Being a NP and Chiropractor

kansasdc · Feb 16, 2014

I believe there is one program with a direct entry in my area. I am waiting to talk with an advisor. It is direct entry but for only certain fields of nursing. I have hear a negative downside to direct entry is that you may not be hired to work until

completely finished because you don't have the required BSN technically. I can't verify this as of now just what I've read...I need more information on the program.

Dranger · Feb 17, 2014

I think being a chiropractor and combing it with PT and or OT makes far more sense.
Being a chiropractor and NP just seems bizarre with a very little synergy between the two fields.
Especially with so much of nursing being evidence based practice, and so much of chiropractic being erm ... science fiction ?
Combining two different professions is always tough, and when one is holistic and one isnt makes it all the more tougher. Adding a dual degree in PT/OT youd get far more bang for your buck and would build on any muskoskeletal knowledge you have.
It would also offer you some serious career opportunities down the road to open your own practice.
I don't know if youre from the Palmer chiropractor tree or one of the more scientific base dones but id be legitimately concerned about an NP Chiropractor. There are so many regulations pretty much forcing you to offer certain patients either statins, beta blockers, vaccines and other medications (under certain conditions). So I feel like it would be a conflict of interest for many chiropractors to do these things on a daily basis.
I know you said youre not "anti medicine" but I think its worth pointing out that if you were opposed to things like having to offer all patients vaccines or something in a hospital that it could be a major problem for you

Funny you take a crack at DCs when just as many people feel the same about NPs and their education. My roommate was a DC, his gross anatomy and physiology knowledge was unparalleled even over MDs. I'm sure the transition to online NP school would be erm...easy.

kansasdc · Feb 17, 2014

I hate to even get in this debate. All I know is a year of human anatomy, physiology, and gross was one tough year! I'm thankful it was so hard. I can say that now that it's done and over with.

Wile E Coyote, ASN, RN · Feb 17, 2014

I too know a DC that leans far to the 'physical medicine' side of the aisle ( evidence-based practice for us nursey folks) and who's grasp of physiology is simply stunning. Coincidentally, she asked me about DC to NP route a few years ago. I should look her up and ask for an update.

kansasdc · Feb 17, 2014

Please let me know if you hear from her. I want all the information I can get before I make a decision.

kansasdc · Feb 17, 2014

Thanks!

zmansc, ASN, RN · Feb 17, 2014

kansasdc -

I know of a few DC/NP combined practitioners. It is not a step backwards, it allows them to treat the whole person. I also know a few DOs who do manipulations as well as their medical practices. I find it funny that people think this is an odd combination. I commend you for researching the option of getting your NP to go with your DC.

I'm not an expert on your questions, so I'll let you know what I do know and leave it at that. Here in NM, the two DC/NP's I know both have their own independent practice, which is allowed in our state. They see pt for both fields. I'm not sure of the billing, insurance, liability side of it at all, I don't know how they deal with that side of things. I just know they do treatments from both scopes of practice. I would guess the best place to look for answers on how the practice would work in your area would be to look up providers in your area and try to talk to them. They would have insight on both the DC and NP practices in your state as well as how they have dealt with insurance companies, malpractice insurance, and the whole litany of issues that goes with that. Of course, you mentioned above you like surgery, so maybe you are wanting to do something different and won't need those answers. In either case, I would guess they would have some insight for you that is more relevant than that you could get from other states unless you plan on moving.

From an education side of things, you will have to become an RN either an ADN or BSN equivalent first, then get your NP training. There is no way around that. Yes there are combined programs where you go straight through, apparently you are already researching those. Each program is different, so I won't assume how the program you pick will work for you, but in most of the discussions on this subject in the past the issue many have had with this is that the education takes so much time they end up having to close their existing DC practice. I don't think this would be technically required, but it would just be a logistical and scheduling nightmare to try to keep your practice and go to nursing school full time.

There are other options besides the direct entry as well. Many of which would allow you to work part or full time and go to school online once you finished the RN portion of the program. It would be worth researching these paths as well. Especially if there was a way to preserve your DC practice over the period in RN school where you were stretched thin (second provider, reduced pt load, whatever). This would probably not be the shortest journey to your goal in terms of years, but you might find one that is less disruptive of a transition into combined practice. Just a thought.

