An Advanced Degree was the Key to My Career

by traumaRUs traumaRUs, MSN, APRN, CNS

Specializes in Nephrology, Cardiology, ER, ICU. Has 30 years experience.

Nursing is a wonderful career. It has afforded me a comfortable standard of living, and a job where I feel I can make a difference. However, it’s been a journey.

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An Advanced Degree was the Key to My Career

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There are so many avenues to a nursing career nowadays both traditional like an ADN or BSN and non-traditional direct-entry MSN or DNP programs. All lead to the coveted RN credential. Everyone has a different journey and a different reason for pursuing it. Here’s my story…

The Beginning

I was raised in a very traditional household where education was not emphasized. When I graduated from high school I was on my own to move out and get a job. I had worked since I was 16 at the usual high school jobs: fast-food and stocking at a local pharmacy. After graduation, I got a job at a local hospital as a nursing assistant (this was before certification was necessary) and started taking pre-requisites for nursing school. It wasn’t easy working nights at the hospital and going to school during the day. I managed this for approximately a year but then realized I didn’t know if I REALLY wanted to be a nurse. So, one day I decided I needed a change. I went to the military recruiters locally and everyone was out to lunch except the US Navy recruiter. I took the necessary tests and then signed up. I quit school and within a week or so I was off to boot camp. I had asked for a health-care related job but the military in their own military way decided I was destined to be a journalist, specifically a broadcast journalist. After boot camp, I was off to school again - this time I was to learn how to be both a print and broadcast journalist. Japan was my first duty station: Tokyo was so busy and so big! Quite a bit different from my midwestern roots. I became friends with an Air Force guy and we eventually married. Fast-forward a few years and multiple moves in multiple countries; we moved back to the US. I then realized that I really DID want to be a nurse. So, off to the local community college, I went fully expecting to be greeted with open arms. After all, this was the early 1990’s and there was always a need for nurses, right? Remember when I quit school? Well, guess what? I didn’t drop any classes, I just quit going….I didn’t get a “W” indicating I withdrew from a class. Nope, not me. I ended up with all “Fs” that semester and ended up with a 0.7 GPA. Who knew that you could have a GPA < 1? Apparently, the school wasn’t too impressed either because while they admitted me to the LPN program, they made it very plain I was on academic probation.

LPN Classes

I just thought school was difficult when I was working nights! Well, school, job, two children and an active-duty husband who wasn’t always home was ten times more difficult. However, I had a lot more motivation the second time around - I retook all the prereqs and proceeded into the LPN program and clinical and did well. I enjoyed the clinical at the nursing homes and clinics. I was prepared to go on to the RN program immediately after completing the LPN portion of this 1 plus 1 program. Life had other plans though. My husband came down on orders for us to move cross country. So, off we went. I immediately started checking out schools but the waitlist for state schools was 2 years long. As I was concerned about the possibility of yet another move, I checked out private schools that offered an LPN to RN program. I was able to quickly get into a school that offered a three-semester LPN to ADN program. I had it made!

ADN Program

Clinicals for this program were centered in the hospital setting on several types of floors from ICU to OB to medical-surgical to ED. I instantly fell in love with the ED - the chaos, never knowing what was going to come thru the door, the busyness and most of all the adrenaline rush! Wow! I was in my element. However, when I graduated with my coveted ADN and subsequently passed NCLEX, there were no ED jobs available for new grad RNs, even ones with 2 years of LPN experience. Okay, so we gotta pay the bills and the kiddos gotta eat; I went job-hunting. I landed a job in an ICU at the local VA hospital where I worked for about a year and a half before my husband retired from the USAF. He landed a job in another state so we moved yet again.

Another Move

Now, however, I had some RN experience and I was able to get hired into an ED at a level one trauma center. Night shift - knife and gun club, staffing issues, but some of the best years of my career.

Fast forward to 2004 and more and more hospitals were applying for Magnet status and I was told I needed to have a BSN in order to advance further. I checked into several schools including the state schools but most were on campus in the classroom. I got my BSN in 2004 and MSN in 2005 from the University of Phoenix. However, the MSN concentration was Management and Leadership so non-clinical. Once I got the MSN it really fueled my ambition to go further. What to do? I shadowed several CRNAs because that sounded like an absolutely cool job and for sure, they made $$$$$. However, I found that I just couldn’t stand still or remain in one little area for a long period of time. The CRNAs I shadowed and those I know today though 100% love their jobs. It’s a great career path. However, I chose the CNS route not really knowing the difference between CNS and NP and I regret that I didn’t do more investigating before registering. In retrospect, this is what I recommend:

  • Talk to CNSs and NPs, especially those who work in the hospital as well as those in offices and clinics. There are many specialties and types of work environments
  • Decide in general where you want to work. If you wish to work in the hospital, ensure you have clinicals and choose a concentration which will prepare you for that environment ie acute care for critical care or hospitalist role, primary care for clinics or family practice, pediatrics if you want to care only for children
  • Shadow APRNs in different roles to learn the “real” job of what they liked and didn’t like
  • Look into the forecast for availability of jobs and the projected vacancy rates (these statistics can be found at the Bureau of Labor Statistics
  • Join an APRN organization and attend some of the meetings - a great place to network and learn “off the clock”
  • If you plan to stay at your facility after you obtain your APRN, make sure they project some openings
  • Look at the certifying organizations (ANCC, AANP, etc) to ensure that your certification has longevity (see Consensus Model)
  • Learn about legislation and state regulations that might affect your ability to work - again look at the Consensus Model. Does your state endorse this? If so, how will it affect your ability to get a job in the specialty where you wish to work?

What Did I Choose?

In the end, I did opt for an adult health CNS. When I finished in 2006 there were few jobs in the area and I wasn’t able to move due to a family situation so I continued in the ED for another 3 months. I interviewed at several private practices and was fortunate to get hired in large well-respected nephrology practice. I’ve been in my position for over 13 years. Along the way, I went back for a pediatric CNS and as a result, I can see all ages.

It has been a journey and one with many steps. There are certainly easier ways to get an advanced degree but I certainly do appreciate it. The advanced degree:

  • Opened the door for much more autonomy
  • Allowed me the schedule flexibility so that my work-life is balanced
  • Afforded me benefits that include a very generous PTO allowance as well as a generous salary
  • Offered me the chance to precept and impact student APRNs in different settings

In conclusion, I do feel that an advanced degree was the key to my career! Don't let life slow you down.

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1 Comment(s)

Asystole RN, BSN, RN

Specializes in Vascular Access, Infusion Therapy. 2,313 Posts

I always laugh when people say, "I hate nursing." Like your career highlights, there are so many incredible options for nurses and so many levels of practice.

Both my wife and I have been around the block a few times and work non-traditional nursing jobs and it makes me smile that we are still are practicing nursing. So many specialties, so many care settings, so many levels of practice.