How to be an APN in ten easy steps....or how to spend oodles of $$ on your education

How to become an advanced practice nurse in ten easy steps! Nurses Announcements Archive Article

How to become an advanced practice nurse in ten easy steps!

My very different educational path has probably furnished some professor with a new BMW or Lexus. I am not endorsing this route but rather explaining why you should look before you leap...we have to start in the beginning...

I am now middle-aged (ouch, even hurts to type those letters). But, let's face it; my 50th birthday was last year and unless I plan to live to be past 100, I AM middle-aged. As such, I think I have earned the right to reflect back on my path..

Graduated from high school in 1977 and went right into nursing school. Got a little apartment, worked nights as a nursing assistant (before they had to be certified) and toiled away at school. Okay, now its May 1978 and I've been in school for over a year and have just one semester left (I had done my pre-reqs while in HS). I'm getting tired of the grind and want something different. So...I wandered into the military recruiting office. The Air Force guy was on the phone, the Army people were out to lunch but hey, here is a Navy man, all decked out in his whites - not too shabby! "How would you like to be in the Navy?" Okay what do you have to offer me? $$$ for college (sounds good to a broke student), chance to travel and meet new people. So..he sits me down and I take this aptitude test: "wow, he says, you are smart." Being all of 19, I was flattered. Like a used car salesman, he then tells (sells) me that "he doesn't want me to waste my life" and that I could get valuable experience in the Navy. And...I would get a regular paycheck and my rent, meals, uniforms would all be paid for by the Navy. What a deal! Less than one week later, I was in Chicago and then Orlando for boot camp. First big mistake of my life: Florida in May, June and July! Hot, hot, hot!

Anyway, fast forward to 1980, met my husband, got married and oh oh...since he was in the Air Force, we couldn't be stationed toether. Ooops, forgot to figure out that one should fall in love with someone in the same branch of the military. Okay, I'll get out and follow him around..done deal.

Again, fast forward to 1990 - after moving all over the world (literally), I head back to school. Now, I KNOW I want to be a nurse. However, stupid person that I was, I didn't drop my classes when I joined the USN, I just quit going to school, leaving me with a 0.7gpa. Needless to say, few schools were impressed. Did pre-reqs again, got accepted into an LPN program on academic probation. I'm now a serious student and do fine, gpa-wise. Hubby still on active duty, we keep moving..went from the LPN program right into an ADN program and voila....I'm an RN! Moved yet again and took an ER job..after a few years, I realized that going back to school was going to be necessary...

Had I been smart, I would have looked into an ADN to MSN program. Nope, not me..type A person that I am, I just jumped into an online BSN program, finished that, then went into an MSN program. However, when I finished the MSN program, I realized that I didn't like management and it was a non-clinical MSN track. Oh oh, goofed again! Back to school for a post-MSN adult heath CNS. Ok - finished that and oh oh again, no jobs! Took a job outside the ER and figured I would get back to the ER sometime..fast forward to now and I'm heading back to school to pick up yet another post-MSN CNS, this time in child/family.

My convoluted path has caused many problems: spent too much time, money and effort in school. Looking back, I wished that I had stayed in school the first time. However, then I consider I would never have met my husband (we are at our 29th anniversary in two weeks), never would have had my two sons, never would have had my grandchildren. Life happens for a reason....and I'm just now accepting that. Well....I have another 50 years or so to accept it I guess!

Specializes in Nephrology, Cardiology, ER, ICU.

I apologize for not returning to this thread sooner. Thank you to everyone! I kinda thought I wasn't the only one in this boat - we will have to ask Noah to build us a bigger one - lol.

Specializes in psychiatric, UR analyst, fraud, DME,MedB.
How to become an advanced practice nurse in ten easy steps!

My very different educational path has probably furnished some professor with a new BMW or Lexus. I am not endorsing this route but rather explaining why you should look before you leap...we have to start in the beginning...

I am now middle-aged (ouch, even hurts to type those letters). But, let's face it; my 50th birthday was last year and unless I plan to live to be past 100, I AM middle-aged. As such, I think I have earned the right to reflect back on my path..

