10 Most Stressful Nurse Practitioner Jobs in 2023


Written By: Kasee Wiesen DNP, APRN, FNP-C


Are you a nurse interested in pursuing a career as a nurse practitioner? But do you have some questions or concerns before committing? This is understandable as nurse practitioners have more responsibility, including diagnosing and developing treatment plans specific to the patient.

If this sounds like you, is one of your questions what are the most stressful nurse practitioner jobs? Below, you will find the 10 most stressful nurse practitioner jobs in 2023.


WHAT ARE THE MOST STRESSFUL NURSE PRACTITIONER JOBS?


So, what are the most stressful nurse practitioner jobs? Below you will find the 10 most stressful nurse practitioner jobs in 2023.


Stressful NP Job #1: Emergency Nurse Practitioner


What Do They Do:

Emergency nurse practitioners provide care to patients of all ages in the emergency department or urgent care setting—there are pediatric-specific emergency departments you may also work in. Emergency nurse practitioners quickly but thoroughly assess their patients to determine which diagnostic tests are needed.

Once the tests are completed, the emergency NP must interpret the results and define the next steps. This may include pharmacological or non-pharmacological treatment plans including education based on the results and discharge instructions. Or, you may have to order additional tests, facilitate an admission or discuss further with a specialist to ensure appropriate care. Emergency NPs are always on their toes and ready for whatever enters their department.

What Makes this Job One of the Most Stressful:

Working in the emergency department is one of the most stressful nurse practitioner jobs, and is also exciting because you never know what will walk through the door. You never know or can predict what your patient caseload will look like or what treatments your patients will need. You may have five or more patients, with three being critically ill and requiring immediate attention, another needing sutures, and another having symptoms of upper respiratory infection.

You may also have to work with the hospitalist to coordinate an admission or even another hospital to facilitate a transfer to ensure their patient receives the most appropriate care. Emergency departments are also almost always busy, never giving you a break in your shift regardless of the shift worked.

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Stressful NP Job #2: Adult-Gerontology Acute Care Nurse Practitioner


What Do They Do:

Adult-gerontology acute care nurse practitioners provide care to adult and geriatric patients primarily in the hospital setting—some work in specialty clinics. The adult-gerontology acute care NP assesses, diagnose, and treats patients while they are in the hospital. This includes ordering and interpreting diagnostic tests and then developing treatment plans based on these results. They work closely with the interprofessional team when providing care, including nurses, respiratory therapists, physical and occupational therapy, and other specialties.

What Makes this Job One of the Most Stressful:

This job is stressful because you care for acutely sick patients. When patients are admitted to the hospital, they are typically very ill, and it is your job to figure out what is going on and how to improve them. You must learn about the patient and their health history quickly as it impacts the treatment plan. You also have a continuous flow of new admissions and discharges that may interrupt your day.


Stressful NP Job #3: Family Nurse Practitioner


What Do They Do:

Family nurse practitioners care for patients across their lifespan, including birth to death. They play a significant role in coordinating and managing patients’ healthcare. They focus on disease prevention, health promotion, and addressing acute and chronic health problems. The FNPs perform many skills in their office, including suturing, splinting, and skin biopsies, but also work very closely with specialists and refer patients to specialists when needed.

What Makes this Job One of the Most Stressful:

This job is stressful as FNPs are their patient’s primary care providers—and can care for newborns through the end of life. This means they are often the ones patients seek to see first with their healthcare concerns, and the FNP typically initiates the workup. Based on the findings, the FNP may continue to manage the health concern or refer to a specialist as needed. This is a lot of responsibility, coupled with the family practice physician shortage, which means FNPs are getting busier and busier. They are also responsible for ensuring patients are up to date on cancer screenings, vaccines, and other health promotion screenings to help ensure optimal health for their patients.


Stressful NP Job #4: Pediatric Acute Care Nurse Practitioner


What Do They Do:

Pediatric acute care nurse practitioners provide care to pediatric patients in the hospital setting—in other words caring for patients who are acutely sick or have a critical health concern such as a fracture. The pediatric acute care NP will assess the patient, order diagnostic tests, and, as needed, formulate a diagnosis and then develop a treatment plan that is specific to each patient.

What Makes this Job One of the Most Stressful:

This is one of the most stressful nurse practitioner jobs as you care for pediatric patients in the acute care setting. You may be caring for a newborn, a five-year-old, and a 17-year-old all at the same time—there are significant developmental and health-related differences between these age groups that you must be knowledgeable about. You must also have solid time management skills and be able to care for your inpatients while simultaneously coordinating admissions and discharges are needed.


Stressful NP Job #5: Pulmonology Nurse Practitioner


What Do They Do:

Pulmonary nurse practitioners care for patients with pulmonary concerns. You must be very knowledgeable as you are the expert on the pulmonary system. You will order and interpret appropriate diagnostic tests for each patient and develop patient-specific treatment plans. In many organizations, you will also care for inpatient and outpatient patients.

