What makes you tick as an NP?

[CardiacDork, MSN, RN]

RN with five years of acute and critical care experience.

As a nursing student I saw the bedside RNs venting and complaining. Of course I never really understood the significance or reasons until I experienced them for myself.

At my current job as a bedside ICU Nurse I don’t really interact with NPs or PAs but I want to know... what makes you tick as an NP? What are the concerns or annoying things about being an NP?

RN kind of stuff = short staffing, rude families or patients for 12 hours, dealing with truly incompetent providers (not just providers you disagree with), nursing politics (everyone’s in some competition to get ahead by throwing each other under the bus), SO ON SO FORTH.

So tell me, what kind of stuff is the kind of stuff that does affect you daily or has the possibility of popping up that causes you anxiety or dread? Maybe even burn out.

[Corey Narry, MSN, RN, NP]

ICU NP for over 10 years here. I'd say I enjoy my role 100% than when I was a bedside RN. I do still have to deal with difficult providers but that's tempered by the fact that I am also a provider and there seems to be more open and collegial exchange when disagreements occur between providers. I sometimes felt left out of those discussions as a bedside nurse and at times, never got a clear "bigger picture". I have my share of difficult patients but don't have to spend 12 hrs a day with them.

Short-staffed? It's different as an NP, we don't have patient ratios to speak of and we don't cap at a set number of patients but you're also not answering call lights, phonecalls from every department, addressing bedside tasks on patients every hour, you know what I mean. You still get called on your break and you do respond just in case it's a true emergency. That said, I live and practice in a state and institution where bedside nurses don't deal with short staffing, missed breaks, rude physicians, etc.

Stresses? It's a heightened responsibility to patient outcomes. You have to know what you're doing especially since you're the one writing the order. We also do procedure and it's not as simple as a nurse saying "I need a central line" and you do it. You think it through and weigh your risk and benefits and still worry about the patient's anatomy and whatever else they may have that could make your procedure not straightforward and thus setting you up for complications on your watch.

Other NP's throwing me under the bus? It depends on the overall culture of your group. NP's are nurses too and I've heard of infighting and toxic work dynamics from other NP's in other departments, luckily I don't see that in my group. We do have high achievers in our group who will stick their noses into every committee just to get their name out there. I don't see that as a bad thing as long as it doesn't affect me and my annual evaluation. We are union so all that fluff doesn't add to your annual raises.

[CardiacDork, MSN, RN]

22 hours ago, juan de la cruz said:

ICU NP for over 10 years here. I'd say I enjoy my role 100% than when I was a bedside RN. I do still have to deal with difficult providers but that's tempered by the fact that I am also a provider and there seems to be more open and collegial exchange when disagreements occur between providers. I sometimes felt left out of those discussions as a bedside nurse and at times, never got a clear "bigger picture". I have my share of difficult patients but don't have to spend 12 hrs a day with them.

Short-staffed? It's different as an NP, we don't have patient ratios to speak of and we don't cap at a set number of patients but you're also not answering call lights, phonecalls from every department, addressing bedside tasks on patients every hour, you know what I mean. You still get called on your break and you do respond just in case it's a true emergency. That said, I live and practice in a state and institution where bedside nurses don't deal with short staffing, missed breaks, rude physicians, etc.

Stresses? It's a heightened responsibility to patient outcomes. You have to know what you're doing especially since you're the one writing the order. We also do procedure and it's not as simple as a nurse saying "I need a central line" and you do it. You think it through and weigh your risk and benefits and still worry about the patient's anatomy and whatever else they may have that could make your procedure not straightforward and thus setting you up for complications on your watch.

Other NP's throwing me under the bus? It depends on the overall culture of your group. NP's are nurses too and I've heard of infighting and toxic work dynamics from other NP's in other departments, luckily I don't see that in my group. We do have high achievers in our group who will stick their noses into every committee just to get their name out there. I don't see that as a bad thing as long as it doesn't affect me and my annual evaluation. We are union so all that fluff doesn't add to your annual raises.

Thank you for your thorough response, insightful.