My career plan feels shaky

[GK-Seedy]

Hey everyone.

I'm a pre-nursing student basically right now, I'll explain my situation before I move to the actual questions, so you guys have some info to go on:

1) Worked at hospitals for 1½ years as a scribe before any actual medical training

2) I became a medical technician for the Air Force which is EMT training plus some nursing courses

3) I became a flight medic in the Air Force which meant more nursing courses

4) I have 3 years worth of University undergrad as a pre-med biology student. All of my gen ed is 100% done, but I only have 8 semesters of lower division bio, and only got intro chem and chem 1 out of the way (no organic or bio yet). I took an anatomy class but hadn't taken the physiology counterpart yet before I left the university, and I took microbiology class but it was Microbiology: Virology” and none of the RN programs accept that in place of general micro because it didn't cover bacteria. That means I just need a semester that includes A+P 1 and general microbiology before I start the program. That will be cake given all the knowledge I already have on those subjects.

–All in all I actually have 221 credit hours worth of college coursework but no degree to show for it because I never fully completed my two Community College of the Air Force (CCAF) degrees or my undergrad. 38 of those credit hours are from nursing specific coursework identified on my CCAF transcript.

5)I spent 2 years homeless and jobless following a major mental breakdown that was the result of a very ugly end to my military career (don't worry, I still got an honorable discharge out of it).

6)I'm getting back on my feet and a huge part of it was ditching the pre-med idea because I realized I'm in my 30s now and if I stick to the med school goal, I won't be officially starting the stable part of my career until I'm in my mid 40s. I am eager to get back in the med field and I already have a foot and a half in the door on the nursing career. Sadly my EMT, CPR/BLS, and ACLS certs have all been long expired, but at least I have proof that I can pass those tests.

7) I'm own a house in Colorado but I'm currently staying in California with my mother as part of my rehabilitation. I've been here 4 months and have already lost 60 lbs, quit drinking, am seeing counseling, etc… and I'm planning on taking a semester of fun” classes at the local community college here before I head back home to Colorado in the fall. I was too late to get into the prereq classes I need by the time I decided this is what I'm going to do.

8)I have 9 months left (out of 36) of Post 9/11 GI Bill (aka Chapter 33 GI Bill). I am working on getting disability through the VA, once that goes through, I will be able to use 12 months of vocational rehabilitation (Voc Rehab) student aid to cap off the 48 months of military education benefits I'm allowed. Then by the time that's up I should be back in good standing financially, and can just use pell grant, work money, and saved GI Bill money I might have to pay for any semester I have left (if any).

9)I have been accepted into the RN program in Colorado. So once I get those prereqs out of the way I'm all set.

Current plan:

1) Take fluff semester since I can't get my prereqs, which will get me back into the college mindset that I haven't had in years.

The classes I've signed up for aren't actually fluff, I just don't need them as prereqs. They are good classes though:

–Biopsychology (can actually be a pre req for certain some programs I've seen)

–Lifespan Development (I got the developmental psychology prereq waived from other psych classes I took, but I want to take this version anyway)

–Medical Terminology (I'm obviously not required to take this, but it will be good for a brush up that I sorely need)

–Kinesiology (I think this will be great knowledge to have as a future RN – only physical class, the other 3 are online)

2) Take actual prereq semester in Colorado. A&P and Micro are 4 credit hours so I'll just need to find one more 4 credit class to get full time student aid.

3) Complete RN program at same college

4) Get job as RN

5) Get into RN –> RN BSN program (hopefully paid for by an employer) as soon as humanly possible

6) Get NP as soon as possible after that.

7) DNP maybe? Who knows.

My actual questions for you actual nurses! (finally, right?)

1) Does anyone know how well the RN earned in Colorado transfers to other states?

–An RN at the clinic I go to, told me that California is the best state to get your RN license because the coursework is apparently more intensive or something, and therefore you can transfer easily to any other state.

2) Do any of you have experience with military nursing and how it might affect the nursing core requirements of a civilian RN program?

