Does everybody want to be a NP?

Ruby Vee, BSN · Nov 5, 2015

I'm not sure what the intensivist's duties are but the truth is I operate in the same role as a psychiatrist. I absolutely identify with physicians as my peers now. Its my role, what I'm paid for, and I will not be one of these bleeding heart "nurse hybrid NPs" working for peanuts and still doing duties that would be better served by nurses or techs.
While I adore, respect and rely heavily on my RNs, techs and unit secretarys the bottom line is I am an attending.

"My RNs, techs and unit secretaries"? YIKES! I hope the doorways in your facility are all cut extra wide to accomodate your ego!

Jules A, MSN · Nov 5, 2015

"My RNs, techs and unit secretaries"? YIKES! I hope the doorways in your facility are all cut extra wide to accomodate your ego!

No worries it is.

Dogen · Nov 5, 2015

Or it just helps them understand what her job entails. Most families have no idea what an NP is, especially in a hospital setting. She can't say she is the staff RN because she isn't. She's more like the physician if anything.

Yeah, I do this all the time. When some people hear nurse practitioner they think that means nurse, and assume you're there to get their vitals. So, for people who need a brief explanation for whatever reason, I say we do things like a psychiatrist would do for them. Sometimes I throw on, "but a little differently."

allnurses Guide · Nov 5, 2015

I think some of this highlights one of the biggest challenges for NPs, one that has been demonstrated in the literature: role confusion. It is a major barrier to novice NP role socialization. I think that many NPs don't understand it until they have been in practice more than a year, and very few RNs understand it.

NPs are pulled in two different directions. Novice NPs need to learn to socialize into a role as a provider. This is the role the job demands so it has to happen. That socialization is challenged by the novice provider's ties to their nursing pedigree and it can be exacerbated by RNs, that in some ways try to pull novice NPs back towards the RN role. The novice NP has to, at some point in their socialization, make a break in their ties to their past role. This break can be fluid and smooth or it can be violent, with the latter ending up inspiring posts like the OP, who clearly has been at odds with an NP.

I think of it like siblings when one is "left in charge": one needs to set the rules and the other doesn't like it too much, but it needs to happen in the end. Some are better at it and some are not, on both sides.

Early in my career as an NP I had my breaking moment, and I am not sure I handled it well at the time, but since I have gone back and made my amends. I am sorry it happened the way it did, but I needed it to happen.

brandy1017, ASN, RN · Nov 5, 2015

Or... should I say does every NP think all nurses want to be NPs?! In my experience, that's how they act. Even when I'm being seen as a patient, the NP is hurried, and seriously has an air like "yeah, bet you wish you were an NP". Even the nurses who are just in NP SCHOOL say things like 'yeah, I'm going to get my REAL education so that I can be a REAL professional/get a REAL job.' So rude!
Is being an NP really that much better than say having an MBA? Or being a PT? Or a registered dietician? I don't even think we should compare NP with floor nurse, because a typical floor nurse will not have an advanced degree. Am I wrong?

I think you are being too sensitive, why take any comments so seriously. I think an NP is a superior job to floor nursing because you have advanced education, responsibility, authority and pay and aren't subjected to the wear and tear on your body and get to use your brain and not your body and don't have to be the CNA and HUC, etc!

That said I'm not willing to go back to school and take out student loans to become an NP at my age. I've spent too many years with the student loan monkey on my back to go backwards! I'm saving money for retirement and paying off my mortgage so I won't have to work till I die! lol

But I'm all for others going on and getting their NP. Good for them! Floor nursing is overrated and can be brutal especially on your back! I find it ironic the push to call floor nurses professionals when really I feel we are more like educated blue collar workers. That is what the nurses mean when they say they will finally be a professional to be able to wear nice clothes, stay clean and not due to rough and tough and dirty work.

nursling> · Nov 6, 2015

I have not seen this in the area where I work. What I have seen as a new grad at my first job is: many people just love to toot their own horn! Yes, we nurses are great and some have so much knowledge tucked in their brain that they are like 'superhuman" or something. I respect you and I am happy for you and can't wait until I reach that stage in my career.

