In the following story, ONA member Cinol (last name withheld) reflects on her experiences as a practising RN at a large urban hospital while concurrently advancing as an NP student at a nearby university. Navigating high-pressure clinical environments, she confronts the tension between immediate patient care responsibilities and the analytical lens of advanced practice education.
The day starts before I am ready.
By 0730, the unit is already bursting, stretchers lined down the hall, monitors beeping like an alarm that never shuts off. Another patient from the emergency department rolls in, no beds left, hallway protocol activated.
The charge nurse sighs: I can see the weight pressing down on her shoulders. I take a deep breath, steady my hands and dive into the storm.
Bloodwork results flash across the screen. As an RN, I’m not expected to analyze every lab value in detail; my role is to notice the critical ones, to escalate, to act. But as an NP student, I can’t turn off the other part of my brain.
My mind races through my pathophysiology lectures: electrolytes, differentials, what this combination might mean. My heart wants to stop, to think, to piece it together. But the reality doesn’t wait. The next patient needs meds. Another transfer is arriving. My feet move even as my brain spins with unanswered questions.
And I ask myself, what if I were an NP today? Would I be sitting with this patient, explaining their lab results, building their care plan? Would I have the time and the authority to follow the threads that my RN role forces me to drop?
The rush doesn’t stop. Over census. Gridlock. My patient calls, short of breath. I adjust their oxygen, check vitals, reassure them. The hallway is alive with the shuffle of stretchers, the crackle of overhead announcements, the clipped conversations of physicians moving from bed to bed. My pulse quickens with the rhythm of it all.
I catch myself peeking at the medical students clustered around a chief doctor, soaking in bedside teaching. My chest tightens with longing. I want that. I want to be there, not just watching from the sidelines, but contributing, questioning, learning. Yet, I remind myself: I am learning, even here in the chaos. Every interaction, every decision, every frantic moment is shaping me into the nurse and the NP I am becoming.
Still, the tension never leaves. Who am I in this space? An RN carrying out the immediate, critical tasks of care? An NP-in-training whose brain refuses to stay quiet, who sees more, questions more, craves more? Or am I something in between, stretched thin, but growing wide, living in two identities at once?
Even on break, I can’t escape it. I sit down, take a sip of water, but my mind runs back to my patients. What if I missed something in the lab? Could that pain mean something deeper? What would the differentials be? The doctors’ speed at diagnosis impresses me, sharp, decisive. But then I feel a rush of pride: my way of seeing is different. Slower but richer. Rooted in connection, in the way I notice the tremor in a patient’s voice, the subtle anxiety in their eyes, the story behind their symptoms.
And that’s the answer. I don’t need to choose between RN and NP. I don’t need to apologize for the tension I live in. This is who I am: a nurse in transition, balancing the weight of two worlds, learning to stand strong in both.
Elegant? Maybe not in the traditional sense. Sweaty scrubs, pounding heart, unfinished charting. But there is elegance in the persistence, in showing up, in weaving knowledge and compassion together in the middle of chaos.
Because no matter what letters follow my name, one thing stays constant: I am a nurse. Distinct. Essential. Human. And in the noise of hallway protocols and endless beeping, I prove it again, for my patients, for my team and for myself.
To my fellow RNs: never underestimate the power of your observations, your advocacy, and your comprehensive approach. Even in the busiest moments, your presence and connection matter.
To NP students and those aspiring to advanced practice: embrace the tension between knowledge and action, between learning and doing. Your foundation as a nurse is your greatest strength.
Whether RN or NP, the essence of nursing is unwavering commitment, human connection, and advocacy for those in our care.
Whether RN or NP, the essence of nursing is unwavering commitment, human connection, and advocacy for those in our care. You don’t have to choose between roles; you can integrate experience, curiosity and compassion to serve your patients in the best way possible.
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