Return to the bedside

Specialties NP

Updated:   Published

I have been an FNP for one year and I just resigned from what was an absolutely terrible job. I have many years ( 20+) of PACU, ICU, CCU and ED experience. As an RN that is. Those willing to hire me as an NP are only offering one terrible job after another. I have spent my life working in hospitals and I miss it soo much. Yet, I can't get a job working in a hospital as an NP. They want 3 years of experience in the area of specialty as an NP. They don't care about my RN background.

In fact, most worthwhile jobs want 3 years or more of NP experience.

I hate the long hours, rotten pay and poor benefits that seem to be the fate of an office FNP. I hate the office environment period.

I feel awful, I regret this more every day and I want to return to hospital RN life.. I want to return to three 12 hour shifts in a PACU or ED as a staff nurse and get my life back. In addition to rotten pay and benefits, My FNP experience was very lonely and beyond boring. I miss the fast pace of the hospital and the camaraderie of fellow nurses. All that time and money on my education will be wasted, but I'm starting not to care about that because I'm so miserable.

Has anyone else done this? Has anyone out there quit and gone back? Will I be able to go back? Will hospitals

allow it?

ANY advice on ditching this career path is greatly appreciated.

Thanks.

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I also quit a horrible NP job I was in for 6 months. I'm going to return to the bedside as well. I miss having my 4 days off. I keep hearing that if you go back to being an RN from an NP, you will be held to a higher standard. But the hospital usually dictates your scope of practice, especially if you're practicing as an RN. Most people become NP's because they're sick of the bedside and make more money, but if you were happier as an RN, why not go back to being happy? I plan on going back to the bedside, and keep applying for NP positions that I'm interested in, maybe part time. Maybe you can go back and do Acute care NP while working as an RN? I feel the same way, I'd rather take a paycut and be happier as an RN. Have time to actually do things you wanna do. Good luck, be happy.

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Thanks and good luck to you. Can't wait to get those 4 days back as well.

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Specializes in ICU, LTACH, Internal Medicine.

I know one guy who keeps licenses (and, accordingly works) as an RRT, RN and per diem hospitalist NP. He somehow does it in the same hospital and brags that it is his own way to have only one set of each scrubs and wash them only weekly because he hates doin' laundry.

Please look VERY carefully on your state's laws re. scope of practice and its legal limitations. You, undoubtedly, know that as a bedside RN you would only be able to practice within what your RN license, scope of practice and job description capacities, but there can be more to that. In Michigan all NPs (as well as CRNAs and CNMs) enter "gray zone" regarding what their education might be seen should they get involved in a lawsuit once they officially graduate. For example, if a physician orders to d/c from ER a patient who came with obvious s/s of early stroke and orders no imaging, ECG and antithrombotics, and the patient dies and family sues the hospital for neglectful care, then the RN who happened to have an NP education (even without active license) and who cared for and discharged the patient might potentially be held liable because of his/her knowledge should supposedly be enough to evaluate the patient, recognize that the physician had made a grave mistake and act to prevent it, even if, as an RN, he or she could do very little or nothing. It is not so about any other Master's or higher degree prepared nurses (MSN/Ed, CNS, Leadership, etc) but all "clinically" prepared students are advised to stop working at bedside as soon as they graduate. I am not sure that Michigan is the only one state with such a ridiculous clause.

If you like better benefits, look for hospital staff positions. Also, speak with doctors whom you were working with and were on good note as an RN, especially intensivists and ER staff. Some of them might need an NP, or know a specialist who needs one.

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I am a primary care AGNP and I simply do not understand the view that this work is boring and poorly paid. Yes, initially an NP might make less than an experienced RN, but not for long. I also don't know where you live.

