crossroads: NP or PhD first

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Currently, I have a BSN from a top school (no, it is not upenn) and worked for a year and a half on a general medicine med surg floor. I am at the age of 25, turning 26 this year. I was thinking about getting my MPH at UNC first (already applied to that school) due to tuition reimbursement (going to school for free basically) and then debating whether I should go and become an NP first or go straight to the PhD. I have always loved research and originally wanted to go straight into research after working for a few years as an RN. My interest is underserved populations and how we can better improve primary care for them, etc. etc. I use to dread the NP role because I was so set on research.

Lately, I have been interested in the NP role as I would also like to serve those in rural areas, provide health education and primary prevention as well as provide them with care. I particularly interested in working with underserved populations, those who are homeless, etc. I think that being an FNP would allow me to achieve those goals.

However, I am more of a population focused person. I'm not a super one on one person and I discovered that as a bedside nurse.

Things about me: I am single and no kids. If i get married and have kids, I might be prioritizing my kids and my household. If I do a PhD and get married, I might consider being a stay home mom so that I can be with my children and help them grow etc.

May I ask for opinions on whether I should go do my NP first and then go back for a PhD if I decide to or should I just go straight to PhD. There is also the option of doing a PhD and then later, if I decide to- go for an FNP.

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I say get your PhD first! You have always loved research, and the patient-care aspect of FNP doesn't seem to align with your personality traits. Additionally, a PhD seems that it would work well in the future if you decide to start a family ?

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NP first, so you can gain patient experience and real-world strategies. Your future husband needs to make lots money in order to pay for a stay-home wife and children.

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I would say again to get NP first then get PhD if you like. Being NP will allow you more population focused. You will not be a bedside nurse forever, but you can grow from there (to be an NP). You are 25, you still have time to do PhD, which I think it is a long-term expensive investment. What is a realistic rate of return on the (PhD) investment? NP opens new job opportunities. Once you are an NP, it would be affordable to pursue further.

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I guess the concern for me is like age. I probably won't feel ready to pursue my FNP until 2 more years as a bedside RN so I will be 27 when I go for an FNP, 29 when I graduate. Working for a few more years before pursuing a PhD so maybe I will start the PhD at around 31, graduate at 35, postdoc for two years will be 37- hopefully becoming tenure at the age of 43... HOW AM I GOING TO SAVE FOR RETIREMENT? And the older we are, the harder it is for us to pursue more education because of having a family, etc.

I know that many nurses pursue their PhD later in life but some professors I am speaking with say that nursing is changing- how now younger people fresh out of school are going straight for their PhDs. Granted, we won't know how it turns out as there are both benefits and consequences are having experience prior to going for a PhD. Benefits include having real world knowledge which will def. help with research. Consequences may be that we would make less of an impact given that the older someone is, the sooner that person may retire.

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Why did you say "feel ready to pursue FNP until 2 more years as a bedside nurse"? Did you feel ready to be a RN after passing NCLEX? Feeling Ready Will Never Happen: Start Anyway. “Do not be satisfied with waiting for a 'ready' that may never come.”

As you mentioned "SAVE FOR RETIREMENT", I would suggest start NP first anyway. You will learn as a student and on job.

Yes, the nursing is changing. Lots people did not have RN experiences before going to NP school. Job market is opening.

Don't worry about "age".

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I guess another concern is about NP jobs? I got into Vanderbilt for AGACNP with only med-surg experience. Back then I didn't know what to do so I applied to acute care. But, its very hard to be hired as an acute care NP without at least step down floor experience if that makes sense. It is also online and I am more of a in class person.

I also applied to UNC AGPCNP program but haven't heard back. Prob wont get in because i thought my application was BS.

I have been hearing that it is very hard now for NPs to get jobs, esp. with this "oversaturation" that I keep hearing about. I also would like to go for an FNP residency if I choose the NP route so that I have more time to develop my skills. I mean, I would like to use my NP degree after I get it if that makes sense.

My dream school would be UCSF so that I can go back home and then UNC because of tuition reimbursement as I enjoy debt free education, with the third being UCLA where I went for undergrad in nursing. I started volunteering at a health care clinic that serves uninsured individuals who are below the poverty line and signed up to volunteer with remote area medical and plan to volunteer with them at least once a month.

It is also quite difficult to get into an NP program I heard, esp. the good ones like UCSF, UCLA, Upenn, UNC, Emory, Yale, Columbia, etc. etc. etc. As where we graduated from can help us get a job (or at least it helped me for undergrad). Im not sure if I can get in next year. That was why I said that it might take me two more years: 1. so that I can prepare my application and gain more experiences to prepare for a job after I graduate, 2. to learn Spanish with my tuition reimbursement as that will help with my application and for my job, 3. To help me with maturity needed to become a provider.

I also heard of some dual NP-PhD programs like Upenn, Yale, University of Rochester just to name a few.

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Hay! You should not talk too much about *you* in any public social media or public forums.

Step-down or ICU experience is more marketable. However, meg-surg is also valuable. If you are thinking about job market, go NP first. You will learn as a student and on job. Since you have got admitted into one NP school already, you can do it and later pursue even advanced study.

Finding job is hard, finding an idea job is even harder. That is why some RN work for one year, they would change to work for different hospitals. So, the way it is set up is: Keep looking and learning.

Nothing is easy.

As for these well-known schools, you will never feel your application is ready. You don't have to do so much work. If you have good personal statement, recommendations and RN experiences, that would do. If you spend too much time preparing, you will lose the real opportunities.

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You have lots concerns. Maybe you are over thinking?

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possibly. LOL I also have to consider whether I will like the NP role you know? Don't want to be in a job that I don't like. I realized that Im more of a nursing theory person then a patient care person. I have always been interested in the "why" behind things. Im considering shadowing one of the NPs at the place I volunteer at.

During my undergrad years, I thought that if I wasn't going for a PhD, then I would do Clinical Nurse Specialist as its more research related and quality improvement, etc. but now, its not easy to get a CNS job. I also figured that Im interested in public health and was thinking of possibly going for public health nursing or primary care.

The other concern is whether to do AGPCNP or FNP. Granted, FNP is the most flexible but I'm not as passionate about working with children and pregnant women if that makes sense? Im more interested in working with adults with chronic conditions.

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Since you always have "other concerns", take AGACNP. Good luck on the AGPCNP application. After you move one more step, you will be fine.

If you are interested in working with adults with chronic conditions, AGACNP or AGPCNP is the way to go.

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May I ask, what do you think about the MPH degree?

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