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Will there be too many NPs?

NP   (10,481 Views | 27 Replies)

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It seems that there is a huge trend of RNs going back to school and choosing NPs instead of other emphasis (CNS, Education, Leadership, etc). There are so many online colleges and actual "normal" physical schools offering NP programs that its made me though if there will be a point where there will be TOO MANY of them?

Is NP a career that you foresee being completely saturated and difficult to obtain a job in the next 5 years? What are your thoughts?

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248 Posts; 9,649 Profile Views

This favorite topic appears again :) My thought is 'yes', unless the push for DNP is realized. However, this will not avoid and only delay the inevitable. Although it is true that there is significant increased in utilization of NP across the country compared to the past, the growing demand will not keep up with the predicted oversupply. NP field is like not other fields like psychology where American Psychological Association (APA) where accreditation is reserved for traditional, on-campus programs, making fully online APA-approved clinical psychology programs unavailable. I am not saying that we should move in that direction but there should be more stringent accreditation requirement.

Edited by harmonizer

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1,068 Posts; 26,499 Profile Views

There will be a need for NPs in the US, but not in all markets or all cities. In my own town of Charlottesville (population 45,000), the FNP market is fairly saturated with the only jobs opening when someone moves away or retires. There are, however, primary care NP positions in rural counties 30+ miles away and I know folks who choose to live here and drive and commute 30-60 mile/day. There are positions in town for acute care NPs with certain specialties (hem/onc, transplant, peds cardiac surgery, etc) and I also know some with FNP certifications who are going back to school for AG-ACNP certifications.

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132 Posts; 4,832 Profile Views

I live in the Northeast, which seems to have a better market than places like Florida, but I do worry the market is becoming more saturated. I was lucky and got a job within a month of graduating (and had multiple places interested) but not all classmates have found positions. And some of the offers were ones I really didn't want to have to take - after all that work and with all the extra responsibility you don't want to be in a begging position taking whatever is left over.

It is a big worry that even brick-and-mortar schools like mine are just ramping up their admissions. I graduated with a couple dozen other ANP/FNPs.....graduating classes used to be 8-10. In my first year, we had over 40 people in our Pathophys class and there weren't even chairs for everyone. Every term it was a struggle to find clinical preceptors, because the school had overadmitted and outstripped the local resources. This was a problem for the last 3 years and yet they're still admitting large numbers. Then we come out in May along with all the other local schools, and compete for what's out there.

Not a sustainable system in my view. To avoid this problem and to be seen as more professional, I do think there should be national limits on the number of schools and graduates as many other fields have. If you look at basic supply and demand, you run into trouble by endlessly increasing supply. I feel like I went back to school and got a job just in time, but I still worry for the future. The schools, however, will continue to push for more RNs and more NPs and talk about a shortage til they're blue in the face. They love that tuition money, and it just keeps going up.

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zmansc is a ASN, RN and specializes in Emergency.

867 Posts; 11,145 Profile Views

It's a good question, and one that if people don't get overly opinionated about by post #4 it will be a major miracle!

There are several things that come into play here. First, on has to define the market that NPs are trying to work in. The market that fits for most NPs is the primary care market, which is in a fairly strong change state currently, and most would agree how it is going to look in 5 and 10 years from now is very difficult to gauge. What will be the provider mix? (DO/MD/PA/NP), How will the demand change due to ACA and other forces? These and other questions like them have made there be a wide variety of projections on provider demand and supply.

Secondly, one would then have to factor in how they see not only NP schools production, but also schools for PAs, and even MD/DO. Adjust those numbers for those going into specialties in each area since these may affect how many are competing for the primary care positions.

Third, consider changing legislation and reimbursement models and how that will affect the need for providers in each group again. This will likely affect the demand in certain states over the next few years.

I'm sure there are other major factors to consider that aren't coming to me off the top of my head, but once you factor all of that in at a national level, then as mentioned above regional markets, urban/rural considerations, and other factors will play a role in the local markets and how saturated they will become.

I hope that helps!

All of that is to say, that all predictions are guaranteed to be wrong, the only question is by what amount! Having said that there are some concerns:

- There are far more NP programs, producing far more NP graduates than in the past. All I can say about this is I'm glad I'm at the head of the curve instead of at the backend. I expect it will be harder for students entering programs in a couple of years to find preceptors and get that all important first job than it will be for today's students. However, I'm not convinced this will lead to further impacts on experienced providers (regardless of degree) as I think they will remain in demand for the foreseeable future (just my opinion, I don't have numbers or a forecast to back this up).

- There will always be pockets of over saturation of providers. About 10 years ago a friend of mine, and a DO in primary care decided to move to a trendy town. She had 5+yr of experience in a town about two hours away. She had met a new love and decided to relocate. She knew many of the other DOs in that town, found a practice and came to an agreement to work there. Turned in her notice to her current practice and moved. Turns out there were just alot of providers in the town, didn't matter that they were MDs, DOs, NPs, PAs, etc. There were too many. So as she went about trying to build a panel, she struggled. She ended up taking a job at a local ER and working there for a couple of years. It was not her choice, she didn't want to do ER work, but she did because it put $$ in the bank. She is now working on starting a practice again. There is a national shortage of PCPs, but that doesn't mean that she just needs to open the door and she will be inundated with patients! Each opportunity has to have a good business plan and part of that is identifying how you are fulfilling a different need than your competitors. She learned that lesson, and is actively marketing her practice more aggressively than she did last time. Hopefully that will help her succeed. Irregardless of saturation level, we as NPs need to do the same. Either in our own practice, or make sure we sign up with practices that understand this important business concept.

