I'm ready for grad school... but, not sure what role I'm meant for.

[RNcDreams]

Hey everyone!

I'm posting today to get some advice and opinions regarding the next move in my nursing career. I've got 4 years of bedside experience, with time spent in ER (at a community hospital), Telemetry & Medical Stepdown, and CCU/MICU currently (at a mid-size trauma/teaching hospital in an urban area).

I had a similar issue when I was in college for my BSN. I knew nursing was for me, and was a very dedicated and engaged student, but wasn't the type that had a pull toward a particular specialty. I had to try a variety of nursing specialties/care areas until I found a good fit.

While I enjoy MICU, and learn something new every day, I have somewhat come to the realization that I'm getting a little bit... burned out. I'm not feeling bitter or jaded, but I am starting to feel some of the passion slip away. Coupled with the fact that I'd love to move on to a role that did not involve night shifts, weekends, and holidays... I'm ready to move forward. Overall, I feel tired from the night shifts, stressed by the crazy workloads, and like most of these issues could be prevented in the first place.

As a result, I have been exploring all the different programs out there to advance my skills and change up my practice. I've ruled out CRNA, because I think I'd become unhappy with having such a narrow (albeit intense and very complex) area of practice.

As for NP degrees, I've been gathering information on FNP, ACNP, and even considering education roles. I've tried to look at what I've enjoyed most about my work over the past 4 years, and am trying to work backward to arrive at whatever master's degree/advanced practice role encompasses these qualities.

While I do enjoy acuity and complexity, I think eventually I'd get tired of the hospital setting. I feel most satisfied when I get a patient that is pretty sick, and then I have them for a few days, and we get them better and back to their families. I think this means I enjoy wellness and prevention more than I do "crisis" care. Thoughts?

As for age groups, I know that I don't love babies or little kiddos. I'm comfortable with teenagers up to the old folks. I don't really love the super-old folks much, though. (and by super old, I mean the 85+ group with 3 page long med lists, PEG tubes, contractures, etc). However, I'm indifferent with them in my current role.

I think I like to teach, too. Silly things like explaining how to start an IV and then watching the person do it, and talking about the process after, makes me feel good!

When I was in college, I was a gym class instructor and took quite a few nutrition courses. I think there's a part of me that really feels a pull toward prevention/wellness, and overall just keeping people happy, healthy, and self sufficient.

In summary, this makes me think that an ideal role for me might be Family NP with a focus on young/ middle age adults, and then maybe a little teaching on the side in a nursing program. I can always return to school for a post-masters certificate in ACNP if I feel that I want more acuity.

Lastly, I am paying for this degree myself. As such, I'd like to choose the program that will give me the best preparation with the widest scope of options.

Based on your experiences and current roles, what do you think? What was the degree process selection like for you?

Thanks in advance for your thoughts, and my apologies for writing such a LONG post :)

P.S.

I will be shadowing an ACNP soon, to get a feel for their daily role. I'm pretty clear on what the FNP's do, as I have seen them before for my own healthcare needs, but I'd consider shadowing for further clarity.

[sandanrnstudent]

I personally am just starting nursing school, but I understand where you are coming from. With that said, my advice is only to encourage the very thinking included in this post. You are definitely considering all the right things for a conclusion you will like.

Just keep the way you are. Sorry if this didn't help any.

sandanrn

[germanshep]

What about a health educator? It sounds like you have a wide knowledge of nutrition, exercise and prevention, in addition to nursing. Health educator involves a tremendous amount of teaching. Good luck! You will find your niche :)

[juliemjkim]

My undergraduate nursing program offered clinicals at an affiliated teaching hospital where I got the opportunity to work with a RN 2 days a week. Almost all of my bedside nursing skills came from this experience and I learned so much as a student because of the great help and expertise of the nurses I was paired up with.

