Future of Nurse Practitioners

  1. I'm passionate about cardiology and am considering being an outpatient cardiac nurse practitioner, but I hear the NP profession is looking quite grim (supply more than exceeds demand, grossly underpaid, overworked, etc.). What's the future looking like for NPs, particularly those in an outpatient cardiac clinic? Is there a light at the end of the tunnel? Or should I look for something else? I have my BSN, four years of bedside under my belt, and am studying for my CVRN, if that helps. Also when and if I go to NP school, it will be a brick-and-mortar. Thank you so much for the responses!
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    About Lightning Rose

    Joined: Sep '18; Posts: 1

    19 Comments

  3. by   ICUman
    Quote from Lightning Rose
    I hear the NP profession is looking quite grim (supply more than exceeds demand, grossly underpaid, overworked, etc
    Where are you hearing that from? Coworkers?
  4. by   djmatte
    Grim is all in the experience of the individual. If you want to work in cardiology as an np you could easily make some decent money and have a solid job if you have a solid background, the right work ethic/mindset, and an appropriate understanding of your value. You can go that route in either fnp or adult Geri, but the bigger bang for buck cardiology wise is probably adult Geri. Substantial background on a cardiology unit could be beneficial to you As it's a selling point to potential recruiters and hiring staff. Your pay will likely reflect the region, but could reflect your experience and how well you assert yourself during the hiring process (again experience in a chosen specialty goes a long way). Lastly, yes more supply will hurt the profession in the long run. But experience will still carry some weight in most cases and you're capacity to own your profession will make all the difference.
  5. by   lwsoccjs
    I think a great question for you OP is what are your expectations from the profession. Name some end goals, expectations, etc and we can give much better insight. But one persons "grim" is another persons perfect situation.
  6. by   Spadeforce
    Nobody knows for sure but if you are hard set

    Go to a good school
    Work hard
    Move where people do not like to live

    Otherwise it's getting to be an uphill battle in many places with pay cuts galore before everybody ants that rx pad
  7. by   traumaRUs
    Funny - I just got a headhunters email for a cards NP in Chicago for $153k which is excellent pay and no call, good hours...I'd say based on that and from what I know of the current APRN market - no problems.
  8. by   Jules A
    I think the NP role like the RN role is an important part of our healthcare system however I also believe there will be major changes going forward. Less money and in hospitals less opportunities and responsibilities.

    The fact that there many schools with minimal to no admission requirements flooding the market with ill prepared NPs will likely result in our reputations suffering. Hospitals in my area that a decade ago thought NPs were an answer to their prayers are finding that in many instances PAs are a better fit with their superior education and physician's comfort level in working with them. The pay is also going down based on supply vs demand.

    My advice for anyone who wants to be a NP is think long and hard about the increased responsibility for what is likely to be very little increase in pay. If the mass exodus results in a shortage of bedside RNs their rates will increase which will further close the gap.
  9. by   pro-student
    The future of NPs is highly variable but ultimately looks positive. That said there are a few caveats. NP education is highly variable ranging from excellent to abysmal. There is still a hodge podge of standards governing educational programs but generally the regulation is quite loose (at least compared to other professional programs) not at all unlike medicine was when it established itself in the United States. NPs are going through the same concerns were just a couple centuries later to the party. Likely, things will slowly sort themselves out and, just like our medical counterparts, NPs will be recognized and an integral and indispensable part of the healthcare system.

    I want to point out that there is no such thing as a cardiac nurse practitioner. There are NPs who work in cardiology settings both inpatient and outpatient. You may think I'm splitting hairs but I would suggest that, unlike physician cardiologists, there is no single, recognizable way to demonstrate one is professionally prepared to practice in cardiac setting. This can swing both ways. I can mean that one can land a job in cardiology without undergoing any specific educational or professional preparation and leverage prior experience, NP training, and formal or informal mentorship to be a successful provider. But it can also mean that one's experience is less transferable because there is not standardized way to demonstrate competence and work experience can be viewed very subjectively.


