Ree01

I applaud you for your honesty. RN's are going to NP school in droves thinking they won the jackpot as an NP. It's horrible. I went back and got my PMHNP in 2020 after being in medical. Geez I was burnt out from being soo overworked in medical and thought psych - I could work from home, much easier , more money , no physical contact with patients. Geez I got a rude shock . The mental health system is soo broken . Mental health is soo understaffed , poorly reimbursed, and poorly funded. Mental health hospitals take the path of corruption to survive. I was horrified. Telemedicine psych can be viable if you are willing to prescribe a bunch of Adderall & Benzo for drug seekers / people with substance use issues. The one consolation with psych is that patient exposure (COVID) is reduced but still there is safety issues especially if you work out of an office. Really there is no easy way out of hard work and potential burnout - RN/ FNP/PMHNP / CRNA ( doubt it's a stress free job) - there is no bed of roses in the medical field

I feel as if I am the one that contributed to the whole "negativity " thread here. Therefore my response today. It is sad that as educated responsible professionals, we are not able to experience the reality of other professionals. Each person has his or own version of reality which is based on their experiences. None of the " negativity" described by some of the NPs's here are based on fiction writing for entertainment and pleasure or to hopefully make the big screen movie scene or a Lifetime movie. It's real stuff that we are living through, and experiencing. The job of an NP has changed; the role has changed, the expectations, job market has all changed from 20 years ago. This is life. Nothing stays the same. I think we experienced NP's where hoping with change it would get better but no ; it is not and that is reality. In the last two months at my hospital, we had two new inpatient grads get fired and two outpatient grads get fired due to incompetence. We have about 6 new NP grad RNs still doing bedside nursing cos no one wants to hire them. Almost 3/5 Floor RNs are in NP school- with a projected school loan debt of $30000.00 - $ 80000.00 at end of completion. This is the truth. I'm not making it up. I have met RNs who claim they will never go to NP school coz they see what is going on. These RNs are choosing Academia and Education instead. I just trained a new Nephrology Grad this week. He did his undergrad in the Phillipines. He moved to US in 2013. In 2015 he started online NP program. He told me how back in the Philippines, a lot of students applying to Nursing Programs there in hope of getting RN then coming to US to become NP's. So even internationallly, RNs are graduating in hopes of being recruited to US to become NPs. A lot of RNs that are from India told me the same thing - they left India to become NPs in US. They had no chance of going to Med School in their countries but coming to US gives them a chance to be like a " doctor" The international supply of RNs, together with the ever increasing number of online NP programs,and easy admission process are only going to increase the oversupply of NPs. Am I lying ?? No - this is the reality. I'm happy for those that find good NP jobs that they are happy in but to incoming and prospective NP students , I will stick to the fact that this is not the norm.

I do believe you but your situation is as a previous writer notes the " exception " not the norm. Your situation is how things should be not exactly how they are the majority of the time. I have been an NP now for 20 years. I work in a major acute hospital inner city. The majority of NPs that work in the hospital for different specialities feel abused by physicians. This is the a truth that I am sharing with prospective students. I will quote some of their comments; " I work longer hours", " I have less time with my family ", "I have big student loan debt", I feel as I am being spoken to as if I don't have a brain", " You have to put up with a lot of emotional abuse", " the benefits sucks" , and so forth. RNs should not be misled to believe that if they make an extra $30000.00 a year; it is going to come easy; there is a huge price to pay depending on the practice you get a job at. When you are a RN ; you might think it's cool to rock the white coat and stethoscope around your neck as an NP but first please research the definition of scudmonkey

I do believe you but your situation is as a previous writer notes the " exception " not the norm. Your situation is how things should be not exactly how they are the majority of the time. I have been an NP now for 20 years. I work in a major acute hospital inner city. The majority of NPs that work in the hospital for different specialities feel abused by physicians. This is the a truth that I am sharing with prospective students. I will quote some of their comments; " I work longer hours", " I have less time with my family ", "I have big student loan debt", I feel as I am being spoken to as if I don't have a brain", " You have to put up with a lot of emotional abuse", " the benefits sucks" , and so forth. RNs should not be misled to believe that if they make an extra $30000.00 a year; it is going to come easy; there is a huge price to pay depending on the practice you get a job at. When you are a RN ; you might think it's cool to rock the white coat and stethoscope around your neck as an NP but first please get as much information and opinions from other NPs in your area, and research definitions such as scut monkey and so forth.

I do want to provide a few more awakenings and truth to the reality that you have described in your post. In the last two decades there has been a rapid shift in the way that NPs are used in healthcare. Previously NPs were used to serve the underserved and increase access to quality healthcare. Today it is no more the underserved or patient that benefits the greatest from the NPs. It is the physicians. Physicians especially those that employ you in the nursing home or office will use you to generate income for them. I work with one hospitalist physician. He oversees about 5 nursing homes. He has two full time NPs . He told me how he makes $250000.00 on an average from each of them a year. This is after he pays them $90000.00 a year with little or no benefits. Another physician in Infectious Disease told me how she had a fall out with Administration for not paying her a bonus of $125000.00 a year for supervising a PA in the office. This PA was seen 25 - 30 patients a day whilst she cruised in the hospital, left work at 3 pm and did maybe a morning or two of office a week. Physicians abuse NPs- make them do all the hard work then take the profits. NPs are now income generators for Physicians. That is the reality. Also remember physician have to work harder today in this current healthcare system with computer charting, calls, patient volumes etc. Therefore be ware physicians will employ you, pay you a cheap salary and make you do all their work for them. They don't want to work hard but they want to earn that big fat physician salary. You are going to have to work just like a doctor, in some cases even harder just to earn a few dollars more than a RN and less than 1/4 that of a physician. This is the reality. Before you leave your secure job as an RN and sign up for those expensive online NP programs, stop and think very very carefully. The grass is no more green on this side .. it was 2 decades ago but it is quickly drying up.

