Hate floor nursing but reasonable to get DNP?

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Specializes in behavioral health.

i am a 5 month new grad bsn rn and i am really disappointed in floor nursing. i knew that it was going to be hard and i was prepared to be overworked, but this is seriously ridiculous. i recently left my psych night job due to circadian rhythm disaster to a new job as a psych daytime med nurse. i have 15 patients. the dr. writes 7 now orders in 30 minutes and the patients follow me and demand their meds now, when pharmacy is understaffed as well and will not have the order ready for ages..ie..2 hours +. i have one patient getting rude and stalking me about giving her im dilaudid versus po as it is ordered. all of this and if i don't finish our silly pain flow sheets for even tylenol, i might get written up. i am very thorough and can keep a lot in my mind at once, but i am not fast. i literally cannot complete the ridiculous amount of work that the job demands. :eek: i also know that this is pretty much what daytime psych nurses jobs and probably most floor nursing jobs in general are like in this city. anyways, i'm rambling.

i've been seriously considering leaving the field due to these bad working conditions, but i love some aspects of nursing so much that i'm not sure anything else could replace it.

what i really like about nursing:

-anything behavioral health

-patient education

-physiology

-when patients feel they are important and feel encouragement to participate in their own health care

-patient advocacy

what i don't like/hate about nursing:

-not enough time to give good patient care

-med jockeying

-patients who think medication solves everything without effort and patience

-cleaning up after people

-disrespect

-workplace crap

-dementia patients (i feel bad for saying it but.. as bad as i feel for these patients and their families, they annoy me greatly)

-trachs, vents, immobile patients

-keeping 90 year old critically ill patients alive

the big question:

would it be ridiculous for me to get a psych dnp when i didn't even make it as a floor nurse?

any wisdom is much appreciated :redbeathe

*posted here (for a larger response pool) and np forum*

Specializes in critical care.

sorry but not alot of help here. I am an ICU RN so no we do not have 15 patients but we have LOTS of now orders, the only thing you can do is do ONE THING AT A TIME. All nursing requires tons of time managements as well as multi-tasking. That is nursing. I personally would HATE having patients walking after me demanding their meds. That is why I like them VENTED and SEDATED! That way there is no demands for items! Good luck

With a DNP you are looking at a whole different type of nursing. The jobs aren't just everywhere like when you show up at a hospital and they practically drag you inside to work.

As an advanced practice nurse, you'll have to scout out jobs a lot more. In some states you can work more independently but in other states you must have an MD "giving the orders" and protocols for you to use. If you have a great relationship with the MD you won't have a problem, although some of the MDs have their undies in a wad right now because they do not want this DNP business to go any farther. They don't like the competition. So you will be working with that issue also.

You will be more involved in coding and billing and that can be a big headache when it isn't done right. You can be fined heavily from insurance/medicare/caid for problems - whether you did the actual coding/billing or not. So you will be learning a lot more about the business and reimbursement end that floor nurses don't normally deal with.

NP's have to deal with prescriptive authority and DEA issues.

Liability insurance costs more for NPs.

Some states require that you have board certification (think extra money, another test to take) in order to practice as an NP.

The NPs that I know often say that they love having a bit more autonomy but that the pay is not worth it compared to all the extra responsibility. Kinda like staff nurses. I know some NPs who wouldn't trade it and a few others that decided not to practice clinically and went to be faculty.

More NPs that I know have enjoyed their jobs compared to the number of staff nurses that enjoy their jobs. It depends heavily on where your intersts lie and what you can put up with. As an NP you will have to find your jobs, they won't find you. If you do go back to school but then have to take a staff nurse job just to pay bills, you will be held to the standards of your advanced education as far as assessment, getting the doc to order treatments, etc.

Talk to some NPs, check out education/practice requirements in your state as well as job opportunities. The grass isn't always greener so make sure that you like an NP's job enough that you are willing to put up the the baloney that comes with the job.

Specializes in Nephrology, Cardiology, ER, ICU.

Are you sure you want to continue in psych? I think you have a good idea of what you like and don't like about psych but maybe you need to look elsewhere for your niche?

Personally, I think going for a DNP is going to be a wasted effort if you don't have a clear cut goal in mind.

what I don't like/hate about nursing:

-not enough time to give good patient care

-med jockeying

-patients who think medication solves everything without effort and patience

-cleaning up after people

-disrespect

-workplace crap

-dementia patients (i feel bad for saying it but.. as bad as I feel for these patients and their families, they annoy me greatly)

-trachs, vents, immobile patients

-keeping 90 year old critically ill patients alive

How much of what you don't like about nursing would be improved if you were a DNP?

