NP...doing the right thing?

zenman · Jun 14, 2011

I'm a PMHNP and I work in a state where we are totally independent. What that means for me is that I do not have to pay someone to review charts after the fact. If I don't know what to do I can pick up a book or article and become enlightened. This is compounded by the fact that 20 different shrinks might take 20 different avenues. This is further complicated by the fact that all patients are different. If I were in a state where I had to have a collaborating physician, I'd be at their mercy and would have to close my practice if they changed their mind, died, remarried and their new wife didn't like me, etc.. I like being independent and can chat via telemed with the supervisor of this clinic who is many states away anytime I want. I make sure I'm good and know what's going on. This morning I dx a young lady with Bipolar D/O after a lifetime of being screwed around by doctors who couldn't figure out why she failed on so many antidepressants. She should be a new woman next visit. Consider your options carefully. I'm debt free, make well into 6 figures, get free housing, and car allowance for my job, and as I said before "just leave me alone!" :yeah:

Babbott72 · Jun 14, 2011

Thanks for the feedback!

TJFRN · Jun 14, 2011

I'm a nurse and I don't think you are nurse bashing! I'm happy that you admit that you are not "bedside nurse" material! I much rather work with someone who is in it for the right reason, and the patient will appreciate it to! It is not for everyone. I say go for your dream. Don't look back, just move forward. As a FNP you will be able to do what you want to do. That is if you work with a doc that gives you autonomy (or work where zenman does). I'm currently in a FNP program and I would respect you as a fellow classmate with 50 years of bedside nursing or 0 years of bedside nursing (as long as you know your stuff), in other words I welcome you with open arms.... just do it! :)

gettingbsn2msn, MSN, RN · Jun 14, 2011

I totally welcome you! I am much like you as well. I had a business degree and worked as an account manager for 15 years for corporate. I did an accelerated BSN. I worked 2 years on a busy med surg floor. HOWEVER, I wanted to work on the floor to get my feet wet. It was not necessarily needed but helped me with my comfort level. I am now in an adult NP program and am almost finished. I am an older student but that is fine. I have never had any problem being accepted in healthcare. I know Vanderbilt has an excellent direct entry program. You will also spend some time on the floors as part of these programs. In summary, you should be fine!

Babbott72 · Jun 14, 2011

I appreciate the feedback from both of you. If all goes well I would be working as an RN for a year after nclex while doing post bac courses toward the MSN. Add working while completing my masters work and I will have racked up 2-3 years experience as an RN. I appreciate your understanding of my honesty! I welcome any feedback. Thanks!

NAURN · Jun 15, 2011

I am an RN, will be (hopefully) starting my FNP program this fall. The thing with FNPs, is their practice "rules" are different in every state. Many states have complete independence where they need no collaborating MD (basically an MD who has to look and sign off on x amt of charts every x amt of months and you have an agreement as to what you do, what kinds of meds you prescribe, etc and this all varies by state). PAs always work with an MD... so if you want the OPTION of possibly being more independent, or opening your own clinic or what not, then FNP is for you. What state do you live in? Different states allow NPs to prescribe different schedules of drugs and some do not have any limitations... States also differ as far as how independent they let their NPs be. I have heard that Texas is pretty strict, as well as FL. I really wish they would standardize this more so its not so difficult differentiating what you can and can not do based on state, etc. PA is pretty standard throughout. What a PA does in California is what a PA does in NY... with NP, that may not be the case, and is probably not the case.

On the flip side, if you think you might ever want to go back to med school, PA will be better for you because of the specific classes... they will transfer better. PAs also, from the research I have done, tend to make slightly more, but I think that is also because there are more men in that field and men tend to make more for the same job.... (Doesn't seem fair, but they statistically do... )

I think either option is a great option, I think its just a matter of preference for you. Also, with the FNP, you have the option of working as a nurse before you start the master's work, as opposed to PA where you really can't work as anything medical until you're finished. (Not sure what you do now or anything, whether you would be working during your programs, etc... just putting that out there in case you were not planning on working) At least with the BSN, you can start working and being exposed to the clinical area while you pursue the masters.

Lastly (then I will shut up), I love to teach, so part of the reason I am doing this is because I would really like to teach nursing someday.

I understand the stigma with males and nursing, but really, we love our male nurses! And although I think there will always be kind of that stigma with some people, males are respected as nurses and I really don't think you have anything to worry about if it's being a "nurse" that bothers you. I have an EMT friend that wants to go to PA school because, although he respects nurses, he doesn't want to be one... Even though it would be less schooling and less debt to go RN then MSN, he just can not get past the fact that he would be a "nurse". If you can get past that, you will be joining a great profession!

Babbott72 · Jun 16, 2011

Thanks so much NAURN for your insight. Due to so many factors a FNP makes much more logical sense than a PA at this moment (location, costs, growing family, etc.). Not really sure how I will feel as a nurse until I get in there...and then take the next step toward the NP. Again, I appreciate the information. I know I will learn a tremendous amount. I guess it's equivalent to wedding night jitters :)

A month away from such a big journey towards such a different career (from what I am currently in).

NAURN · Jun 16, 2011

Good luck in whatever you choose. Please let us know what your final decision was and how its going!

Jasil · Jun 26, 2011

Go to med school!! If your GPA's are that good 1 year of pre-reqs and a solid MCAT and you can get in. Old premeds .com and studentdoctor.net nontraditional forum will enlighten you.

My neighber 3 houses down is 37 and is in his 2nd year he couldn't be happier!!

carachel2 · Jun 26, 2011

Count me as one of those who doesn't understand why the charge nurse you were following suggested you go NP? It really makes no sense for someone who has no desire to be an RN and who is older. It is the long way around for sure AND is going to be way more expensive than PA school. I would imagine with PA school you are going to need about a year of pre-reqs such as chemistry, A&P, etc. but then PA school will be a quick 2 years (full-time of course) for you. Nursing school is going to seem like a LOT of BS to you as you float along being forced to learn care plans and nursing theory :uhoh3: .

If you don't want to be an RN and you think you have a reasonable chance of getting into a PA school, I would somehow hold off on the nursing school and focus your efforts towards PA.

You say you don't really care for a huge amount of autonomy, but you do want some AND you are one who recognizes your limits. I think you will do fine in either role.

allnurses Guide · Jun 26, 2011

I went into nursing as a second career and did the Direct Entry route. I really didn't want to do bedside nursing, except in a few specific areas, and RN jobs just weren't available in my area. I did a Direct Entry program full time and immediately got a job as an FNP in a community health center. It's not my dream job, but I've learned a tremendous amount and have gained wonderful experience. I'll be well positioned to look for that dream job when my contract is up. I also considered the PA and MD route. Med school was out for several reasons; the expense, the time I would be out of the workforce, and the lifestyle (long hours, being on-call, etc). NP just felt like a better fit for me than PA. Not all the reasons are tangible, but I didn't really like the people I met at the PA school. They seemed very technically and task orientated, and not as patient oriented as I wanted. I'm happy I made the choice to go with NP. I make a decent salary, work 4 days a week, and never have to be on call. I work with a great bunch of NPs and MDs and have more than enough autonomy. It works for me.

Best of luck with whatever path you choose.