r/nursepractitioner

We can’t talk about student loan caps without talking about why tuition has gotten so high, far beyond the rate of inflation. Saddling nurses with more and more debt, without any accountability is horrible.

Now with NP degrees headed towards the DNP level, nurses will be graduating with similar debt to physicians coming out of medical school.

Lets also remember damn near every NP school in the US are in direct violation of CCNE standards to provide their students with appropriate clinical rotations. The VAST majority of programs openly force their students to find their own preceptors, or either sit out a semester/year, or even worse turn to predatory private preceptor companies, charging thousands out of pocket for students to be able to graduate on time.

Nursing academia and graduate education have traded the professional integrity of our trade for money. We are quickly headed towards a tipping point of obscurity as more and more degree mill programs churn out ill prepared and inexperienced NP’s, further diluting our professional reputation.

The future is looking very bad. We need sustainable growth that promotes quality over quantity, and not at the expense of massive student loan debt.

I live in a remote area with many wealthy elderly residents. Many are widowed/single and live alone. No uber/lyft if they are unable to drive.

Healthcare in our town is inadequate, including no home health, no hospice. No nursing homes. I do not & have never worked for any local or hospital system in my state. I have no intention of doing home hospice.

Full practice state.

Many years of primary care experience, oncology & home infusions (among other experience)

I’m considering offering home visits for cash. I would require that the patients keep their primary care and specialists.

For example, someone who has had major limb preserving arm surgery at a facility two hours away who needs dressing changes. This example is my neighbor & literally there are no options for the dressing change to get done, even though all of our local hospital/ortho/primary care are a part of the system where they had the surgery. I am doing it for free because she is my neighbor & I am her friend.

Someone post hospitalization (chf, thyroidectomy) who needs someone to drop in and be a second set of eyes, weigh, check incisions, drains, medication checks.

Most of their children live far away, usually out of state. We are a 2+ hour drive from an airport.

In general these patients are 85+ years old but more like 65-75 as far as overall health/independence compared to most Americans.

Thoughts? Things to consider? Pitfalls?

Do not plan to prescribe anything. More of a “your incision is healing well, changing the dressing q 3 days” or “you’ve gained 10 lbs & have 2+ pitting edema, let’s call your cardiologist”.

I do have my own malpractice insurance already.

I’m currently working bedside in CICU for the last 4 years and have 1 year Neuro ICU experience. My main goal is great work-life balance and a primarily remote/ WFH job. I don’t feel a particular passion for either track but am interested in both. I really enjoy the part of my job that deals with helping people during end of life care so palliative care appeals to me but mostly I just want to work from home and be with my own family.

For the last five years I've been precepting students but an issue has come up recently that I'd love some input on. I know that every program may be different but should students be expected to have to do work outside their clinical hours such has reading up on patients they will be seeing the next day or finishing up notes? My current student told me that she is in school full time and works full time and so should not be expected to do any work for clinical outside of the clinic day. Of course, that severely limits the amount of hands on experience they are getting because she takes a long time writing notes. This is her third clinical rotation.

I realize that I should have clarified expectations about this at the start of clinical but would love thoughts about it this now. Thank you!

Wondering if after I receive my FNP I can kiss my 7 days off PTO-free goodbye...

… should I be surprised to be offered a position that would pay me 215k annually? No start date yet. They will train me for 6 months. 14 pts max. 5x8s. Specialty clinic. VA LA. Are they that desperate? I would take it for sure. What’s your experience? 26 days PTO 13 Sick Time 11 holidays. This is a dream offer. Imposter syndrome is kicking in.

EDIT: I spoke too soon. They rescinded the offer. Back to Indeed! 🥺🥺🥺

I’m looking for honest advice from people who have actually been through these career paths because I genuinely feel stuck trying to figure out what direction makes the most sense for my future and long-term quality of life.

I’m 33 years old. I currently work as an ICU nurse with about 1 year of RN experience, and before nursing I worked as a paramedic for years. Right now I only have my ASN, so I still need to complete my BSN before I can even realistically apply anywhere for advanced practice programs.