Graduated from high school in 1977 and went right into nursing school. Got a little apartment, worked nights as a nursing assistant (before they had to be certified) and toiled away at school. Okay, now its May 1978 and I've been in school for over a year and have just one semester left (I had done my pre-reqs while in HS). I'm getting tired of the grind and want something different. So...I wandered into the military recruiting office. The Air Force guy was on the phone, the Army people were out to lunch but hey, here is a Navy man, all decked out in his whites - not too shabby! "How would you like to be in the Navy?" Okay what do you have to offer me? $$$ for college (sounds good to a broke student), chance to travel and meet new people. So..he sits me down and I take this aptitude test: "wow, he says, you are smart." Being all of 19, I was flattered. Like a used car salesman, he then tells (sells) me that "he doesn't want me to waste my life" and that I could get valuable experience in the Navy. And...I would get a regular paycheck and my rent, meals, uniforms would all be paid for by the Navy. What a deal! Less than one week later, I was in Chicago and then Orlando for boot camp. First big mistake of my life: Florida in May, June and July! Hot, hot, hot!

Anyway, fast forward to 1980, met my husband, got married and oh oh...since he was in the Air Force, we couldn't be stationed toether. Ooops, forgot to figure out that one should fall in love with someone in the same branch of the military. Okay, I'll get out and follow him around..done deal.

Again, fast forward to 1990 - after moving all over the world (literally), I head back to school. Now, I KNOW I want to be a nurse. However, stupid person that I was, I didn't drop my classes when I joined the USN, I just quit going to school, leaving me with a 0.7gpa. Needless to say, few schools were impressed. Did pre-reqs again, got accepted into an LPN program on academic probation. I'm now a serious student and do fine, gpa-wise. Hubby still on active duty, we keep moving..went from the LPN program right into an ADN program and voila....I'm an RN! Moved yet again and took an ER job..after a few years, I realized that going back to school was going to be necessary...

Had I been smart, I would have looked into an ADN to MSN program. Nope, not me..type A person that I am, I just jumped into an online BSN program, finished that, then went into an MSN program. However, when I finished the MSN program, I realized that I didn't like management and it was a non-clinical MSN track. Oh oh, goofed again! Back to school for a post-MSN adult heath CNS. Ok - finished that and oh oh again, no jobs! Took a job outside the ER and figured I would get back to the ER sometime..fast forward to now and I'm heading back to school to pick up yet another post-MSN CNS, this time in child/family.

My convoluted path has caused many problems: spent too much time, money and effort in school. Looking back, I wished that I had stayed in school the first time. However, then I consider I would never have met my husband (we are at our 29th anniversary in two weeks), never would have had my two sons, never would have had my grandchildren. Life happens for a reason....and I'm just now accepting that. Well....I have another 50 years or so to accept it I guess!

:wink2: You are so cool and honest. I really appreciate people who are so down to earth and not afraid to say , I made a mistake" ! It is refreshing....it is life after all! Me at 63 , I am still thinking of getting either a masters or a specialty masters like Gerontology.......... I am currently a medical reviewer or UR for an insurance company , currently a medical reviewer w/ Medicare. I am interested in the geriatrics now ( I am getting there too ! :chuckle) but fortunately , I am healthy, and hope it stays that way for a while , because my dreams and plans do not stop because of age !:clown:

Specializes in CCU, OR.

Well, my back is giving me pure awfulness, my PT is killing me both in sessions and when I do my exercises at home, my ability to show up to work is completely up in the air, so I am seriously looking at various employment opportunities out there that may be gentler on my poor back....

Looked into becoming a WOCN- and the programs vary from 3 weeks in Charleston to a year post Master's certificate! Yee Gods- why can I do this in three weeks or get both a MSN and a post ed cert? Something sounds and smells inconsistent here.

