I stepped down from NP practice.
When I became an NP a few years ago, I followed the Noctor sub mainly out of curiosity but overtime my curiosity led to me siding with the overarching position that NP practice as it stands is not only dangerous but can prove substandard to medical practice.
For context, I’ve been a RN for over 15 years. I have worked in most clinical specialties with the exception of L&D and the OR. Those two specialties are just not my jam lol. For half of my career, I worked in behavioral health and decided to further my career to become a psychiatric-mental health NP. I felt my experience in inpatient psych and other combined experience prepared me for advanced practice.
What I did not realize is my education was subpar and the advanced practice expectations were the same for a physician, who has significantly more experience and education. In my opinion, the NP education, whether brick and mortar or online, is not advanced enough to permit independent practice. We are held to the same expectations as MDs, like psychiatrists, with less education/experience and lower reimbursements for similar professional expectations.
In my state, NPs require supervision for 3-5 years (legislation recently changed) and the NP may apply for full autonomy with MD sign off after supervision requirement has been met. I was on the path to full autonomy and I woke up one day like “what the hell am I doing?”.
NP practice has evolved into something incomprehensible. What started off as a role of physician extender, such as handling routine/follow up cases, has evolved into the role of medical leader with limited formal “medical” training. Several factors are driving this including shortage of MDs, expansion of Medicaid/increased access to care, payers/insurers trying to cut costs, etc.
I support increasing efforts to increase access to medical schools, changing NP educational requirements (including requiring at least 10 years of RN experience prior to program admittance, standardizing clinical requirements, changing the existing treatment model, etc.), and developing MD-NP initiatives to revert to the original NP model in which we served as extenders of MD-led settings handling prevention, health promotion, vaccines, minor procedures, routine and follow-ups, less complex cases, etc. because this is what I signed up for.
I haven’t received the best support for “stepping down” because people really don’t get it. But I know it was the best decision for me.