Pros/Cons to becoming a NNP?

Gompers, BSN, RN · May 4, 2006

Well, those first 2-3 years experience are really vital, in my opinion. Even though some NNP programs let you start taking classes right away and clincials start after 1-2 years of experience...it's just not enough. The first year, in particular, is best done wth just working - no school. You don't learn squat about NICU in nursing school so there is a ton to learn during orientation and for the first 12 months after that. Why try and do graduate school at the same time? You will feel much more comfortable after 1 year, and by 2 years you'll really feel in the groove of things. That is the absolute earliest I'd encourage anyone to start taking more than 1-2 graduate courses at a time. This is all just my opinion, of course.

NNP pros: money, prestige, education, autonomy, lots of procedures

NNP cons: less flexible schedule, frustration with working under the doctors, much less time spent with the babies and their families, many do not recieve overtime pay even if over 40 hours/week

RN pros: flexible schedule, less stress and responsibility, more time with families and babies

RN cons: less prestige, frustration with lack of autonomy, scheduling conflicts, less money than NNPs

I hope no one flames me for my views on experience before NNP school. I have the right to my opinion.

Editorial Team / Admin · May 4, 2006

Gompers, you are the speaker-of-the-truth!

Most definitely! Experince in ones' specialty area before grad school as an NP in ANY track.

Excellent advice. I totally agree with your pros and cons as well.

llg, PhD, RN · May 4, 2006

No flames from me, Gompers. I agree with you 100%

I'll share the reasons I chose NOT to become an NNP. Though everyone, please understand ... I have many good friends who are NNP's and I like and respect them very much.

I chose not become an NNP because I didn't want to be working "under" a physician. I wanted to be a leader of nurses -- not a physician extender who would always be the junior member of the medical team. Now, we NICU folks know that NNP's are highly competent, respected professionals ... but most people with MD behind their names and administrators tend to view nurses in physician-extender roles as being "less than" physicians. In may not be right, but that's usually the way it is. Few NNP's are treated by their hospitals as well as the physicians.

I also didn't want the inflexible shifts, the 24-hour call shifts, etc. that often come with the role.

So ... I chose to get my graduate education within the "traditional" nursing role -- focusing not on learning to provide medical care as a lower-ranking member of the medical team -- but rather focusing on how to help nurses provide nursing care in a nursing leadership role. I became a NICU CNS and Staff Development Educator and have never regretted it.

Eventually, I got my PhD and moved out of the NICU and began focusing on hospital-wide projects for a children's hospital. (But clinically, I have never done anything except NICU).

Good luck OP, whatever you decide. If the NNP role is the right choice for you, do it. It is an honorable career path. However, I would highly recommend working in a NICU for a little while first -- both to prepare yourself for grad school and also to see the NNP up close before you make a final decision. I have found that a lot of nursing students (and nurses) have very little understanding of the many different types of roles out there for nurses. They hear about one role and think that is all there is. Be sure to thoroughly explore all of the possibilities before committing yourself.

llg

elizabells, BSN, RN · May 5, 2006

I'm in a DE NNP program now, and I can tell you that I will be taking more than the mandated one year off to work. Now that I'm actually DOING it, I think one year is ridiculous, and wish I had gone a more traditional route.

But in re "working under physicians" as an NNP, I can tell you that at the hospital where I'm doing my senior preceptorship, the NNPs are essentially on the same level as the neonatal fellows in terms of autonomy. Yes, they work under an attending, but only from a structural point of view. They are above the peds residents who rotate thru the unit. So it is possible to find a place that won't treat NNPs as physician extenders.

llg, PhD, RN · May 5, 2006

.....
But in re "working under physicians" as an NNP, I can tell you that at the hospital where I'm doing my senior preceptorship, the NNPs are essentially on the same level as the neonatal fellows in terms of autonomy. Yes, they work under an attending, but only from a structural point of view. They are above the peds residents who rotate thru the unit. So it is possible to find a place that won't treat NNPs as physician extenders.

Yes, I too, have worked in some hospitals in which the NNP's are treated well. But I have also worked in places where they are treated much like residents -- and have to rotate shifts, work some 24-hour shifts, work holidays, etc. It really does depend on the particular hospital.

As a CNS and Staff Developoment instructor, I have voluntarity worked some night shifts, weekends, holidays, etc. -- but only when it has been reasonably convenient for me. I haven't HAD to work those hours on a regular basis and I really appreciate the flexibility of my schedule. If I have a doctor's appointment at 1400, I simply leave and come back -- or leave work early, etc. As a salaried employee, I can come and go as I please, as long as it is within reason. I prefer that type of schedule to a rigid shift that HAS to be worked as decided upon by whoever makes out the schedule.

llg