The tuition isn't pretty either. One six week course cost 4300 bucks. While I know that scholarships are out there, and certified wound care nurses are pretty scarce, I find myself asking- do I truly want to take a 10 week course at say, the Cleveland Clinic, learning about wound healing, ostomy placement, care and continent ostomy care, both urinary and fecal? Or bladder and bowel training on those who still have all their pipes in place? I simply don't know if I were accepted, offered a good scholarship, if I could stomach the whole thing.:barf02:

Next; legal nurse consultants. Tuition can be up to 14,000 dollars, but you are assured that after your 5-7 day seminar(during which you have to get there, stay somewhere, eat and the like), you'll have all the tort law basics you'llneed, plus how to present paperwork in legal style and how to write nursing legalese......and for that high price, you will also get a number of case histories to study, a huge class on how to market yourself to that 25% of all attorneys who will consider using a legal nurse consultant, unless you are lucky enough to start out with a hospital risk management position, ditto health insurnace company or a lawyer who has a high enough volume of malpractice, class action medical issue suits, and personnel injury claims to hire you as a fulltime employee with benefits. As you can see, I'm rather concerned about spending money(and there are classes that cost much less than the one I mentioned)on various legal orientation classes, tort law and then figure out how to eke out a living, single case by case, by putting out a substantial amount of $$$ for the business attire, the professional brochures, cards, placards, etc and cold calling.:banghead:

I'm not trying to sound like a major downer, here, but if I end up being invalided out of where I am trying to work, I'm going to have a rough time finding any kind of nursing job again- especially if I have to voluntarily resign from the State's employ. There are a lot of local, county and state places to work, and if I sign anote that says I won't apply at any state facility again- wow.......there goes a huge employer.

So, back to square one. I looked up ADN instruction. Just thought that a Dip, plus years of clinical experience and a BA could get me in the door as a clinical instructor, but back to must have an MSN.....I wonder what credentials I need to teach nurse's aides? I've been one, I've worked with a great many and I'd bet that I need a BSN to do that....:chuckle

I'm 56, came back from near death and had hoped and prayed that I would be able to work long enough to get a decent retirement, a little house of my own with a garden and that if and when grand kids show up, I'd have the wherewithal to spoil them rotten! My 10 year from now dreams were/are; to still be with my boyfriend, to be retired in some comfort, healthy enough to travel and to spoil the grandkids.

Now I am so very worried that I'll loose the house, end up living in a single room and have trouble making ends meet. ARGH.

Thanks for letting me vent my fears, woes, worries and the like. I'm just scared.

Specializes in Nephrology, Cardiology, ER, ICU.

I'm sorry you are so scared! That is a lot of change in a short period of time. Some things:

1. Teaching at a tech college for medical assisting or medical transcription?

2. Utilization review or MDS at a NH?

3. Case management at a hospital?

4. School nursing?

5. Home health or private duty?

6. Some type of office triage or telephone triage?

I wish you the best.

Specializes in psychiatric, UR analyst, fraud, DME,MedB.
Well, my back is giving me pure awfulness, my PT is killing me both in sessions and when I do my exercises at home, my ability to show up to work is completely up in the air, so I am seriously looking at various employment opportunities out there that may be gentler on my poor back....

Looked into becoming a WOCN- and the programs vary from 3 weeks in Charleston to a year post Master's certificate! Yee Gods- why can I do this in three weeks or get both a MSN and a post ed cert? Something sounds and smells inconsistent here.

The tuition isn't pretty either. One six week course cost 4300 bucks. While I know that scholarships are out there, and certified wound care nurses are pretty scarce, I find myself asking- do I truly want to take a 10 week course at say, the Cleveland Clinic, learning about wound healing, ostomy placement, care and continent ostomy care, both urinary and fecal? Or bladder and bowel training on those who still have all their pipes in place? I simply don't know if I were accepted, offered a good scholarship, if I could stomach the whole thing.:barf02:

