What’s the better career: a registered nurse or a nurse practitioner?
Routinely I am asked about what I do for a living. I would argue at this point, my key answer is “educator” since I work for a university of medical sciences full time and founded and teach for Skills On Point. Nevertheless, as someone who has had careers in both nursing and as a nurse practitioner, I would like to discuss what key differences exist in 2022 for the two professions.
Nurse practitioners are all nurses first.
This is important when considering the timeline it will take to become a nurse or a nurse practitioner. Nurses may enter their careers though multiple pathways: licensed practical nurse to registered nurse, associate’s degree in nursing, bachelor’s degree in nursing, accelerated bachelor’s degree programs and various other slight variation. Registered nurses are all certified through the NCLEX-RN examination process and state licensure follows national certification.
Many nurses will work for a period of time in healthcare, developing their skillset and expertise before advancing to a nurse practitioner role, although some enter directly from RN to the nurse practitioner role without any clinical practice. Stigma still exists in this regard against those who are nurses and have gone straight to advanced practice; however, considering the skillset of a physician assistant who likewise has no “nursing time” before their entry to practice, the skillset of nurse practitioner is uniquely defined and separate of the role of nurse. Nurse practitioners will undergo either a master’s degree or doctorate before eligibility for certification through one of two certifying bodies, the American Association of Nurse Practitioners (AANP) and the American Nurses Credentialing Center (ANCC).
The roles of RN vs. NP are completely different.
The vast majority of nurses work in direct patient care, and as the COVID-19 pandemic has shown, this is a vital role currently in jeopardy. People are not robots and the emotional, psychological, and physical toll nurses face from a daily onslaught of stressful patients means the “shelf life” of a nurse lessens by the day. By 2025 it is suggested over 75% of the current nursing workforce will leave the profession, leaving a wake of vacancies for future nurses to fill. While nursing is in itself a profession, many will pursue advanced practice degrees to obtain what is considered the terminal degrees in the specialty of nursing: the PhD or Doctor of nursing practice (DNP).
The workplace for a nurse is truly diverse, from clinics and hospitals to schools, private industry and medical product sales, pharmaceutical sales, case management, quality improvement, legal review, and countless others. The role of a nurse includes assessment, diagnosis, planning, implementing, and ongoing evaluation of the care of a patient, regardless of the environment, with a defining focus on holistic care, education, and advocacy. The role of the nurse practitioner involves identifying, diagnosing, prescribing and managing the health whether in collaboration with physicians or independently with full practice authority. More and more states are allowing for NPs to function in this regard and as a full practice authority license-holder myself, this is a large step for access to healthcare for many rural and underserved areas of medical care.
Nurse practitioners routinely oversee a large panel of patients in a primary care setting with panels of several thousand, or several dozen inpatients for those who practice in a hospital setting. Roles are as varied as healthcare, with some NPs working in range from education, direct patient care, insurance, legal, travel, and business. Since nurse practitioners are also nurses, the carryover effect for focusing on holistic care, advocacy, and patient education commonly brand nurse practitioners as the healthcare professionals who listen and engage relationally with patients more than others.
The outlook remains wonderful for both
The need for nurses and nurse practitioners continues to expand. For good reason, the nurse practitioner was named the best job in the US by U.S. News and World Report, with physician assistant consistently along side in the top 3 year after year. Some attribute the longevity of nurse practitioners to the increased wage compared to nurses historically, where over the past decade, entry level nurses ranged in the Midwest US from $25-40 per hour (pre-COVID) generating annual full time salaries of $50-80,000 while entry level nurse practitioners typically commanded around $50-65 per hour, generating a full time salary of $100,000-130,000. MGMA data reporting has shown slight annual increase consistent with inflation over the past 5 years, however nursing has been skyrocketed in average pay due to the phenomenal revenues of travel nursing during the COVID-19 pandemic and since. Hospitals reeling after large exodus of staff to travel have implemented internal versions of travel programs, with guaranteed high pay in exchange for retention and working in undesirable areas.
Quite bluntly, nursing is experiencing a shift in supply and demand and quite honestly, nurses are just much more in demand than NPs right now. However, as with any crisis, eventually, this will normalize and I would propose a new normal will emerge with nurses making more money at base and nurse practitioners being those who are interested in a different role, rather than a different earning potential, but time will tell that story for us all.
Nursing CEU Courses
If you are on the fence of entering the training for nursing or nurse practitioner, remember both care for their community, family, and friends, while enjoying a career with many different ways to guarantee something new is available if you ever get bored. Should you ever get the opportunity to pursue the role, consider the nursing CEU courses and resources Skills On Point has for both student nurses, registered nurses, nurse practitioner students, and licensed nurse practitioners. We have helped tens of thousands of nurses make the transition just a little bit less scary and at the end of the day, I’m proud to say I am both a nurse and a nurse practitioner owner of Skills On Point.