What's the difference

I am often asked when I say I work as a nurse practitioner, "What's a nurse practitioner?" I'll also get, "Oh, is that like an LVN?" or "Oh, my friend's a nurse and...". I have learned that many people don't know what an NP is. So how is my job different than an RN? Well, I am an RN too, but I no longer work at the bedside. The easiest way to describe the difference is to say how my job changed from when I worked as a nurse to what I do now. As a nurse, I carried out all the orders the physician, nurse practitioner, or physician assistant wrote. (As a point of reference, I worked in the ER). I did functions such as placing IVs, drawing blood, placing Foley catheters, placing NGTs, performing EKGs. Those were fun things, but there were a lot of not-so-fun things. For me, that was namely cleaning up after bowel movements. Now, I was in the ER, so fortunately that wasn't nearly as often as nurses who work the floors/ICUs have to deal with. But for me, the bigger downside was not having more control over the patient's management. It was one thing to have to "anticipate the doctor's needs" but it's another to actually make those orders.

Now as nurse practitioner, I manage my patient's care. I write orders for tests or labs they need, interpret the results, write prescriptions for meds they need both inpatient and at discharge, discharge patients from the hospital, work with the interdisciplinary team to prepare for discharge (like needing a wheelchair or placing in nursing facility). Some other functions include pulling chest tubes, downsizing or discontinuing trachs, and doing VAC changes. During grad school I learned how to place chest tubes and central lines, but the job I took doesn't have the NPs do this- in part because I work at a teaching hospital where all the residents are dying to do them and need to learn as part of their residency. What procedures you do will vary according to the job, and according to your state's reguations.

For me, moving from the bedside to have more autonomy was the right choice. I know many nurses though that have no desire to have authority to manage the patient's care. And this is certainly not because they are not capable of the work. But realistically with the autonomy comes more responsibility that some nurses just don't want. Not to mention the sacrafices of going back to school after you already have a great job, and potentially worse work hours than you had. Some NPs take call- I fortunately don't. All-in-all, I think going back to become an NP was a great decision and I would support anyone considering the idea of working as an advanced practice nurse!