Fired as NP, Should I Go Back to an RN Job?

[Nurse Beth, MSN]

Dear Nurse Beth,

I graduated as a women's health nurse practitioner in 2011. I worked for 6 years with one company as an NP, then went to another and got fired after 2 months. I am considering going back as an RN instead. The concern is that I have never worked as an RN before. I always wanted to be a postpartum or labor and delivery nurse. Two other RNs that I worked with told me that I can't do it and would have to go back to school in order to work as a hospital nurse. Is this true? Any thoughts as far as how I could transition over to an RN position?

Dear Transition,

While RN licensure is a prerequisite to APRN licensure/ authorization, RN experience is not always required for NP school.

To work as an RN, you have to hold current RN licensure. Some states require simultaneous APRN and RN licensure, but not all. Some states also have minimum practice and educational requirements for renewal, but these vary widely from state to state.

Regulatory wise, if you have an RN license, you can work as an RN.

Many APRNs do work as RNs, and the biggest challenge for you will be lack of experience and a perception by employers that you may be over qualified for a clinical bedside position. You would need a supportive and flexible orientation since you never worked as an RN. Technically, you may qualify for a residency but with your background as an NP, it's not likely to land a residency position.

If you do work as an RN, role clarification will be highly important, as you cannot practice outside of your RN scope. You could be held to the assessment skills of an NP, though, for instance in an emergency delivery or situation. Be sure and keep up your insurance coverage.

Are you sure about your decision? Could this be a reaction to being fired? You successfully held an NP job for 6 years, so being fired as an NP doesn't define you. You mention you've always wanted to work postpartum or L&D, and these are very different areas with different skill sets. Starting over as an RN poses a whole new set of challenges.

Best wishes in your decision,

Nurse Beth

Author, "Your Last Nursing Class: How to Land Your First Nursing Job"...and your next!