Dislike RN role-- love NP role?

Dodongo, APRN, NP · Jan 25, 2018

When you graduate go into ICU. It's the only area of nursing I was even remotely able to tolerate.

I did not like being a nurse. I went into nursing to move onto either the CRNA or NP role. And let's be clear that the RN and NP/CRNA roles couldn't be more different. An NP is more like a physician than a nurse.

So did I like the RN role? No. Do I like the NP role? Yes, I love it.

Just go to a decent school. Search this forum to find out how to determine what separates a good school from a bad school.

NEMurse95 · Jan 25, 2018

When you graduate go into ICU. It's the only area of nursing I was even remotely able to tolerate.
I did not like being a nurse. I went into nursing to move onto either the CRNA or NP role. And let's be clear that the RN and NP/CRNA roles couldn't be more different. An NP is more like a physician than a nurse.
So did I like the RN role? No. Do I like the NP role? Yes, I love it.
Just go to a decent school. Search this forum to find out how to determine what separates a good school from a bad school.

Thanks for the reply. Much appreciated. Why didn't you like being an RN? Also, what makes you say the ICU is more tolerable than other settings? I'm doing an associate's program, but I'm starting my BSN bridge in the fall. So, I'll have a two year overlap before I start my FNP program. Debating what type of RN gig I want to get prior to that.

Dodongo, APRN, NP · Jan 25, 2018

Thanks for the reply. Much appreciated. Why didn't you like being an RN? Also, what makes you say the ICU is more tolerable than other settings? I'm doing an associate's program, but I'm starting my BSN bridge in the fall. So, I'll have a two year overlap before I start my FNP program. Debating what type of RN gig I want to get prior to that.

I just never wanted to be an RN. It's not that I hated it - it simply wasn't what I ultimately wanted. I wanted to be in the provider role. Diagnosing. Prescribing. Doing procedures. Bedside nursing is very task oriented and your decision making ability is obviously quite limited. Different roles, different purposes.

ICU nursing felt, to me, to be a bit more cerebral than other areas of nursing. You just see more, do more and learn more in the ICU. And there's more responsibility when you're caring for a patient who is ventilated, on pressors or ino/chronotropes, CRRT, ECMO, etc. Plus, you have 1 or 2 patients and you can devote all your time and energy to them.

Make sure you know what specialty you want to practice in as an NP before you choose a NP track to pursue.

NEMurse95 · Jan 25, 2018

I just never wanted to be an RN. It's not that I hated it - it simply wasn't what I ultimately wanted. I wanted to be in the provider role. Diagnosing. Prescribing. Doing procedures. Bedside nursing is very task oriented and your decision making ability is obviously quite limited. Different roles, different purposes.
ICU nursing felt, to me, to be a bit more cerebral than other areas of nursing. You just see more, do more and learn more in the ICU. And there's more responsibility when you're caring for a patient who is ventilated, on pressors or ino/chronotropes, CRRT, ECMO, etc. Plus, you have 1 or 2 patients and you can devote all your time and energy to them.
Make sure you know what specialty you want to practice in as an NP before you choose a NP track to pursue.

Fair enough. I will probably at least start in Med-Surg to gain some experience and deepen my familiarity with the RN role. My thought for going for FNP is it's versatile. I want to work in a primary care or other non-acute care setting. As deep as I want to go into acute care as an NP would be urgent care. What's your NP gig?

NHGN · Jan 25, 2018

I agree with the above! I did nursing in undergrad with the goal to be a crna, from the get go. Hated anything but the ICU in school. Started in a prominent trauma/SICU as a new grad. I decided I didn't want to go the crna route and started psych np school. Worked as an RN on a psych unit during school to make sure I liked it. That was pretty easy work, but being in the NP role is much more fun.

NEMurse95 · Jan 25, 2018

I agree with the above! I did nursing in undergrad with the goal to be a crna, from the get go. Hated anything but the ICU in school. Started in a prominent trauma/SICU as a new grad. I decided I didn't want to go the crna route and started psych np school. Worked as an RN on a psych unit during school to make sure I liked it. That was pretty easy work, but being in the NP role is much more fun.

