Changed My Mind

[CraigB-RN]

Well since I can't decide what I want to be when I grow up, I've decided to drop the NP as of now. Going to finish a MSN, which I can get done in less than a year (education & Informatics). Now I know I'm taking a chance that a year from now I won't be able to find a post grad certificate program, but I'm keeping my fingers crossed.

I looked at scope of practice and how midlevels are looked at here in Atlanta, I looked at what i was learning as an FNP student ( I found out I don't care about pelvic floor dysfunction) and I'm not sure how the ACNP is going to be handled in ER's etc yet, so I figured why wast time and money.

Plus I was one of those people who took whatever short cut they could. I was having to spend to much time learning the chemistry, math etc and it was to hard to keep up and work full time.

[jjjoy, LPN]

Instead I was accepted into a Master's Entry Program in Nursing which included an accelerated year of RN training and then I started my graduate program immediately after... I even considered stopping grad school and continuing my career as a RN, but I figured I was already half way through, might as well finish it, and continue with my original plan knowing that I would always have the option to return to RN work.

In my experience many people who plan to become NPs do so because they think it's what they "should do". It's viewed as more prestigious "you're almost a doctor". The majority of people who were in my cohort in my masters entry program were pre-med. I found this outlook ridiculously annoying. You are and always will be a nurse! And that is something you should be proud of!

But I digress...

I do think it would be putting one's head in the sand to not acknowledge that many people make NP as their goal because it IS considered a "mini-MD" - good pay and prestige with a MUCH smaller investment of time and effort. I'm not saying it's *easy* to become a nurse or NP, but it is *easier* (and definitely faster) than becoming an MD - all things otherwise equal.

Perhaps it's almost TOO "easy" & quick to become an NP these days. With direct entry programs, a person could theoretically be working as an FNP in the same time it would take it complete an ADN program... and not have to work night shift or regularly deal directly with vomit, feces, etc. ... see just one patient at a time... working with fairly healthy patients (in primary care) ... and make decent money to boot!! If you already have a bachelor's degree and are even somewhat interested in health care, why wouldn't you choose that as a goal?!

[VivaRN]

If some of you don't mind sharing ... at what point in your career did you decide to aim for an FNP specialty?

Hi llg!

I am one of those who decided to pursue a dual degree FNP/MPH while in nursing school. I sought advice from profs and got varied opinions, but after shadowing and knowing the FNP's in my life I knew this was for me. I envisioned myself in the outpatient environment working to keep people healthy. It was that simple.

When I started grad school I had 8 mos of BICU experience (Burn ICU was offered to me as a new RN and I thought, why not!). I continued there P/T and also worked inpatient HIV during school. Going through grad school I got fascinated with HIV (great mix of clinical + public health) and have been offered a job as an HIV NP. I wouldn't do it any other way - when I'm 34 I'll have 10 years of experience! I want to use that to be active in research, advocacy, policy and in building capacity for HIV management both here and abroad. There is plenty of work out there for this 'soon to be' NP :nuke:

As with anything it depends on the person and your assessment of why they want to go to grad school. Help them think their decisions through. I have always been very driven and thoughtful about what I want, which has helped me thus far.

And that's my story!

[PMHNP10]

this thread is troubling in a sense--I read a lot of disappointed accounts, but no details why it isn't as rewarding as you had hoped

why are folks not particularly happy with their career as a NP? I can't even imagine being happier on the floor, since for me floor nursing = misery

I know that the variety of jobs is not as broad as it is for undergrad RNs, but there are still many settings available to a RN, so is it something about the role as a NP is less satisfying than the role as a floor RN? do you feel like you are practicing too much medicine and not enough nursing? do you feel you are less respected or valued than you were as a floor RN? is it more demanding/stressful than being a floor RN? is it pay? is it hours of work? do you feel you do not get to spend as much quality time with your patients as you do as a floor RN (this would absolutely boggle my mind if this is the problem)? so what is it?

[jalma527]

I agree with jjjoy - it is easier and faster to become a NP than an MD if that is your goal, but in my experience the work as an NP is not as comfortable. My job does not hold any different expectations for me than what are placed on the MDs, and I definately get paid less. Perhaps that is part of my dissatisfaction. Being an NP is A LOT of responsibility. This may also be due to where I practice but I can certainly say I am not always "working with fairly healthy patients". The majority of my patients have multiple chronic conditions and are uninsured and therefore lacking necessary tests and specialty consults that I am certain will cost them years of life as well as deplete their quality of life. This is a constant source of stress for me.