Next; legal nurse consultants. Tuition can be up to 14,000 dollars, but you are assured that after your 5-7 day seminar(during which you have to get there, stay somewhere, eat and the like), you'll have all the tort law basics you'llneed, plus how to present paperwork in legal style and how to write nursing legalese......and for that high price, you will also get a number of case histories to study, a huge class on how to market yourself to that 25% of all attorneys who will consider using a legal nurse consultant, unless you are lucky enough to start out with a hospital risk management position, ditto health insurnace company or a lawyer who has a high enough volume of malpractice, class action medical issue suits, and personnel injury claims to hire you as a fulltime employee with benefits. As you can see, I'm rather concerned about spending money(and there are classes that cost much less than the one I mentioned)on various legal orientation classes, tort law and then figure out how to eke out a living, single case by case, by putting out a substantial amount of $$$ for the business attire, the professional brochures, cards, placards, etc and cold calling.:banghead:

I'm not trying to sound like a major downer, here, but if I end up being invalided out of where I am trying to work, I'm going to have a rough time finding any kind of nursing job again- especially if I have to voluntarily resign from the State's employ. There are a lot of local, county and state places to work, and if I sign anote that says I won't apply at any state facility again- wow.......there goes a huge employer.

So, back to square one. I looked up ADN instruction. Just thought that a Dip, plus years of clinical experience and a BA could get me in the door as a clinical instructor, but back to must have an MSN.....I wonder what credentials I need to teach nurse's aides? I've been one, I've worked with a great many and I'd bet that I need a BSN to do that....:chuckle

I'm 56, came back from near death and had hoped and prayed that I would be able to work long enough to get a decent retirement, a little house of my own with a garden and that if and when grand kids show up, I'd have the wherewithal to spoil them rotten! My 10 year from now dreams were/are; to still be with my boyfriend, to be retired in some comfort, healthy enough to travel and to spoil the grandkids.

Now I am so very worried that I'll loose the house, end up living in a single room and have trouble making ends meet. ARGH.

Thanks for letting me vent my fears, woes, worries and the like. I'm just scared.

:nurse::redbeathe Thank you for sharing. I do not know about the others.....but I can sympathize w/ you. I worry quite a lot fo things that I have no control of, and I do remind myself that there are cases or situations of which I can change of which I am in control of, and some you can't ---this one you conciously do not worry becaseu it iwll not do you any good and it will just make you hyper and run around in circles , like a chicken w/ it's head cut off ! I am also aware of those ridiculous prizes out there , to get a specialty certification. I beleive this is really a money making thing....I think the best way to get a certification is for your work place to send you to one for free-----that is if you have an employer who is smart enough to allow this ---sure you can sign a contract and sign that you will work for them for two years!! Cool!! now you have a t least a guaranteed 2 year job and a specialization training !!! It is funny that I was thinking of an MDS certfication also ( there is a CMS website that claims that they will give you a certification for free? ) I placed it in my favorites but have not revisited it to see if it is indeed what they claim it to be. and the wound certification !! I too was thinking of that, and yes there is a need---I think you can have your own business w/ this and contract w/ the hospitals ...I do not know at this point. but if you noticed there are a lot of certifications out there....like the Case mgmt. I have colleagues who takes the test for $400.00 --this is a test only ,not a training !!! and the cost to renew is just as extravagant.....what is this all about? It makes me think , are we nurses really that obsessed w/ long titles after our names? :confused:

Specializes in CCU, OR.

When I was in nursing school in 1979-82, I simply couldn't imagine what difference a BSN or and MSN would make if you were a nurse. NOW if you don't have a BSN, the many road blocks to many areas are right there.

Nurisng has gone generalists to specialists, complete with degrees. In the old days, if you were "just" a nurse, you could migrate into infection control, or wound care, or this or that. Now that more and more are pushing for a BSN as a basic degree(and with my diploma, BA and 1/2 an MA, I think I have better and more education that any BSN), to "just" migrate requires Initials, Degrees and Certifications.

How does one break into Case Management? I dunno. All the positions I've looked for require EXPERIENCE. Ditto phone nursing, ditto certain other areas. Do I take a course in Case Management and trot back to those who demand EXPERIENCE and say, "Look at my shiny new set of initials!!!!! Can I play now, coach?" and see what happens.