Interesting. I've noticed a lot of my classmates have CRNA aspirations. I've floated the idea in my head, but I don't think I would truly enjoy it. The idea of primary care is much more enticing to me. I've also thought about starting in psych (because there are multiple openings at a local psych center), but I'm afraid not having that acute care experience will hurt my chances of getting into NP school. Do you mind telling me a bit more about your role as a psych NP?

djmatte, ADN, MSN, RN, NP · Jan 25, 2018

Hello all. I'm currently in my last semester as an RN student. I went into nursing with the idea that I want to be an NP in a primary care office or maybe urgent care. I LOVE learning about diseases and LOVE learning about medications. I work in a pharmacy now and am obsessed with learning new meds and knowing the pharmacological action of them.
My concern is, I truly truly do NOT like my exposure to the RN role right now. I've been mostly on med surg, but I do not like doing these assigned tasks like trach care, wound dressings, etc. I feel like there are too many tasks and too many patients to really focus on one and get to understand their individual situation. I'm very discouraged right now, so I'm wondering if there's anyone out there who did not like their experience as an RN but love their job as an NP. Thank you so much for taking the time to read this and respond.

I think you need to recognize the roles that people have and while you may *want* to get into the nitty gritty of an individual's situation, it often isn't the role an RN has. The various types of care we provide isn't just a list of tasks. They are vital parts of patient assessment that if not performed optimally with a trained eye it could be the difference between a patient going septic or improving their outcomes. There are some tasks we delegate that can easily be handled by unlicensed staff or LPNs, but there are others that require our assessment skills. Seeing that wound go from red to pink, or red to purulent will make big changes in how that patient gets treated. Changing that bedding and noticing his/her BMs have a particularly foul odor may be the difference of an appropriate antibiotic getting started.

Another thing to consider is these are very personal situations you are engaging in with your patients and a really good opportunity to get to know them, understand where they came from, and really develop a situation that allows you to become their advocate. You see their family dynamics, are often the first to report a change in their status, and you develop a real understanding of a patient's clinical situation hits them personally. I've just saw today a patient who turned a complete 180 because his nursing staff wasn't adequately assessing him overnight. An MD is in and out of that room in 5 minutes, often only once per day. So in many aspects, you are their life-line.

I remember being in nursing school and thinking how ridiculous nursing diagnoses were. I felt they were an added step that didn't have value in the grand scheme of things. MDs didn't respect (or understand) them and I needed whole books to read through and translate what I was seeing into what they were asking for. It wasn't until I was actively working where I realized they gave a framework on how to effectively prioritize and perform a nurses role. You aren't there to save that patient. You are there to provide them the appropriate conditions to which they will heal so that provider treatments can be most effective. Be it ensuring their trach is cleaned effectively, their wounds are appropriately dressed to best heal, and their support structure when they are really down in the dumps. Sometimes you may even be the best thing for them as you see that bed sore start to show and you know per protocol to get some form of padded dressing over it's place or to get them moving in bed. I had 3 colleagues throw a bunch of drugs at a patient in pain and not a single one considered ice for at least some topical analgesia which ended up helping significantly. These are the simple but effective things nurses are there to implement where MDs might be over preoccupied with their overall census.

In reality as a student, you really haven't been too exposed to an RN role. You are learning the tasks for skills you will someday master and maybe put the puzzle together. You to some degree are operating about to the level of a CNA...which is expected for a student. If you move to advance practice, understanding these delineations of roles may make you a better provider as you learn to recognize the process. Many MDs aren't fans of nursing processes because there is a lot of policies and procedures behind them. But those will save a nurse's license and understanding the *why* of nursing procedure is one of the best things you will learn when you are in the real world.