–Like I said, I have 38 credit hours of nursing classes on my CCAF, and nearly 3 years of in hospital work experience – I understand that a federally regulated college would have different standards and practices than a local college, but SHEESH it would seem INCREDIBLY unjust if all 38 credits count for nothing I have to take every single RN class the same as some fresh out of high school kid who never so much as put a bandaid on someone other than themselves. *exhale*

3) How hard is it to get a specialty you want as an RN or RN BSN?

–All 3 years of my scribe and med tech experience have been ER (and some ICU/CCU), except for the rotations I did for 2 months during school, so I really want to be an ER nurse for comfort reasons but also because I need a job that keeps on my feet doing stuff constantly. It helps me stay fit but also I've had really high intensity jobs my whole adult life, so jobs that require a lot of sitting and have more down time make me insane.

4) Is nurse anesthetist something worth shooting for?

–It's the holy grail of nursing salaries, according to google, which makes me wonder what the catch is. I'm curious because I was originally planning to be a surgeon, so I thought CRNA might be a way to still have a key job working in an OR, but as an NP instead of an MD. I can only imagine the pay is much higher than other NP and DNP disciplines because it's a much more difficult job to have and/or get into. I thought maybe the malpractice insurance costs must have been really high (because I heard that many times about anesthesiologists) but google says CRNA average annual malpractice averages $3,900 which seems reasonable. So what's the deal, guys? I guess I'll just throw it up on a poll, if that works.

5) Does anyone here have experience with opening up a small private practice as an NP or DNP, that could maybe answer some questions privately?

Thank you so much if you made it this far. It seems like I have an okay plan on paper, but I can't help but feel like this is a huge bag of snakes where I can only straighten out one snake at a time while the others curl back up.

[LessValuableNinja]

Without answering all your questions, since I sleep momentarily: look up "veteran to BSN" "veteran BSN" programs. They're a real thing now. If you want to move to Texas or apply to Texas schools I can point you in the right direction. Otherwise, Google and the BON are your friends. These programs are typically much faster than a traditional BSN and are geared towards veterans who did... Medical stuff.

[reggaemuffin, MSN, NP, CNS]

Okay a couple of things that pop out here to me. CRNA and NP are two completely different degrees and professions.

DNP is non clinical degree called-doctorate of nursing practice - it is not only for NPs. Although many NP programs are eliminating their MS programs in preparation for mandate (that may or may never come to frutition) that DNP is new entry level requirement.

I think before you decide that you want to go to NP school as soon as possible after graduating you need to do some research. I would also recommend getting some RN experience so you can see what you like/don't like. I also personally don't think new RN grads are fit to be independent provider.

You mentioned not wanting to go to medical school due to length of time for completion. CRNA schools require at least two years of specific RN experience as do most (reputable ) NP programs. Also I believe (not positive) CRNA programs are currently switching over to the DNP format which will add years to your program.

Please dont choose your profession on salary-there's so much more to advance practice nursing. Also If you aren't an LPN you shouldn't have those credentials in your screename- people give blood, sweat and tears for the right to have that degree! Good luck to you!

[SierraMoon, ADN, BSN, RN]

It's ok to be interested in being a CRNA but keep it quiet. It rubs people the wrong way because it seems like every pre-everything student everywhere is planning to be one without even understanding what it means to be a nurse.

CA and CO are pretty competitive nursing markets so you might not get ICU as a new grad. You need ICU for CRNA school.

I don't think it matters to licensing where you go to school as long as you graduate from an accredited program.

