Regret Becoming an NP

[psych.nurse]

After working as a nurse for four years, I went to NP school. Most of my RN experience was in psych, and I thought about becoming a psych NP, but with the advice of peers, decided to become an FNP, since I was told it would be a more useful, fulfilling, and marketable degree. I felt fortunate when I received a job offer two months after graduation. There are so many NP's here in Boston, and the job market is competitive! I stayed at my first job for 11 months, during which time I became miserable and burnt out. I took a couple months off and just started a new job, but I don't feel confident that I'll be happy.

I'm applying to PhD programs right now. For awhile, I've known that I'd like to teach and do research. I now wish that I'd just stayed an RN and proceeded with the PhD. The NP program cost a lot, and now I'm paying it off! Colleagues have given me positive feedback on my work, but I have yet to feel good about the work I've done, or happy as an NP.

I'm wondering if there are other NP's, especially newer NP's, who feel the same way?

[GoodNP]

If you need a change of course because the role of the NP in general is not a good fit, then it is what it is. But if you are considering a change because you are currently not allowed to practice to your full scope of practice, then I recommend finding a different job. There are plenty of places you can find where the physician is completely hands off (which is sort of my situation), and many shades in between the two extremes.

[Kansasmomandnurse]

I have an interest in psych ( always have) and have thought about pursuing the psych NP path but not sure of actual duties and do not want to make a mistake in pursuing. Know it varies but can you give a description of duties, what u like, etc? Would really appreciate it! Thanks a ton!

[Oldmahubbard]

Kansasmomandnurse said:

I have an interest in psych ( always have) and have thought about pursuing the psych NP path but not sure of actual duties and do not want to make a mistake in pursuing. Know it varies but can you give a description of duties, what u like, etc? Would really appreciate it! Thanks a ton!

There are different jobs, but in most positions you will be expected to focus on medication prescribing. This because of the insurance reimbursement schedule.

Mental health providers can't make a living anymore doing 45 minute or one hour appointments, partly because patients don't show up.

You will be expected to see people in rather short appointments, usually 15 minutes, and decide what type of drugs they need.

Usually 20 patients a day, sometimes more.

This is very difficult to do, without a large amount of RN psych experience at the inpatient level.

Because a short course of "clinical" in NP school can't possibly prepare you for this type of work.

And by inpatient RN experience, I don't mean just sitting on your fanny in the nurse's station. Taking orders. Of course giving shots from time to time. Then going home without giving it another thought.

Much more preparation is involved,

Or, you could be like many of the psych NPs we are now churning out, that simply give whatever drugs the patient requests.

Hint: there are a large number of malingerers, drug, and disability seekers in psych. At least 50% of the people who walk through the door.

Without substantial experience, you will not have a clue.

[blixkanaan, MSN, APRN]

Hey Psych.Nurse, I just stumbled on this page because I was surprised by the title and to see why one would say that they regret becoming an NP. I am sorry for the experience you've had so far. I must say that I agree with the some of the comments made and that maybe getting a post masters cert in psych may better fit your needs, since your background is in psych. But if I'm not mistaken, you already work in psych, kind of? Nevertheless, I understand that it is a big commitment (to go back to school) and that getting more education won't necessarily change the dynamics or the demands of the job. And I mean the pressures of seeing large volumes of patients. I think one way to mitigate that is by learning and reading at home. Keeping log in your mind of certain clinical questions that were left unanswered during the day while rushing through cases and researching those conundrums at night. At least thats partly what I've done and I feel that over time I've gotten better at my job because of my growing command on clinical decision making. As you get better clinically, you may see that you enjoy the work more. Full disclosure, I'm a new grad FNP as well and just started about 3 months ago. My experience in this new role has been excellent and lucrative too (believe it or not, FNPs can earn a good living as well). I love family medicine because you get to see it all. I personally have never liked the idea of being niched into one area (even though most of my RN experience has been in cardiac care) and enjoy the versatility of family medicine and urgent care (which I also do at the practice I work at). I wish you the best of luck and I think if you stay patient, you will enjoy the work more.

[SanJose_FNP]

What I love most about the NP role is the autonomy that RNs don't have. As an NP, I can prescribe, diagnose, order and interpret labs and do more than bedside nursing. I also don't have to do heavy lifting and many dramas in hospitals. And don't forget the perfect schedule to raise a family with all the quality time with your loved ones. In contrast to you, I really and totally love my NP role. Sorry to hear about your experiences. Good luck in your future endeavors.

[michael22]

Thank you for the information as I am trying to decide on becoming an FNP or a Psych NP as well, I appreciate the input. I moved to Boston after nursing school which was a complete career killer. Gone were the opportunities and dreams of becoming an ICU nurse. None of the hospitals would train me for any specialty not even the one I worked at for the first 2 years after nursing school. I learned after living in Boston for a decade that Boston has so many colleges that are churning out nursing students that the competition for all jobs is stiff. I made my mind up to leave when I was at Massachusetts General Hospitals nurse employee appreciation event. I was talking to a supervisor from MGH who was introducing me to her daughter, who just graduated from nursing school with her BSN. This young woman was accepted into a new ICU training program that payed somewhere around $10.00 an hr, I believe it was for 6 months. My co-worker and I a 30 year emergency room nurse were appalled that such an institution as MGH would pay someone such a pathetic wage, this was in 2013. I with a decade of nursing could not get into the ICU but they were taking new grads and paying them $10hr. I left Massachusetts and never looked back!