I wanted to take a SANE course. Irt was recommended for nurses in the ER, critical care and the OR. I was turned down flat by my department, as it wasn't required for the job.

Right now, my ability to concentrate on much of anything is awful and I can't see trying to take an online course only to waste the bucks.

The local tech college is hiring part time folks based on experience and they want Master's prepared folks to teach WHATEVER. Even medical technology? Hard for me to accept, but there you have it.

If I end up on Disability, after the crying stops, I'll be busy looking at school. Probably qualify for scholarships and grants as disabled....If I get an MSN, what do I take that will allow my back the easiest of effort? I dunno.

So, I'm still looking. I may have to get my lawyers to fight for enough money to let me be "vocationally rehabbed" since the state won't help you once you have a degree. So if I just had had a diploma, I might have been able to get the state to treat me to an MSN, those years ago, when I was on SSDI for something completely separate.

T'any rate, I just worry about what the next month will bring.

Specializes in psychiatric, UR analyst, fraud, DME,MedB.
When I was in nursing school in 1979-82, I simply couldn't imagine what difference a BSN or and MSN would make if you were a nurse. NOW if you don't have a BSN, the many road blocks to many areas are right there.

Nurisng has gone generalists to specialists, complete with degrees. In the old days, if you were "just" a nurse, you could migrate into infection control, or wound care, or this or that. Now that more and more are pushing for a BSN as a basic degree(and with my diploma, BA and 1/2 an MA, I think I have better and more education that any BSN), to "just" migrate requires Initials, Degrees and Certifications.

How does one break into Case Management? I dunno. All the positions I've looked for require EXPERIENCE. Ditto phone nursing, ditto certain other areas. Do I take a course in Case Management and trot back to those who demand EXPERIENCE and say, "Look at my shiny new set of initials!!!!! Can I play now, coach?" and see what happens.

I wanted to take a SANE course. Irt was recommended for nurses in the ER, critical care and the OR. I was turned down flat by my department, as it wasn't required for the job.

Right now, my ability to concentrate on much of anything is awful and I can't see trying to take an online course only to waste the bucks.

The local tech college is hiring part time folks based on experience and they want Master's prepared folks to teach WHATEVER. Even medical technology? Hard for me to accept, but there you have it.

If I end up on Disability, after the crying stops, I'll be busy looking at school. Probably qualify for scholarships and grants as disabled....If I get an MSN, what do I take that will allow my back the easiest of effort? I dunno.

So, I'm still looking. I may have to get my lawyers to fight for enough money to let me be "vocationally rehabbed" since the state won't help you once you have a degree. So if I just had had a diploma, I might have been able to get the state to treat me to an MSN, those years ago, when I was on SSDI for something completely separate.

T'any rate, I just worry about what the next month will bring.

:yeah:Thank you ! You expressed the same kind of :confused: confusion that I have when I hear about these things. I think nursing has gone ballistics about titles ! Also noted about the nursing masters required to do a job that does not really equate w/ the training. When I interview , I silently observe the employer as to how he handles degrees vs, experience. The employers who know their stuff , would take a candidate that do not have the degrees and substitute it equally w/ the years of experience ----this makes sense to me. Somehow there is a movement out there to get certifications such as case manager ( I tell you that you can learn this on hands in the hospital) and you know how much it is to sit and take the test ? $$400.00 ...and this was 4-5 years ago. This is all money making. If I am the employer , I will hire the one w/ experience vs. the mastered degree nurse w/ little experience.

I am not againts higher education----- the theoretical must be useful w/ the clinical , and can be applied to the clinical ....otherwise the degree just becomes a useless paper.

It is not all about titles ....................if you do have one be prepared to use and apply it.

Specializes in CCU, OR.

Have you looked at the advertisements from the Fed? Most of their nursing ads are confusing if htey are posting for a number of different types of nurses in an area. However, the basic requirement is graduation from an accredited nursing school- dip, adn, bsn. Or they'd like you to be a nurse with a four year degree and an rn, or an rn with commiserate experience, or this or that........The Feds are a lot more interested infinding someone to fill the job than to look for fancy degrees. That being said, there are various civil service rankings you can get to and go no further when you have a diploma, BA and x amount of years, vs BSN, MSN and less experience. They do have a certain logic to their needs, but reading the ads and trying to make sense of them is a bit trying.

