Do you feel more people are entering nursing only to become APRN's?

[BiscuitStripes]

I am not a nurse yet, but I'm an EMT, have worked in and around the hospital, and I am currently finishing my last two prerequisite courses before applying for ABSN programs. It seems like 90% of my current classmates in nursing prerequisite courses, along with other prospective nurses I've worked with, are entering the nursing profession with the goal of become a Nurse Practitioner or CRNA.

Do you, especially those already working as nurses, feel a lot of new graduate nurses are entering nursing for the sole purpose of becoming an APRN? I feel like since APRN's are gaining more popularity, people are entering the nursing field to become an APRN and not a "nurse", in lieu of becoming an MD/DO or PA. I'm not saying more education is bad, but it seems like people want to be an NP, not a nurse, if that makes sense. Which leads me to believe (and I know it's been discussed before) a huge over saturation of APRN's is in the near future.

Thoughts? Again, I'm not a nurse yet, so I could be completely off base.

[KatieMI, BSN, MSN, RN]

I'm in the Midwest and we have the same trend. Many have difficulty finding available preceptors. Plus, with the ease at which some can obtain advanced degrees without much hands on experience, has been off putting for some.

I have no interest in it personally as a recent new grad, heck I'm irritated that I have to get a BSN when my associates suits me just fine.

Unfortunately, the useful skills learned at bedside nowadays often have very little to do with what is required on provider's level. When you run for 12 hours documenting, doing tasks supposed to be done by everybody else and "providing excellent customer service" instead of assessing, analyzing and thinking critically, it may look like you're doing great job as a bedside RN, but it reality it pushes you down, not up.

[KatieMI, BSN, MSN, RN]

Nursing is often a backup plan for people who don't make it into med school, and advance practice is the alternative.

Also for those who are smart enough to calculate that doing 3 years accelerated BSN with prereqs right after high school, 2 years in ICU and then CRNA school will put mean potential earnings within the next 25 years WELL above ones for a general internist MD, with less liability risks and overall better lifestyle.

[KatieMI, BSN, MSN, RN]

Yep. That is what I am seeing. Most of the students and new grads that I work with are using their BSN's and hospital staff nursing jobs as quick stepping stones to a grad school for an APRN role. It's contributing to my hospital's turnover problem and making us question whether we really want to hire the "best and the brightest" new grads anymore -- because most of them have no intention of doing hospital nursing for more than 1-3 years.

Maybe if you treat new grads better and openly recognize the benefits of having the "best and brightest" new nurses and the potential they bring for your agency, then at least some of them would stay longer.

In my MSN class with mean composit GPA 3,89 90+% of students either experienced workplace layeral violence or reported witnessing it toward others. These are your "best and brightest". Does it seem surprising if they are fleeing bedside?

[Nurse Beth, MSN]

It seems clinical bedside nursing practice is becoming the domain of new grad nurses and nurses with 2-3 yrs experience.

[BostonFNP, APRN]

One way to look at this is to consider the numbers:

By graduates/education:

The number of NP graduates between 2010-2013 is about 52,000.

The number of RN graduates between 2010-2013 is about 144,000.

The number of NP graduates in 2010 was 11,000 and in 2015 it was 20,000.

By workforce data:

In 2011 there were about 100,000 NPs and that increased to 128,000 in 2014, a 28% increase over 4 years.

Between 2003 and 2014 the total number of nurses in the workforce increased from 2.44million to 3.04million, a 24% increase over 12 years.

It shows that the number of NPs is increasing exponentially but the number of NPs compared to the number of RNs remains a small fraction of the total RN workforce.

[KatieMI, BSN, MSN, RN]

One way to look at this is to consider the numbers:

By graduates/education:

The number of NP graduates between 2010-2013 is about 52,000.

The number of RN graduates between 2010-2013 is about 144,000.

The number of NP graduates in 2010 was 11,000 and in 2015 it was 20,000.

By workforce data:

In 2011 there were about 100,000 NPs and that increased to 128,000 in 2014, a 28% increase over 4 years.

Between 2003 and 2014 the total number of nurses in the workforce increased from 2.44million to 3.04million, a 24% increase over 12 years.