NEMurse95 · Jan 25, 2018

I think you need to recognize the roles that people have and while you may *want* to get into the nitty gritty of an individual's situation, it often isn't the role an RN has. The various types of care we provide isn't just a list of tasks. They are vital parts of patient assessment that if not performed optimally with a trained eye it could be the difference between a patient going septic or improving their outcomes. There are some tasks we delegate that can easily be handled by unlicensed staff or LPNs, but there are others that require our assessment skills. Seeing that wound go from red to pink, or red to purulent will make big changes in how that patient gets treated. Changing that bedding and noticing his/her BMs have a particularly foul odor may be the difference of an appropriate antibiotic getting started.
Another thing to consider is these are very personal situations you are engaging in with your patients and a really good opportunity to get to know them, understand where they came from, and really develop a situation that allows you to become their advocate. You see their family dynamics, are often the first to report a change in their status, and you develop a real understanding of a patient's clinical situation hits them personally. I've just saw today a patient who turned a complete 180 because his nursing staff wasn't adequately assessing him overnight. An MD is in and out of that room in 5 minutes, often only once per day. So in many aspects, you are their life-line.
I remember being in nursing school and thinking how ridiculous nursing diagnoses were. I felt they were an added step that didn't have value in the grand scheme of things. MDs didn't respect (or understand) them and I needed whole books to read through and translate what I was seeing into what they were asking for. It wasn't until I was actively working where I realized they gave a framework on how to effectively prioritize and perform a nurses role. You aren't there to save that patient. You are there to provide them the appropriate conditions to which they will heal so that provider treatments can be most effective. Be it ensuring their trach is cleaned effectively, their wounds are appropriately dressed to best heal, and their support structure when they are really down in the dumps. Sometimes you may even be the best thing for them as you see that bed sore start to show and you know per protocol to get some form of padded dressing over it's place or to get them moving in bed. I had 3 colleagues throw a bunch of drugs at a patient in pain and not a single one considered ice for at least some topical analgesia which ended up helping significantly. These are the simple but effective things nurses are there to implement where MDs might be over preoccupied with their overall census.
In reality as a student, you really haven't been too exposed to an RN role. You are learning the tasks for skills you will someday master and maybe put the puzzle together. You to some degree are operating about to the level of a CNA...which is expected for a student. If you move to advance practice, understanding these delineations of roles may make you a better provider as you learn to recognize the process. Many MDs aren't fans of nursing processes because there is a lot of policies and procedures behind them. But those will save a nurse's license and understanding the *why* of nursing procedure is one of the best things you will learn when you are in the real world.

Thanks for the thorough reply. I didn't mean to say anything negative whatsoever about the RN role other than that I think I could better utilize my skills and interests in an NP role. Since starting nursing school, I have NEVER doubted the importance of RN's. The things they (soon, we) are responsible for recognizing, assessing, and reporting are often the difference between life and death for a patient. I have a deep respect for the profession and I intend to make the most of my time in the role and do good by my patients. This post was mostly just to get some reassurance that it's rational to still look forward to the NP role if I'm not in love with the RN role. Different strokes for different folks.

djmatte, ADN, MSN, RN, NP · Jan 25, 2018

Thanks for the thorough reply. I didn't mean to say anything negative whatsoever about the RN role other than that I think I could better utilize my skills and interests in an NP role. Since starting nursing school, I have NEVER doubted the importance of RN's. The things they (soon, we) are responsible for recognizing, assessing, and reporting are often the difference between life and death for a patient. I have a deep respect for the profession and I intend to make the most of my time in the role and do good by my patients. This post was mostly just to get some reassurance that it's rational to still look forward to the NP role if I'm not in love with the RN role. Different strokes for different folks.

Perfectly rational. And I didn't see your post as negative. :) I simply wanted to make a point about our roles and while they can appear tedious to a newer nurse they are some of the best things we do.

What is frustrating from a student perspective (and sometimes a nursing perspective) is just how much things there are to do and the time you think you should be spending understanding a patient's situation just isn't there. But what you do eventually is just become more efficient at performing those tasks and that starts to open up time for your patients. You will also learn as you get into more advance roles is the time to understand a patient doesn't really improve. You only get a handful of minutes with a patient every few months to years and in this case your tasks just become a different complexity and in many circumstances even more detrimental to patient outcomes.

BioNerd19 · Jan 25, 2018

Ive searched and noticed that low GPAs = bad school but besides that what are some things i can look for, for bad nursing programs

I have heard of some 2-3 year regular pace BSN programs and obviously the online programs that have made me suspicious considering the regular pace takes 4 years no exceptions at other programs

I am interested in ABSN (older age, second degree) to DNP so looking for all programs possible that would eliminate me from having to apply to different DNP programs after my BSN is completed

Oldmahubbard · Jan 25, 2018

In the end, all in all, I did not like the RN role, although I did it for 13 years. Hospital nursing was definitely not for me, way too much bullying, short staffing, evening and night shift work and stress.

I had some traumatic experiences, ie bullying, and had to seek therapy and medication as a result, which I have mentioned in previous posts.

I ended up in home care, which I enjoyed to an extent for nearly 5 years, until we got a new supervisor who had paranoid personality disorder.

After I started my Psych NP program, I found a position which was my favorite, working in an Assisted Living program that consisted of mostly mentally ill adults. My role was "RN coordinator", and I did a little of everything, loved getting to know the residents and identifying their health needs.

Unfortunately, I was replaced by an LPN.

As long as you have RN after your name in this area, you can get something, but most of it is not very good.

Being an NP has had a couple of ups and downs, but many more ups, and eventually, quite a bit more money.

I love the NP role! RN's do not get any respect, and don't even respect each other.

When I hear about folks doing "direct entry" now, I must admit I feel a little jealous, because I went through 13 years of what was essentially a pile of crap.