Financially, I’m actually in a solid position overall, which is part of why this decision feels so important to me. I’m completely debt-free. I have about $20k sitting in a HYSA as a 6-month emergency fund and around $122k invested across my 401k, Roth IRA, and HSA combined. I’ve become extremely focused on retirement planning, investing, financial independence, and building long-term stability. I’m trying to think strategically and not make emotional decisions that could set me back financially for years.

At the same time, I also don’t want to spend the rest of my life feeling like I played it too safe.

One of the biggest things driving me lately is that I genuinely want to experience more out of life outside of work. I want to travel internationally, see the world, take multiple trips a year, and actually have the income and schedule flexibility to enjoy life while I’m still relatively young and healthy. I already know I don’t want my entire identity to revolve around working bedside forever.

That’s part of why CRNA keeps pulling me back in.

The compensation is obviously attractive, but honestly it’s more than just the money itself. It’s the idea of:

• Higher income ceiling
• Better benefits
• More schedule flexibility
• Working fewer shifts
• Greater long-term financial security
• Ability to aggressively invest and retire comfortably
• Having more freedom to travel and enjoy life outside the hospital

I know money isn’t everything, but realistically a CRNA salary combined with fewer workdays could completely change my quality of life and ability to achieve my personal goals.

But then reality hits me.

I still need:

• BSN completion
• More ICU experience
• CCRN
• Competitive application prep
• Possibly leadership/preceptor experience
• Shadowing
• Graduate-level science readiness

By the time all of that realistically happens, I’d probably be around 37–39 before even starting CRNA school, assuming I even get accepted on the first try, which I know is unlikely for many applicants.

And honestly? I don’t even fully know if I’m smart enough for CRNA school. That fear is very real for me. I know how brutally difficult those programs are academically and mentally. Sometimes I feel motivated and capable, and other times I wonder if I’m romanticizing it because of the salary and lifestyle.

I’ve also considered NP school, but the more I research it, the less convinced I become. I constantly see discussions about:

• Saturation
• Burnout
• Lower salaries than expected
• Regret over debt/time investment
• Lack of respect in some settings
• Poor job markets in certain specialties
• APP oversupply concerns

And if I’m being honest, I don’t even know what NP specialty I would truly want to pursue. I know one thing for certain: I do not want to stay in ICU or ER long-term. Bedside critical care is already mentally exhausting me, and I can’t picture myself doing high-acuity bedside nursing forever.

Part of me wonders if the smartest move would simply be:

• Stay RN
• Move into a procedural specialty like cath lab, IR, OR, GI, or PACU
• Maximize RN income
• Pick up strategic overtime/travel contracts if needed
• Continue investing heavily
• Maintain flexibility and lower stress
• Avoid massive student loans and years of school

Especially because I’ve realized there are ICU nurses making very respectable incomes already through overtime, differentials, travel work, procedural areas, and smart financial management.

I also wonder if there are other career paths I’m overlooking completely.

Healthcare informatics?
Medical device sales?
Perfusion?
AA school?
Industry roles?
Leadership?
Remote healthcare positions?
Something outside the hospital entirely?

I guess I’m struggling to determine whether CRNA is truly the right path for me… or whether I’m mainly attracted to what the career could provide financially and lifestyle-wise.

I don’t want to wake up at 45 regretting that I never tried.

But I also don’t want to spend the rest of my 30s stressed, buried in school, delaying life, and potentially sacrificing years of freedom if there are better paths for someone in my position.

If you were genuinely in my shoes at 33 years old, what would you realistically do?

I am an AGACNP through ANCC and have moved to oncology biotech side since 2023 and haven't practiced since. I still maintain both RN and NP licenses and my certification renewal is due 9/2027 (last done in 2022).

Anyone else in this position and what have you done to maintain your certification?

