Changing careers (sort of)?

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Hello! I'm a primary care PNP that had gone through a direct entry masters program (read: I have very little RN experience) with an itch to return back to inpatient RN work. I have been in primary care for the past 3 yrs. Do you or any of you have any advice on how I could go about doing so? Or would you recommend a post masters acute care PNP if I want to do inpatient work?

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Specializes in DHSc, PA-C.

Do you want to be an RN or an NP? If you want to work as an inpatient floor nurse it would be pointless to get a post-master's acute PNP cert. Certainly, the knowledge would be great but you wouldn't be functioning as an NP.

Are you not happy with being an NP?

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Do you want to be an RN or an NP? If you want to work as an inpatient floor nurse it would be pointless to get a post-master's acute PNP cert. Certainly, the knowledge would be great but you wouldn't be functioning as an NP. Are you not happy with being an NP?
I want to be an RN, but have heard mixed opinions on an NP working as an RN (biggest thing is liability and issues revolving around being "overqualified" for the job, despite my actually not have much inpatient RN experience outside of clinicals/rotations in school). So some have suggested that I get my acute care PNP, that maybe that would be a good track for me.

Unfortunately, I don't think I am too happy with working in primary care as an NP, at least not at this point in my life. I know what I do is important...but I know many RNs, and when I talk to them, there's a large part of me that just wishes I could be doing what they do.

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Specializes in allergy and asthma, urgent care.

As others have told you, you will be held to the standard of a NP if working as a RN. I don't really see the point of getting another NP certification unless you want to work inpatient as an acute care PNP. Do you think you could be happier as a NP working in a different setting, like a specialty pediatric practice? Also think about what else is involved in working as a RN in a hospital setting-possibility of not working day shift, having to work weekends and holidays, staffing issues, and losing your autonomy as a provider.

I hope you can find what makes you happy. We spend too much time at work not to like it.

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Specializes in DHSc, PA-C.

I've heard this "liability" issue flying around but don't understand it and have never seen a specific legal case reflecting it to be a real issue. If you are working as an RN then you do RN work. That is simply it. You aren't going to be held to a higher standard legally just because you have an NP license if you are not performing NP duties.

Yes, some employers are going to question why you want to be a floor RN when you are an NP. However, some employers are also going to realize that many NPs either do both NP and RN jobs or once was an NP and no longer wants to be.

I would do the acute care cert and work as an NP inpatient and see if that is a better fit for you before giving up on being an NP and being a floor nurse. Unless you feel that RN is really your true calling.

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Specializes in CVICU, MICU, Burn ICU.

I also am very dubious about the idea that you will be held to the standard of NP while in RN practice. Especially given the fact that you are certified in primary care and you are talking about returning to an acute care RN role. These are two very very different roles and settings.

But I have an idea for you. Firstly, you should contact your board of nursing and just ask the question. Secondly, is it possible for you to work a part-time or per diem RN job? This way you can test the waters a bit without giving up your Provider practice just yet.

I also would hesitate to do more schooling unless you are sure about being an inpatient provider. But that does beg the question: what specifically is drawingbyou to the acute care RN role? I say this as a nurse who loves that role -- never been a provider. Is it the Provider role you are not enjoying or is it the fact that it is Outpatient? Are you wanting more one on one time with patients? Or is it more that you want to be involved in treating higher acuity patients?

Just trying to help you process.

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Do you think you could be happier as a NP working in a different setting, like a specialty pediatric practice? Also think about what else is involved in working as a RN in a hospital setting-possibility of not working day shift, having to work weekends and holidays, staffing issues, and losing your autonomy as a provider.

Perhaps, I think that's why I've also considered doing inpatient as an NP Since I don't currently have a family or anything, I actually prefer to do shift work instead of the 8-5pm M-F that I have now.

Yes, some employers are going to question why you want to be a floor RN when you are an NP. However, some employers are also going to realize that many NPs either do both NP and RN jobs or once was an NP and no longer wants to be.

I was hoping that I could get in touch with any NP that has /not/ wanted to be an NP anymore, if you know of contacts I would love to message/email them for some advice!

But that does beg the question: what specifically is drawing you to the acute care RN role? I say this as a nurse who loves that role -- never been a provider. Is it the Provider role you are not enjoying or is it the fact that it is Outpatient? Are you wanting more one on one time with patients? Or is it more that you want to be involved in treating higher acuity patients?

Just trying to help you process.

Thanks for asking such good questions! I personally miss the one on one time with people, and want to treat higher acuity patients. Even though I haven't done inpatient RN work outside of clinicals, I really do miss being a floor nurse. I'm hesitant to want to work inpatient as a provider though, I know I'd want to shadow or at least speak with NP's working inpatient before I sell myself into doing it.

It might be that I'm just frustrated with primary care in a community health setting, where everything is an uphill battle with insurance and I'm only getting 10-15min per patient regardless of how complex the concern or patient is.

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Specializes in allergy and asthma, urgent care.

Community health is tough. I did Adult Primary Care in a community health center for 3 years and was totally burned out. I completely understand what you're saying about insurance, and the push to see more and more patients in less and less time. You never feel like you're giving good care. I switched to a specialty practice and am much happier.

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Yeah, I feel kind of horrible that I feel tired of primary care at 3 years but I am looking for a change. But I don't know that I necessarily know what specialty I'd want to go into-- for reasons listed above, I'd much rather try to get back into inpatient care.

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Specializes in CVICU, MICU, Burn ICU.

I was hoping that I could get in touch with any NP that has /not/ wanted to be an NP anymore, if you know of contacts I would love to message/email them for some advice!

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If you search AN, you will find several threads that feature users who are NPs who wish to leave advanced practice and return to bedside. Maybe you could reach out to one of them.

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I have an NP certification for two years but work as an RN. In spite of an agressive job serch, I have not landed an NP job. I still need an income so I work as a staff nurse . I do not do any NP duties while at work even though the extra knowledge is helpful. I had to sign a release that I would not perform NP dutied while on the job. I don't think employers would question why you want to work as a staff nurse. Our job market is so saturated with many people, I literally do not go a week without some other staff nurse saying that they are goung back to school to be a nurse practitioner. I am older than some of the other candidates and believe that there is age descrimination.

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Hi Amalay,

You sent me a private message but I am not able to respond because I haven't been an active enough AllNurses member...?

Anyway, I can't give you much good advice because I did not end up switching positions. I am still an FNP in the same clinic. I was unable to find any RN positions that would provide adequate inpatient bedside training (though honestly I didn't search very hard, no interviews, etc). I still enjoy my side job as a SANE RN, but that also isn't typical RN work.

I did look into getting a post-master's certificate in midwifery (I think I would love it!) but even with my current experience it would be 2y of schooling (1 of didactic, 1 of clinicals) and $40K tuition. I couldn't justify that since I am still paying off my last degree. I will totally do it if I have a windfall of cash!

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