Why you shouldn't become a nurse practitioner

[chillnurse]

You may not be able to work in your favorite specialty.

Currently, work in the ER as an RN? Do you love it? Good, well your first job out of school may not be in the ER as you have lingered during your nursing career. Love the ER? Well, recruiters love experienced NP's in the ER, so you may be out of luck for a few years.

You may take a big pay cut.

WHAT, A PAY CUT???? I MAKE 45 DOLLARS AN HOUR AS A LOCAL TRAVEL NURSE AND MY STARTING NP PAY IS LIKE ONLY 38 AN HOUR, DUHBULL YEW TEE EFF. Yeah, that's right, your first job might land you in a local community health center making less money with a masters degree, than with an associates degree.

You have to learn an entirely new trade.

The term "advanced practice nurse" is really misleading. We don't practice in any way as an RN does. Our role more so mimics physicians. "Man I have been an ICU nurse for 12 years and an ER nurse in a level trauma center at 16 different Mayo clinic locations, I GOT DIS BRUH." No, you don't get dis. What you have is a new steep stepping-stone into a new trade. You are on the other side of the brick wall now writing the orders for your old self to follow. Welcome to "advanced practice nursing."

Another 30-70k in loans and other fees.

Running short on change due to having to support a family, bills, expensive hobbies, or for some other reason? Well, the solution sure isn't to take out another student loan. Becoming a nurse practitioner costs A LOT OF MONEY. Yeah, it isn't medical school, but we also don't make what physicians make either. Count your coin prior to becoming an APRN.

Time

Looking for a 1 day a week online nurse practitioner program that requires no travel graduates in 5 months, 10 clinical hours, and a 2.1 GPA to get into? Looking at some of the online programs that exist, I wouldn't doubt there are at least a few of these. I am sure there are some great online programs out there, but trying to take the easiest shortcut probably won't pay off in a competitive market such as todays. A good program will require a decent time commitment. Should getting a master's degree not at least be as much work as your associates? Some seem not to think so, they seem to believe that once you have your RN you should instantly be crowned Dr. Nurse with the wave of a magic wand and the writing of a few 'nursing policy' papers.

Labels and role confusion

Get ready for this one... Labels. The patient walks in the room. "WHAT A NURSE, I WANT TO SEE A DOCTOR, WHAT IS THIS NURSE DOING HERE." All that extra school and you still get called a nurse. Where did the word practitioner go? Oh, that's not in a good amount of people's vocabulary. Nurse is a nurse is a nurse is a nurse nurse nurse. Don't think that big white coat with the MSN FNP flashing around is going to make people bow down to Dr. Nurse. You will need to present yourself well to avoid this dilemma.

Poor support from licensing agencies

This is a big one. Look around online and I see adds all over the place stating garbage such as: "EASTERN FULL SAIL UNIVERSITY OF PHEONIX GOVERNERS UNIVERSITY is now taking applications for their CNA-to-DNP program. Please apply online, no GRE, college education, high school diploma, or GED required." Wow. Good job ANCC, AANP, or whoever credentials these places, you sure do make sure that only the highest, and I mean HIGHEST standards of education are upheld in the prestigious field of nursing. I am sure the AMA would rather get kicked in the balls multiple times before they would allow the credentialing of a fully online medical program from a fully for-profit university with teachers posting online quizzes and tests from their garage. And people are lobbying for less nurse practitioner restrictions? I know there are great nurse practitioners and programs out there but PLEASE, let's be real.... Until some limitation is put on the quality of these bed-bug ridden basement nurse practitioner programs, we will never have the support for unregulated practice.

Now I am not saying that become a nurse practitioner is terrible, but these are some things to consider. I am sure this is going to be rather controversial, so I have put on my jock strap and am ready for low blows to the land down under.

Thanks for reading, if you made it past the 3rd paragraph without cursing me under your breath, we may be able to be friends.

Best of luck to you all!

why-you-shouldnt-become-a-nurse-practitioner.pdf

[BostonFNP, APRN]

If you work in a pain clinic you earn every bit of that money. Tough job.

[Ally082]

This reminds me of another post/blog I saw somewhere else except it was, "Why you don't want to become a PA". This post, just like that one gets its point across to the intended audience who are people like me currently researching career paths.

To people who are already in the field of nursing it may seem offensive in some way but understand it is meant to be an eye opener for me and my peers who have BIG dreams and lots of assumptions regarding what majors to pursue and why, then educating ourselves on such things.

I am not a traditional student, I'm in my early thirties and some of the things that my fellow students who are more than decade younger than me seem to think about building and growing a career are just not realistic. They think that they can go from point A to C and find ways to bypass B all while making boat loads of money and OPENLY sharing stories of their Xanax and Adderall popping along the way (with no rx mind you) and doing little research into the career choices they make and ultimately end up disappointed.

By the way some of these people think the NP job is some what similar to an RN with more money, a rx pad and a title change, so I'm not surprised the OP made reference to that.

So thank you for providing some insight to a potential nursing student. I will pay more attention to school accreditation standards and stay open minded about salary expectations for my particular market here in Philly.

