Halfway Through School Crisis

[lilstudent20]

All of a sudden, I'm confused about what I want my career to be, and I don't know if I want to be a nurse any more. I'm freaking out. I'll be starting clinicals in the fall... I don't know if my fears are normal or if I need to try to sort things out.

When I was in high school, I was wrestling with the thought of being a doctor or a nurse. Both appeal to me in different ways: nursing is highly interactive and focuses on holistic care, and medicine is complex and independent. My college is unique in that they reserve students nursing school spots directly out of college. I applied to the school of nursing because it is almost impossible to transfer in, and thankfully I was admitted.

As much as I love nursing school and nursing, I have some fears. I've noticed that I don't click with my fellow nursing students as much as I expected. While nursing school is challenging in its own way, sometimes I don't feel simulated by my coursework. I'm also scared that once I actually start working with patients, I wont have as as much control or independence over their care as I want. My professors always stress how the nurse has their own scope of practice and autonomy, but there are still things a nurse can't do. I don't want to eventually feel restricted by my profession. The ideals of nursing school are very different from he realities of practice.

I don't know what to do or feel. Should I stick with nursing and get my NP like I originally planned? Should I try out other pre-health coursework? Or should I shift gears all together?

I'm sorry if I'm not making sense. I'll try to clarify if anyone has questions.

[Sour Lemon]

It's only partly about what you want. Pre med is a bit more challenging than pre nursing. If you have doubts about what you'd truly like to do and you have academic capability, it might be better to test the MD waters before you're any further along. Just be honest with yourself and don't waste time and money if it's not a realistic goal for you.

[lilstudent20]

Pre med is a bit more challenging than pre nursing. If you have doubts about what you'd truly like to do and you have academic capability, it might be better to test the MD waters before you're any further along.

If I wanted it, I could push myself to go to med school. I guess I just don't know what I want. The main things I worry about are the stress, uncertainty, and of course the time and debt that goes into MS. All I know is that I am an overachiever with multiple interests, and I like to learn.

I don't want to feel like I'm turning my back on nursing because I'm not, but I'm so full of guilt for even being a little bit confused. I've broken down so many times these past few days because I'm so conflicted.

[Here.I.Stand, BSN, RN]

Have you spoken to your advisor? There are pros and cons of any decision; it's not a bifurcated holistic+caring vs independent+complex answer.

A LTC resident with reclining status relies heavily on his/her nurse; odds are, the on-call family practice MD has never seen or heard of this resident. In my experience, the resident physicians covering the ICU really listen to the experienced nurses' feeling about what's going on. (I've had many instances of pts who were slightly declining but overall not looking TOO bad.... but my observations+spidey sense say "we need to be worried NOW.") A critical care transport nurse might be working with an EMT-P, but wouldn't be contacting an MD for individual orders.

MDs have their limitations too. They may need to make a decision that the pt's insurance allows -- not what is in a perfect world, best for the pt. They can prescribe what they want (assuming it's legal) -- but med orders have to be cleared by a PharmD before the pt can have that med. A complex pt being cared for by multiple specialties... uff da. Some of the neurology critical care vs neurosurgery disagreements are epic!

Some cons that stteered my decision from medicine:

1) Residency. I'm simply not interested in an 80+ hour workweek, and needing to make critical decisions while that sleep deprived.

2) No guarantee of any specialty. Not everyone is going to be anesthesiologists or cardiologists or trauma surgeons. Someone has to get that spot in proctology.

Of course not all nurses get their dream positions right out of school...actually most don't. But we are still qualified to move from LTC to ICU to public health at some point in the future. That proctologist can't get a job in CVT surgery after a few years' experience.

3) I love timeclocks. My shift is over when it's over, and another RN arrives to take over my work. I can also work as much or as little as I want.

But that's just me. Plenty of people feel differently, which is great -- it's sort of nice to have a dr when we need them.

Becoming an NP is a good option too, if you want both the holistic/nursing model but also want diagnostic and prescriptive authority.

If you really want to be a physician though, I wouldn't spend more time on the nurse track.