RegularNurse

Think of it this way... NP training is market driven. There is a strong market for NPs, and a large pool of nurses who wish to be NPs. Schools compete based on the flexibility and ease of their programs. As long as a school maintains accreditation, there is a huge incentive to compress and streamline training. As long as there is a large population of nurses who want to become NPs, schools do not have to invest in preceptor coordination etc. There is little incentive for accrediting bodies to crack down on schools, because the more schools that offer the training, the larger they are reimbursed in fees.

You are being paid market value for your work. Compensation isn't about being nice or fair. Employers want to pay the least amount possible in the form of raw wages and benefits for labor. As a staff nurse, you have little bargaining power. Do you actively generate revenue for the organization? Is nursing an exclusive field requiring tremendous knowledge to be minimally qualified for? At best, nursing limits billing losses from things like central line infections, falls etc. There are 3.5 million nurses, hardly an exclusive club to be in. Nursing has commoditized itself. You can go from BS in psych to an NP in 3 years or less now. These are just the realities of the free market. I'm sure many accountants don't feel great about people paying their taxes by taking a picture of their W2.

I see OP's point, but if you are working with the general public, be prepared to be disrespected.

Well Said.

Obviously this is happening. New nurses know that all you need is some experience and few years of grad school to get a comfortable 9-5 job with no nights, holidays, and weekends. Most pay even better than bedside care. Only in nursing is there a culture that decries people for wanted to improve themselves professionally. Accept the reality that there will be a huge decrease in the number of experienced bedside nurses. Young people don't want to deal with the nonsense of being a shift worker.

This is your time in the trenches. Bedside nursing is about getting work done. Its not about musing on the pathophysiology, or the right drug regimen. Bedside nurses need to be smart and hard working. Aides and RNs do the medical labor, they physically take care of sick people. Nursing school is designed to make you minimally qualified for entry level employment. Whatever goals you have in nursing beyond this level are aspirational. You need to learn how to follow orders before you give them.

It doesn't matter where you get your BSN. Graduate nursing school remains wide open. You will probably get accepted into every NP program you apply to. Best of Luck!

This post captures the problem perfectly. Nursing school behavior will only be policed by market forces. If employers refuse to hire inexperienced NP graduates, they will tighten up their admission standards. Regarding vernacular, why bother dropping the nurse title? NPs are overseen by the BON...

You don't have to do anything. Just tell your employer that you won't work unless they have additional staff present.

Insulin and pressure ulcer staging

A nurse practitioner is a clinical degree. Healthcare administrators typically have advanced degrees in business or healthcare administration, in addition to years of clinical experience. If you are not already a nurse, you will need to do a BSN then get your MSN, and pass the NP boards. Then you may need to have experience as a nurse prior to getting administrative responsibilities. If you stay in your current specialty. You could work up the SW ladder. Otherwise, the typical career path in healthcare administration is having a BSN and working as a staff nurse, then working as a charge nurse, then getting a grad degree (MSN, MBA, MHA) and becoming a nurse manager. From nurse manager things open depending on the position you are seeking. There are DONs and VPs. At large academic institutions, its not uncommon for senior nursing leadership to have DNP degrees. Depending on what state you live in, an NP may be able to manage a clinic or multiple clinics. This is also an option. I don't know much about policy advocacy. It sounds like public health, which sometimes requires doctoral level training to implement large scale projects. For example, many research grants etc. require a PhD for primary investigator. You have options, options are a good thing. Best of luck!

I'm not looking up the specific rules in your state, but in my state, refusing to take a drug test does not constitute guilt. Your employer has the right to fire you over it, but your employer is not a police department, or the BON. You never HAVE to do anything. Nurses do not lose their license or have to attend AA/NA over simply refusing a drug test. People on allnurses are trying to scare you. Just move on with your career. When you apply for a new job, just say that you wanted a different opportunity. It is against the law in most states for previous employers to give the reason you no longer work there.