NPs work in a variety of settings, but most NPs work in primary care, not in hospitals. You should have researched this. NPs work in urgent care, schools, LTC, clinics, and private practice. Right now I am working in a psych clinic and do 4 ten hour days and am starting at $90K with raises to $140K within 18 months and no OT or on call. And there are no physical demands. I also received an offer to be a Director for a hospice, starting at $120K and no physical demands, starting a new program, which would certainly be interesting. I also received an offer to work in a sports medicine and osteopathic practice starting at $100K. All of these were fascinating jobs. Urgent care is a very interesting - did one of my clinical rotations in Urgent Care and it was the most interesting. I also did a rotation in a LTC and the NP had a great job. She had a list of patients to see every day for routine checks, plus enough time to see any urgent cases that came up. She had complete autonomy, left at 5 pm every day and every day was different and interesting.

It has been noted elsewhere on this forum that too many RNs are looking to be NPs just for career progression. This post is a great example of this.

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Specializes in DHSc, PA-C.
Missmilo said:
I have been an FNP for one year and I just resigned from what was an absolutely terrible job. I have many years ( 20+) of PACU, ICU, CCU and ED experience. As an RN that is. Those willing to hire me as an NP are only offering one terrible job after another. I have spent my life working in hospitals and I miss it soo much. Yet, I can't get a job working in a hospital as an NP. They want 3 years of experience in the area of specialty as an NP. They don't care about my RN background.

In fact, most worthwhile jobs want 3 years or more of NP experience.

I hate the long hours, rotten pay and poor benefits that seem to be the fate of an office FNP. I hate the office environment period.

I feel awful, I regret this more every day and I want to return to hospital RN life.. I want to return to three 12 hour shifts in a PACU or ED as a staff nurse and get my life back. In addition to rotten pay and benefits, My FNP experience was very lonely and beyond boring. I miss the fast pace of the hospital and the camaraderie of fellow nurses. All that time and money on my education will be wasted, but I'm starting not to care about that because I'm so miserable.

Has anyone else done this? Has anyone out there quit and gone back? Will I be able to go back? Will hospitals

allow it?

ANY advice on ditching this career path is greatly appreciated.

Thanks.

If you knew you wanted to in inpatient, then why didn't you do an ACNP program? You chose FNP which is an outpatient clinic specialty and now are upset you can't land your dream inpatient job....sounds like you didn't do your homework before becoming an NP.

NP experience is a provider with the ability or diagnosis and prescribe is a different career from an RN and thus experience is not equal.

I don't agree with being held liable for discharge a patient with a missed diagnosis by a physician if you are working as an RN and only at the level of an RN. The gray zone is an NP working as an RN and thinking s/he can do more then other RNs and then attempting to do more then they should.

There are certainly jobs you can find as an NP working 12 hours shifts. An ER or urgent care would be one. I did acute care working 3 12's every week and a 4th shift every other week. Jobs are out there, but perhaps just not where you are looking.

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Specializes in CVICU, MICU, Burn ICU.
shibaowner said:

It has been noted elsewhere on this forum that too many RNs are looking to be NPs just for career progression. This post is a great example of this.

^^^ This is a real thing for sure. So much so that I'm almost inspired to write an article addressing it. Becoming an NP is more of a career CHANGE than a career PROGRESSION. And this is certainly why direct entry NP programs can even exist. I agree the OP's post illustrates, what may be, a misunderstanding of the facts.

Have you ever talked to RNs who say, "I NEVER want to be an NP". It's very interesting. It's because they know doing so would mean more than progressing as a nurse. It would mean leaving much of what nursing is. The truth of the matter is that APN requires one to straddle the fence of nursing and medicine. It is a completely unique role in that way.

Considering taking on the role of provider should give nurses pause. Not because it is so difficult and only the best and brightest nurses will or can do it well (though there is argument for this), but because... is it what they really. want. to. do? There's a student article on AN right now about the concept of influence -- interesting read. A nurse is in the unique position in healthcare to be the greatest human influencer regarding patient trust, motivation and compliance. But this is a nurse most likely NOT in an APRN role --- because APNs are providers who must spend the bulk of their (very) limited time with patients diagnosing and prescribing treatment. Yet too often APN has been viewed as the pinnacle of nursing. An arrival of sorts. But, IMO, this is a serious misunderstanding of the various roles in nursing and advancement of those various roles.

