Good morning! Thank you for reading this post. I have been an ICU nurse for 7 years and love what I do. Three years into my staff nurse position at the ICU, I managed to get a part-time job at a large insurance company doing case management but I continued to work in the ICU as well. I have been working both jobs for the last 4 years while my husband went back to school to get his PharmD. I currently work full-time as a work at home clinical advisor making $69,500 annually for the same insurance company and working prn as an ICU charge nurse 4-5 shifts a month. My husband will get his PharmD in June and has secured a job with Walgreens in which he will be making $119,000 annually. We have talked about me going back to school to become an NP because I need something else and I want to take care of transplant patients. I would like to specialize in Nephrology and take care of kidney transplant patients because my husband got a kidney transplant at the age of 27. I do have a Bachelor in Business prior to getting my BSN and I went into nursing school my husband was diagnosed with end stage renal disease at 21 and I wanted to be a nurse so I can take care of him. So this is where we are at. Ten years and 2 kids later, my husband is doing great with his mom's kidney and we are grateful but we also need to plan for the future. The future is different for our family because we know there is a chance that my husband will need another 1 or 2 kidneys. Therefore, I can never stop working and I need to always be making decent money.
So here is the fork in the road...Should I try to climb the ladder at this insurance company and make more money to secure my family's future or should I go back to school to become an NP. Remember, I work at home as a clinical advisor with absolutely no stress making $69,500 and working the prn gig in the hospital to pay for out of pocket healthcare costs due to my husband's frequent check ups. We have two boys and want to have another child in 2016. We also have about $150,000 in student loans (private business and nursing schools for myself, Master in Teaching and private pharmacy school for husband). We also have a mortgage but those are our only debts. The NP practitioner program that I am looking at is about $30,000. I do have to take two pre-reqs which will be around $3,200 for both. The insurance company that I am working for does have a tuition reimbursement of $5,000 annually. If I go the NP route, I plan to still work full-time for this insurance company as a clinical advisor (no climbing the ladder because that may require me to go back to the office and may have added stress), drop the prn gig at the hospital (because I can't do it all), take care of 2 boys (thank goodness my mom lives with us and provides childcare, housekeeping and cooking services), do well in school (because once I set my mind to something, it has to be successful) and take care of my husband (because I love him).
HELP! I wish I can travel into the future and try both! :) I know it shouldn't be all about the money but I have a spouse who may have some serious health issues in the future. I need to think about how I can get the best medical care my husband and feed my boys.
Stay with insurance company and climb the ladder to make more money, no NP school: Pros (no stress in current role but may have more stress due to more responsibilities that come with the promotion and more pay), Cons (won't be able to take care of transplant patients)
Go to NP school, continue to work current role as a clinical advisor to get tuition reimbursement and contribute to 401K and help husband pay back student loans, No climbing the ladder: Pros (get to learn something new, possibility of making more money, learn more to take care of husband, insurance company that I currently work at may employ more nurse practitioners in the future), Cons (more money for school, husband wants to pay as we go because we can't afford any more student loans; the struggles between MDs and NPs)
@RNDude2012 Thank you for your help! There are 2 transplant hospitals in my state. The one that my husband had his transplant at is 2 hours away. This hospital just opened a satellite office in my city but I think they just have one nephrologist and 2 nurse case managers. They don't have any NPs yet. My husband is finishing up his last rotations for pharmacy school and he is on the transplant floor at the same hospital that he got the kidney transplant. He saw a kidney transplant yesterday! This teaching hospital has 3 main transplant surgeons, a lot of resident physicians, pharmacy and medical students and 1 NP. The other transplant hospital is 25 minutes from our house and it's in the heart of downtown. The only problem is this hospital has a bad reputation and I agree because I worked there for 5 years as a pharmacy technician. The other option that I have is to work at a nephrology office and I may get a chance to take care of transplant patients every now and then.
Another skill that I have is that I am fluent in Vietnamese. The only problem is that there are less than 2,000 Vietnamese in my city so this skill is not as marketable. I see that you are from California. Any Viet NPs there? My husband and I want to move to the Pacific Northwest after we pay off the debts and house because the weather here is too darn humid in the summer and too cold in the winter. It does not help that we live in a valley. The polluted air does not have anywhere to go! The fact that everybody and their horse smoke here does not help the situation either! Thank you for your help, RNDude!
Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
I'd stick with the work-at-home position and supplement with PRN hospital employment, just as you are currently doing.
It seems that everyone (and their mommas) seems to be enrolling in NP programs. I foresee a very real NP glut in the coming years that may result in deflated salaries and increased competition for jobs.
In addition, I'd be depressed by a lifestyle that entailed 50-60 hour work weeks and rounding on 30+ patients per day.
I say go for it! You seem to be very motivated and passionate about taking care of that population of patients! You already have a plan for how you would pay for it so I would definitely look into programs at public schools compared to private schools so it's less expensive. Start with programs in your state first. It seems like many are enrolling in NP programs but I wouldn't worry about a shortage of jobs because currently NPs are filling the gap in the primary care provider (MDs/DOs) shortage we're experiencing. It's a great way to advance your career! You'll have more work stress compared to your current job but you'll also be making more. Go for an FNP program for more job opportunities. If you wait for the "right" time then something will always come up so may as well enroll and get it over with! The time flies by!
It's very hard to be in the NP program and work FT. You also have to remember that with your current job, there's no call, and as you said, very little stress. Do you think you could handle the stress of school, a new baby, and work? Also, climbing the ladder with the insurance company... What does that mean? What kind of salary are you looking at? If you're looking at making the same amount of money as you would in the NP field, I would say climb the ladder and save yourself some of the stress. I think your intentions are honorable, but sometimes peace is worth a whole lot more than honorable/the best of intentions.
No one can really give you advice because we don't live your life and know exactly what the deal is. You've done a great job explaining your situation but it's all in your personal preference.
I would say definitely check the job market in your area. Where I am... you would take a pay cut for a more stressful job. But again if your cost of living is higher than where I am it could be a pay increase for you.
hkRN83
32 Posts
@RNDude2012 Thank you for your help! There are 2 transplant hospitals in my state. The one that my husband had his transplant at is 2 hours away. This hospital just opened a satellite office in my city but I think they just have one nephrologist and 2 nurse case managers. They don't have any NPs yet. My husband is finishing up his last rotations for pharmacy school and he is on the transplant floor at the same hospital that he got the kidney transplant. He saw a kidney transplant yesterday! This teaching hospital has 3 main transplant surgeons, a lot of resident physicians, pharmacy and medical students and 1 NP. The other transplant hospital is 25 minutes from our house and it's in the heart of downtown. The only problem is this hospital has a bad reputation and I agree because I worked there for 5 years as a pharmacy technician. The other option that I have is to work at a nephrology office and I may get a chance to take care of transplant patients every now and then.
Another skill that I have is that I am fluent in Vietnamese. The only problem is that there are less than 2,000 Vietnamese in my city so this skill is not as marketable. I see that you are from California. Any Viet NPs there? My husband and I want to move to the Pacific Northwest after we pay off the debts and house because the weather here is too darn humid in the summer and too cold in the winter. It does not help that we live in a valley. The polluted air does not have anywhere to go! The fact that everybody and their horse smoke here does not help the situation either! Thank you for your help, RNDude!