NEWS & RESEARCH
How the Growing Number of Nurse Practitioners Affects Hospitals and Why Registered Nurses Are the Solution
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EveryNurse Staff
- Last Updated: 09/20/2021
It’s an exciting time for the nursing profession as new options for advancement rise. Increasing educational opportunities have led to an exponential growth in the number of nurse practitioners (NPs) over the past several years, many of whom were initially registered nurses (RN). Although NPs are filling considerable gaps in the outpatient healthcare arena, their loss at the bedside is substantial.
According to one study, hospitals are floundering for help as approximately 80,000 registered nursing positions have been vacated due to the increasing numbers of RNs transitioning to NP positions. So why exactly are RNs leaving in droves? Is it truly for career advancement, or is there something more alarming at play? Here, we examine some of the reasons why nurses are retreating from the bedside to become NPs and how to reverse their escape.
Burn Out
Even before the Covid-19 pandemic, bedside nurses were experiencing burnout. Nearly two years later, the word “tired” doesn’t begin to describe their plight. A study by JAMA found that 31.5% of nurses in 2018 left their jobs due to burnout. America, we have a problem!
Not only does this pose a financial dilemma for healthcare organizations, but the loss of trust by consumers is concerning. JAMA cited that the top reasons reported by nurses for burnout included poor staffing ratios, lack of leadership support, and little to no collaboration between physicians and nurses. Although many nurses are not ready to leave their coveted profession, they seek relief from burnout by leaving the bedside and becoming NPs.
Autonomy
Not much feels better to a nurse than having autonomy. In 2010, the Institute of Medicine (IOM) made recommendations for nurses to work within the full extent of their licensure. What better way to achieve autonomy than owning a private practice or operating independently in an outpatient clinic? Having the ability to provide holistic, patient-centered care on one’s terms is priceless. Bound by endless policies and license restrictions, RNs can feel pigeonholed with no room for growth. Ditching long shifts, sleeping at night, having a work-life balance, and being one’s boss has become a profitable and obtainable option for many NPs.
More Money
According to the U.S. Bureau of Labor Statistics (BLS), NPs make approximately $30,000 more a year than RNs. Although most nurses aren’t in this profession purely for money, extra income is a welcomed sight. The cost of daily living, in addition to student loan debt, leaves many bedside nurses working nights, weekends, or extra shifts to cushion their wallets. Unfortunately, low-paying hospital wages contribute to nurse burnout, leading to the pursuit of more lucrative nursing careers.
The Solution
It may sound like a bleak situation, but there is a solution. Keeping future and current nurses at the bedside is essential to the longevity of the nursing profession and vital for positive patient outcomes. Nurses can’t keep working this hard, but they also can’t keep leaving the bedside or the profession. How does the current healthcare paradigm change? Well, they don’t call RNs superheroes for nothing!
Become A Change Agent
More than ever, bedside nurses need to be change agents. It may sound like a daunting task, but the current situation must be reversed. Who better to represent those in the trenches than the ones who reside there? Joining a shared governance committee is a great first step.
A study published by JONA found that nurse participation in shared governance improved patient and nurse outcomes. Implementing a bottom-up approach to policy change rids organizations of the disconnection between senior leadership and bedside nurses, allowing for quick improvements of its pain points. Gaining professional momentum by sitting on policy-making boards and utilizing clinical ladder programs are also valuable for implementing change.
Get Certified
Nurses, by nature, seek opportunities for self-improvement and professional growth but often feel they need to “move on” to achieve this. What if this ambition could be satisfied while remaining at the bedside? Obtaining a nursing certification allows RNs to do just that. In addition to being considered a subject matter expert (SME), certified nurses report having increased confidence and empowerment in the workplace. According to Rose Sherman EdD, RN, NEA-BC, FAAN, the value of being a certified nurse is evident in clinical practice as patient outcomes improve when units have a large percentage of certified nurses. A list of popular nursing certifications can be found at www.nursingce.com.
Be a Nurse Leader
RNs have the power to lead cutting-edge healthcare initiatives, equipped with clinical experience, a nursing certification, and the desire to make a real difference. Nurse retention should be at the top of the list, as high turnover rates cost hospitals thousands of dollars each year. In addition, a 2017 study found that leadership practices were a determining factor in employee satisfaction and retention.
Transformational leadership, empowerment, inclusive decision-making, and having a sense of cohesion were listed as significant attributes resulting in better retention rates.
In addition to improving orientation and mentorship programs, nurses can be relied upon to advocate for better staffing ratios, better pay, and increased promotional incentives. Since committed nurses equate to better patient care, healthcare organizations must invest in excellent nurse leadership.
Final Thoughts
Though this article does not want to derail a nurse’s dream of being an NP, it is a call to action for those merely seeking relief by leaving the bedside. You do not stand alone on the battlefield; therefore, retreating should not be an option. Alfred Wainwright said, “There’s no such thing as bad weather, only unsuitable clothing.” Armed with scrubs, a stethoscope, and comfortable shoes, RNs need to put down the white flag and conquer the conditions of poor staffing, low pay, and deprived work-life balance. It’s time to replace battle wounds with badges of honor by reforming the landscape of bedside nursing. America’s healthcare system depends on it.
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