A vocational rehab counselor told me that the ads for nurse able to do x, y and z along with LMNOP initials is what the employer is hoping for, but not what the employer might "settle on" instead.

It's so confusing.

T'any rate, I find myself interested in epidemiology, which means an MS degree and a lot of catching up to do- my GRE is so old is has bats hangng from it! Plus there are classes such as demographics and the like that I'd probably need to take before being accepted. Or is it a MPH that I should look at? ARGH. I feel like Charlie Brown believing that Lucy won't pull that football away as he takes his kicks! LOL

Specializes in psychiatric, UR analyst, fraud, DME,MedB.
Have you looked at the advertisements from the Fed? Most of their nursing ads are confusing if htey are posting for a number of different types of nurses in an area. However, the basic requirement is graduation from an accredited nursing school- dip, adn, bsn. Or they'd like you to be a nurse with a four year degree and an rn, or an rn with commiserate experience, or this or that........The Feds are a lot more interested infinding someone to fill the job than to look for fancy degrees. That being said, there are various civil service rankings you can get to and go no further when you have a diploma, BA and x amount of years, vs BSN, MSN and less experience. They do have a certain logic to their needs, but reading the ads and trying to make sense of them is a bit trying.

A vocational rehab counselor told me that the ads for nurse able to do x, y and z along with LMNOP initials is what the employer is hoping for, but not what the employer might "settle on" instead.

It's so confusing.

T'any rate, I find myself interested in epidemiology, which means an MS degree and a lot of catching up to do- my GRE is so old is has bats hangng from it! Plus there are classes such as demographics and the like that I'd probably need to take before being accepted. Or is it a MPH that I should look at? ARGH. I feel like Charlie Brown believing that Lucy won't pull that football away as he takes his kicks! LOL

Oh that sounds very interesting ....now this is where you need your masters in sciences. Yu could get a job or position in CDC ! That will be exciting----definitely not a boring job! So I noted that a lot of nurses are talking about going to masters , maybe even phd ---- my question is how are you financing yourself---- student loans or are you just independently rich ? I would like to know because I am in the process, but to a very specific area, and would like to work in this population, but I definitely do not want a purely managerial work.....I am looking at gerontology.Can anyone give me some advice? :wink2:

Specializes in Nephrology, Cardiology, ER, ICU.

I financed my first MSN via student loans which I'll be paying off long after I'm in a nursing home - lol.

My first and now second post-MSN certificates I'm paying for myself.

Specializes in CCU, OR.

I was looking at the Duke Master's in Nursing program. They state that 80% of their students get some kind of financial aid. There are many suggestions for funding, outside of the usual(Pell grants, Stafford loans, etc) such as looking into scholarships from large and small sources. Johnson and Johnson, for example, fund a great many scholarships. Then you can look into nursing scholarship sources, which are sometimes very specific and funny, i.e., nursing students from two counties outside of Detroit Michigan or full coverage for people from a certain town whose lasts names are XXXXX. It takes a lot of time to winnow out the large chaff. As a Jewish person, I've looked at possible Jewish scholarships for nurses. Sometimes, looking at places like the drug companies, Coke a cola or Pepsi- it's worth writing essays for 250.00 or whatever.

Right now, I'm still trying to get proper treatment for my back injury, however I have to do it. Until my life normalizes, I simply don't have the concentration required for school, sorry to say.

I've also started thinking about trying to finish that MA in anthropology, because after all these years, I'm still in love with it.

Good luck to everyone....

Wow your story has really really inspired me...I started off as a child wanting to be a nurse I dropped out of a Vocational program in nursing in High School, went to college at 18 majored in nursing, dropped out wanted a job and make money, went back majored in nursing again to only change my major to english...Got a degree in english to only come back to nursing.....I guess when a calling is on your life theres no running or hiding from it...It will follow you where ever you go in life!