And I sort of think that would be worth writing about. Now to find the time...

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shibaowner said:
It has been noted elsewhere on this forum that too many RNs are looking to be NPs just for career progression. This post is a great example of this.

You should go to NP school because you want to be an NP. Plain and simple. I have a friend who is going to NP school because she wants a better M-F schedule. That's her main reason. And I won't be surprised if/when she dislikes working as an NP. You will be disappointed if you are doing it for the schedule, or the money, or the prestige, or simply because you think you have to at this point in your career.

Let's be honest, being an NP is more like a physician than a RN. So you need to like the role of physician (diagnosing, prescribing, etc) more than you do RN.

DizzyJon said:
If you knew you wanted to in inpatient, then why didn't you do an ACNP program? You chose FNP which is an outpatient clinic specialty and now are upset you can't land your dream inpatient job....sounds like you didn't do your homework before becoming an NP.

This is a perfect example of the "I chose FNP so I would have more options" phenomenon. There are other tracks for a reason. Do your homework. I had *zero* desire to be a FNP. You will absolutely find a job as an ACNP/WHNP/PNP, and if you want to work inpatient/psych/women's health/peds specifically, then choose that specific track. You will be trained better for it, and it will only help you in landing that "dream job".

WestCoastSunRN said:
Becoming an NP is more of a career CHANGE than a career PROGRESSION. And this is certainly why direct entry NP programs can even exist.

Considering taking on the role of provider should give nurses pause. Not because it is so difficult and only the best and brightest nurses will or can do it well (though there is argument for this), but because... is it what they really. want. to. do?

Yet too often APN has been viewed as the pinnacle of nursing. An arrival of sorts. But, IMO, this is a serious misunderstanding of the various roles in nursing and advancement of those various roles.

Yes. If you love nursing it does not just follow that you will love being an NP. Deep down I don't fundamentally agree with direct entry NP programs, but I completely identify with those who went into nursing to pursue an advanced degree. I went into nursing to be an NP or CRNA (ultimately chose NP) not a RN. If you're a good nurse, you don't have to go become an NP or CRNA. Stay a bedside nurse. Get a generalized master's and become a charge nurse, nurse leader, unit director, etc.

As an NP, you could pay me a RN wage and have me working crazy hours but I'd 100% still choose NP over RN - because I like the work.

To the OP, if you like being a bedside nurse, go back to it.

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I'd like to point out that plenty of NPs work 10 or 12 hour shifts. However, that is usually in acute care or urgent care. An FNP can certainly work in urgent care, although they want people with 1 to 2 years of NP experience. An FNP w/o acute care training can also get a post master's certificate to switch to acute care. Some primary care facilities allow 10 hour shifts, so an NP can do 4 10 hour shifts a week.

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When I was night shift I met more than one NP that picked up nights as a resource/float nurse because reasons. Their NP jobs, as they described them, sounded very crappy to me.

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jaderook01 said:
When I was night shift I met more than one NP that picked up nights as a resource/float nurse because reasons. Their NP jobs, as they described them, sounded very crappy to me.

No one is forcing RNs to become NPs. It is an individual's responsibility to understand their career choices. RNs have many options for career advancement other than becoming an NP.

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Wow lots of judgments passed here. Like the OP, I also hated being an NP for many of the same reasons. I tried several different jobs and disliked all of them for different reasons. I longed to go back to the bedside. I chose a different option however, which is that I stopped working altogether. At least for a while. If I do go back to work, I am pretty sure it will be as an RN.

People go to NP school for all different reasons. Telling someone that they "should have known" what being an NP is like is not helpful.

It is true that there are many different NP jobs, and hopefully everyone will find one that they like. But one thing that almost all NP jobs share in common is that you bill, and with that comes certain pressures and responsibilities. Although the RN jobs I had prepared me well for being an NP, I found the NP job totally different in all respects.

If the OP wants to return to the bedside, to a job she was happy and satisfied with, she certainly can do so.

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