Hello! Not going to add a ton of location details to stay a little anonymous but I work in a small (less than 15 staff) private practice clinic within my specialty. I work in a relatively large city with a diverse population from teenagers to 80s for clinic population. We are one of a handful of small private practices within our specialty in our city and then there’s two large hospital affiliates. Lately we are STRUGGLING. Paying patients aren’t coming in, medicaid isn’t paying out, general patient populations are down, etc. I’m the newest provider at the clinic and I worry I and likely multiple staff members will have to seek other employment soon. This sucks because I truly love my job and my clinic and it’s genuinely a joy to wake up and go to work. I love 99% of my job and I’m truly lucky to be where I am. My questions here are

1. Any other clinics in this situation or have been and it‘s gotten better or worse?

2. Has anyone gone from a close knit, very chill and small private practice where it feels like staff and patients are basically out of a delightful sitcom and then you had to go into a huge hospital affiliate ? How was that transition? Advice?

3. If our clinic closes or reduces staff, would a high recommendation from our MD even be worth anything in a city where everyone knows everyone basically?

Thanks! Sorry for the long post?

https://www.reddit.com/r/unpopularopinion/comments/1tfq6nl/nurse_practitioners_should_not_be_allowed_without/

Thoughts?

Hello,

I'm really considering of wanting to go back to school to become an AGPCNP. I have a total of 13 years experience of nursing 4 years as an LPN working in LTC and 9 years of RN working as a medical-surgical-tele float but I have experience working in Observation/CDU, LTC and LTAC. I've floated to renal,cardiac,Oncology, transplant, GI/GU, neurology, ER Inpatient holds, psych, orthopedics on the top of my head.

My goal is to work in a lower stress environment (like corporate wellness, occupational health, or specialized wound care). There is an opportunity for my workplace to train me on becoming a WOCN nurse and I may take advantage of that opportunity if they decide to hire me.

I have two main questions:

1. Is my Med-Surg/Tele background sufficient for Primary Care, or should I pivot to ER/ICU for a year? (Note: I am NOT doing Acute Care). I don't want to set myself up for failure.

2. For those who are from Georgia or FL, ​What are the best brick-and-mortar or hybrid schools in Georgia or Florida that 100% handle clinical placements? I refuse to find my own preceptors. I've considered Emory, GSU and USF.

I'm open to constructive feedback. I do greatly appreciate.

Looking for recommendations on the best and fastest post-master’s PMHNP certificate programs for an FNP. Preferably fully online with good clinical support and the shortest completion time possible. Would love to hear personal experiences and recommendations!

Finally graduated (yay). Hoping to take my FNP boards (planning for AANP) sometime in late June/early July as I’ve accepted a position that starts in September and want enough time to do all the things that I have to do license wise.

Question:
What did your study layout look like? How many weeks/how many hours a day? I’m using Leik and UWorld, may add in a live board prep sometime in the middle. Any suggestions are appreciated!

Hello! My school is requiring malpractice insurance for all students. Does anyone know of good options that don’t cost an arm and a leg?

Thank you!

Hi everyone,

I'm an RN currently working in a burns and plastics unit in a large hospital system, and I'm planning to go to NP school with the goal of eventually working as a dermatology nurse practitioner.

My main question is:

Do dermatology NP jobs typically consider wound care experience as relevant experience?

In my current role, I regularly manage: complex burn wounds, post op grafts, post-op plastic surgery patients (most of the time it's flaps), wound care and dressing changes, skin integrity and healing complications

I know dermatology involves things like biopsis, procedures, and outpatient skin conditions, but I'm wondering how much my current experience would actually "count" when applying for dermatolgoy NP positions later one. Would I be at a disadvantage compared to someone who worked in a dermatology clinic as an RN? Should I be looking to leave my current role for dermatology outpatient jobs?

Any insight from derm NPs or hiring managers would be really appreciated. Thank you!

Hi all!
I am getting my first student clinical placement at urgent care. I’m excited but I haven’t precepted yet as an APRN so I don’t know what to expect and I want to make it a good experience for her! What are your biggest tips and/or advice for having a student? TIA :)

Hey guys! I recently passed my AANP exam on my first attempt and honestly it was challenging but I wanted to pay it forward to anyone who wants any advice on how I studied and wants to know what worked best for me! Let me know by commenting or sending me a private message. Wishing anyone and everyone who is scheduled to test soon, the best of luck!

Morning,

For those of you who took/passed boards prior to graduation can you give some insight into when you started studying prior to taking boards?

Thanks.