Should I pursue an NP degree? I need advice

djmatte, ADN, MSN, RN, NP · May 3, 2018

I say stick to what you're enjoying now and not worry about the np side unless you develop an honest interest in disease management more than improving patient outcomes through stellar nursing care. Both are a value in different ways. You can do bedside as a np, but you'd have to go agacnp and that will require bedside experience anyway.

In before admin no doubt moves this to a student forum where NPs won't actually find it....

vmm1995 · May 3, 2018

djmatte, thank you for your reply. so you think it's definitely possible to do bedside as an NP? I think NP is definitely appealing, I just want to make sure it's right for me.

djmatte, ADN, MSN, RN, NP · May 3, 2018

djmatte, thank you for your reply. so you think it's definitely possible to do bedside as an NP? I think NP is definitely appealing, I just want to make sure it's right for me.

It's a different kind of "bed side", but yes. You would need an adult Geri acute care np degree to do it. But requires a year of experience in most schools. But mind you , those jobs aren't acting as nurses per se. They are rounding on patients and helping direct care vs passing meds and being more personally involved.

FullGlass, BSN, MSN, NP · May 3, 2018

Hi, so I am currently in an accelerated BSN program to become an RN and I absolutely love it so far. My program offers a dual-degree NP path and I just was wondering if anyone could give me some advice to help me decide if I want to pursue it. So far I love everything about nursing and having patient contact, love bedside nursing and I have no complaints. I've spoken to people and read a bunch of blogs that say NPs love their jobs 100x more than RNs, better hours, more money, more autonomous, more respect, etc. But I am worried I will lose beside nursing if I pursue an NP.
If I work as an NP, will I still be having a ton of direct patient contact? Will I be able to do bedside nursing, forming relationships with my patients? I know that NPs are often considered similar to doctors, but I still want to be a nurse at heart, and not lose what I've been enjoying doing so far. Does anyone have advice?

If you love nursing, then do that for awhile and learn more about healthcare and the different roles and advancement paths for RNs. RNs have many different paths that offer career growth - CNS, RN first assist, management, public health, research, teaching, case management, NP, CRNA, Nurse Midwife, etc. Some RNs start their own businesses, go into politics, or become attorneys. If you're not sure what path you want to take, work as an RN for awhile before deciding on next steps. Good luck!

Jules A, MSN · May 3, 2018

It is refreshing to see someone new who enjoys and values the nursing role. Take your time, try a few areas as a RN and see what you enjoy and have a talent for before taking the plunge to NP. Also worth considering in most cases the time spent with patients is significantly less for NP vs RN.

Christopher Ljucovic, BSN, MSN, RN, APRN, NP · May 3, 2018

Hey there!

First and foremost, I'd like to welcome you to the nursing profession! I'm glad to hear of your love for nursing and I hope you continue to feel that way throughout the remainder of your studies and for many years to come! Before answering your question, I'd like to start off by saying that my response to you is solely my personal and honest opinion regarding advanced practice registered nurses (APRN). With that being said...

I STRONGLY advise you, and any nursing student and/or new graduate nurse, work at the bedside for a MINIMUM of 1-2 years before applying to any APRN program. Personally, I don't even believe a year is enough time. That's why I think all universities should require 2-3 years of recent and relevant bedside nursing experience prior to allowing entrance into an APRN program, but I digress!

Most, if not all, APRN programs are meant for baccalaureate prepared nurses who are experts in their specialty care area. This foundation allows for a smooth transition from the bedside nurse to the advanced practice provider role. Furthermore, many of the NP programs are now only offered online (distance learning/education) and mostly autodidactic (self-teaching & self-learning), with few to NO required days on campus. So, you can see why I can't stress enough how important it is to get your "on-the-job" training and "hands-on" experiences. I know this all too well as I, myself, am third year Family NP student currently enrolled in a part-time "distance education program" at a local state university and let me tell you... it is not easy! Even with my seven years of bedside clinical nursing experience in critical care, emergency med, and hospice & palliative care. I also have two board certifications through the AACN and ANCC in critical care (CCRN) and med/surg (RN-BC) nursing.