I also agree that it is perhaps too easy to become a NP. I worry that the integrity of the APN, as well as the RN, professions may be jeapordized with the influx of people entering the field looking to make money and "help people" but who quite frankly are not that smart.

[7starbuck7]

I am reading this thread with such interest...keep the responses coming! I have been an ICU nurse for 8 years. What the pp said about becoming a NP because "you should" describes me to a tee. The only thing I know 100% is that I don't want to be a bedside nurse forever.

I started an ANP program and HATED it (online format) and I am switching to FNP in a traditional on-campus setting. I am not completely confident in my decision. But I feel like the looming DNP is putting pressure on me to make a decision. For me it is not so much ANP v. FNP v. ACNP but do I want NP at all? It seems like the next logical choice, but I am not sure it is?

[Corey Narry, MSN, RN, NP]

If some of you don't mind sharing ... at what point in your career did you decide to aim for an FNP specialty?

I am in a position to advise a lot of nursing students. So many of them seem to have decided that they want to be an FNP (or PNP) even before they start nursing school (or while they are in school.) I always advise them to keep their options open for a few years to get a chance to actually experience nursing practice and to find out "who they are as a nurse" before making such a big investment in a graduate program.

I usually suggest that they work for at least a year before entering graduate school ... and then to start school part time if possible to give themselves a chance to find out what they really like and don't like about nursing and to find out where their true talents lie. I tell them that I have met lots of people who have gone through all or most of their graduate programs only to discover that they don't like where it has gotten them.

So ... at what point in your careers did you decide to head in the NP direction? Why did you pursue that? ... And where did you go wrong in your decision-making process?

Really, I don't mean to offend anyone. NP's are fine people and it is the right career choice for a lot of people. However, I have talked to very few BSN students who DON'T say they plan to go to grad school very soon after graduation and become an NP. I know it is not the right choice for all them and I need to understand that phenomenon so that I can give them good advice.

Thanks.

To me, being an NP was a natural progression after having been a Registered Nurse for many years. The pathophysiology of various adult medical conditions always caught my interest even way back in nursing school. As I gained more experience as a nurse, I became better at predicting what orders the physician would write for a specific patient with a specific medical condition. I didn't come to know any NP's until the late nineties and this was while I was working at step-down unit at a hospital. Still lacking enough knowlegde about medical therapeutics and management, I began to admire these NP's skills and knowledge and found them easily approachable when I had questions as to why certain medications and treatments were ordered on my patients. That became my voila moment - the time when I realized that this is the field that I know I would enjoy doing.

My initial impulse was to pursue the FNP route. I thought that this would be a broad field and the scope of practice would allow caring for patients of all age groups. However, I began to question that decision as I never enjoyed caring for infants and children and had no interest in women's health issues neither. I sought many advice from practicing NP's and many swayed me towards the ACNP route. These NP's I knew felt that my personality and interests fit this particular specialization the best. They also helped immensely in my decision regarding which school to choose. I also later asked them to write my recommendation letters for graduate school admission. I have been happy with my decision to become an ACNP for 4 years now. I couldn't have picked a better specialty as an NP.

[PMHNP10]

I worry that the integrity of the APN, as well as the RN, professions may be jeapordized with the influx of people entering the field looking to make money and "help people" but who quite frankly are not that smart.

funny because while earning my first bachelor degree (in psych; early-mid '90s) I was a pre-med student; I went to a private university of about 12,000 students; about one third of the entering freshmen were in the same boat; however, by the end of that fresman year, more than half of those people became business majors (that was the running joke at the school)

by my junior/senior year I also started wondering about the individuals who survived the first 3 years of college (including myself); although there were some geniuses I went to school with, there were also many dunces; the only reason some didn't become business majors was because they happened to get lucky and take classes with some of the easier professors; also, seems all of them wanted to "help people" and make $$$$; did I really want to spend my young adulthood confined to an education just so I could make a decent paycheck? And then I watched the movie "Gross Anatomy" and subsequently the thoughts of entering a profession where drug/alcohol abuse, divorce, and suicide lead all professions, started to weigh heavily on my mind; I decided no, no amount of $$$ is worth that; point of my rambling is that I don't think the issues you mention above are unique to nursing

[jalma527]

What about public health nursing, school nursing, outpatient clinic, management, medispa work, or teaching?

