Glut of NPs in coming years?

guest769224 · Apr 25, 2015

There is good and bad to the swelling number of NP grads.

Mind elaborating?

Jules A, MSN · Apr 25, 2015

One positive is the more NPs in the work force the more powerful our NP organizations will become and the more people will become familiar with our roles and abilities which will likely result in increasing opportunities to work to our full scope.

My biggest concern as I added above is that there will be a significant number of sub par providers due to inexperience and poor education. As someone who has been the first NP on the behavioral health unit at 3 hospitals I can say the microscope is turned up. The physicians I work with expect me to know what I'm doing and pull my weight. One recently said one of the things he likes about me is that I'm not like many of the bleeding heart NPs who wear frumpy dresses and knee highs with their sandals. I guess the good news is now that we are graduating so many with no experience who are barely 19 years old we won't automatically be considered a profession of dowdy old women. :)

Dranger · Apr 25, 2015

The only problem I see is that admission criteria is far too relaxed. In my opinion you should have a certain number of clinical experience hours (several years worth) to even be considered. All of the schooling in the world doesn't replace actual hand on experience. I want a practitioner who has assessment skills and book smarts...not just the latter of the two. Aside from that I think it's great that people are becoming NPs. Do it before DNP is mandatory. If you do nursing or NP for the money then you are doing it for the wrong reason.

I agree. Just in my own social media circle I have many former classmates, who I thought were sub-par RN students to begin with, getting into NP school right and left with little more than a year of med surg or clinic experience. Sorry, but if you suck in RN school I don't think grad school is going to fix the underlying problem.

CraigB-RN, MSN, RN · Apr 25, 2015

I agree there will be a glut. In some places there is. One of the issues is RN's seem to go to NP school and expect to find jobs where they live. Unlike MD and PA's who expect to move somewhere else for a job. In certain area's you can't find a job (or at least the job you want) as an NP. I walked down the hallway of the SICU at an east coast hospital and of the 12 nurses who were working, 8 of them were ACNP's who were looking for jobs still.

I agree that to many RN's are going into NP programs, because they don't like bedside nursing, or they think it will be an "easy" MSN" where they won't need to do the nursing theory stuff.

Psychcns · Apr 25, 2015

NP is an attractive career option- regular hours, autonomy etc

RN is shift work, team work, chain of command, holidays.

It's often said they are two different jobs.

When I got my BSN the NP was new and it was expected to do hospital work first. Now, I can see people wanting to do direct entry or add on a couple more years to be an NP and it is one field where there are jobs.

PG2018 · Apr 25, 2015

I think we will see a continued growth, and then...problems, and they're economic.

In 2010, I had a really nice managerial position with A LOT of perks, and I made the decision to enter healthcare. After examining medical school, dental school (a quick out because I'm not a hands on guy), pharmacy school, etc. I decided becoming a PA would be optimal. In the right clinics, the salary is excellent, and the educational pathway was appealing to me. In the end, I decided not to move anywhere BECAUSE I could become a NP from the comfort of my own home, and upon learning that NPs and PAs are often used interchangeably the pragmatist in me chose NP. Of course, I had to become a RN, which I really had no interest in doing, but nurse school (during which I worked full-time with flex hours) made me realize that I didn't like ANY hands on patient care. A physical exam is fine, but beyond that I don't like procedures, clean up, etc. My focus then became pathophysiology, pharmacology, health assessment, and mental health although the physical health was interesting as well - just the hands on was not.

I graduated, passed the licensing exam, and immediately enrolled in a MSN/PMHNP program in 2012, and I have continued to work full-time since in various unsatisfying nursing roles. I didn't know anything about psychiatry, but I was intrigued by it and soon spent much of my time learning what grad school had to offer and pursuing my own interests in psychiatry and tangential fields of neurology, endocrinology, psychology, etc. Here's the problem, and it's a matter of reward.

I beat the herd. In my state NO ONE wanted to enter psychiatry. In the 11 undergrads in my fast track course nine wanted to become NPs. Most wanted family because "they can do anything." Can we see the eye roll? I don't know if any others have pursued this, but I beat the pack. There are a few really great psych positions in my state, and some good ones. The rest are low paid, community health positions. Without sharing my base salary (which is 80% more than the next highest offered me) offer and productivity incentives (+25 to 75k/yr) I'll be making more than most primary care physicians with only my master's degree. The conundrum is that another PMHNP program just opened in my state, and another university is taking applications for PMHNP faculty to begin a psych program in two years. I also lost my second job offer (THANKFULLY!) to a PMHNP infusing in from another state.