[emmy27]

The "catch" is that CRNA school is highly competitive and demanding. You need several years of critical care experience as an RN (something that is not guaranteed to a new grad- some are able to start their careers in ICU but many are not) and excellent grades to get in, and then it is (reportedly) a challenging and demanding program. It's not a bad goal to have but it is a lengthy career path with multiple potential roadblocks along the way. I don't know that I'd consider it "shaky" as a goal but I would consider what you plan to do/how happy you foresee being for the years that stand between you and even potentially starting CRNA school, and what it would mean for your plan and life satistfaction if you are not able to obtain admission to or successfully complete a CRNA program. I agree with the prior advice to keep your CRNA goals relatively quiet early in your career- it will make a more favorable impression on the people you need to impress to obtain the training and ultimately recommendations you will need if you appear to view being an RN as more than just a stepping stone to another career. It will benefit your practice if you can actually achieve this perspective, too.

How difficult it is to obtain a specialty is highly variable, dependent on location, grades, and sometimes personal ability to network and market yourself. If you live in an area with a high demand for nurses, new grads may be accepted to ED and ICU- in others it may be challenging for new grads to obtain hospital work of any kind. If you make a great impression on ED or ICU staff in your clinical rotations or work in an ED or ICU as a tech or secretary during school, that can also lead to better employment odds. Conversely, making a bad impression can permanently trash your odds- more than one worryingly overconfident clinical student/preceptee was pre-emptively vetoed to the manager by floor staff in one ED I worked in. Make sure all the people you meet as a student think of you as someone they'd want as a coworker. But again, this only matters if the hospital you're seeking employment in is willing to hire new grads to critical care areas at all. Also, be aware that while ED does involve critical care, some CRNA programs want ICU experience specifically- ED experience is too varied in what it includes for them to consider it reliable critical care experience.

With few exceptions, licensure by endorsement in any state is available to a graduate of an accredited program who has passed the NCLEX and been licensed that way in any other state. It can be a somewhat expensive and time-consuming process to get a new license by endorsement, depending on the states you are moving between, and CA is reputedly one of the lengthier states to obtain a license in due to some problems with their process at the board, but there is not any advantage to going to school in CA in this regard that I am aware of, nor do employers look more favorably on licenses originating from one state than another (other than in the sense that you generally must have a valid license in the state where you will be employed).

Hope some of that helps.

[HouTx, BSN, MSN, EdD]

THANK YOU FOR YOUR SERVICE.

Your sincerity is coming across loud and clear. Congratulations on turning yourself around and moving ahead. This takes courage.

However, a couple of items in your story stick out a bit. Were you were hospitalized to treat your "mental breakdown"? Are you in a mandated rehabilitation program? (you mention overcoming a problem with alcohol). I don't want to dwell on the negative, but in some states (like mine), you will need to pass a very thorough background check as part of your admission to nursing school & these issues could pose a roadblock. Make sure you investigate the state in which you want to attend a nursing school to determine their rules.

Make sure that all your pre-requisites are still active. Although there is a variation among programs, it is not unusual for science courses to expire after 5 years. Clinical courses just don't transfer. The primary reason is that (again) program curriculum is not standardized. Although everyone has to include same essential content, they can package it up in any way they choose. Some schools may let you 'test out' of the intro classes, but this is not widely available. On a positive note, if you've already taken these courses in the military, making excellent grades should be pretty easy.

Wishing you absolutely the best of luck on your nursing education.

[klone, MSN, RN]

I can speak to the Colorado license thing. CO is a compact state, so you can easily transfer to another state. That said, unless you took some weird hybrid online or unaccredited nursing program (like Excelsior or ITT), you should not have difficulty endorsing your license to any other state, including California.

[LessValuableNinja]

Also I believe (not positive) CRNA programs are currently switching over to the DNP format

Some are, some aren't. It's something that's been talked about since before I met my first CRNA student in 1999. Does not appear to be a rapid process.

[OrganizedChaos, LVN]

Without answering all your questions, since I sleep momentarily: look up "veteran to BSN" "veteran BSN" programs. They're a real thing now. If you want to move to Texas or apply to Texas schools I can point you in the right direction. Otherwise, Google and the BON are your friends. These programs are typically much faster than a traditional BSN and are geared towards veterans who did... Medical stuff.

Texas A&M Corpus Christi has an e-line Military BSN program.