I wanted to add one more comment to this thread. Yesterday I was have lunch in the doctors lounge with a Wound Care/ Othopedic surgeon who has practiced for greater than 25 years. He has had a Physician Assistant for last 8 years. He was ranting about how the incompetent NP hospitalist admits his patients and almost kills them. He was saying about how he is going to do admissions himself rather than get hospitalist groups who employ incompetent NPs. Then other physicians chimes in mostly surgeons. One of the remarks was: " we see some of the most incompetent RNs becoming NPs". Then the Physician Assistant remarked yep cos they all doing online programs! Just thought I share this

I have been a young NP for 21 years now and the number of incompetent RNs graduating with online NP degrees over the last three years is alarming. What s the board and government doing to regulate standards of NP training?

I totally agree and I think there is a shortage of quality preceptors. It may not even be the schools fault. Preceptorship May be the leading problem now in this age of online training- all schools both online and in class need to improve on clinicals . Who can be good advocates for this are none other than ourselves , someone like me with years of advanced clinical experience- Ineed to take on more students and train - I think that would be a more proactive apporoach to problem rather than just criticizing programs. I'm grateful to this forum and those who have responded to my thread .. you have opened my eyes on what I should be doing to help my fellow professionals. Thanks again for feedback and comments- did not mean to offend anyone

I am sorry if I offended you or any other NP. That was not my intention.

Please note that my intentions are not to discourage future RNs from pursuing a NP program or their career goals; neither is it to emphasize how incompetent new NPs are in comparison to Med students or residents. I really wrote this to caution prospective students to be cautious when choosing a NP school. I have shared the same sentiments with RNs in the hospital and they have been so grateful for my honesty. For example one RN that worked for 18 years as a clinical manager in Pre Op. She was about to do this online FNP program. She waited a couple of years before she could get in to University of Miami Psych DNP program . She graduates next May and has a job lined out for her making a very substantial salary. Also her clinicals were done with rotating Psych residents and Psychiatrists, NPs etc.

I am a NP certified in Adult, Acute Care.I graduated from my program at a prestigious university 21 years ago. It was a very competitive program, where you had to take GRE. I was 26 when graduated and am now 47 years old. I worked for ten years in Cardiology in open heart unit, then Cardiac ICU. I then worked one year in hospitalist program before transferring to Renal Transplant/ Nephrology division. I work at 450 bedded hospital that supports the training of NP and PA students from local universities. In the last few years I have worked with NPs and RNs that have graduated from Universities that are so unfamiliar. When I started as a NP , there were few jobs but but they were easily available. NP's were sometimes even considered better than some doctors. Patients back then preferred a NP to a MD. They felt NPs spent more time and were more thorough . But now in recent years that has changed. NP's do not have as good a reputation. They are not so popular amongst physician groups and patients. Part of the problem is that most NPs are overworked and can not provide same level of care that they used to with patients. Another part is educational standards. In the last few months I have witnessed some of the following mistakes by new NP's: 1. Prescribing Torsemide and Furosemide for same patient 2. Prescrbing Aldactone for patient with elevated potassium. 3. Missing a diagnosis of Pulmonary Embolus on a patient admitted with pleuritic chest pain, cough and apprehension. 4. Prescribing Glucophage on a patient with significant renal impairment. I also find that new NP's today order a lot more expensive unnecessary imaging studies on patients and send out a lot more unnecessary consults than before. TTherefore I question the training . Remember it was not long ago that Obama administration went after for profit universities that over promised vulnerable students degrees that did not result in gainful employment . Students get suckered into taking huge federal loans that leave them in debt. I believe the same thing may be happening with RN to NP programs. The more information prospective students have, the better. It would be good if we could have physicians write on this forum.

Yes but are the clinicals done in a setting that supports adequate training and supervision of students especially core physical assessment, diagnostic skills. Compare the training of a RN to that of a NP ( online) - RN training is heavily supervised and regulated by their educational institution- online training is not. Compare the clinical training of a medical student / Resident to that of an online NP - there is no comparison and in the end both NP and Medical Student/ Resident get to write prescriptions, see the same number of patients and make same diagnosis- how is that safe ?

Yes but are the clinicals done in a setting that supports adequate training and supervision of students especially core physical assessment, diagnostic skills. Compare the training of a RN to that of a NP ( online) - RN training is heavily supervised and regulated by their educational institution- online training is not. Compare the clinical training of a medical student / Resident to that of an online NP - there is no comparison and in the end both NP and Medical Student/ Resident get to write prescriptions, see the same number of patients and make same diagnosis- how is that safe ?

I totally agree with you. Part of the problem is the huge availability of online NP programs. Nurses no more have to do GRE, attend classes, practicals , tutorials in order to become an NP. The standard is lowered now. all you need is a BSN, computer and huge loan, then you will be an NP. The role of an NO is totally different to an RN. You can't learn to save a life and perform a focused physical exam on a patient online. I know that here in Florida a lot of physicians are catching on and won't even hire an NP with online degree. Physician Assistants will now be in more demand because there training is going to be more marketable than an NP. The role of an NP is not for everyone-it involves a lot of medical knowledge; expert clinical skills, communication skills and so forth. I feel bad for those RNs who especially are sacrificing time with their children and money for a degree that is not going to benefit them or their families in the long run.