopefully with backup and I'd rather be asking a lot now and working really hard and be really good at it if you have strong ICU rns working with you they will make your life hell too if you don't know what you are doing

    Another thing I could also say independence is over rated to me at times esp when I have to cover 25 ICU beds.. I sure am happy my intensivist is around to bounce back things and split work.
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    and as for the male there were half male in my class doubt there will be an issue to that and a I have at least 3 male coworkers too 2 pa one np
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    sorry i think this post was meant for the original poster rx
  9. 0
    From what you have written about what you are doing now and what your interests are for the future, I think nursing sounds like a great fit for you. I feel like nurses and nursing school puts a very strong focus on helping less fortunate people and treating all people equally. If you really enjoy developing the therapeutic relationships with your parents, you may be entirely satisfied as an RN. You have a lot of autonomy depending on the position you work in. I think it just depends on your perspective and how you view the role of the nurse. You do have to follow (generally) the orders written by the NP or the MD, but there is so much work that nurses do that isn't part of the orders and how you perform those nursing functions is completely up to the nurses. So, I think it sounds like you are on the right track by going to nursing school. Then once you are out working as a nurse you can find out more about what you like and where you want to go with your career. NP school might be what you want to do, but if not, you still have a career that is rewarding and where you can make a huge difference in people's lives. PA school is much more limiting in terms of career options.

    Since you're just a freshman now, my advice would be to explore all of the different types of jobs that RN do and work on figuring out what area you want to work in. Once you get there, then you can start exploring NP roles. NPs do function in similar or in some cases, identical roles to MDs. There are some great things about being an NP, but you give up some of the great things about being an RN. An NP is not just a nurse with more responsibility, but rather a completely different role from a nurse. Although NPs draw on their nursing experience and maintain the nursing perspective of care most of the job is completely different. So, I think it is important to learn what you enjoy doing the most and then decide if you'd be happier as an RN or an NP. Definitely doing some shadowing could help you figure some of that out, but really you don't understand nursing until you are one. There are so many subsets of nursing that it is impossible to understand all of nursing with just a few shadow days.


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