I am yet another mid-life career-changer. I've been afraid to even post on this board, as I believe I will get attacked by all the nursing traditionalists. But I would like the opinions of the experienced, and I can't get them without putting myself out there. Besides, if I am going to tread this path, I need to develop a thick skin.
I've wanted to work on the clinical side of healthcare for most of my life. Since I was a kid, I wanted to BE something – CRNA, radiologist, ER doc, pharmacist, nurse practitioner. The various options cycled through my mind, but I just KNEW I was going to grow up to be one of these. I've always been fascinated by the human body, disease processes, how the mind works, even down to nerve impulses and what causes that movement from neuron to neuron. I have always wanted to know the why.†Just what†has never been good enough.
I got to college and my dad didn't believe I could handle pre-med/medical school. It took the wind out of my sails. I didn't even understand I could apply for student loans. I did what he told me, got my business degree, and got out.
Within two years of graduating, I wanted to go back to school. However, I soon got married and my husband wasn't ready. Then I landed a lucrative job on the business side of healthcare, in a sales role. I liken this to golden handcuffs.†The money was great, but it made it more difficult for me to go back to school. I was the bread-winner.
Then we had children, making it nearly impossible to go back at that time. Sure, I could go, but it seemed extraordinarily selfish. Yet again, I put it off.
By this time, we had moved back home, to an area with a couple of very good nursing programs. In addition, there was a PA program and a very good B&M NP program, which included an option for those without nursing experience. That became very appealing to me, as the years flew by.
To make a very long story a little shorter, now that my children are a little older, I finally got it together and applied to that MSN program. I also applied to an Accelerated BSN program. I quit my job and started taking pre-requisites. Ultimately, I got into both programs. I was torn: the MSN program was my dream (highly-ranked and I could start doing what I really wanted sooner); but I had heard that having a BSN could be more flexible and perhaps better for me as it relates to getting RN experience first. As of now, I plan to attend the MSN B&M school this fall.
Here comes the BIG BUT – I read this board and it scares me. Am I being completely irresponsible by becoming a nurse practitioner when I have not been a nurse? I recognize my lack of experience as a nurse, believe me. I am, however, not green.†I have been a working business professional for 17+ years. While I absolutely do not have clinical experience, I do have something of value, in both life experience and business acumen, to bring to the table. As well, my work was in healthcare and I've acquired a fair amount of knowledge along the way.
I have a lot of confidence in the school that I've chosen. They are one of the top-ranked institutions, as well as my specialty being extremely highly-ranked. My preceptors are selected for me; the clinical hours are high; I have the option to specialize further (which adds to my clinical hours); I believe if any school is going to prepare me, considering my lack of experience in this area, they are one of the best. I also fully expect there to be a large learning curve. But am I being completely naïve?
This is something I have always wanted to do. I am no longer in my 20s or 30s. I don't want to spend years and years starting over with a BSN, and then going back later for another degree. It seems to be not only additional time but additional money. Is it reasonable to think that I can gain experience as an NP and become competent, even without RN experience first? I am more than willing to work hard, ask questions, know what I don't know, seek help from peers, and put forth diligent effort. In fact, I look forward to it.
The last thing that I think about is: I see so much written on this board about salary. I am actually in a position where I do not have to work. However, I will say it again – this is something that I WANT to do. And even though I don't have to work, I am not looking to do this for charity. I would like to be paid what I'm worth. I recognize that I will initially be an inexperienced NP, but that won't be the case for long. Am I crazy to think I can make $150K at some point? I see $80-90K and it bums me out. It seems ridiculous for the work NPs do. I am in the Southeast. I can go back to my old profession and make $150K easy. I just don't want to.
Sorry for the length. Would appreciate your advice.
umbdude, MSN, APRN
1,228 Posts
@simcc
Have you take pre-reqs yet? If not, start there first because it could play a role in your decision making. DE programs generally require very high GPAs.
First off, OP applied to a Acute-Care NP program. ACNPs are trained to work in pretty much the same environment as acute-care nurses with many similar procedures, monitoring, and diagnoses. The roles of a psych RN and psych NP are much more different. Furthermore, the kind of experiences you get as a psych RN vary widely depending on where you work (some are good, others just aren't useful for advanced practice). If you PM me I can give you some of these examples from my own experience.
I am a PMHNP student working as a psych RN. I did not choose a DE program for a couple of reasons: 1) I wasn't entirely focusing on NP when I was making a career change from finance to nursing; and 2) although I had a gut feeling that I wanted to work with the psych population, I had zero exposure to this specialty. I worried that I would end up liking another specialty more because I was fascinated by medical sciences in general. I ended up going through a traditional BSN program (5 semesters) and worked as a psych tech during my BSN.
Although I don't regret my choice based on my situation, in retrospect if I had the exposure to psych (knowing that it's the right specialty for me) before applying to nursing school, I would have chosen a DE program in a heart beat. No doubt, I have learned a lot as a psych RN even in a short time, and I've become comfortable with meds, medical comorbidities, and working with this population which will help me as a provider. However, there is much more to practicing as a psych NP than what you'll learn as a psych RN, and no amount of psych RN experience will truly prepare you to be a PMHNP. My view is that if you want to be a psych NP, get the most relevant experience right away, which is psych NP experience. But having psych RN experience is valuable and is an advantage when you look for job.
More options to consider if you decide on a DE program: (1) some DE programs allow students to become part-time NP students (thus, work PT or FT) after the RN portion, or even take time off in between BSN and MSN to work as a RN. If you go part-time, in the first 1-2 years (non-clinical courses) you can work as a RN for 16-40 hours while in school (it's hard, but doable and financially beneficial); (2) There are New-Grad Psych NP residencies (eg, VA hospitals and weitzman institute) that I think are ideal for those who want more practice and supervision; (3) One of the DE PMHNP students I worked with was uncertain about her abilities, so she found a job within a hospital with supervising psychiatrists who love to train new PMHNPs and are always available to answer questions, and that made her feel much more comfortable. These might be good options for you if you are concerned about not having enough "medical" knowledge.
In the end, I think since you are already familiar with the psych population and might have some years of work experience as a LMHC, DE-PMHNP program might be a better option. Applying to an NP program separately after your BSN can be a pain and time consuming. Ultimately, you have to consider your own comfort level and circumstances when making that choice. Good luck.