And:

By 2025, between 14,900 and 35,600 primary care physicians. Non-primary care specialties are expected to experience a shortfall of between 37,400 and 60,300 physicians.

New Research Confirms Looming Physician Shortage - News Releases - Newsroom - AAMC

These according to bare-to-bones norms, NOT what is considered to be "optimal". And there are absolutely no tools except for moral encouragement to perpetuate new US medical school grads consider first 4 (yep... they now made it four years) years of slaving out 80+ hours/week in FM residency and then live in the middle of nowhere and paying $200000 or more of debths off $125000/year or less income minus Liability Insurance, office management and everything else.

And now we're having an administration which seems to set hard onto restricting access to US residency training for foreign trained physicians who would consider low prestige residencies and jobs in exchange on green card.

It was a topic a while ago about what sort of medical care Boomers are going to have... food for thoughts.

[llg, PhD, RN]

Maybe if you treat new grads better and openly recognize the benefits of having the "best and brightest" new nurses and the potential they bring for your agency, then at least some of them would stay longer.

In my MSN class with mean composit GPA 3,89 90+% of students either experienced workplace layeral violence or reported witnessing it toward others. These are your "best and brightest". Does it seem surprising if they are fleeing bedside?

Sorry, Katie, but you missed my point. This has nothing/little to do with how we treat them. They have no intention of working in a hospital even before they enter school. I've talked with high school students who tell me their plan is to get "1 year of experience in a hospital" and then go to grad school and do ....

Even when we treat such people well, it doesn't change their underlying motivation and plans. As a profession, we need to map out different career paths for such people to avoid wasting the resources they consume during that mandatory 1-2 years of hospital experience.

We need to preserve those resources for the people who are interested in hospital-based careers. And we need to present attractive images of hospital-based careers (at all levels) so that students can see them and include them in their consideration of their choices. Many nursing school faculty invest a lot of time and energy recruiting students into the APRN graduate programs and academic careers. Because those faculty members have not spent a lot of time in hospital-based roles themselves, they don't always know much about those types of careers.

This is one realm in which the infamous nursing "practice - academia split" hurts the profession as the practice environments and academic environments don't always work well together. Students graduate unprepared to succeed in the world of practice and end up running away to alternative careers because of their lack of preparation.

[Ruby Vee, BSN]

I'm in Southern California and have noticed the same thing. It seems like every new grad goes straight to NP school, as at the very least, aspires to. CRNA seems like a loftier goal ...don't hear people talk about that much except for on this site. I have wondered where they're all going to end up working. It doesn't seem like there's that much of a demand.

I agree -- almost every single new grad we've had over the past ten years either aspires to be an NP or is only in our CVICU for the minimum possible time to get accepted into anesthesia school. A few of them don't even make it off orientation before they're giving notice that they've been accepted to CRNA school. Not only is this likely to be problematic for the future of nursing AND Advance Practice Nursing, it's a problem NOW. All of these future NPs and CRNAs aren't really interested in the job they've been hired to do right now, and the patients get short shrift. Preceptors are worn out from CONSTANTLY precepting new grads who have no interest in our patients. Colleagues are worn out from and ever-changing sea of new grads who aren't interested in the long-term and seem to be only interested in getting through their shifts with the minimum possible "disruptions" by patients. Worse, these new grads seem to look down on us, the senior nurses who could show them/teach them/help them to become competent nurses.

After being repeatedly disrespected by a youngster who told me she was better than me because she had a Master's (this was an NP who had NO experience at the bedside and was being precepted at the bedside because she had demonstrated a shocking lack of basic knowledge about nursing care, how a nursing care unit functions and the basic job descriptions of the members of the health care team), I told her that if having a Master's was the criteria, she wasn't better than me, she wasn't even as good as. "I have a Master's AND a few decades of experience." Cue the tears and the running to management complaining of being bullied!

[Ruby Vee, BSN]

Maybe if you treat new grads better and openly recognize the benefits of having the "best and brightest" new nurses and the potential they bring for your agency, then at least some of them would stay longer.