I know you expressed your concerns about losing your "bedside nursing skills" once you become and NP. My answer to that is: Yes and No. You will inevitably lose the skills that you no longer perform regularly, like managing a patient district, getting patient's out of bed for meals, and timely medication administration. Believe it or not, many of your nursing skills will be enhanced. You'll build on the foundation of your nursing assessments through performing detailed physical exams that will ultimately lead you to a diagnosis and prescribed treatment plan. You'll also gain more pertinent skills and knowledge that relate directly to your specialty area, like for example, in the acute care setting, the NP will be suturing and debriding wounds, inserting arterial lines, and maintain a patent airway through intubation and etc. In my experience I would say that the primary care NPs lose the most of their nursing skills as they won't be doing any of the fun acute/critical care interventions like I mentioned above. Although they have weekends and holidays off, so you'll have to decide which you want. Also remember that you will no longer be carrying out the provider's orders but actually calling all the shots! It's a tough transition for many nurses at first but most get through it!

I think I've said all I can. So, I'll leave you with this saying I always tell my nursing students and fellow colleagues, "the more knowledgeable you are, the safer the patient". No matter what path you choose please don't ever forget that. You can truly never learn or know enough! Good luck and keep us posted!

vmm1995 · May 3, 2018

CLjucovic, thank you so much for your in-depth reply and for everyone else's as well. I really appreciate all of your advice. So the thing is that I'm currently in NYU's ABSN program, and they offer this dual-degree NP Path, which we need to apply to in our third sequence (crazy, I know), which is this summer for me. So I need to decide very soon if I want to pursue NP, and which speciality I want to go into. It's very stressful.... the deal is that if I get into the program, I am required to work as an RN for 1 year, then I go right back into school. That is why I am contemplating the idea of applying to this program, wondering if I will love the 1 year as working as an RN, but then feel ready to go back to school after that 1 year is over.

I know as an NP, I have similar responsibilities to a doctor. I have no doubt that I am capable of handling those responsibilities. I just don't want to lose those meaningful interactions and close patient care that nurses have with patients. Do you have any additional advice?

umbdude, MSN, APRN · May 3, 2018

I think NPs have a different kind of relationship with patients.

In primary care, NPs don't normally see a patient just once. NPs spend ~1 hour for initial eval, then the patient comes back for follow ups. In a way, you build longer-term relationships. Many of the patients I work with have the same NP or MD for years (I work with people with severe mental illness). As an RN, you often see the patients for a few days, and you either never see him/her again or when that patient returns to the hospital, he/she might be assigned to another unit or another RN.

Good luck with your decision. I think your school has the right idea to require 1 year experience.

Hoosier_RN, MSN · May 3, 2018

Look at the area in which you wish to practice. Many markets are flooded with NPs, and this drives salaries down. Also, make sure that the school will supply the preceptors as well. Many NPs will no longer precept due to liability, or agreements that they have with the facilities in which they are employed. Good luck!

sasera · May 3, 2018

You should apply. Just because you apply, and just because you get in, doesn't mean you have to go. So I say apply, do your 1 year of bedside nursing, and then decide if you want and feel ready to do the NP portion.

Dodongo, APRN, NP · May 3, 2018

There's no rush. Get a job as a bedside RN (ICU, ER, OR, etc - it doesn't have to be med-surg and maybe shouldn't if you plan on going on to get your NP). If you still love nursing, go get your CNS or nursing educator or something that allows you to stay a bedside nurse with an expanded job description.

By going to NP school you will no longer be a bedside nurse. I function similarly to a physician. I review the chart (labs, imaging, etc), conduct consults (H&Ps), formulate diagnoses and treatment plans, and then place orders that address my plan - I also first assist in the OR which involves pre and post op management and orders. There is no overlap between the two careers. I do essentially nothing that a bedside nurse does ,and vice versa.

Too many nurses think that in order to advance their careers they need to be an NP or CRNA. That is simply not true. I would say a large portion of NPs probably should have pursued something different.