[forward25]

Hello,
I am trying to make a choice between two graduate programs and need some insiders' perspective.

Basically, it comes down to this:

The program at University of California San Francisco is a 3 year
accelerated MSN degree. It would qualify me as a Clinical Nurse Specialist
in advanced community health/international nursing/ HIV/AIDS. The
Johns Hopkins program is a BSN- MSN which would qualify me as an
Adult/Acute Care nurse practitioner, that would take about 3 1/2-4 years. While time and money are factoring into my decision; it is less important to me than getting the best education and the best preparation for my career.

I have identified these concrete things about what I want to do in the
future:
1. Work in Latin American and/or India and if I have to be in the
states... with refugee/immigrant populations
2. Would like to work in a clinical setting such as a community clinic,
public hospital or with an ngo where I could be involved with direct
patient care as part of my job description. Would like to have
prescriptive authority and feel confident to function at least in my clinical
specialty (HIV/AIDS) without a physician.
3. It is equally as important to me to be involved with community-based
initiatives such as advocacy, outreach, program planning, and
fostering collaboration between ngo's, the private sector and the public
sector.

My ideal job would involve maybe 40% of my time in patient care and 60%
of my time doing #3 (arbitrary %'s, but just to make the point that I
would need both to feel fulfilled.)

I have done quite a bit of research about the differences
and similarities in the roles of a CNS v. an NP, but am still unclear about the real scope of these advanced practice specialties in the context of my career goals and which would be a better option for my studies. I have been considering many other factors and will continue- to but any light that can be shed on this question would be helpful. I need to make a decision by next Tuesday and am far from being pulled in one direction or the other! Thanks to everyone who takes the time to read this post and provide guidance.

[pinoyNP]

Hi forward25! You know, us NP's always tend to say in these threads that it is important to know the job market in your area before planning your future advanced practice nursing field. But I think, in your case, it is different. You know exactly what field you want to get into and you are probably willing to relocate in order to get to do the job you want. Is that right?

I just have a few opinions to pass on. Both schools you picked have excellent reputations as far as training in community health - I'm sure you already know that. Although UCSF's program seem to match your goals a bit more, the program prepares you for a CNS role. You should realize that as far as having prescriptive authority, clinical nurse specialists are not able to obtain the authority to write medication scripts in all 50 states. Also, while NP's in general have prescriptive authority across all the states, some if not many, have provisions for physician delegation or collaboration.

I would be inclined to pick the ACNP route if I am in your shoes. This is because most ACNP programs I know of (mine included) allow a greater degree of flexibility in individualizing the clinical portion of the program to meet the student's career goal. If your interest is in HIV/AIDS, your program can arrange clinical rotations that are specifically for this field. On the downside, I would like to point out the limitations of an ACNP certification as far as treating the pediatric population, unless of course, the NP is dually-certified in adult and pediatric ACNP. In addition, the ACNP role tends to be viewed as a purely in-patient NP role by some (meaning, the training is specfic to hospital-based medical management). This is not true of all ACNP's as some do have out-patient roles in addition to in-patient management.

Good luck to you and I hope you get what you are after with the degree you end up picking.

[imenid37]

Hopkins has a Program w/ the Peace Corps. They also had, and probably still do, a program in Public Health, for tropical medicine. I am sure you already saw that. There are many new Latino immigrints in East Baltimore. I am sure you would get a lot of interaction w/ the immigrint population in either area. I would think NP would be better, though I am going for educator, but I do agree re. the prescriptive authority. Good luck!