My future in nursing

[Mr.murse]

For as long as I can remember I've known I wanted to go into heath care, but was always unsure on which route to take. I'd always juggled the PA vs nursing routes, and finally by the time I was a senior in high school I decided I'd go for the PA. I had the grades and was studious enough to eventually make it, so I began to plan for one of the most important aspects of admission into any good PA program, the clinical experience hours (1,500 min.). At this point I'd been a lifeguard for four years and although there are times when you get legitimate emergency care experience, I knew this job would not cut it for clinical hours. I decided I'd like to get into a more personal type of care, and became a CNA.

Over that Summer I began working at a local nursing home and started accumulating those required hours. A few months in the nursing home started to experience some problems. It had always been under staffed, but with the loss of a few good CNAs we were dangerously short-handed, and word of strict nurses and poor management spread keeping many CNAs from applying. I didn't really mind any of this until I started getting scheduled down what most considered to be the worst hall in the facility.

At the time I couldn't imagine what might be so different about this hall than the others, but I quickly found out, and was disgusted with what I experienced. It wasn't so much the fact that the most difficult and debilitated patients were thrown down this hall, but more so the med aide acting as a nurse who made it so terrible. She would overstep her boundaries any chance she got, and loved demeaning CNAs, housekeeping, and other nurses at any opportunity.

I guess between her and all of this I started to get annoyed. I began to hate my job, yet love the residents more and more. They eventually became the only reason I'd show up for work. To say the least, this became the main reason I changed my mind on the PA route. I didn't want to spend another 2,000 hours in that facility or any other. I think what I like the least about it is the tedious tasks. If I spent the day doing what the nurses there do I would thoroughly enjoy it, but its the small, monotonous ADLs that eventually got to me.

This does not, however, discourage me from the nursing route. I've got most of the requirements completed to enter the nursing program (all but advanced CNA), mainly because the pre PA program classes are synonymous to those of the nursing program. This will also help if I want to go RN to BSN, because a lot of the classes I've taken (microbiology, statistics, inorganic/organic chem, med terminology, anatomy/physiology, etc.) so I really benefit from going this route. It also helped that my high school offered a lot of dual college courses that put me ahead of the majority of students. I had 34 college credits coming out of high school, most of which were pre reqs.

Anyway, there are some questions I have now regarding how the next few years will go:

- Is being an advanced CNA less frustrating? i.e. less complete dependence by the residents, more skilled care, happier nurses, less of the monotonous tasks of getting 6 or so people up, cleaned, dressed, groomed and ready for the day and then back cleaned and down for bed in the same little time frame? Basically which is better?

-Would I gain some good experience becoming a home health aide? I always thought this sounded like a good idea, and I have a great aunt who use to work at the same nursing home as I did that decided to go this route and says its so much better. I like the idea of actually spending time with someone.

-When I was going the PA route, I wanted to put an emphasis on an endocrinology specialty, can I do the same type of specialty if I get into more advanced nursing with a higher degree level?

-What are some standard skills of nurses, or I guess what do you do on a daily basis (depending on setting).

-Does it help to have a broad medical vocabulary and great understanding of biology, anatomy, and physiology? This is where I believe I would excel. I don't know much about the hands on aspect of nursing, so I'd be right there with everyone else.

-Is nursing more hands on than knowledge, or equal in both?

-How difficult, in comparison to becoming a PA, would it be to become an NP?

I plan on doing an RN to BSN for sure, but if I ever felt like taking it further yet, how difficult would that be? Is it more of a "you need time and money" thing, or more of a general intelligence?

-What can you so with a BSN, just some examples please.

Feel free to only answer as many questions as you feel comfortable with, or care to. I'm really just looking for insight.

[missnurse01, MSN, RN]

Anyway, there are some questions I have now regarding how the next few years will go:

- Is being an advanced CNA less frustrating? i.e. less complete dependence by the residents, more skilled care, happier nurses, less of the monotonous tasks of getting 6 or so people up, cleaned, dressed, groomed and ready for the day and then back cleaned and down for bed in the same little time frame? Basically which is better?

I have no idea what an advanced cna is, we do not have them here. Have you tried working at a different facility, or in the acute care hosp? icu, er tech etc?

-Would I gain some good experience becoming a home health aide? I always thought this sounded like a good idea, and I have a great aunt who use to work at the same nursing home as I did that decided to go this route and says its so much better. I like the idea of actually spending time with someone.

I do not think home health aide experience is going to put an warm fuzzies to PA selection committees but you could always call and ask them. They want you to have exposure to the medical field, including different diagnosis, tests, meds etc.

