Second Thoughts on leaving Bedside for NP role

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Specializes in in primary care pediatrics and NICU.

My decision to complete NP school was not a hasty one. I took 4 years to decide if I should go for MSN Ed or NP, versus staying as a bedside RN in the ICU at a Magnet Children's Hospital...where I make excellent money after 16 years now. I chose an affordable, highly ranked NP program and paid my way through. Debt free. This was critical because I want to retire in 15 years. I'm in my late 40's.

Now, I'm an official PNP, all certified and looking at jobs, but having second thoughts -almost panic attacks. The NP money & schedule, not so great. I make the same pay at bedside or even MORE than the NPs! I knew this pay gap may be an issue when applying to school, but didn't think I'd be demoted. It's insulting. I ultimately finished MSN to have options, an ace in the hole. (That was my deciding factor). But, do I need to play my hand now?

Not sure how to move forward. Co-workers keep asking why I'm still there. Anyone else have this dilemma? Would love some insight. Every NP I talk to basically hates their job, but won't admit it until the newness wears off. We need some truth sharing.

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Specializes in NICU.

Sorry to hear about your troubles. This is a common finding amongst RNs with extensive bedside experience- unfortunately your potential for growth won't be as much as someone who became a NP in their 20s or 30s. This was factor for me when I considered going to school.

Are you in patient or out patient? You might consider looking into in patient that has 12 hour roles that might suit you better. I can say that even if I was making the same as a nurse, I wouldn't go back to bedside. I truly enjoy what I do and there's a lot more perks to being a NP than just the money. I get better parking, more money for conferences/CEUs, autonomy, and being able to not be a slave to my patient's beeping alarm, among other things. Obviously your mileage will vary.

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Specializes in in primary care pediatrics and NICU.

Thank you for your positive insight on the role, babyNP. You are correct, all are good points taken, except parking...that's really not a deal breaker. But funny. I'm a primary care peds NP, so my options for inpatient are limited. Currently, the market is saturated in my area and facility. I think I would enjoy teaching as part time adjunct at a local college, while keeping my RN bedside part time for benefits. However, I feel like a traitor for not putting my NP skills to best use! And can I ever go back if I want to do clinic in the future? So many thoughts...

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Specializes in NICU.

oh- just saw you are from Florida which where you are practicing I presume. That might be a big part of your problem. Florida is a terrible state for nurse practitioners in regards to pay and autonomy. Last state in the union to be able to get a DEA license! I don't know if you are tied down to Florida, but you'll find better pay and conditions elsewhere...

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Specializes in in primary care pediatrics and NICU.
oh- just saw you are from Florida which where you are practicing I presume. That might be a big part of your problem. Florida is a terrible state for nurse practitioners in regards to pay and autonomy. Last state in the union to be able to get a DEA license! I don't know if you are tied down to Florida, but you'll find better pay and conditions elsewhere...

No, I can't leave FL due to elderly parent obligations. So, yes anyone considering moving to FL as an NP should reconsider. Good luck in your career babyNP and thanks again!

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With 16 years of experience bedside, I would bet you are at the top of the pay scale at most hospitals. So if there is a slight pay cut, I wouldn't look it as a demotion. I would look at it as further opportunity for advancement. Also consider hours worked to annual pay when comparing the two. If you are working over-time to really accelerate your bed-side pay, then compare the two jobs on an even scale of hours worked and see how much the "cut" really is.

I would look at it from this perspective. You are starting a new career essentially and your long-term outlook for pay vs. work/life balance are much broader as a PNP. Your starting pay is pretty much at or near where an RN with over 15 years of experience might be at. Also the job ideally won't require much extra hours to still maintain this higher pay level. Over the next 5 to 10 years, it should be expanding by tens of thousands if not more where most RNs at the top might see a cost of living increase if they are lucky. Also, where a bed-side RN might be worn out by 55-65 (presuming you retire when you wanted to), your PNP role might be better able to let you do smaller scale jobs much later if you still have the passion for it.