Also, if you can find a 'dedicated education unit (DEU)' unit that you are interested in that also offers a position as a DEU nurse, why not try that out? I also had a preceptorship for 1 month at the end of the year in which I basically had the same schedule with my precepting nurse and we worked together like that during her shifts. Sometimes, students can be placed in high acuity units- I was lucky and was placed in an urban level 1 TICU! In my opinion, this was the best experience I could ask for before stepping out into the real world of nursing.

Also, if there are any universities that offer their nursing students clinical experience, why not look into being something along the lines of a clinical professor?

Just my 2 cents if it helped for anything!

[Yiggs]

I'm feeling you! My thought is that with your vast amount of knowledge and experience, plus your passion in caring for critically ill patients, you should consider education. You could specialize in teaching critical care courses, or become a Clinical Nurse Specialist in ICU. At least you will still have the opprtunity to influence pt. positive pt. outcome. Students need professors who teach not because they want to get away from the bedside but because they want to be mentors and pass the baton on to the next generation of nurses. All the best. Yiggs

[paulnp]

My two thoughts were occupational health np or adult/family np with a focus on college health. Possibly also acnp with an ed or urgent care focus. Good luck!

[love-d-OR]

I second the CNS or Educator role. Also, you may want to look into case management or diabetes educator

[RNcDreams]

All excellent suggestions so far! Thank you :)

[RNcDreams]

Hey everyone!

So, I've done quite a bit of soul searching. Here's a few thoughts I've been toiling with, and some possible plans I've mapped out to help me reach my goals.

I considered the Educator role/preparation for a bit. However, I don't think it meets my needs at this time. My reasoning is that I'd like to choose a program that will allow the most flexibility with employment, including clinical practice AND teaching options (even if that teaching is just a basic A&P class every now and then, for extra money and a change of pace).

As such, I've decided on the NP route.

What do you all think of these possible "game plans"?

a.) Acute Care NP with a post-graduate certificate in FNP

b.) FNP with a post-graduate certificate in Acute Care NP

I just can't picture myself fully happy in JUST the office or JUST the hospital... which makes me think I should just create a plan that incorporates both. There's hardly any Dual-Certified programs out there in the adult realm for Primary and Acute care, so I'll just make one myself with a Post-Grad certificate. Hahaha.

Anyway, I'd love to hear what your thoughts are! Also, if you care to share what kind of jobs/areas you work in, I'd love to hear about it.

Will report back with my experiences shadowing! Thanks for your responses. :)

[NickiLaughs, ADN, BSN, RN]

I think you should go for FNP, and after working for a few years and seeing how much your happiness is being met, then maybe go for the ACNP. It sounds like you have a very good idea of what you want. I worked with several FNPs on a college campus, the hours are fantastic, they often had seminars a couple times a month doing patient teaching, STD prevention, etc. And the occasional chest pain and so forth did come in. The role was pretty wide though, they helped develop the immunization programs and requirements for the school, got to attend a lot of seminars, and I think the best thing: some had july and august off!

[bsnanat2]

I'm feeling you! My thought is that with your vast amount of knowledge and experience, plus your passion in caring for critically ill patients, you should consider education. You could specialize in teaching critical care courses, or become a Clinical Nurse Specialist in ICU. At least you will still have the opprtunity to influence pt. positive pt. outcome. Students need professors who teach not because they want to get away from the bedside but because they want to be mentors and pass the baton on to the next generation of nurses. All the best. Yiggs

I agree!

Check and see if your state recognizes Clinical Nurse Specialist as Advanced Practice. The Adult CNS is great because it allows one to treat Adolescents through Gero and allows for primary and acute care, per the Consensus Model. The CNS role is about the things you describe as it encompasses education, treatment and system evaluation and change (whatever system that may be including practice policies and best practice issues). The CNS role may require that you educate yourself and others about what it is, but it may be just the option. Besides that, some schools will allow you to take a few extra classes and you can get an almost simultaneous ANP or ACNP with the CNS (and you can get a Critical Care CNS cert also).