Some of these may be a better fit for you then primary care NP work. But if you're already in the program and can stick out, do so and just know that you don't have to be a traditional NP. You will be a RN with a greater breadth of knowledge and scope of practice, and that can only benefit you.

[7starbuck7]

Jalma

I am not in yet...I start next month. My employer offers an on-site MSN-Education that is completely paid for (you have to sign a two-year work commitment). I have seriously considered that.

I keep coming back to...if I am a FNP I can still teach. But if I am MSN-Education I can teach but I certainly can't be FNP. I am trying to decide if it is worth the $$$ and time to get a degree that I am not that enthusiastic about.

I think I am having an early mid-life crisis :) I really don't know what I want to be when I grow up. My biggest fear is that I won't do the FNP now and in 5 years I will really regret that decision.

Thanks

[PMHNP10]

The only thing I know 100% is that I don't want to be a bedside nurse forever.

AMEN!!!

I started an ANP program and HATED it (online format)

I'm hitting OT all over the place in this thread, but I can't help it. I do apologize to the OP.

So re: the quote above, that is my concern as well. I think online NP programs are a scourge on specialized education. Although I do absolutely love online classes for lecture based classes--pharm, patho, stats, research, public health, dx testing, etc., I strongly believe online formats are toxic for portions of a program when great learning can occur when you are face-to-face with your colleagues and when you can share your experiences, thoughts and feelings with individauls who may have had similar experiences; it just isn't the same online

the MHNP program that was just reinstated to restart Fall '08 at UTHSC-Houston is going to an online format; I've spoken with the coordinator many many times and she agrees that it is not ideal for an online format, but the school would not have approved her program otherwise; although I think she's going to buck the system a bit and make it so there is some face-to-face interaction ((((SHHHHHHHHHHH, don't tell anyone)))))

[jalma527]

Jalma

I am not in yet...I start next month. My employer offers an on-site MSN-Education that is completely paid for (you have to sign a two-year work commitment). I have seriously considered that.

I keep coming back to...if I am a FNP I can still teach. But if I am MSN-Education I can teach but I certainly can't be FNP. I am trying to decide if it is worth the $$$ and time to get a degree that I am not that enthusiastic about.

I think I am having an early mid-life crisis :) I really don't know what I want to be when I grow up. My biggest fear is that I won't do the FNP now and in 5 years I will really regret that decision.

Thanks

Sounds like you're not ready yet. Trust your gut. If it doesn't feel right to do it now because you're not sure - wait.

The upcoming DNp programs are not going to obliterate master's prepared NPs, there are 2 many of us to allow that to happen! And despite all of the exposure in favor of the programs there are also many in the field of advanced nursing who are against it as well.

I feel for you. I know it's a tough decision and you don't want to regret anything, but the program and the opportunities will likely be there next year right? So why rush?

[jalma527]

this thread is troubling in a sense--I read a lot of disappointed accounts, but no details why it isn't as rewarding as you had hoped

why are folks not particularly happy with their career as a NP? I can't even imagine being happier on the floor, since for me floor nursing = misery

I know that the variety of jobs is not as broad as it is for undergrad RNs, but there are still many settings available to a RN, so is it something about the role as a NP is less satisfying than the role as a floor RN? do you feel like you are practicing too much medicine and not enough nursing? do you feel you are less respected or valued than you were as a floor RN? is it more demanding/stressful than being a floor RN? is it pay? is it hours of work? do you feel you do not get to spend as much quality time with your patients as you do as a floor RN (this would absolutely boggle my mind if this is the problem)? so what is it?

I have pondered this question of why I am dissatisfied for sometime and this is what I've come up with so far:

1. I miss the commaraderie of having other nurses with you on the floor with bedside nursing. Maybe I had a unique experience when I was a staff nurse, but I worked with a group of RNs that provided me with support and laughs. It wasn't always great - I definately had beef with some, but overall it was a great sense of working with a team. I don't get this with my present job.

2. High stress due to liability issues. I really don't think it's fair that I carry the same burden of liability as the MDs in my practice and yet get less compensation. I have no doubt that if something goes wrong with one of my patients I will be held accountable and not my medical director.

3. M-F, 8-5 is what some people are looking for, but I can't wait to go back to 12 hr shifts!

4. Ultimately more than any of this I am tired with some of the redundancy in primary care. It's a lot of the same. I know this is true in all specialties, but in primary care it's so much reassuring of well status to paranoid anxious patients and lecturing of healthy lifestyles to unhealthy patients with very few patients changing that sometimes I think I might go crazy!