Tell me the downsides.

Specialties NP

Published

Specializes in Critical Care.

I like to be pragmatic.

So please NPs of allnurses. Tell me what sucks the most about being an NP?

I know that everything isn't filled with meadows and butterflies.

Anyone willing to just simply list some of your top complaints and perhaps things you wish could change about the NP industry?

Thank You in advance

CardiacDork, RN (BSN student)

Cardiac ICU Nurse

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I wanna know too

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Specializes in ICU, LTACH, Internal Medicine.

If you, like myself, enjoy communications with people who are intellectually either equal or above yourself, then, as an NP, you'll experience, say, 10-fold increase in just such communications as compared with your nursing practices. Which would be immensely good and enjoyable. Most of these communications would be completely optional.

The only one problem is that increase in communication with people whose intellectual level would be well below yours and often frighteningly so, would be at least 100-fold at the very same time, and you cannot avoid 99% of them.

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Specializes in Critical Care.
If you, like myself, enjoy communications with people who are intellectually either equal or above yourself, then, as an NP, you'll experience, say, 10-fold increase in just such communications as compared with your nursing practices. Which would be immensely good and enjoyable. Most of these communications would be completely optional.

The only one problem is that increase in communication with people whose intellectual level would be well below yours and often frighteningly so, would be at least 100-fold at the very same time, and you cannot avoid 99% of them.

Sounds fascinating. I would definitely enjoy having interactions with intelligent individuals. The most enjoyable times I've had as an ICU Nurse are rounds with the attending and residents. When the attending speaks, I'm all ears. I would love to be able to interact in such manner with physicians as an NP - the idea is appealing.

Question, why in your experience does your interaction with those that are frightening unintelligent also increase? Is it the larger volumes of patients you're treating from different backgrounds?

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In primary care at least, that never ending inbox of lab results, consults, radiology reports, med refills, patient questions, staff questions. Staying caught up on those and getting notes done on time was the thing that would stress me out the most. Even when I was off it would always be at the back of my mind that I knew things were building up and since I have EHR access at home i would log in most nights to try to make some headway. I would always think to myself if those were MY lab results I would want them reviewed quickly. If it wasn't for that I would actually say that primary care is EXACTLY what I wanted when I set out to be and FNP. I actually find it quite satisfying!

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Specializes in ICU, LTACH, Internal Medicine.

Question, why in your experience does your interaction with those that are frightening unintelligent also increase? Is it the larger volumes of patients you're treating from different backgrounds?

Patients and families - yeah, and there are immediately more of them. WAY more. But at least that's understandible to the point. It is nothing new for me. But then there come insurances, QA/utilization, higher administration of every place you contact and healthcare providers of every kind, including your former colleagues. Too many of them are, well, not at the level they supposed to be. Or they "justdoingtheirjobs". Or they just do not think at all. And that's when reality knocks from below where you thought the bottom was.

- we do not have separate computer station for providers. Our interior designer opposes it.

- no, consult not approved by insurance. If you want to order that med, that's fine, it is approved (the newest miracle pill costing $$$$$ of your hard-earned tax-payer dollars and about which you have very little ideas - as so everyone else except that consulting guy. Got to catch him in corridor somewhere)

- you missed ordering b-blocker again! No, it doesn't matter that patient is on 3 drips and Q1H bolus - he has CAD, therefore b-blocker must be ordered and order then deleted

- patients' WHAT??? Blood pressure? Oh, I do not know it, let me go and find a CENA to take it, hold on... (it's midshift, mind you)

- can patient have something for secretions? He's coughing after respiratory therapy!

- patient refuses his meds for 1 week and he's actually not eating anything for a few days... maybe a week, I do not know exactly... and he's actually not verbal any more... can he just have something for drooling and constipation?

- the staff message distributed (date) contained a significant misprint. All privileged providers MUST respond on this letter within 24 hours by a short email including MANDATORY screenshot of email box "messages" folder with the above message deleted

I can go on, and on, and on.

And yeah, I still like it more than bedside.