Try to only work nightshift or dayshift; work multiple shifts in a row; accept that the first shift will be brutal

Opportunities for in-house nurse informaticists are lacking. A hospital doesn't need many informatics nurses to run. There are a lot of opportunities to work for consulting and on-boarding firms as EHR systems are implemented. However, these jobs typically require travel etc. I would only recommend nursing informatics for people who want to work with data or want to code/build EHR systems. The nursing workforce is polarizing. There are a lot of young and old nurses. If you are early in your career, the days of simply training people in a new EHR are gonna end, if only because young people intuitively know how to use systems. I can't speak for the florida market.

You have a goal and stick with it! Do not become a nurse. Every nurse I know who has ever wanted to become a doctor was miserable in the nursing role. Just keep on trucking. Honestly, consider paramedic school as a way to make cash on your journey.

I think you raise a good point here. As APRNs expand their scope of practice and attain full autonomy in primary care nationwide, do similar outcomes between physicians and APRNs mean doctors are overqualified for the job? I think everyone can agree that there is no real comparison in body of knowledge between MD and NP. Is all that training really necessary to be a PCP? What are your thoughts?

I think a lot of what you wrote is right on the money. However, I think nursing schools raised admission standards due to increased demand for nursing education. Schools must thin the herd of applicants to stay within their enrollment capabilities. I'm not sure its a bad thing that smart people are becoming nurses. After all, the smarter the people becoming nurses, the smarter the NPs will be. I think good non-clinical opportunities for nurses with graduate degrees are overstated. Administrative staff are being cut nationwide (loosening the grip of administrative control measures in healthcare is one of the key selling points of all healthcare reform policies). The healthcare crisis in America is not due to staffing, but the result of sick people (mostly from lifestyle decisions) using significant costly healthcare resources. In short, healthcare ineffectiveness is not a provider problem, but a system and public health problem. Most NPs I've met are regular people. They just want to go to work and go home, they do not want to solve the nations healthcare disparities. I tend to agree that care will shift more peripherally, but I'm not sure many NPs want to work in telehealth or make home visits. In my experience, people put forth the effort in grad school etc. to get a nice comfortable 9-5 with solid compensation. Many of those roles are a departure from that. Thanks for your post, you brought up some nice angles on healthcare that I hadn't considered.

Well said and "liked" One of the overarching issues in nursing is the simple fact that nurses don't want to be bedside nurses anymore, and there is nothing wrong with that. This is the root cause of the impending surplus of APRN providers. Why is there so much demand (right now) for APRNs? They are cheap compared to doctors. Bottom line. They are only cheap due to reimbursement restrictions outside of primary care- and also in primary care in some states. If public and private payers reimbursed for NP care the same as doctors, then the payroll convenience of having them is nullified. Although, the abbreviated training would still keep supply up, and control wages. Yes, there is still tremendous APRN opportunity for those who want it. The problem going forward will be that everyone wants it because nursing schools cherry pick students because the field was oversold. It is unreasonable for anyone to expect the best of the best students to settle for staff nursing. Nursing is in a weird place right now in the US. As a field, there was a huge push for all this education etc. Now that everyone actually got it, institutions are saying, "now what." I think nursing will have to re-evaluate the scope of undergraduate education. It's not good that so many nurses report nursing school to be some sort of helpless drudgery that does little to prepare them for actual practice. And its not good that graduate level nursing education does little to prepare people to hit the ground running- especially in the absence of residency programs. I think a lot of it comes down to nursing's weakness in expertise. There is no shortcut in becoming an expert at anything. Nursing has tried to dance around this reality in both education, practice, and high level administration. Unfortunately, these issues are beginning to manifest themselves in small ways with labor surpluses. Nursing has been marketed as a field of convenience and exposed for the pitfalls of that very approach. There is nothing "convenient" about becoming truly competent in the workforce. Until nursing changes this culture, the glass ceiling, clinical and otherwise, will remain.

