DNP-NNP How Do You Know If You're Ready?

Hoosier_RN, MSN · Feb 10, 2020

At 10 years, you either know your stuff, or you don't. I say go for it!!!

babyNP., APRN · Feb 10, 2020

What is your RN NICU background? As long as you have a decent amount of Level III/IV, you should be able to be okay. You don't need to be a "rockstar" per say. There were plenty of older nurses who could run around me when I went back to school at 4 years experience. Don't worry about your physical nursing skills- this is a huge misnomer in the NICU world. Doctors and PAs don't come to the NICU knowing how to do IVs and it's not part of your job to put in IVs. Sure if you're at a little level 2 where they can't get an IV they may ask you, but if you can't get it, you would just put in a UVC and call it a day and ship out. Even if it goes in the liver you can just use it as a low-lying and again, ship it out. Anyone can get a low lying UV. It's like putting in an NGT.

I myself have probably only put in 1-2 dozen IVs in my entire career, 6 years as RN, 4 as a NNP. This is mostly because my RN background was a children's hospital where most the kids had a central line and many of the chronics had junky veins that the culture was "don't stick the one good vein!" I admit that I felt very sensitive about this kind of thing and wondering if I could possibly be a good NNP with this lack of experience, but it turned out to be a completely ridiculous notion. There are some NNPs put in PICC lines but often times there is a dedicated RN PICC team that does this kind of thing to keep things uniform about insertion, infection control, etc. One place I worked at they would not allow to deign a NNP to join their team, lol, without an extensive amount of effort.

If you think you want to, then just do it. Many times in life you have lots of self-doubt and you are going to do just fine because we tend to sell ourselves short. The sooner the better- there are many RNs who have trouble transitioning to a provider mindset after being at the bedside for too long. I have seen more successful NNPs with 5 years RN experience than those with 20 years. Like with anything there are not so good NNPs with 5 years experience and awesome NNPs with 20 years RN experience and your mileage may vary. But it is a trend I have noticed having worked at several NICUs.

Another consideration is your salary. Depending on where you live you will hopefully make more starting out. But if you wait much longer you may only break even or even take a pay cut as one my colleagues did due to her extensive RN experience. From a financial perspective- better to do it as soon as you can. I went from making $75k as a RN to about $95k as a new grad and now make $160k base salary (although tbf in a bit of a higher COL area although nothing crazy like the bay area)

Keep us posted on what you decide to do and let me know if you have any questions. I have a few resources for aspiring NNPs that you can PM me if you would like to know more.

chi_rn23 · Feb 11, 2020

7 hours ago, babyNP. said:
What is your RN NICU background? As long as you have a decent amount of Level III/IV, you should be able to be okay. You don't need to be a "rockstar" per say. There were plenty of older nurses who could run around me when I went back to school at 4 years experience. Don't worry about your physical nursing skills- this is a huge misnomer in the NICU world. Doctors and PAs don't come to the NICU knowing how to do IVs and it's not part of your job to put in IVs. Sure if you're at a little level 2 where they can't get an IV they may ask you, but if you can't get it, you would just put in a UVC and call it a day and ship out. Even if it goes in the liver you can just use it as a low-lying and again, ship it out. Anyone can get a low lying UV. It's like putting in an NGT.
I myself have probably only put in 1-2 dozen IVs in my entire career, 6 years as RN, 4 as a NNP. This is mostly because my RN background was a children's hospital where most the kids had a central line and many of the chronics had junky veins that the culture was "don't stick the one good vein!" I admit that I felt very sensitive about this kind of thing and wondering if I could possibly be a good NNP with this lack of experience, but it turned out to be a completely ridiculous notion. There are some NNPs put in PICC lines but often times there is a dedicated RN PICC team that does this kind of thing to keep things uniform about insertion, infection control, etc. One place I worked at they would not allow to deign a NNP to join their team, lol, without an extensive amount of effort.
If you think you want to, then just do it. Many times in life you have lots of self-doubt and you are going to do just fine because we tend to sell ourselves short. The sooner the better- there are many RNs who have trouble transitioning to a provider mindset after being at the bedside for too long. I have seen more successful NNPs with 5 years RN experience than those with 20 years. Like with anything there are not so good NNPs with 5 years experience and awesome NNPs with 20 years RN experience and your mileage may vary. But it is a trend I have noticed having worked at several NICUs.
Another consideration is your salary. Depending on where you live you will hopefully make more starting out. But if you wait much longer you may only break even or even take a pay cut as one my colleagues did due to her extensive RN experience. From a financial perspective- better to do it as soon as you can. I went from making $75k as a RN to about $95k as a new grad and now make $160k base salary (although tbf in a bit of a higher COL area although nothing crazy like the bay area)
Keep us posted on what you decide to do and let me know if you have any questions. I have a few resources for aspiring NNPs that you can PM me if you would like to know more.

Thank you for providing your insight on this! I'm a NICU RN with 5 years of experience in a big city in a couple Level III & IV NICUs, and I have just a little over a year left in my DNP-NNP program. I have so much self-doubt about the whole thing because, like the OP mentioned, I'm certainly no "rockstar" in my crazy, chaotic unit but feel like I have a good and comfortable grasp on how things go. I've debated whether getting more experience at the bedside would be useful compared to what you have said, and what my gut tells me, that I should jump in before the transition is more difficult. What you've said has helped to ease the doubt in my mind (even if just a little) that I am going through this at the right time in my career!

babyNP., APRN · Feb 12, 2020

23 hours ago, chi_nnp23 said:
Thank you for providing your insight on this! I'm a NICU RN with 5 years of experience in a big city in a couple Level III & IV NICUs, and I have just a little over a year left in my DNP-NNP program. I have so much self-doubt about the whole thing because, like the OP mentioned, I'm certainly no "rockstar" in my crazy, chaotic unit but feel like I have a good and comfortable grasp on how things go. I've debated whether getting more experience at the bedside would be useful compared to what you have said, and what my gut tells me, that I should jump in before the transition is more difficult. What you've said has helped to ease the doubt in my mind (even if just a little) that I am going through this at the right time in my career!

glad to be of some help. Just fyi, if you are not a NNP yet, you should probably edit your user name. It's against terms of service to have titles you haven't gotten yet, like a nursing student calling themselves RN. But hey, change it back in a year ?