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Specializes in Critical Care.
In primary care at least, that never ending inbox of lab results, consults, radiology reports, med refills, patient questions, staff questions. Staying caught up on those and getting notes done on time was the thing that would stress me out the most. Even when I was off it would always be at the back of my mind that I knew things were building up and since I have EHR access at home i would log in most nights to try to make some headway. I would always think to myself if those were MY lab results I would want them reviewed quickly. If it wasn't for that I would actually say that primary care is EXACTLY what I wanted when I set out to be and FNP. I actually find it quite satisfying!

Thank you for your honesty. Can I please ask you, what did exactly is that you enjoy that you believed primary care would be like? I want to see how my current visions of primary care align with your past visions and current satisfaction of the profession.

Again, thank you for your response.

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Specializes in Critical Care.
Patients and families - yeah, and there are immediately more of them. WAY more. But at least that's understandible to the point. It is nothing new for me. But then there come insurances, QA/utilization, higher administration of every place you contact and healthcare providers of every kind, including your former colleagues. Too many of them are, well, not at the level they supposed to be. Or they "justdoingtheirjobs". Or they just do not think at all. And that's when reality knocks from below where you thought the bottom was.

- we do not have separate computer station for providers. Our interior designer opposes it.

- no, consult not approved by insurance. If you want to order that med, that's fine, it is approved (the newest miracle pill costing $$$$$ of your hard-earned tax-payer dollars and about which you have very little ideas - as so everyone else except that consulting guy. Got to catch him in corridor somewhere)

- you missed ordering b-blocker again! No, it doesn't matter that patient is on 3 drips and Q1H bolus - he has CAD, therefore b-blocker must be ordered and order then deleted

- patients' WHAT??? Blood pressure? Oh, I do not know it, let me go and find a CENA to take it, hold on... (it's midshift, mind you)

- can patient have something for secretions? He's coughing after respiratory therapy!

- patient refuses his meds for 1 week and he's actually not eating anything for a few days... maybe a week, I do not know exactly... and he's actually not verbal any more... can he just have something for drooling and constipation?

- the staff message distributed (date) contained a significant misprint. All privileged providers MUST respond on this letter within 24 hours by a short email including MANDATORY screenshot of email box "messages" folder with the above message deleted

I can go on, and on, and on.

And yeah, I still like it more than bedside.

Wow, I truly want to thank you for your candid response. These are the type of responses I was hoping for.

I want sheer honesty about what I may be putting myself into.

I also appreciate your comment at the end about enjoying it more than bedside, I definitely see myself enjoying it whole lot more.

I see myself in a provider role. I see myself in that role, confidently and happily. Bedside has taught me a lot but I'm ready to care for patients from a completely different angle, and I want to LEARN.

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Specializes in Nephrology, Cardiology, ER, ICU.

The never ending chronic disease processes!

Yikes - I just wanna treat'em and street'em. It gets boring telling ESRD pts to quit eating phosphorous, watch your K+ intake, don't drink so much.

And...with my HF pts, its watch your sodium intake, take your meds and don't drink so much.

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Back when we had a collaboration requirement, getting the assigned physician to do the chart review, which should take about a half hour, and sign the paperwork on a quarterly basis was potentially a huge chore. Because they didn't want to do it.

As a psych NP, being repeatedly lied to, or told the story from an extremely skewed perspective.

Being constantly hit up for sleeping pills.

Dealing with PCPs, who can prescribe psychiatric drugs within their scope of practice, and do so in a truly frightening manner.

When I first started, making less than RNs in the building.

I could go on, but most of the issues have been fairly minor and the pay has exceeded expectations.

Probably the biggest thing- it is just a dull, routine job most of the time, like any other.

The "big wins" are few and far between.

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Specializes in CVICU, MICU, Burn ICU.
The never ending chronic disease processes!

Yikes - I just wanna treat'em and street'em. It gets boring telling ESRD pts to quit eating phosphorous, watch your K+ intake, don't drink so much.

And...with my HF pts, its watch your sodium intake, take your meds and don't drink so much.

LOL. This is the ED nurse in you! :)

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Specializes in Critical Care.

Thank you for your time, honesty, and responses. I welcome all NPs to share!

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