    That being said, NPs have forged successful roles for themselves in nearly every area of healthcare. Nonetheless, geographic and political factors play a major role in determining the opportunities available for NPs. The more flexible you are, the more likely you are to find a match to your professional goals. Some places are insistent on using NPs in a primary care capacity even in specialty clinics (such as cardiology), require specific certifications/licensure (acute vs primary care, adult vs family vs peds), and work schedules/responsibilities, and earning potential.
  10. by   britt_possible
    I graduated two years ago with my Adult Gero Primary Care cert and i work as outpatient cardiology NP. It was my goal when i started my NP program. During my NP clinicals i specifically requested cardiology rotations or internal med rotations. My entire experience as a tech/RN was inpatient cardiology (4 years total). I had two offers for interviews in outpatient cards with in 48 hours of applying for those jobs. I graduated from a well known brick and mortar which helped ALOT. i knew id have to move for a job, because my home town NP market is VERY saturated. I moved out of the region to the mid atlantic -- Cardiology NP jobs are plentiful here. The pay could be better, and i know i am low balled. But im making about $40K more than RN salary with better work hours, no weekend, no on call.
    Last edit by britt_possible on Sep 19
  11. by   rsingleLPN
    I live in downstate Illinois, I'm originally from Chicago. My BSN friend stated that it would not be profitable to get my NP ,and move back to Chicago. She claimed that there aren't many jobs, that those nurses are working in the hospital to make wage. Could it be that my friend is confusing CNS and CNL with NPs working in the hospital.
  12. by   traumaRUs
    Quote from rsingleLPN
    I live in downstate Illinois, I'm originally from Chicago. My BSN friend stated that it would not be profitable to get my NP ,and move back to Chicago. She claimed that there aren't many jobs, that those nurses are working in the hospital to make wage. Could it be that my friend is confusing CNS and CNL with NPs working in the hospital.
    I live in central IL - plenty of jobs here
  13. by   Spadeforce
    Quote from pro-student
    The future of NPs is highly variable but ultimately looks positive. That said there are a few caveats. NP education is highly variable ranging from excellent to abysmal. There is still a hodge podge of standards governing educational programs but generally the regulation is quite loose (at least compared to other professional programs) not at all unlike medicine was when it established itself in the United States. NPs are going through the same concerns were just a couple centuries later to the party. Likely, things will slowly sort themselves out and, just like our medical counterparts, NPs will be recognized and an integral and indispensable part of the healthcare system.

    I want to point out that there is no such thing as a cardiac nurse practitioner. There are NPs who work in cardiology settings both inpatient and outpatient. You may think I'm splitting hairs but I would suggest that, unlike physician cardiologists, there is no single, recognizable way to demonstrate one is professionally prepared to practice in cardiac setting. This can swing both ways. I can mean that one can land a job in cardiology without undergoing any specific educational or professional preparation and leverage prior experience, NP training, and formal or informal mentorship to be a successful provider. But it can also mean that one's experience is less transferable because there is not standardized way to demonstrate competence and work experience can be viewed very subjectively.

    take it as you will, its been watered down


    That being said, NPs have forged successful roles for themselves in nearly every area of healthcare. Nonetheless, geographic and political factors play a major role in determining the opportunities available for NPs. The more flexible you are, the more likely you are to find a match to your professional goals. Some places are insistent on using NPs in a primary care capacity even in specialty clinics (such as cardiology), require specific certifications/licensure (acute vs primary care, adult vs family vs peds), and work schedules/responsibilities, and earning potential.
    Felt like I was reading a pseudothesis going through this post lol. Too many fancy words like "integral, caveat, indispensable, etc etc, with no data to back it up.

    NPs have been established and essentially they are becoming in some ways Unestablished with weaker educational standards. USED to, the top nurses, with experience, etc would attain an FNP degree, which is not now true (in before the hate from direct entry people of which I have no opinion of) and now everybody does it because its "cool" and you get a "white coat"

    The school I went to used to be somewhat hard to get into (for NP schools) and even required the GRE (which may or may not be a great test but at least you have to put forth effort to do average on it), now they have dropped that, dropped any hard GPA requirement, etc.
  14. by   Goldenfox
    Quote from pro-student
    The future of NPs is highly variable but ultimately looks positive. That said there are a few caveats. NP education is highly variable ranging from excellent to abysmal. There is still a hodge podge of standards governing educational programs but generally the regulation is quite loose (at least compared to other professional programs) not at all unlike medicine was when it established itself in the United States. NPs are going through the same concerns were just a couple centuries later to the party. Likely, things will slowly sort themselves out and, just like our medical counterparts, NPs will be recognized and an integral and indispensable part of the healthcare system.

    I want to point out that there is no such thing as a cardiac nurse practitioner. There are NPs who work in cardiology settings both inpatient and outpatient. You may think I'm splitting hairs but I would suggest that, unlike physician cardiologists, there is no single, recognizable way to demonstrate one is professionally prepared to practice in cardiac setting. This can swing both ways. I can mean that one can land a job in cardiology without undergoing any specific educational or professional preparation and leverage prior experience, NP training, and formal or informal mentorship to be a successful provider. But it can also mean that one's experience is less transferable because there is not standardized way to demonstrate competence and work experience can be viewed very subjectively.


    That being said, NPs have forged successful roles for themselves in nearly every area of healthcare. Nonetheless, geographic and political factors play a major role in determining the opportunities available for NPs. The more flexible you are, the more likely you are to find a match to your professional goals. Some places are insistent on using NPs in a primary care capacity even in specialty clinics (such as cardiology), require specific certifications/licensure (acute vs primary care, adult vs family vs peds), and work schedules/responsibilities, and earning potential.
    Part of your post is incorrect. Nearly every specialty area in medicine has advanced certification programs for clinicians who don't have board bona fides but want to specialize. This includes cardiology. Here is just one example:
    About Us | Cardiovascular Credentialing | ABCMCertification.com - American Board of Cardiovascular Medicine

    Some reputable brick and mortar universities even offer the CV subspecialty in their program.
    Cardiovascular Subspecialty

    Some of these NP certification programs are more stringent than others. I remember looking into the one for dermatology some time ago but I was not qualified because they require 3,000 clinical practice hours in the field before they will allow you to apply to take the certification exam. I have seen that other certification programs have similar requirenments, which, I believe, is a good thing.

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