Does everybody want to be a NP?

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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?

There is nothing "mid-level" about (most) NP practice. NPs have comparable if not better outcomes than physicians. They are held to the same quality measures as physicians. They practice collaboratively but independently in most settings. It's simply an archaic term from when NPs were first being given limited prescriptive authority; things have changed drastically since that time, though the AMA still argues for it because it cements in the public's mind that nurses (RNs and NPs) are less than them.

You can take whatever benefit you want from it, but every time you are understaffed and underpaid at work, just think about the hospital paying a physician an extra nurse's salary because they buy into the fact they are higher level than you.

I would never equate an NP with a physician, or think they were comparable in terms of skills and education, because they aren't.

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Specializes in Adult Internal Medicine.
I would never equate an NP with a physician, or think they were comparable in terms of skills and education, because they aren't.

They are comparable in terms of outcomes.

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The national pass rate for the board exams is in the mid-80s depending on the exam, slightly less but similar to the NCLEX. Compared to the USMLE steps in the mid-upper 90s.

Sure the exam could be harder but that's not fixing the real problem, IMHO.

What do you see as THE problem? Is it your 3 points you made? Is it that NPs and PAs are viewed by the public as interchangeable?

I think a harder exam would be a start for what Cola is saying her experience is- that everyone and their mother is going to be an NP.

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Specializes in Neuro ICU and Med Surg.

I am in the process of getting my BSN, and everyone is asking me if I want to be a NP. I haven't decided what I want to be when I grow up. I have had a physician tell me that if I go for my NP he would hire me. I am not sure I see myself in that role. I really don't know. I think the only way I would be a NP is if I worked in the ER (we have NP's in our ER that write orders for the patients once admitted, I would be able to do that) or did acute care rounds with a physician.

I cannot see myself in the office all day.

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They are comparable in terms of outcomes.

Sure, if you look focus on the areas of medicine where NPs can practice.

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I am in the process of getting my BSN, and everyone is asking me if I want to be a NP. I haven't decided what I want to be when I grow up. I have had a physician tell me that if I go for my NP he would hire me. I am not sure I see myself in that role. I really don't know. I think the only way I would be a NP is if I worked in the ER (we have NP's in our ER that write orders for the patients once admitted, I would be able to do that) or did acute care rounds with a physician.

I cannot see myself in the office all day.

I have my BA in Psych and as soon as I said I was going to slowly bridge to BSN, all I heard from docs who knew me was "just get your Masters and be an NP!"

There's no "just" about it, and I don't want to be a Practitioner. I am happy as an RN.

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Specializes in Adult Internal Medicine.
Sure, if you look focus on the areas of medicine where NPs can practice.

Sure why would we try and compare them in areas they can't practice?

Though there is some data from Europe on NP's in surgical/procedural settings where the outcomes are similar....

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Sure why would we try and compare them in areas they can't practice?

Though there is some data from Europe on NP's in surgical/procedural settings where the outcomes are similar....

You can't, but don't try to make it sound like the two professions are fully equivalent.

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The national pass rate for the board exams is in the mid-80s depending on the exam, slightly less but similar to the NCLEX. Compared to the USMLE steps in the mid-upper 90s.

Sure the exam could be harder but that's not fixing the real problem, IMHO.

You can't really compare the 3 USMLE or COMLEX steps to the NP exams. Steps 1 is basic biochem, micro, physio and hard sciences that really isn't touched anywhere in the nursing realm. Step 2 CK/CS (with oral boards and practical testing) is more clinically based but still with a foot in the hard/basic science. Step 3 (where I think you got your high 90s%) which has the highest pass rate is just a capstone which most physicians don't even study for. There was a trial some years ago when NPs trialed an "amended" step 3 and about half failed. I have not taken the NP license exam but from practice books and official practice questions, the content really isn't impressive compared to Step 1/2 practice tests I have tried. These step exam scores (rather than just pass/fail) are also vital for med students and residency matching. NPs just need to pass.

Step 1-8 hours

Step 2-9 hours plus 12 live patients H/P scenarios

Step 3- 16 hours over 2 days

If the nursing regulation bodies are going to do nothing to stop the flood of NP students and programs, a more difficult licensure exam will be needed to filter those who are truly ready to practice. I would even welcome multiple exams.

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Specializes in NICU, Trauma, Oncology.

I feel like it seems like everyone wants to be an NP because we are looking at the microcosm of the nursing world. And I do feel that with the current state of healthcare coupled with the aging population and the decline in family practice MDs coming out of school there will continue to be demand for FNPs. At least that is just my perspective.

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Specializes in Adult Internal Medicine.
You can't, but don't try to make it sound like the two professions are fully equivalent.

Right, they aren't. What they are equivalent in is producing the same outcomes in the same roles. There are many other things very different about NPs and physicians, including thing like more than 50% of NPs choose primary care settings, where there is desperate need for quality providers.

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Specializes in Adult Internal Medicine.
You can't really compare the 3 USMLE or COMLEX steps to the NP exams. Steps 1 is basic biochem, micro, physio and hard sciences that really isn't touched anywhere in the nursing realm. Step 2 CK/CS (with oral boards and practical testing) is more clinically based but still with a foot in the hard/basic science. Step 3 (where I think you got your high 90s%) which has the highest pass rate is just a capstone which most physicians don't even study for. There was a trial some years ago when NPs trialed an "amended" step 3 and about half failed. I have not taken the NP license exam but from practice books and official practice questions, the content really isn't impressive compared to Step 1/2 practice tests I have tried. These step exam scores (rather than just pass/fail) are also vital for med students and residency matching. NPs just need to pass.

Step 1-8 hours

Step 2-9 hours plus 12 live patients H/P scenarios

Step 3- 16 hours over 2 days

If the nursing regulation bodies are going to do nothing to stop the flood of NP students and programs, a more difficult licensure exam will be needed to filter those who are truly ready to practice. I would even welcome multiple exams.

I was not comparing the exams, just the pass rates.

All you have to do is browse the student NP forums to see that lots of graduate NPs fail the board exams, as "easy" as they are. They may be a bit more difficult when you are sitting in front of the screen taking them though too.

Making a more difficult NP credentialing exam could help stop the non-quality programs but at a significant cot to the system. Stopping the accreditation of the programs is much easier and more financially responsible.

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