What Makes this Job One of the Most Stressful:

This is one of the most stressful nurse practitioner jobs as you must have strong knowledge of caring for various pulmonary disorders in the inpatient and outpatient settings. You are the expert in caring for pulmonary diseases—including acute and chronic problems. Pulmonary NPs have been working in overdrive due to the Covid-19 pandemic making their specialty even more in demand.


Stressful NP Job #6: Cardiac Nurse Practitioner


What Do They Do:

Cardiac nurse practitioners care for patients with cardiac symptoms or problems. They can work in inpatient and outpatient settings, and it is common for them to work in both. They will assess, diagnose, and treat various problems, including hypertension, hyperlipidemia, or various arrhythmias. They may also manage patients in the inpatient setting who just had a heart attack or even open heart surgery.

What Makes this Job One of the Most Stressful:

This job is stressful because you are caring for the heart and the expert on this organ. If the cardiac system is not working as it should, it can impact other systems, including the renal system. There is also a growing number of patients suffering from cardiac problems, so the need for cardiac nurse practitioners is growing.


Stressful NP Job #7: Psychiatric Mental Health Nurse Practitioner


What Do They Do:

Psychiatric mental health nurse practitioners provide mental health services to patients across the lifespan—and may work in inpatient and outpatient settings. This is done through assessment, diagnosis, and development of patient-specific treatment plans that include pharmacological and nonpharmacological methods. The psychiatric mental health NP will also have routine follow-ups with their patients to allow for close monitoring of any changes.

What Makes this Job One of the Most Stressful:

Working as a psychiatric mental health NP can be stressful due to the growing need for their services and the simple fact that the demand for psychiatric mental health NP is high! Psychiatric mental health nurse practitioners are experts in mental health, which can be complex as many patients have multiple mental health diagnoses, and appropriate medication management is key.


Stressful NP Job #8: Endocrine Nurse Practitioner


What Do They Do:

Endocrine nurse practitioners care for patients with various endocrine problems, including type II diabetes, thyroid disorders, obesity, and hormone disorders. While there are many endocrine problems, it is not uncommon for the endocrine NP to specialize in one or two conditions instead of managing all diseases—but please know that this is not true for all endocrine NPs. Endocrine NPs primarily work in an outpatient setting, but if they have a patient in the inpatient setting, they may see them there based on their needs.

What Makes this Job One of the Most Stressful:

Working as an endocrine NP is stressful as the demand grows. More and more patients need endocrine services to manage their diabetes, thyroid disease, obesity, and other concerns. You are also an expert in the endocrine system, which can be a challenging system to grasp fully.


Stressful NP Job #9: Critical Care Nurse Practitioner


What Do They Do:

Critical care nurse practitioners work in the hospital setting. Their job includes assessing, diagnosing and treating patients who are critically ill or suffered a critical injury. In other words, they typically work in intensive care units but may follow their patients to step-down units. They work closely with the healthcare team including other medical specialties, nurses, physical and occupational therapy, radiology, respiratory therapy and many others to ensure their patient is receiving appropriate care.

What Makes this Job One of the Most Stressful:

The patients that the critical care nurse practitioner cares for are critically ill or critically injured making their job stressful. They typically have a short window of time to make an accurate diagnosis and formulate a treatment plan specific to their patient. They must be able to perform strong and accurate assessments and be ready for changes in their patient's status and be able to alter their treatment plan as needed.


Stressful NP Job #10: Neonatal Nurse Practitioner


What Do They Do:

Neonatal nurse practitioners care for critically ill neonates and infants in the hospital—typically the neonatal intensive care unit (NICU). They complete thorough assessments, interpret diagnostic tests, and formulate treatment plans based on these results. They care for these critically ill neonates and infants alongside a healthcare team that includes other specialties, nurses, respiratory therapists, and many others.

What Makes this Job One of the Most Stressful:

Working as a neonatal NP is stressful as you care for neonates and infants that are critically ill. This can be stressful as you are caring for tiny babies, medication calculations have to be calculated very carefully and patient-specific, and there is added stress due to the acuity of the babies. Plus, you are caring not only for the patient but also for the family and others who are at the bedside with the patient.



My Final Thoughts


Did I answer your question, what are the most stressful nurse practitioner jobs in 2023? After reading about the 10 most stressful nurse practitioner jobs in 2023, I hope you are still interested in becoming a nurse practitioner—and please note there are many other specialties for the nurse practitioner to pursue! If anything, this list motivated you or helped narrow down the specialty you want to work in as an NP.


Kasee Wiesen DNP, APRN, FNP-C
Kasee Wiesen is a practicing family nurse practitioner. Her nursing background includes emergency medicine, pediatrics and peri-op. Education is a passion of Kasee’s, and she has taught BSN, RN-BSN and DNP students, and has enjoyed every moment of it!