If this is really something you want to do as the next step in your career, I hope you figure out a way to do it! Everyone should be happy with what they do, and chase their dreams. Please let us know as you progress along this path.

kansasdc · Feb 18, 2014

Thank you for the words of encouragement! I have a few meetings this week with fellow colleagues who have done the same to get a better understanding. I hope to meet with DO's and MD's as well to see if they would hire someone with a DC/FNP, and if they could see a benefit to me being a part of their practice. I will keep you posted. Sorry of any grammar errors it's hard to type on the i-phone and see the entire screen.. Thanks!

DC2RN · Mar 1, 2014

I practiced for 10 years as a chiropractor before becoming a nurse. I have never regretted it once. I have had many bad days in nursing, but I still really love the profession.

I made the change with very fixed ideas about how I would practice as an RN. Reality turned out much different. I "knew" that I wanted to work in the ICU, and would "hate" working on the floor. As it turned out, I hated the ICU and found my niche on a cardiology floor. Keep an open mind about the opportunities that are available.

Chiropractors tend to go into nursing with the intention of finding practice synergy of nursing and chiropractic. I think this a mistake! I walked away from chiropractic altogether, and I am glad that I did. Nursing is a wide open profession with so many opportunities to learn new things and find what you love. In my 10 years as a nurse, I have worked in cardiology, cardiothoracic ICU, cath lab, general OR, med/surg as a supervisor, child psychiatry, home care, and medical case management. I completed most of my NP degree, but never finished.

The opportunities to learn and grow in nursing are endless. My suggestion is to find your place as a RN before you go on for your NP. Don't just look at it as a stepping stone to your NP degree. Good luck!

kansasdc · Mar 3, 2014

Thank you for your advice. One thing that I want is to take my time as an RN and experience as much as I can. That way I find what I like and interests me. I think I would like acute care, surgery, and possibly peds, but it's one thing to think ill like it compared to reality. What was your experience finding a job once you graduated? What was the feedback on your DC degree?

DC2RN · Mar 6, 2014

I graduated about 10 years ago when there was a big shortage of RNs. I distinctly remember getting hired almost immediately with multiple offers from different hospitals. While filling out paperwork in the HR office, nurse managers from other floors came down to the HR office to try to recruit and steal away the nurses that had been hired by other floors. Back then, in the hospital where I currently work, 38% of the RN postings went unfilled. There was just so much demand for the new nurses. It is certainly not like that anymore. It is tough to get hired for that first year of experience.

Most people are impressed that I am a chiropractor. Most people are unaware of the difficulties that chiropractors experience. I have been on many interviews and only once did the interviewer challenge my "chiropractic philosophy' as incompatible with nursing and medicine. Needless to say, I didn't get that job. Overwhelmingly, my chiropractic background is viewed as a positive.

backtalkdoc · Mar 10, 2014

I am a DC finishing my NP and I love it (60 days). The comment about being a conflict of interests because as a DC you just try to get them off meds is one of the most ignorant I have ever read. JNC7 and 8 guidlines for hypertension even suggest trial period of lifestyle modifications to reduce HTN, then if it proves unsuccessful, you add HTN meds. My DC/NP friend sees roughly 30 people a day in his practice and shares a building with a DC/DO. They both do family practice, manipulations, joint injections, exercises, rehab.... My other buddy is a DC/NP and he partnered with an orthopaedic surgeon. He does a lot of the evaluation/management and does surgical assist. NP vs. PA... If you went with an second degree BSN accelerated program you would probably have to shut down practice to do that, but could work while doing NP school. Or If you have a night school that does associates degree nursing program, some schools will still accept you into the MSN program if you have a current RN license and bachelors in another field. PA school is more focused and would be a quicker route, but the entire question is autonomy. NP's have full autonomy in several states and the list is growing. I am completely independent and in Idaho I can write schedule II medications ( Alabama, NP's have to have collaborative agreements with MD's and just barely got the rights to right schedule III-V meds). So some states are better than others. In Idaho although my buddy shares an office with the DC/DO, they are totally separate businesses and he doesn't answer to the DC/DO. The fight for autonomy for NP's is growing and they are making a lot of progress. So if you want to do your own thing... go NP. Some PA's have their own little clinics, but they either have agreements with Docs or they have charts reviewed by a supervising physician. Either way, you will still get snide comments from some doctors that "mid-levels" should leave the real doctoring to them, but if you are a DC you are used to snide comments. I actually just got a job offer to work with a hospitalist group here in idaho. The doors are wide open and the future is great. I don't regret a single thing about going back for my NP. I go to SAMFORD university for my FNP and they have graduated a ton of DC/NP's. They even say they love their chiro students. We do a great job and they have always treated us chiropractors well. I recommend them, give them a call, or shoot me a message. Good luck