Anyone got a Post-Master's FNP after WGU master's?

unplannedRN · Apr 12, 2012

Dear "WannaBe",

Funny you should ask: Those were EXACTLY my concerns before entering WGUs ASN-MSN program with a BA in Psychology. I had wanted to be a clinical psychologist since HS, and I am middle-aged. I checked into distance-learning psych programs and saw that only 2 are APA-accredited, and they are very expensive! I would not have time to pay off the loans and still retire before age 85. So...the Masters in Nursing.

I did get advanced placement for my science, math, and social science courses, but was required to repeat some things I felt should be covered.

I had hoped to get the MSN, and start using it as a Certified Diabetes Educator, then work on a PMHNP, with the idea of going into bariatrics/disease prevention/public health environment. I would so love to work with the Indian Health Service! But not as a "regular" nurse--I've done my time on the floors FT.

I have decided, though, I will probably leave for the direct route to MHNP when I complete the BSN this summer, as the WGU format is solid education but makes me (an experienced "independent learner") wacko. Not only that, but if this whole DNP-for-Advanced-Practice-Nursing thing does happen in 2015, then I want to be "grandfathered in" at the Masters level, so I will have a working license, and do the DNP afterward PT, for personal achievement.

I don't have the time at my age to be taking 4 more years--understanding I have an ASN-plus and a BA and a semester yet to go for the BSN--to begin practice as an APN.

I do feel this is the way the profession is going; if nursing continues to grow in a nursing direction, though overlapping with medicine somewhat in practice, as we always have--common sense requires it. Nursing IS a doctoral profession at its highest level, and has been for a long time. The money and the educators have just not been there.

Four extra years, though, is too much for a working nurse, and they will NOT get working nurses to go 6 extra years PT, nor 4 FT beyond a BSN, and to pay 60 or more extra thousands of dollars...to become health practitioners earning 25% or less of what MDs make--some who have just a couple of more years of training!

(I know, I know--they can have residencies lasting many years--but how many psychiatrists and FPM doctors actually do? I have written elsewhere and feel passionately that NPs are NOT "demi-doctors", "assistant" or "junior" doctors (as a Physician Assistant actually is); we're a whole other discipline. But when you decide on the financial feasibility and worth of a career--and it does matter--then you must look at the ratio of years in training + debt: future income...)

...Particularly if your whole 40-year career is not ahead of you! Particularly if you must stop school, start paying back your loans for 1-2 years of required nursing experience, then go back to school. If you start to live as a working nurse, rather than on a poor student's income, you will amass personal debt that will not allow you to leave work to go back to school FT unless your spouse foots the bill, either. (And yet nurses starting green with an NP really aren't as good for at least a few years...nor are green MDs; that's why nursing grad schools are trying to slip in what amounts to a "pre-residency" in general nursing, a lot like the intern is getting, after the didactic part of his/her training.)

Many of these grad nursing schools require a year or 2 of nursing experience for entry, so it must be considered part of the training--just like an MD's intern year, no? And so if you look at that, you must conclude that to be a working APN with a DNP, you need to have 4 years of college-BSN, plus 1-2 years FT experience (in critical care for CRNA programs), then 4 years of graduate school, then at least 540 hours of post-DNP residency. Can we add? Yes, we can: TEN years, people. TEN. Oops--with the 540 hours, it's actually TEN and a FT quarter-year. A quarter you will have to stop work to get, or squeeze in around your regular job--so it costs income, too.

Many MDs have 8 years or training plus a residency of about 3 years. Few have more than that unless they're going for advanced surgery/specialty, or something in acute care, and long before they go into independent practice they are senior residents making good money (relative to nurses, not physicians in private practice), and have had a license for YEARS that allows for paying off some student loans through moonlighting. NPs, meanwhile, have no such license or capability while still officially in residency, and they are more tightly restricted to their area of practice.

For example, I have seen neurology residents working in psychiatric emergency rooms as fully-paid MDs doing psychiatric work-ups I could frankly have done better. Neurology is not psychiatry, though psychiatrists would do better to have more pure psychology and neurology training--but that's another topic!

I don't want to have my cherished dreams of (corny or not) "making a difference" and finally using more of my mind just crash and burn. I don't want to find myself cynically screaming: "Show me the MONEY!!!" after a few years in expensive school, while working FT, with no end in sight. I sure wouldn't want to start practice (especially in mid-life) owing 40-60% of what an MD does in student loans, with 25-30% of the earning capacity of a Family Practice or GP physician.

So I am 99% sure I'm making the switch, going the FNP route if that's what's affordable, and getting the PMHNP post-Master's if that's more feasible (start dates, program hours, PT options, cost per CH, etc.) though if I were as young as I suspect you might be, then I might go the straight DNP as I hoped to do.