In my MSN class with mean composit GPA 3,89 90+% of students either experienced workplace layeral violence or reported witnessing it toward others. These are your "best and brightest". Does it seem surprising if they are fleeing bedside?

Believe me, it has nothing to do with treating new grads better. These folks are boasting that they're applying to an NP program or only looking for ICU experience to get into anesthesia school before they've spent even a single day on the unit.

[Ruby Vee, BSN]

Sorry, Katie, but you missed my point. This has nothing/little to do with how we treat them. They have no intention of working in a hospital even before they enter school. I've talked with high school students who tell me their plan is to get "1 year of experience in a hospital" and then go to grad school and do ....

Even when we treat such people well, it doesn't change their underlying motivation and plans. As a profession, we need to map out different career paths for such people to avoid wasting the resources they consume during that mandatory 1-2 years of hospital experience.

We need to preserve those resources for the people who are interested in hospital-based careers. And we need to present attractive images of hospital-based careers (at all levels) so that students can see them and include them in their consideration of their choices. Many nursing school faculty invest a lot of time and energy recruiting students into the APRN graduate programs and academic careers. Because those faculty members have not spent a lot of time in hospital-based roles themselves, they don't always know much about those types of careers.

This is one realm in which the infamous nursing "practice - academia split" hurts the profession as the practice environments and academic environments don't always work well together. Students graduate unprepared to succeed in the world of practice and end up running away to alternative careers because of their lack of preparation.

I wish I could like this a few dozen times.

I completely agree with your ideas that we need to cease wasting resources on those folks who have no interest in actual patient care so that we can invest them in the rare new grads who actually ARE interested.

[WestCoastSunRN, MSN, CNS]

Sorry, Katie, but you missed my point. This has nothing/little to do with how we treat them. They have no intention of working in a hospital even before they enter school. I've talked with high school students who tell me their plan is to get "1 year of experience in a hospital" and then go to grad school and do ....

Even when we treat such people well, it doesn't change their underlying motivation and plans. As a profession, we need to map out different career paths for such people to avoid wasting the resources they consume during that mandatory 1-2 years of hospital experience.

We need to preserve those resources for the people who are interested in hospital-based careers. And we need to present attractive images of hospital-based careers (at all levels) so that students can see them and include them in their consideration of their choices. Many nursing school faculty invest a lot of time and energy recruiting students into the APRN graduate programs and academic careers. Because those faculty members have not spent a lot of time in hospital-based roles themselves, they don't always know much about those types of careers.

This is one realm in which the infamous nursing "practice - academia split" hurts the profession as the practice environments and academic environments don't always work well together. Students graduate unprepared to succeed in the world of practice and end up running away to alternative careers because of their lack of preparation.

Great post. You hit the nail squarely on the head. And Katie, your calculations of debt vs. earnings support this idea as this is now math people are doing well in advance of nursing school. I'm not in favor of direct entry APN programs (which admittedly is one way to distinguish between career bedside nurses and future APNs education-wise), but I do agree we need a hospital-nursing campaign of sorts to attract smart, compassionate people to take on bedside nursing as a long-term gig.

[BiscuitStripes, BSN, RN]

I wish I could like this a few dozen times.

I completely agree with your ideas that we need to cease wasting resources on those folks who have no interest in actual patient care so that we can invest them in the rare new grads who actually ARE interested.

This thread has had some great responses, I really appreciate everyones input. So from what I'm gathering, many new grad nurses who enter the workforce with the intent of being an APRN aren't the best floor/bedside nurses upon graduation of their RN program because many of them are just looking at working in the hospital as a requirement, stepping stone, or roadblock to becoming an APRN.

Are there new grads out there (whose intent is to be an APRN) that are good new grad floor/bedside nurses who care about nursing and patient care, while simultaneously preparing to enter an APRN program? Or are most of these types of new grads pretty wishy washy and the majority of good, hardworking, caring new grads those who plan on staying an RN bedside nurse for a while?

The way I see things, if you're a new grad and want to become an APRN, why would you not learn everything you possibly could while you're working on the floor, to better serve you as an APRN? Why would you want to put in the bare minimum? You're doing a disservice to you, your patients, and your future patients.