However, that holier than thou attitude is no help to a new nurse trying to absorb as much info as possible during orientation. So please be kind and just a little more patient and remember back to when you were a new nurse.

adamRn79, BSN, RN · Nov 6, 2015

You sound jealous of NP students

applesxoranges, BSN, RN · Nov 6, 2015

Psh, we know everyone wants to be ER/ICU/surgical/OB/school/flight RN anyway.

I think the majority of people are chasing a dream.

nursling> · Nov 6, 2015

Don't be confused WKShadowRN. It was 3am and I got a little off subject.

Sunni4198 · Nov 6, 2015

I am a Hospice Nurse and I don't know what I would do without the NP's at the doctors' offices. They call us back and I can get to them faster than I can get to the doctors and get orders more quickly. I know they are very very busy in their own role there and I am greatful that they are there.

ixchel · Nov 6, 2015

Granted it is n=1 but by the time I graduate I will have 16. My program (BSN to DNP, a whole other can of worms) doesn't take anyone with less than 3 years of bedside experience.
Most people I work with don't even know I'm in school because I don't go around shoving it in anyone's face. If NP students aren't answering their call bells at work because they're doing school work, that needs to be dealt with as a workplace disciplinary issue and not used to swipe NPs or NP students in general.

Mine allows direct entry, and is DNP only. I'll start in the fall at 2 years of experience. I've requested part time options. Full time would be 4 years. Part time I would aim for 5-6. So I'm looking at 6-8 years at the bedside before graduating.

The thing that saddens me about direct entry is the realization that a fresh BSN grad has absolutely no clue what they don't know. Those of you who didn't go direct entry knows exactly what I mean.

In my personal opinion, the NP with bedside experience in the specialty they want as an NP (even those without experience in their specialty) have a HUGE leg up over PAs. Maybe not forever, if the PA takes the time to learn what they missed out on not being at the bedside, but those who do not never gain that knowledge. Even MD residency will give some of that to the new MDs.

And in my personal experience, I have yet to meet a PA who actually listened well and trusted my own report of symptoms over their own textbook knowledge. In nursing, we learn to listen to what patients report. If a patient says we're not getting something right, we know that's worth hearing. What a hugely needed skill for PAs, MDs, and NPs. Even if the patient ends up being wrong, in my limited experience, more often than not, they do end up being right.

I know this isn't the PA vs. NP thread, but I am really bad at staying on topic. lol

Dranger · Nov 6, 2015

Mine allows direct entry, and is DNP only. I'll start in the fall at 2 years of experience. I've requested part time options. Full time would be 4 years. Part time I would aim for 5-6. So I'm looking at 6-8 years at the bedside before graduating.
The thing that saddens me about direct entry is the realization that a fresh BSN grad has absolutely no clue what they don't know. Those of you who didn't go direct entry knows exactly what I mean.
In my personal opinion, the NP with bedside experience in the specialty they want as an NP (even those without experience in their specialty) have a HUGE leg up over PAs. Maybe not forever, if the PA takes the time to learn what they missed out on not being at the bedside, but those who do not never gain that knowledge. Even MD residency will give some of that to the new MDs.
And in my personal experience, I have yet to meet a PA who actually listened well and trusted my own report of symptoms over their own textbook knowledge. In nursing, we learn to listen to what patients report. If a patient says we're not getting something right, we know that's worth hearing. What a hugely needed skill for PAs, MDs, and NPs. Even if the patient ends up being wrong, in my limited experience, more often than not, they do end up being right.
I know this isn't the PA vs. NP thread, but I am really bad at staying on topic. lol

I think direct entry can be a good option for a select few. By select few I don't mean that one nurse who just graduated and would be mediocre at her first RN job. I am talking about the gunners who could easily make it into med or PA school. The types of students who are smart and come from a hard science background, those are the types of NPs we need. Perhaps they didn't want to commit to 8 years plus of medical education so NP was the next best option, these kind of students are usually thoughtful, bright and go-getters.

I have seen people argue ad nasueum that nurses or NPs have this monopoly on two way communication or reflective listneing. It just simply isn't true. I have met tons of PAs or MDs who are just as good or better.