[ThePrincessBride, MSN, RN, NP]

In some job markets...of course the cost of living compares...bedside nurses with experience make $60.00 plus, plus in the Boston area. I know that is a fact personally. So yes it is possible for a FNP to make that.

Good point!Cost of living definitely needs to be taken into account when talking about salary. Sixty bucks per hour in California or NYC is nowhere near as impressive as making sixty bucks per hour in the midwest.Still, as a nursing assistant, I can't imagine that kind of money. To OP, I forgot to ask but what do you think about nurses extending in their own specialties as NPs? For example, my short term goal is to work as a NICU nurse. Long term? Neonatal Nurse Practitioner. Or how about the psychiatric nurse with ten years of experience wanting to advance as a psychiatric NP? I don't think you can clump those examples with pre-pre nursing students looking to become an NP for "quick big money" and not a modicum of healthcare experience or a clue as to what it means to be an NP.

[chillnurse, BSN, RN, NP]

I would totally base my decision on more of if you like the current setting you are in than relating the decision to how long you have practiced in that setting. Previous experience in one area will help some, but not as much as many portray. I would do what you like, not what you are experienced in. The role of an NP is very very very different than that of an RN. somebody who has done what you have stated may be able to answer this question better than I.

[Riburn3, BSN, MSN, APRN, NP]

I would totally base my decision on more of if you like the current setting you are in than relating the decision to how long you have practiced in that setting. Previous experience in one area will help some, but not as much as many portray. I would do what you like, not what you are experienced in. The role of an NP is very very very different than that of an RN. somebody who has done what you have stated may be able to answer this question better than I.

Very true. When you become an NP you are another provider with a scope of practice that differs greatly from a regular RN. The big difference is the approach to a situation and the type of thinking comes from a nursing perspective. I find myself to be a much better teacher than many physicians I've worked with during my clinicals simply because I've spent so much time teaching patients as an RN.

Similarly, previous experience helps, but the quality of that experience is important. I've worked 7 years in critical care, most of it as a charge nurse. The type of nursing I do is very independent and full of critical thought, which has been a tremendous help in my NP program. If I were a cath lab nurse handing over supplies, I probably wouldn't value my experience as much in NP school. Additionally, having experience was a huge asset when it came time to having to find my own preceptors. I can't imagine being less than a year out of school and having to find people.

[tuxedopenguino]

Very true. When you become an NP you are another provider with a scope of practice that differs greatly from a regular RN. The big difference is the approach to a situation and the type of thinking comes from a nursing perspective. I find myself to be a much better teacher than many physicians I've worked with during my clinicals simply because I've spent so much time teaching patients as an RN.

Similarly, previous experience helps, but the quality of that experience is important. I've worked 7 years in critical care, most of it as a charge nurse. The type of nursing I do is very independent and full of critical thought, which has been a tremendous help in my NP program. If I were a cath lab nurse handing over supplies, I probably wouldn't value my experience as much in NP school. Additionally, having experience was a huge asset when it came time to having to find my own preceptors. I can't imagine being less than a year out of school and having to find people.

Ohh, I see. I was wondering why many NP programs require at least 1-2 years experience as an RN before applying even though the OP says it's a very different role and RN experience won't help very much.

This thread was useful. I always felt kind of weird when I was in my undergrad RN program because I got a sense there was a lot of pushing for advanced degrees and becoming an NP. Professors with so many titles in front of their names. Classmates who already decided from the beginning they want to be an NP. I understand knowing what options are available for the future and thinking about where you want to be, but right now I'm trying to focus on how to be a better nurse, and figure out what my niche in nursing is, never mind what I want to go to grad school for.

I think this is common for colleges in general though, since a lot of undergrads get sucked into the allure of getting a PhD/masters right after getting their Bachelor's without getting any job experience first. Colleges these days just want to make money. Of course it's a personal decision at the end of the day, so what can I say.

[avictoria]

After reading the original post and few replies, I can say I really enjoyed the perspective as a non-nursing undergrad who wants to be a NP. It reminded me of all the reason I want to be an NP verses other professions including RN. So many students want to finish up school and get on the fast track to NP and do not take the time to research all the details. but I want to work my way from CNA to NP and enjoy every step. I don't just want to graduate and become a NP, I want to spend time working at every level so I can have the best perspective of my patients when I reach NP. Hopefully this mindset will help me become the best practitioner that I can be :)

[athomas2244]

I'll just add in my 2 cents. I am currently enrolled at chamberlain college of nursing MSN FNP program. I've been at MD Anderson for over 2 years now and they think very highly of chamberlain nurses, so much so that they are on our approved list of schools for tuition reimbursement. Yes it is a for profit school and sure I was very skeptical. After doing researching decided to apply and here's why. I like the 8 week long courses and online learning environment. However, there is a campus site in Houston and one is opening in pearland. PERSONALLY i log some serious library hours each week researching evidence based articles for my discussions each week.....and yes, there are assignments and readings each week as well. Our professors are very interactive in the discussions with us as well. I also have the campus sites at my disposal for resources and sim lab as well. Then again, THIS IS WHAT IM PUTTING INTO MY EDUCATION, SO THAT I MAY BE THE MOST KNOWLEDGEABLE, CONFIDENT, COMPETENT, AND SAFE NP. I say that to say this.....I 100% agree that CNA -DNP with damn near the only requirement is to have a full name and priors is absolutely RIDICULOUS, and is assuredly putting a sour taste in my mouth about MOST BUT NOT ALL for profit schools.