Now, there are a lot of mentally ill persons waiting to see a prescriber, and with the organization I'm going to work for it was recently ruled, largely based on my state's Medicaid provisions, that the therapists can't even see the patient, past a DI, until they've been seen by a doc or NP which get reimbursed equally for an eval. Presently, there's a log jam, and so we need more psych providers.

However, some day the patient population will become dilute, reimbursement will wane, and income will fall. So yeah altruistically more folks will get help. Individually, we'll get paid less because of it.

allnurses Guide · Apr 25, 2015

Mind elaborating?

Sure.

On the pro side:

1. There are quality programs that continue to produce quality NPs with significant academic rigor and strict admissions criteria.

2. There are more NPs graduating to fill the primary care deficit in our country.

3. An increasing number of PCPs, as a result, are NPs which improves both patient outcomes and the validation of the importance of NPs in quality primary care.

On the cob side:

1. There are lots of RNs (and acute /prospective graduate students, as evidence in this post) that have a limited (at best) understanding of what it truly means to function in the provider role, assuming it is easy access to a good salary and good hours with less "labor".

2. There are a slew of questionable programs being allowed to continue graduating poorly-prepared providers barely able to pass the basic competency exam.

3. There are more and lot people looking for the trifecta to the promised land: easy/cheap, fast, and online.

4. There are programs requiring increase burden on preceptors to provide quality basic education.

Sent from my iPhone.

Yave · Apr 26, 2015

NP's position comes with more responsibility and accountability. I'm unable to envision all that leisure for NP's. The only nursing position I'm aware of that would have all that leisure is bedside nursing. Everything else comes with taking work at home or working extra hours with no pay. Maybe, I'm wrong!

harmonizer · Apr 26, 2015

NP's position comes with more responsibility and accountability. I'm unable to envision all that leisure for NP's. The only nursing position I'm aware of that would have all that leisure is bedside nursing. Everything else comes with taking work at home or working extra hours with no pay. Maybe, I'm wrong!

You are absolutely right. As a provider, you are moving on patients to patients non-stop all day along so at least my brain keeps working. When I see bedsides nurse sit down and chat or just look at computer, I feel somewhat jealous. I have no time for it! I have to wait until I catch up with patients. I have to move on quickly (and safety) to be cost-effective.

Dranger · Apr 27, 2015

You are absolutely right. As a provider, you are moving on patients to patients non-stop all day along so at least my brain keeps working. When I see bedsides nurse sit down and chat or just look at computer, I feel somewhat jealous. I have no time for it! I have to wait until I catch up with patients. I have to move on quickly (and safety) to be cost-effective.

True but look back at the woes of being a bedside nurse. When a patient pulls an IV, rectal tube blows, bed change needs to happen, a patient needs to be restrained, a patient needs to be bathed , admissions need to be done, meds passed etc etc it's all on the RN not the provider.

I rarely get to sit down at my job and much rather be using my brain than doing mundane housekeeping tasks. Grass is always greener

LadyFree28, BSN, LPN, RN · Apr 27, 2015

Grass is always greener

Or it can be brown everywhere.

As someone who may become an NP after years of experience-only because I want clinical exposure before I take that leap; Despite studies that say there is no difference in outcome with providers vs physicians; I think having good sound experience with assessments, clinical advocacy and clinical judgment helps create a good foundation towards being an NP; I find myself working with a few that are lacking that and I am bouncing off what my clinical findings are the exact clinical findings they need and would be missed if not with my clinical intervention; I find it disheartening that there is the potential of such missed findings; but then again, that's the beauty of having a solid healthcare team, but I guess my expectations of NPs is of sound clinical skills honed as a nurse first.

Jules A, MSN · Apr 27, 2015

True but look back at the woes of being a bedside nurse. When a patient pulls an IV, rectal tube blows, bed change needs to happen, a patient needs to be restrained, a patient needs to be bathed , admissions need to be done, meds passed etc etc it's all on the RN not the provider.
I rarely get to sit down at my job and much rather be using my brain than doing mundane housekeeping tasks. Grass is always greener

I agree with you but also underestimated just how stressful and time consuming it is to be only relying on my brain. The housekeeping tasks are actually kind of refreshing in hindsight. :)