Here's a link:

Bachelor of Science in Nursing (BSN) - eLine Military - Texas A&M University Corpus Christi

[LessValuableNinja]

Texas A&M Corpus Christi has an e-line Military BSN program.

Here's a link:

Bachelor of Science in Nursing (BSN) - eLine Military - Texas A&M University Corpus Christi

Chaos, were you 91C/91WM6/68WM6?

[OrganizedChaos, LVN]

Chaos, were you 91C/91WM6/68WM6?

No. I have epilepsy so I was never able to enlist. I just know of the school.

[GK-Seedy]

Okay a couple of things that pop out here to me. CRNA and NP are two completely different degrees and professions.

DNP is non clinical degree called-doctorate of nursing practice - it is not only for NPs. Although many NP programs are eliminating their MS programs in preparation for mandate (that may or may never come to frutition) that DNP is new entry level requirement.

Right, I realize CRNA and NP are two completely different degrees. I am just trying to map out my long term goals, and was wondering which one would be better to shoot for.

I think before you decide that you want to go to NP school as soon as possible after graduating you need to do some research. I would also recommend getting some RN experience so you can see what you like/don't like. I also personally don't think new RN grads are fit to be independent provider.

Well, when I say as soon as possible what I really mean is "as soon as optimal". If you all say it's necessary to get at least 5-10 years experience as an RN BSN, then I would treat 5-10 years as the number for my "as soon as possible" figure.

What do you mean by new RN grads not being fit to be independent providers? What do you mean by independent providers in this context? When I get my RN I plan to just work in a normal RN position (whatever I can get probably) until it's a good time to start working on my BSN. So honestly I'm not sure what you were implying there.

You mentioned not wanting to go to medical school due to length of time for completion. CRNA schools require at least two years of specific RN experience as do most (reputable ) NP programs. Also I believe (not positive) CRNA programs are currently switching over to the DNP format which will add years to your program.

Please dont choose your profession on salary-there's so much more to advance practice nursing. Also If you aren't an LPN you shouldn't have those credentials in your screename- people give blood, sweat and tears for the right to have that degree! Good luck to you!

I don't want to go to medical school because I don't want to spend 12+ years just training before I officially start my career. The idea behind choosing nursing, is that I will be working while furthering my education, rather than doing a ton of education up front. I also did not say that I am choosing my profession based on salary. I even pointed out that I was interested in CRNA as a possible way to get a good job in the OR. The salary difference simply caught me off guard, and in fact made me wary about the job because I was worried it might be insanely difficult or something. Anything beyond 50k and I can live happy. I know 'cause I've been there. Everything else is just extra to me.

Also, about the LPN thing. When I set up this account I thought you had to choose one. I didn't realize it would show up next to my screen name on the forum because it was my very first post. I chose LPN because the training I received to become a fully qualified flight medic in the air force reflects that of civilian LPN schools. I know because several people I trained with immediately became LPNs. Some within 2 weeks of graduating.

I spent 11 years in the military. If you add up all of my time spent on deployments to the middle east, I spent over 3½ years over there. One time when I was there, I took a picture of a thermometer showing it was 145°F at 11 in the morning. Some time I spent there as a mechanic, some as a medic. I've worked tirelessly on people who ended up not making it. I've had that cold feeling in my gut from seeing a guy the same age as me that was just alive 10 minutes ago but now he's not. That nasty chill that starts when I'm dismantling the IVs and getting them squared away for landing--that awkward mixture of regret and a heightened sense of mortality (and how powerless we are over it). It lasts for days sometimes. So please, don't lecture me about sweat and tears just because I checked the wrong box on a forum. I've shed my share of both. Blood, too, if you wanna talk sacrificial bodily fluids as a measure of worth.

Sorry, but it seemed like your entire response to my post was just you pointing out that I don't know what I'm talking about, and didn't earn the three little ASCII characters that WERE next to my username. I realize I don't know about this stuff. That's why I'm here. I'm asking you guys for guidance on how to set up a career plan because I clearly don't know enough to do that on my own yet.