[fsalazar1]

I agree with the OP as well as other contributors like Retired APRN and Blue Devil. I have been an RN for two years coming in October, and practicing in ICU for 1 1/2 years. Before I got my job in February 2013, I was admitted into an ARNP program at a private school. When I was in nursing school, I was told that because I have a degree in a previous field coupled with my ASN, I could bypass the BSN and become an advanced practice nurse right away. It's like the professors encouraged that, considering that most nursing students these days make that their goal due to the demand that has been placed in today's economy. The problem is - I HAD NO NURSING EXPERIENCE! Sure, with new job, I would work and go to school, and by the time I was done, I would have 3 years of ICU experience (this was a part time only program). Sounds great right?

Not so in my case. I had to drop out of the program that semester due to the ICU training, and while I still hold provisional acceptance in that program, I had to come to terms with the fact that I currently (and maybe never) not interested in the role of an NP. I'm just not. It's not what the Lord has placed in my heart or desire to do. I struggled with that because I figured that if I wasn't meant to be an ARNP, then why would I get into such a competitive program in my area? Truth is, the school got accepted to is a private school, so if I was willing to pay for it, then they're like come on in! I've had great grades in school, thank God, so that's an extra bonus, none of that matters if the only purpose for going to NP school is because you're expected to. Or because you don't like bedside care anymore. Or because you're going to make more money or earn respect. YOU HAVE TO WANT IT. I also believe that having experience in nursing care, especially acute care, make you extremely knowledgeable and resourceful. You have to want to be a health care provider. I just come to the conclusion that I don't want to do that. It's not in my heart. I may not like ICU as much, but I'm grateful for the experience and exposure. There is so much that you can do with a BSN that can take you away from bedside, should that be the issue for some. I just think that a respect for the ARNP profession should be elevated. The program shouldn't be so easy to get into. I would screen nurses and make sure that they truly have the 2-3 years experience in appropriate areas in order to perform properly as an NP. I think also finding yourself in nursing is important before you do something that you truly that you don't want to do. You just might find yourself in a NP program and hate it, realizing that you would rather be an educator, in management or wherever. I'm just saying that it should be thought out and counseled through thoroughly before loans are processed, more debt is added, and potential disappointments are realized.

That was long, but it was on my heart. Thanks to whomever will take the time to read all that. I will now stand behind my spiritual shield in case others STRONGLY DISAGREE. (joking :-))

[BostonFNP, APRN]

I would screen nurses and make sure that they truly have the 2-3 years experience in appropriate areas in order to perform properly as an NP.

Based on what?

[AWanderingMinstral]

The OP has some VERY valid points...even if s/he could benefit from a basic grammar course. In addition, it is important to remember that s/he is a whopping 25 years old and has been a nurse practitioner for one year. So, s/he likely possesses a whopping three years of experience as a nurse (assuming they didn't go from BSN to NP).

Now, I will relocate in order to focus on my area of interest, infectious diseases, as well as to earn the hourly rate that I am worth (ACNP, MPH) (many people either won't or "can't" do that). If I am going to undertake ANOTHER graduate degree, then I am prepared to learn a new and different skill set. Furthermore, as a part-time student at an in-state university, I won't end up broke or spending all day AND every day with my nose in a book. Finally, I am fine with being (slightly) under the thumb of a physician ("It's on YOU, dude!"). Of course, this all helps that I have an awesome spouse who $upports me in EVERY way. Good luck and take everything that people say, here and elsewhere, with a grain of salt. Oh, and become a nurse practitioner...if that's what your heart desires!

[Riburn3, BSN, MSN, APRN, NP]

Based on what?

Likely based on their own limited personal experience.

While I agree that having solid nursing experience during NP school is useful, the closer I get to graduation (3 months away), the more I realize that it probably isn't as important down the road. To start, my CVICU/ICU experience has been huge in helping me understand patho, various medications, and with independent thinking, all critically important to any learning NP student. Additionally, it was really useful in helping me find preceptors because I knew such a wide array of physicians across numerous disciplines.

That said, down the road a few years from now, I imagine the differences between myself and classmates that had much less experience going into the program is going to be minimal, and largely based on the work experiences obtained after graduation. I think of it somewhat similar to classmates during undergrad that were seasoned CNA's or MA's during our program, with tons of bedside experience, to individuals like myself that had never stepped in a hospital before the first day of clinicals. During school they had a very large upper hand, but a few years out of school, there probably wasn't a single difference.

Overall, the role of any APRN isn't for everyone, and it takes desire and strong constitution to will yourself back to school and completely start anew. Too many people here are focused soley on salary in all aspects, which don't get me wrong, is important. However, that are several other things such as quality of life and personal satisfaction that comes with being an APRN.