Can a DirectEntryNP stay self-employed FOREVER?!

[GirlCaptain]

Hello all,

Long time lurker, first post. This may belong in the entrepreneur section, but I would really like the input of hospital-based NPs as well.

My dilemma (front-loaded for the tl;dr crowd): I do NOT like being employed. I like working for myself and my own clients, and I work hard. If I do a Direct Entry FNP program with the goal of starting my own holistic health clinic, will I be shooting myself and my clients in the foot if I don't first work for someone else?

For more background: After spending two years building a business as a self-employed massage therapist, I've a strong desire to gain deeper skills to be more helpful to people, to have an understanding of Western medicine, and to expand my business offerings/opportunities with prescriptive authority. I am considering going back to school to become a NP through a direct entry program.

When I was younger, my dream was to become a GP (I'm very much a generalist, no interest in anything but primary/preventative care), but the realities of the cost of med school/loans made that seem financially foolish. It's not that I want a short-cut, but I think that this is the reality and the reason why NPs and PAs are becoming so important. It seems to me that the fastest way for me to open a lot of generalist and entrepreneurial doors, develop a solid educational base, and be as helpful as possible in a community primary-care setting is through becoming an NP. But I'll go crazy if I HAVE to work for someone else again (opting to is a different matter.)

I know there is some disagreement about the value of a Columbia or Yale DENP (my best bets, in my mind, for my location and interests). It does seem like the apprenticeship aspect of being an RN and "paying your dues" could be important. But I really like that Columbia and Yale skip that part, the part where you're someone else's employee. (No offense meant. Tons of respect for all RNs, but I know that's not for me.)

Could anybody speak to this? Am I delusional? Have I missed something?

Thank you in advance!

[NAURN]

Most NP schools want you to have at least one year experience as an RN... I think this is reasonable. I have applied for NP school. I have 5 years RN experience, 4 of which are in ICU and I even worry that this may not be enough. Not enough to get in, but enough for me to be competent. Do I know enough? I have great critical thinking skills that I only learned from doing. I could not trade my RN experience for anything. It is invaluable.

And even then, once I finish NP school, it would be the last thing on my mind to open a practice on my own first thing out the door. I would want to ensure that I was competent and efficient as a new grad, before I even thought about opening up my own clinic... I am talking at least 5-10 years down the line. You have to think about the safety of your pts and be sure of your skills before you go on to be so independent. I want to know that I have other experienced NPs and MDs at my fingertips if I have questions or am second guessing myself.

I mean none of this to be critical or condemning, merely my opinion. I think direct entry NP is OK for some people, there sure have been some good arguments for it, but I stick to my opinion that you should learn how to be a nurse first before attempting NP school. I am sure it can be done, but if it is done, at least get some years practicing before you open your own clinic.... for the safety of your pts, you need to be comfortable and confident in your skills. You only get this with time and practice...

Good luck!