In conclusion, to answer the last question on your original post. No, I absolutely do not see NP as being fully saturated in 5 years. I also do not believe experienced NPs will have a significantly more difficult time moving from job to job by then. I do believe new grads will need to work to find jobs and if they do not have a strong network into the provider community it might be more difficult than it is now.

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132 Posts; 4,832 Profile Views

It's a good question, and one that if people don't get overly opinionated about by post #4 it will be a major miracle!

That would never happen on these boards :sarcastic:. I do find the APRN section to be decent about this, though.

Good points - and smart to realize we can't really predict perfectly. Everyone has to look at the factors involved and make an educated guess for their geographic area or look where they might be able to relocate. And yes, once you're experienced it'll be a little different (as with RN jobs).

One thing about primary care, where the projected demand is - the hands down worst offer I received was from a private primary office. There may be a need, but that doesn't mean people can/will pay for it. There's a reason many MDs have avoided primary: it's hard to make money and yet you're responsible for knowing a decent amount about everything that might walk in the door.

I think some practices are perfectly happy to try to use an NP to make more money, but that NP may be subjected to the same productivity requirements without reaping the same benefits. I didn't expect much above my nursing hourly wage, but I was floored by what was offered. And I was a nurse for 5 years - not comparing to working nights/weekends/20 years experience. If that had been the only job around I would have been really upset. Great opportunity to learn, docs that really seemed to like me, but wow am I happy I had other options. Because I want to retire while I can still hobble around and enjoy it!

I'm still happy I went back to school, but if I were looking at starting now I'd be networking like crazy and trying to get a real gauge of the local market. And I'd want to be darn sure being an NP was what I really wanted vs. just moving to a different arena as an RN.

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zmansc is a ASN, RN and specializes in Emergency.

867 Posts; 11,145 Profile Views

Excellent points Adenium. Especially about networking, the more you network the better your chances are going to be no matter what the job market is like at the time.

Regarding your primary care point, there are two main groups where I live, one qualifies for loan repayment and the other does not. The NPs & PAs at the loan repayment clinic make about $30k less per year compared to the other clinic. They also seem to have lesser benefits (all based on discussions with current employees of both organizations). I think some organizations are more short sighted than others.

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6 Posts; 338 Profile Views

Every RN I know is either going back or planning to go back to NP school. Very few jobs in NY area. Pay is much the same of experienced RN.Get your BSN and specialize, that's the need.They need to go to the DNP to stop all these RN's going back for NP.We need staff RN 's in specialty fields more.The physicians and PA's are also increasing their numbers too.Good luck finding jobs as new NP's.Please pass the DNP in 2020.

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Aromatic has 3 years experience.

2 Articles; 352 Posts; 6,099 Profile Views

probably since there is no rate limiting step like there is for doctors. 1. its hard to credential a new medical school. 2. you can't just let everybody into a medical school (or dental school, etc) because some people are not cut out for it/won't be able to pass boards/ won't do the needed work to get through it sine it is a huge time investment and has very difficult boards that need passed. 3. residency spots are limited, which filters out a lot of FMGs from being doctors in america since residencies take american school students first 99% of the time.

so yeah, np profession will become flooded much as law has in the past decade.

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Jules A is a MSN and specializes in Family Nurse Practitioner.

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Interesting point, very similar to lawyers with regard to the glut, which according to this article has finally started to level off a bit.

"The National Association for Law Placement reports that fewer than half of lawyers graduating in 2011 eventually landed jobs in a law firm. Only 65 percent found positions requiring passage of the bar exam. At a time when many law school graduates are shouldering student-loan debts of $125,000 or more, compensation has declined painfully — the median starting salary for new lawyers in 2012 was just $61,000. And quite a few can't find any work at all: Nine months after receiving their law degrees, 11.2 percent of the class of 2013 was unemployed."

The lawyer bubble pops — not a moment too soon - The Boston Globe

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Aromatic has 3 years experience.

2 Articles; 352 Posts; 6,099 Profile Views

yeah a lot of law stuff can be automated now with like rocket lawyer and stuff like that. Used it for a business i owned a year or two ago (small business) never had to consult a lawyer for anything. Unless your from a big 15 school your law degree is just a glorified liberal arts diploma basically.

Apparently the best degrees now are math degrees, stats, actuarial science, raw math, etc. Followed by engineering, medicine, dentisry etc etc.

If i could go back I woulda prolly done software engineering lol :(

If it requires math, it makes big bucks most of the time.

sorry to go off topic >.>

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ICUman specializes in Cardiac Cath Lab.

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Please pass the DNP in 2020.

I hope the opposite. I doubt it will ever be required, not anytime soon. There is no incentive to obtain the DNP over an MSN-NP. An extra year of school and debt is just unappealing with no additional benefit.

I do agree PA's/MD's/DO's are adding to their numbers as well. It will be interesting to see how the healthcare industry adapts in terms of job opportunities. Specialty will be key.

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