The BSN bias with Magnet hospitals can be unfortunately true. I've seen it myself, but I don't know how common it is. Your graduate degree should be aligned with your career goals. Do not get some worthless fluffy MSN degree to simply not be a staff nurse. You will be competing for jobs with other super smart nurses who pursued training specific to the exact role they want. In my opinion, informatics can be soft for some programs. The days of nurse leaders working only as people managers without are coming to an end. Going forward, employers want hard skills. Invest in hard skills, like analytics and programming. Look for informatics programs that can offer you those skills. Best of luck.

Here is my take on this situation: 1. Nursing school has been oversold for the last ten years to boost enrollment and make more money. Notice the sheer numbers of people flocking to nursing schools as a second career and the increase in nursing schools themselves. 2. Staff nursing hasn't changed at all, but the demographics and expectations of nursing students have. For example, I have met very few BSN students who have a career goal of staff nursing. Everybody wants to be an NP, CRNA etc. I have no problem with this, just an observation. 3. Many existing staff nurses are tired of working their butts off doing shift work and want a better job. 4. Nursing schools responded to increased demand for graduate education by increasing the flexibility in programs through online offerings and GRE waivers etc. After all, students will go to the school that requires the least amount of work to get the credential. Why wouldn't they? Summary, staff nursing can be brutal, nobody wants to do it long term. The only surefire way to escape staff nursing is to become an NP or CRNA. Most people who don't want to be staff nurses enroll in these programs. The programs pump out a bunch of grads. The grads will eventually saturate the market. NPs will eventually have the same difficulty current RNs are experience landing jobs. NP wages will stagnate, as their job can be done by PAs, MDs, and DOs. Nursing schools will respond by increasing admission standards. There will be a subsequent increase in disenfranchised staff nurses who only became a nurse to be an NP, Midwife, or CRNA, who can't get into these mega-competitive programs. BSN enrollment will drop due to uncertainty in getting NP degrees and jobs. There will be a new shortage of RNs, which will increase RN wages and pull some NPs back into pool nurse jobs for better wages. The RN market will remain short, while the NP market will remain saturated. NP education will become more rigorous due to job uncertainty, and start mirroring med school curriculum. Perhaps NPs will be forced to take the medical boards once the market becomes truly saturated to demonstrate expertise beyond that of the nursing boards. NPs will have gold standard education, but still be limited in practice autonomy to primary care. The ANA will begin lobbying to get NPs specialist residencies with doctors. Graduate nursing school will then basically be what the DO was 20 years ago. NP school will be viewed as a pathway to medicine and will no longer even be considered nursing.

Nationwide, staff nursing is not a great job. Staff nurses making 45+ per hour is mostly in major coastal cities (SF Bay Area, Seattle, NY, Boston, Philly). Many nurses hover between 25-35 an hour. That is 50-75k for probably around 1k a month in student loans. If you ever want to advance your career, you will need to go to grad school. You will likely be unable to afford grad school while raising two special needs children without taking out additional debt. If you become an NP, the median salary is about 98k. If you want to invest a serious chunk of money into nursing school, you might as well just do a BSN-MSN direct entry program and graduate with an NP degree. Wishing you the best, regardless.

1. Yes, continue working towards becoming a nurse. 2. Buy an NCLEX book and study from that instead of text books. 3. Admin positions require at least a few years experience, so focus on becoming an RN first, then getting your BSN, then getting your MSN before considering leadership jobs. 4. Yes, nursing has been a great fit for me.

In your post you ask which program has less math. What is your goal with this degree? Math, statistical analysis, and MS Excel are big parts of data science. There is a huge trend in healthcare toward big data. I imagine that informaticists are expected to be comfortable with this type of stuff. This is from the HIMSS website: "Nursing informatics (NI) is the specialty that integrates nursing science with multiple information management and analytical sciences to identify, define, manage, and communicate data, information, knowledge, and wisdom in nursing practice."

You already have a plan; now execute it.

Honestly you can probably use YouTube and Wikipedia with similar results.