Waiting for NP job, working as RN

[ChapterTwo]

I'm a new RN (6 months experience) and in the FNP program. I know some people are against doing it so soon, but I worked so hard to get into a second-degree BSN + masters program. And that's how the program was advertised and designed - for seemless entry into the MSN. I work full time as an RN and go to school part time. Anyway, I am getting nervous about the job market for NPs when I graduate (Aug 2011). At first, I thought I could just continue working as an RN, gaining experience, until an NP job comes along. But now I am hearing that you can't work as an RN once you're an NP for liability reasons. What do people do once they are certified and waiting to land their first NP job? Stop working??? I don't want to get a degree that will end up limiting me. Any thoughts?

[Cardiology EP NP]

I also completed a direct entry masters program and received my MSN back in 2006. Exactly six months after graduation, I started an ANP program while I worked as an RN. I just finished the ANP program this past July and landed my first NP job several weeks ago. My first day as an NP is this coming monday.

I think your concerns about the job market are very valid, but I still think the job market for NPs is very good. I actually started my job search process last April way before I graduated and I probably got around 7 to 8 interviews since then. Many places I applied to called me back for an interview. And I was looking to go into a specialty area, cardiology. If I had decided to do general practice, it would have been easier for me.

And I still believe you can practice as an RN even with your NP license. Obviously as an RN you would know your limitations and boundaries. I have been working as an RN since I graduated from NP school but that was only 6 months ago. I just passed my exam a couple of days ago.

And I really don't think your degree will limit you at all. The FNP track is extremely marketable. You can work in a family practice office or even do retail health. You will have a lot of options with primary care, no doubt. I hope you decide to stick with. I know I am so glad I did! Good luck!

[TX RN]

You're correct in that the consensus is to be cautious in choosing to work as a bedside RN once you have attained your advanced practice degree.

> here's my thoughts:

However, my initial thoughts are that as a FNP your focus is on a different patient population, meaning non-acute. Therefore your formal education is focused on outpatient care not inpatient care. This should provide for some clear seperation between your duties as an advanced practice nurse and as a bedside nurse. Not to say you are completely free and clear from any possible liability issues because some FNP's certainly do work in hospitals. What state are you in? Start by looking at the scope of practice guidelines delineated for APRN's by your BON.

[ivanh3]

while this may vary from state to state, or from facility to facility, i know of no rule saying you can't work as a bedside rn if you hold an advanced practice degree/certification.

[jpRN84, BSN, RN]

I know when I was in nursing school, one of our instructors who's an NP worked in the hospital as an RN, and didnt come across any problems. She only did the RN thing PRN though for a summer before our clinicals to refresh herself as working as a bedside nurse after years of working as an NP. Good luck on your job!

[t2krookie]

After talking to several of my friends who have graduated and are actually working as NPs about this very question , the concensus is that there is no restriction (in Texas at least) for a NP to use their RN licence to do basic RN work as well, as long as you stay within the guidlines of the job description. I'm in the Texas Tech Program myself and had wondered the same thing since jobs are not garenteed to pop out the window at graduation.

[elkpark]

After talking to several of my friends who have graduated and are actually working as NPs about this very question , the concensus is that there is no restriction (in Texas at least) for a NP to use their RN licence to do basic RN work as well, as long as you stay within the guidlines of the job description. I'm in the Texas Tech Program myself and had wondered the same thing since jobs are not garenteed to pop out the window at graduation.

Very few states (are there any?) have an actual regulatory prohibition against this, but many employers won't hire/allow you to work below your level of licensure, because there are liability issues. The dilemma is that you are restricted by your employer to the job description of your current position, but, if something goes wrong enough to end up in court, the courts will hold you accountable for your highest level of education and licensure, regardless of the job description under which you were working at the time.

[Cardiology EP NP]

When I was in NP school, I did clinical with a an NP who also worked as an RN in an ICU on an occassional basis. She said she did it to keep up her nursing skills. We're in IL here so it's not a problem.

[t2krookie]

very few states (are there any?) have an actual regulatory prohibition against this, but many employers won't hire/allow you to work below your level of licensure, because there are liability issues. the dilemma is that you are restricted by your employer to the job description of your current position, but, if something goes wrong enough to end up in court, the courts will hold you accountable for your highest level of education and licensure, regardless of the job description under which you were working at the time.

yeah i can see the point. just because you may be a janitor at the hospital on the weekends, if someone drops in front of you, you would still be expected to do cpr if your an rn on the side. (silly and simplified comparison i know, but valid).

my difficulty with this is the obvious transition time between passing my fnp and the time it takes to actually become employed. several of my currently working np friends swear they were flooded with offers in their last year of the program but even then, the credentialing and time waiting for my results seems to be a daunting period. i am the main support mule for my family. in the ed at least i think i might be able to function rather safely being as i would be getting constant input or at least have ready contact with my docs should i require it. what do you think?

[allennp]

I am dealing with this now. I am working half time as a FNP in a ED and remain currently in a half time RN consulting (not bedside) position. Both for the same large system. I am currently waiting for a FTE in the ED. As I was a old ED RN and new FNP, I was happy to get a ED job and fully expect to transition into a full NP ED position in the next month or two when more shifts open.

Transition between the two in doable but not without complications. I would choose to avoid it if I could but my goals are to be a ED FNP so this is my path. I was pleased to get a ED job as a new FNP and figured this was worth it. It takes thoughtfullness and appreciation of roles to transition back and forth.

best to you

AW

[lilla_fjaril]

I work in the OR and one of my coworkers is an NP that chooses to work as an OR staff nurse. She said she did the continuing ed because she likes to learn and the hospital paid for it, but at the end of the day she's happy being an OR nurse and do to 15 years of experience she makes about the same amount of money as a new NP, so why change?

There's no rule at my large teaching hospital about working below your license. When you think about it, an RN with acls licensing can do a lot in an emergency. Unless you're going to start prescribing meds or performing emergency trachs (a procedure not taught in FNP I assume) I don't think there's a whole lot of room for confusion of job duties, is there?

And the job market for NPs is good most places, especially if you want to do primary care.