I know this is a topic that has been brought up many times on allnurses, but I am hoping this thread will give me additional insight. I am a 30-year-old male who has 10 years of Paramedic experience in a busy 911 system and 6 months of experience as an RN in a rural surgical ICU. I live in a rural area around San Antonio, Texas. I transitioned from paramedic to RN so that I could better provide for my family and still work in healthcare. I have found my RN experience enjoyable so far but have found myself contemplating the next step in my career. I entered nursing with the idea that I would work in the field to pay my dues and learn the nursing role; then transition to an advanced practice role such as NP, or CRNA.
Truth be told I had a preference for either working as an NP in the ED or Urgent Care setting, however after looking at the current saturation in the job market as well as the estimate that the job market will worsen over the next decade, I have become concerned with pursuing this route. I learned about the CRNA role more recently and I am investigating it currently, but it does have a big barrier of entry for me as I am the sole income earner for my family and do not live near a CRNA program (the huge debt burden scares me a lot.) I am hoping to gain wisdom and insight from people who currently work as advanced practice nurses and know better than I do searching through info on the internet.
If you are willing and able to answer I want to know if it is still worth pursuing an FNP, or AGACNP degree? Do you believe that this career is one that will sustain my family to retirement, or is the saturation heading to a point where I would be better off staying an RN, or pursuing CRNA? I want to make career moves now, so that I am the most prepared I can be for my career.
Specializes in Former NP now Internal medicine PGY-3.
4 hours ago, Numenor said:
I was an ICU nurse for years and frankly, I don't think it means much. Either you are going to be a competent provider or you aren't. The best NPs I have met were previous engineers (or similar) who PROBABLY could have gone to med school if they were at a previous life stage but for brevity's sake they didn't.
I don't think I could have functioned without a residency and I don't my attendings would have any confidence in me either. It really did forge me as a provider 10x more than NP school. It was fun being in the trenches with the residents haha.
I don't know, you basically are skipping all of step 1 with NP education. They does count somewhat, maybe less so as time goes on...
Yea tell that to the ICU nurses who always talk about how they know everything even though they would probably take 4 hours to write one progress note.
I don't think my previous nursing experience helped much besides familiarity with some drugs and dealing with PITA patients. And familiarity with I guess some basic procedures. Nothing about diagnosis and treatment though. People think titrating levophed = medicine, but its a totally different ballgame when you have to write the orders yourself. Im actually surprised they let a lot of nPs work in the ICU when they make doctors do an additional three years, to top it off some of them are FNPs. don't care if they have 10 years ICU nursing experience, they should have to do residency at least.
Yea tell that to the ICU nurses who always talk about how they know everything even though they would probably take 4 hours to write one progress note.
I don't think my previous nursing experience helped much besides familiarity with some drugs and dealing with PITA patients. And familiarity with I guess some basic procedures. Nothing about diagnosis and treatment though. People think titrating levophed = medicine, but its a totally different ballgame when you have to write the orders yourself. Im actually surprised they let a lot of nPs work in the ICU when they make doctors do an additional three years, to top it off some of them are FNPs. don't care if they have 10 years ICU nursing experience, they should have to do residency at least.
Yeah I always found it interesting when nurses titrated pressors and acted like they were practicing meDicInE. Medicine is nuance. Medicine is knowing when to admit, when to discharge, when to consult, when to watch, when to ignore, when to treat etc etc. Not titrating algorithmic pressors and understanding the basics of a/b receptors and elementary hemodynamics.
Yeah my hospital only hires ACNPs. FNPs were phased out long ago.
Its a lot bigger deal when your name is behind that order. Even residents feel that way after 3 years and they realize THEY are the attending.
Specializes in Former NP now Internal medicine PGY-3.
8 hours ago, Numenor said:
Yeah I always found it interesting when nurses titrated pressors and acted like they were practicing meDicInE. Medicine is nuance. Medicine is knowing when to admit, when to discharge, when to consult, when to watch, when to ignore, when to treat etc etc. Not titrating algorithmic pressors and understanding the basics of a/b receptors and elementary hemodynamics.
Yeah my hospital only hires ACNPs. FNPs were phased out long ago.
Its a lot bigger deal when your name is behind that order. Even residents feel that way after 3 years and they realize THEY are the attending.
Completely agree, people tend to also forget that sicker doesn't mean more difficult and that if some one can "ICU" they can do anything.
But I guess to get back on topic people shouldn't be a provider unless they are willing to take the time to get decent at it. See so many posts on here about how people want to do it to escape nursing because its so stressful then they get some online diploma from a not so great school and realize the juice isn't always worth the squeeze.
Specializes in Psychiatric and Mental Health NP (PMHNP).
I just want to note that FNPs and AGPCNPs can make excellent money, but you must be willing to move if you live in a part of the country that pays crappy.
I just saw a want ad for an NP to perform only routine intake physicals at a prison in California, about 1.5 hours from Bakersfield. $170K a year.
In addition, I know that traveling NPs can make $180 to $200K per year for primary care and a lot more for some specialties. (California)
I suggest doing a cost of living vs salary analysis of different locations. Much of California is still quite affordable, although housing prices are skyrocketing everywhere, but that's true in most of the country. I am baffled at how few people do this. If you are making $80K a year as an NP and have to pay $800 per month rent where you are, and are then offered a job making $130K per year in a location where you have to pay $1000 per month in rent, you are better off!
Tegridy
583 Posts
Yea tell that to the ICU nurses who always talk about how they know everything even though they would probably take 4 hours to write one progress note.
I don't think my previous nursing experience helped much besides familiarity with some drugs and dealing with PITA patients. And familiarity with I guess some basic procedures. Nothing about diagnosis and treatment though. People think titrating levophed = medicine, but its a totally different ballgame when you have to write the orders yourself. Im actually surprised they let a lot of nPs work in the ICU when they make doctors do an additional three years, to top it off some of them are FNPs. don't care if they have 10 years ICU nursing experience, they should have to do residency at least.