I think working in a smaller city with fewer nursing colleges may enhance ones career. As I pursue my MSN whether it is as a FNP or PMHNP I will seek out a smaller city to practice in.

[momofm1998]

I am an FNP. I truly regret going back to school. I worked as an RN in so many different areas and loved ER. Just had to have the NP for "status" "money". As one poster said, I had no clue as to the actual job description and "a day in the life of" I had so many more opportunities as an RN. Looked at an old pay stub from 2003..made same rate as a travel RN as I make now, 15 years later and am paying back a $60K student loan ($45 originally-they don't tell you the interest just keeps on going if one negotiates a lower payment monthly, dumb me). Struggling to find a job in an NP saturated market as so many colleagues here are also. I love being a provider, just would like to have more than 15 minutes to do a complete exam and chart. And the band plays on...schools grinding out NPs by the hundreds every semester. I am considering taking a position as a review RN working from home...same salary as local NPs make and less stress.

[Goldenfox]

Dodongo said:

It's been said a thousand times but I'll say it once more - you should become an NP because you want to do the JOB. Not for schedule, or pay, or respect, etc. Examples like the one above are great for prospective NPs to see. Think long and hard about why you want to become a NP. Because at the end of the day only the job itself will make it worthwhile.

I'd become an NP all over again even if I got paid the same wage as a RN with the same hours as a RN. I want to be a provider. I don't hate being a RN but it is not the role I want to fill.

Its interesting that you characterized being an NP as a job and not as a career. In my years of experience in this profession I've watched it change in ways that have convinced me that many of the folks who hire NPs nowadays share your opinion that its just a job. I remember the days when being respected as a clinician and being paid a good salary for our work was an important part of it. I've watched these decline also. I used to work locum all over the country and even several years ago it never used to be like this. The production schemes are preposterous. In most environments they expect you to rotate patients every 10 to 15 minutes. But many of the patients are very sick and need a bit more care than that. Some clinics claim that they give the more complicated cases to the physicians but that is often not true.

I quit locum to start my own business in a part of the southeast where the market is particularly bad for NPs. I had to come back here because its home and because I didn't wan't to be too far away from my elderly parents; but if I had to work here for somebody else as an NP I wouldn't. The pay and the working conditions are better if you're a bedside RN. I have many NP friends/colleagues here and most of them say the same things about how bad it is but they cannot afford to move or quit and NP jobs are VERY difficult to get so they suck it up and stay.

Not long ago a physician I've known for a long time called me up and told me that he wants to hire an NP and asked if I could recommend somebody. Of course, I know people who want a job but I wouldn't recommend even an enemy to go work for this man. During our phone call, he made some very disparaging comments about NPs, and I found myself wondering if he had forgotten that he was speaking to one. He's not paying malpractice, offering no benefits except 2 weeks paid vacation after 1 year, 1 unpaid week off for CME a year, and an hourly pay rate that was totally ridiculous. I used to earn more as a traveling bedside RN many years ago. He boasted that he doesn't have to pay more because NPs are a dime a dozen. He had put an ad on the internet---requiring that the NP has at least 2 to 3 years of experience and able to see 25 to 30 patients a day. Dozens of people applied (according to him). The one candidate who accepted his pathetic offer didn't really have the 2 years of experience but he hired her anyway. She quit after a couple weeks so he's looking again. It makes me sad to think that another NP who is desperate for work will take that job.

I wouldn't discourage any young person from pursuing higher clinical education, but they do need to do a lot of research, shadow an NP, and calculate the costs before deciding to become an NP. This profession is still changing and some of the things I see happening out there now are not good. Although I don't regret my NP education I wouldn't do it again if I was younger and starting out now.

[ms_sgr, BSN, NP]

I'm a new Adult Geriatric NP and I have been working for less than a month and I really enjoy working with the geriatric population. The pace is slower, which is great. I see patients in the nursing home, assisted living, home setting and hospice. I really enjoy the variety. I wouldn't survive 5 minutes working in a fast paced clinic. I found it interesting that everyone was trying to discourage me from the Gerontology program due to lack being unmarketable. I will admit that finding a job in this area was challenging but I didn't go to school to have a job, but to have a career in something that I love. A lot of FNP's can't even find jobs because the market is so heavily saturated with them. If you want to be a Geriatric NP, then go for it. I relocated for my job, so if you are not in an area where there is a high demand then you will have to be open to relocating.

[Guest05/31/18]

Have you ever thought about independent practice? You have to keep the lights on, but it can be a lot less stressful and you can develop a very comitted patient base. Many patient's will come to you and say you are the best practitioner they have ever had just because you sit down and take the time to listen to them. There are ways to supplement your income to ensure your lights keep on such as providing allergy shots, trigger point injections, etc...

[socal1]

chare said:

Advanced practice isn't for everyone, and I found myself in a similar sitiuation. I worked as an advanced practice nurse for nearly 6 months, and hated each new day more than the previous. I finally reached the point that I couldn't stand it any more. I returned to bedside nursing and am much happier, and have not regretted this move once.

What makes you hate it so much?

[RatchettRN]

I gotta say, after training for the Fnp and doing clinical hours in primary care, I knew I didn't want to churn patients through all day. Specialty is great! I see 13 patients a day, more or less, and get to actually address their needs. This is what I wanted when I decided that being a provider could allow me to do more for my patients. The money isn't really better but the hours are, and the control over doing what is best for my patients. Exploring specialty is a good option if you are careful about who you work with. M.D.s who disparage Np s shouldn't get to hire us and profit from our underpaid labor.