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Specializes in Family Nurse Practitioner.
Over the next 5 to 10 years, it should be expanding by tens of thousands if not more where most RNs at the top might see a cost of living increase if they are lucky. .

This isn't guaranteed and with the way supply vs demand in the very near future is headed ie OPs target retirement date probably unlikely imo. While there are definitely plusses and minuses to justify working for the less, the same or nearly the same rate as a RN while taking on the education cost and liability of being a NP makes no sense to me. Who knows how it will shake out over the long term but my money is on remaining a RN might actually be a better overall return in the next 10-15 years or at least until the fad of becoming a NP corrects similar to the lawyer glut years back.

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This isn't guaranteed and with the way supply vs demand in the very near future is headed ie OPs target retirement date probably unlikely imo. While there are definitely plusses and minuses to justify working for the less, the same or nearly the same rate as a RN while taking on the education cost and liability of being a NP makes no sense to me. Who knows how it will shake out over the long term but my money is on remaining a RN might actually be a better overall return in the next 10-15 years or at least until the fad of becoming a NP corrects similar to the lawyer glut years back.

Which is exactly why, at my age, I'm not going to go to NP school. Return on my investment will likely be in the negative.

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This isn't guaranteed and with the way supply vs demand in the very near future is headed ie OPs target retirement date probably unlikely imo. While there are definitely plusses and minuses to justify working for the less, the same or nearly the same rate as a RN while taking on the education cost and liability of being a NP makes no sense to me. Who knows how it will shake out over the long term but my money is on remaining a RN might actually be a better overall return in the next 10-15 years or at least until the fad of becoming a NP corrects similar to the lawyer glut years back.

Certainly every situation is different. But this person specifically is in a specialty area that isn't overloaded (she's a PNP) when compared to other areas. She's had graduated with no debt. And I'd argue if you are certified now, this is the time to get in because in 4 to 6 years when saturation has likely solidified, you will still be in demand over the thousands of new grads that are being churned out. What I find with hospital pay scales is once you hit the top, your only option from there is overtime and call. The only difference imo is the retirement and these days it isn't hard to find an employer that provides some form of 401k with matching.

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Specializes in in primary care pediatrics and NICU.
Which is exactly why, at my age, I'm not going to go to NP school. Return on my investment will likely be in the negative.

I spent less on my master's education than I did on my honda accord, which will eventually wear out. A much better return on money spent, imo. But, yes, I weighed the cost to benefit ratio before applying to school. Much better return than a luxury vehicle or larger home (of which mine is paid for). I do understand your POV, though. However, it does give me more options for non-clinical positions which may be enticing as I get older, according to djmatte's advice.

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Specializes in in primary care pediatrics and NICU.

A similar aged coworker of mine, former CPA turned RN, told me I was making a lateral move, not up the ladder. However, my fear is that you may be right and she was not. The long run return on NPs may not pan out compared to the benefits of the RN, true. Especially in primary care, where I would be working. Mid levels working in peds do not get paid well. MANY kids have medicaid; we get low balled and take it, no choice. So, will I also be happier working more hours, take home charting and on call for essentially the same (or less) pay? Idk, hence my dilemma. Once I leave my RN spot, my seniority is gone. Lost forever. I'm sure people are asking why didn't I think this through first? Because I didn't know the all the facts about the situation before I got started. Like I said in my original post, many NPs do not tell the truth about how abusive the job can be. Thanks for your sincere opinion, Jules A.

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Idk, hence my dilemma. Once I leave my RN spot, my seniority is gone. Lost forever. I'm sure people are asking why didn't I think this through first? Because I didn't know the all the facts about the situation before I got started. Like I said in my original post, many NPs do not tell the truth about how abusive the job can be.

If you have to stay in Florida then do not give up your RN position. Available NP jobs there don't just pay low and require you to put up with a lot of crap, they also typically come with little or no benefits at all. And if you need health insurance that you have to buy on your own that is another amount that ought to be deducted from the already pathetic wages.

Seems to me that the choice is already clear based on economics and the reality of the situation in the south Florida market. But, ultimately, its up to you.

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