Updated: Apr 21, 2022
Published Apr 17, 2022
Dear Nurse Beth,
I graduated with my BSN in 2018 and had some not so great experiences during one of my rotations. This created a lot of anxiety for me thinking about working in a hospital. I always knew I ultimately wanted to work as a NP in the community/outpatient. I also developed a love for research in undergrad. During my final year in undergrad I applied to a few NP programs and was accepted but decided to change my speciality to a Population Health DNP after a very difficult rotation where my preceptor questioned my ability as a future nurse.
Fast forward 3.5 years - I now work as a manager of clinical research at a large FQHC and prior to that I was a clinical research nurse for the same organization. I graduated with my DNP last December but I am afraid that I narrowed my scope of practice given that I have limited clinical skills. I don't mind managing research studies that are focused on health equity that will ultimately improve health outcomes for communities, but I miss seeing patients 1:1.
I'm scared to apply for a RN position given that I spent so much time and effort (and money) on my DNP and because I lack experience. I'm stuck between applying for jobs around case management or potentially going back to school to be an NP. I'm trying to figure out what void I'm trying to fill but end up getting lost thinking about my career trajectory.
Congratulations on achieving your DNP! and on your manager position at a large federally qualified health center (FQHC). Yet with all your accomplishments you have yet to make peace with your career choice.
Yes, advanced practice and terminal degrees do narrow your field of practice, as intended and designed.
You wanted to work with patients all along but were deterred by a negative experience and a preceptor who undermined you. You defaulted to research which you enjoy but which is not fueling you in the long term.
You don't have to settle. There is nothing wrong with changing your career path. It takes determination, ability, and means, all of which I sense in your letter.
It will be hard to land a position as a clinical RN. You will be seen as both inexperienced and over qualified. Managers may fear you'll not stay put or not be happy with the salary. Hard is not impossible, though, and it would take a willingness to accept more undesirable jobs in order to get started, such as skilled nursing. You may have to relocate. You would have to apply, apply, apply and persist.
You are still interested in becoming an NP, which would also give you the patient contact you seek. You would have to return to school but you are no stranger to school and studying. With your interest in community health and experience working for a large FQHC you could really make a difference.
I really hope you follow your passion and someday look back without regrets.
Best wishes with your decision,
I agree with the suggestion to apply to SNFs. This will get your foot in the clinical door. On a different note, reading your question makes me wonder if managers and preceptors read the posts on Allnurses.com. So many nurses have a variation on the same experience: hostile encounters in clinicals and at work. So many people write about depression, quitting nursing and extreme stress. You wanted to be an NP but were deterred by a preceptor. Imagine if there had been some support or useful feedback-- maybe you would have been able to continue. As a second career nurse, I know there are other industries that are not so hostile to its workers. I don't know what I can do as an individual to make this better, or what we can do as a collective.
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