I'm on psych and I only have 5-6 patients day and evening shift - some days, yeah, someone ties up all your time and you can't get to other patients, but most days seriously aren't bad. I usually feel like I can at least spare 10-20 minutes per patient to talk to them and get a good idea of how they're doing. I work with a lot of geriatrics, though. Though anywhere (unless you only do ICU or somewhere with lots of PCAs!) you're going to have the med seekers.

Anyway, although getting your DNP certainly isn't going to harm you, might consider waiting a bit more until you decide you would really like the work and the population you'd be serving. The NP at my work often gets dementia, med-seeking, borderlines, etc. that drive me up the wall, say nothing of being the final blocking point of "No, you can't have any more meds/your mom isn't safe going home" such.

Specializes in ER, IICU, PCU, PACU, EMS.

If you're willing to reach the doctorate level, then why don't you earn your PhD in psychology?

A psychologist would encompass all of the bullets on your "likes" list. It's the first thing I thought of when I read your post.

Have you considered it?

Specializes in behavioral health.

my browser ate my response. :crying2: I'm tired so I'll reply tomorrow.

Specializes in L&D, medsurg,hospice,sub-acute.

Before you go to a CRNP--do at least one year of floor nursing---if not on the floor you are on, or the facility you are at... try different things...that's the beauty of nursing....burnout can be treated with a career change---try a different speciality--post-op...TCU....post-partum....ICU's...on and on...what you find out there may surprise you--and what you enjoy may surprise you...don't put yourself in a box when it comes to specialities...as for the rest, that's nursing...all your frustrations are shared by many of us...you need to find people who do it well, and cope with the frustrations well, and make them your role models...when you have some more experience under your belt, you will find that you can prioritize better--both clinically and emotionally, and will have a tougher skin...and when and if you do decide to go CRNP, you will be more realistic about what to expect from floor nurses...and if you get through this tough time, you will be stronger and a better nurse for it....

Specializes in ICU.

welcome to the real world! that's day to day nursing. find the fun in it. if you do decide to be DNP, you'll only be served well with the knowledge and experience you gained as a floor nurse but it sure sounds like you'd be jumping from the frying pan into the fire.......even longer hours, even more responsibility and you won't be changing a whole lot on your "what you don't like" list. :bugeyes:

Specializes in behavioral health.

Thank you all for taking the time to respond =). So many difficult realities brought up. I do enjoy the psych population, but I think pure med nursing exposes me to the worst part of it. I usually don't mind med seekers and tend to be much more patient with them than my coworkers, that day was just ridiculous and being an overworked med nurse, you only deal with meds. If I had had time, I would have spent some time talking to these intrusive patients about boundaries and frustration coping. The only 1:1 therapeutic conversation I had with a patient without tons of disturbances was while giving an injection (that the patient wanted). I think I would be much happier at CresentLuna's job =P I was actually somewhat happy, although still stressed, at my night job, but I got really sick from working nights.

Arizona is actually one of the best states to practice NP. I do wish that they didn't discontinue the masters programs =(. I know that it comes with an extra set of bs, but maybe it is bs that I will be better at handling? My biggest problem with floor nursing is tackling the huge amount of workload; too much to get done within its very rigid deadlines! NP work is also going to be very strenuous. But maybe less so 15 people need medication NOW and they are lining up staring at you.

I've thought about psychology and have researched some of the programs. I would have to start all over again with a new bachelors degree unless I moved to a different college.

I'm just really frustrated that I have this bachelors which is only useful to be a nurse and I would like being a nurse if I could keep up with the workload and have time to talk to patients. I'm currently in contact with my managers, hoping to orient to the 3-11 shift in hopes that it is less work enough for me to be able to complete it (because im seriously not a slack).

and no matter how much i research NP jobs, because i definitely will, there are no guarantees in life and so far, my life pattern has been paved with detours.

:selfbonk:

Specializes in behavioral health.

My managers have been very supportive and believe that I can do this job. I'm going to try and work something part-time. Working 24 hours a week for the money I would make at another job for 40 hours is pretty nifty. They told me that they have lost seasoned nurses to this workload >_<. i not sure how this bodes for me that seasoned nurses walk out because it is too much work src="%7B___base_url___%7D/uploads/emoticons/eek.png.d5b0f01500ede3939b07f3c3a607b07c.png" alt=":eek:"> My last shift went very well because we were at half census and I got to talk to every patient and practice actual psych nursing.

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