-When I was going the PA route, I wanted to put an emphasis on an endocrinology specialty, can I do the same type of specialty if I get into more advanced nursing with a higher degree level?

I assume there are some NPs that work in an endocrinologists office. You should look around in your area or hosp directory and see what you find.

-What are some standard skills of nurses, or I guess what do you do on a daily basis (depending on setting).

same crap you are doing, lol. But added on everything else. I feel that you REALLY need to go shadow some nurses, nps, pa's, etc to see what the different job functions are. They can really be different esp in different fields. Do not go into it blind.

-Does it help to have a broad medical vocabulary and great understanding of biology, anatomy, and physiology?

yes. in nursing school you will have to learn every major disease/disorder of each body system and their common treatments, etc

-Is nursing more hands on than knowledge, or equal in both?

both

-How difficult, in comparison to becoming a PA, would it be to become an NP?

I think time frame wise, depending on your education now, it would take longer to be a NP. Both require bachelor's prior to entry.

-I plan on doing an RN to BSN for sure, but if I ever felt like taking it further yet, how difficult would that be? Is it more of a "you need time and money" thing, or more of a general intelligence?

rn-bsn is easy. advanced nursing is like anything else, if you have the drive to do it, you will do it.

-What can you so with a BSN, just some examples please.

you do the same things as adn. They do not open many other types of jobs like they used to. Before you had to be bsn for management but now you need even more. What hosp have done is increased the required for hire bsn so many people with adn have a hard time finding jobs- but it is still the same work.

Feel free to only answer as many questions as you feel comfortable with, or care to. I'm really just looking for insight.

the insight is--you need to go shadow. You have too many questions and there are more that you haven't even thought of yet, to get all your info from little old us. You need to go talk to human resources or nurse recruitment to shadow different types of units. then find different types of np's and pa's out there to shadow too so you can make your decision.

good luck

[Devon Rex, ADN, BSN]

Whoa! You have a boat load of questions! Let's see...

I would encourage you to google: "Nurse Practitioner vs Physician Assistant". There is a very interesting webpage made by onlinenursepractitionerprograms.com that explains the difference and similarities of NP & PA.

The CNA position is an entry level position for nursing. The next level up would be LPN/LVN. The next level would be becoming a registered nurse (RN). You become eligible to take the board examination for RN once you have completed either an Associate of Science in Nursing (ASN) or Bachelor of Science in Nursing (BSN) degree. Then you can pursue a masters degree in nursing or a doctoral degree in nursing. Currently, to the best of my knowledge, there are two distinctive doctoral degrees in nursing... PhD and DNP. I am not familiar with the PA route, so I can't comment intelligently about it... but that's the nursing route in a nutshell.

Question: "Does it help to have a broad medical vocabulary and great understanding of biology, anatomy, and physiology?"

Answer: Absolutely !!

Question: "Is being an advanced CNA less frustrating? i.e. less complete dependence by the residents, more skilled care, happier nurses, less of the monotonous tasks of getting 6 or so people up, cleaned, dressed, groomed and ready for the day and then back cleaned and down for bed in the same little time frame? Basically which is better?

Answer: I'm going to presumed that by "advanced CNA" you mean to be an "RN". The job of the RN is far superior of the CNA or even the LPN. While many complain that all an RN does is to push meds and talk with doctors... the vast majority of what an RN does is within the mind. Critical thinking is key to be a successful RN. While the CNAs and many LPNs do the hard physical work, the RN has to apply other principles into their caring. RNs need to assess patients, develop care plans, implement those plans with the help of CNAs and LPNs, and evaluate the outcome of those plans. RNs educate patients and their family members on their particualr disease or conditions and give instructions of care after discharge. The RNs need to become familiar with medications, dosages, side effects, contraindications, and be able to identify when a patient is having an allergic reaction or abnormal manifestations. RNs needs to be quick on their feet and are ultimately responsible for the patient's well being. RNs needs to become familiar with acronims and medical terminologies to be able to communicate with physicians and be able to record proper information on the patient's charts. The list goes on and on.

Hope this helps!!

[Stephalump]

I have a question!

What is an "advanced CNA?"

[Mr.murse]

Thank you both for your input. As far as the shadowing goes, I did a few weeks with a school nurse and another few with a geriatric nurse during high school for an internship program, but do you feel it would be best to get into a hospital setting?

The advanced CNA allows you to work in a hospital setting where as the CNA (75 hour course) only allows you to work in a nursing home in most cases. The advanced CNA is another class that teaches more skills and gives you more certification.