PharmD student - pursue FNP afterwards?

Guest 360983 · Dec 11, 2009

If I'm not mistaken, most programs require a nursing degree AND experience as a nurse before acceptance into an advanced practice nursing program.

BluegrassRN · Dec 11, 2009

Why? Why would you go to school to be a nurse, only to immediately enter a program to become a pharmacist, only then to immediately enter a program to become a nurse practitioner? What exactly are you planning on doing with all this education?

Why don't you decide what you want to do, and actually do it? Do you have the ability to fund this without debt? Do you ever plan on working full time? I'm just trying to understand the desire to get all these degrees under your belt.

And do you think you can honestly run a clinic and a pharmacy at the same time? Do the heads of either of those clinics ever have time to do anything else? The directors of a pharmacy or a clinic are typically not part time positions. Neither are they positions typically given to those without experience. I would think that, in order to be head of the pharmacy, you would have to work several years as a full time pharmacist. Same goes for the clinical director of a walk in clinic.

Junebugfairy · Dec 11, 2009

you do not all of a sudden become an np, it is a long process.

i want to become an fnp/whnp in the future. i know that in order to enter the program i need a good 3-5 years of *preferably* med surg experience, which is commonplace among np programs, from my understanding.

how can you expect to become a mid level caregiver if you do not have experience in care?

i want to be an np, but i know that i must earn the title through experience in numerous aspects of nursing care, and through education.

jer_sd · Dec 11, 2009

I think it is a good idea. Even if you have your own practice you could have full pharmacy dispensing in your office and save time for patients. Or medication mamangemt ect.. A lot of work and student loans but will make a great clinician

There are PharmD/PAc programs and a NP/PharmD is also a neat idea.

brandy1017, ASN, RN · Dec 11, 2009

I'm curious too, why a BSN then PharmD then NCP? Are you working as an RN now? How much experience do you have in healthcare working as a nurse and where are you working? What state is this PharmD program or is it an online? I've heard of Pharmacists or nurses/practioners getting an MBA or similar if they want to do healthcare management. Your story is very interesting. I'm a RN but think about going back to school and have considered both options but believe NCP is the better option because from what I've read about pharmacy is that it is boring, stressful and almost like a robo-pharmacist if you work for the chains like Walgreens. I've read they monitor how quickly you answer calls, process scripts and you basically run the whole shift just like nursing unless you are fortunate enough to be in a suburban slow store.

Are you in PharmD and now having second thoughts, and that's why you want to change to NCP. How much money is all this costing and what loans are you using to pay for it? Do you plan to work as a pharmacist while going back for NCP. My impression of pharmacy school is that it would be similar to medical school in time and money and you wouldn't have time to work due to the intensity of the program. While many NCP work part or full time while pursing their degree.

OldPhatMC · Dec 11, 2009

First let me provide some background info:
Heck, I'd be willing to run the pharmacy and the clinic at the same time!
Your thoughts?

Aren't they adorable when they're young? :eek:

First of all, the doc-in-the-box type clinics are usually placed in the higher volume pharmacies. I think its unlikely to impossible to manage both the pharmacist role for a 10K script a week pharmacy, AND try to carry a decent patient load that would make such a split feasible. I've been a tech in a pharmacy that was doing half that volume and the PharmD in charge had no slack time. None. Seeing patients as part of the day would have been impossible.

I'm also willing to wager strongly that you would not be compensated adequately for taking on multiple roles. You'd reasonably be expected to pro-rate salaries. Due to legal liability issues alone, I'd expect that you'd be expected to block your time so that you only did one job or the other. And anyway, most of these clinics are separate corporate entities anyway, so you'd be on two payrolls.

Of course, one would be remiss in not mentioning the loss of safety coming from one person fulfilling both roles. I don't need to tell you how vital the pharmacist is to the protection of patient safety. If you write an order for a patient then fill that order, you don't bring fresh eyes to the patient's profile and health history.

Some might raise ethical questions, but I don't think that they would be any different for a separate NP and PharmD. The AMA is unhappy with the idea of in-store clinics funneling prescriptions to the parent pharmacy.

Where I would see a person with your willingness to keep up in two very different professions at the same time would be in rural health. Even there, the loss of objectivity is an issue. But in a town with one pharmacy and maybe a handful of practitioners, your skill-set combination might be a strongly positive difference in an area where the economics of adequate care are not working. After all, they may only be able to afford half a NP and you can earn your keep at the pharmacy.

Obviously in disasters, all bets are off and you'd be welcome to wear both hats, and push a broom while you're at it.

Another, big-city solution is the obvious one. In-hospital clinical pharmacy. Pharmacists that work the floor are amazingly helpful and how hospitals did without them is a mystery to me. Nice side benefit: no FNP necessary.

By the way, if you're looking at doubling up as a way to make the economics of being a pharmacist work for you, I might humbly submit that you need to look at someplace other than the chain that owns the doc-in-the-box you mention. Costco, for example, pays well enough that you shouldn't need two jobs, and definitely a lot more than most chains.

Best wishes to you.

BSNtoPharmD · Dec 11, 2009

The FNP programs I've looked at do not require clinical experience as an RN. If that's such an important requirement, why doesn't it become a standardized pre-requisite requirement for accreditation? (As is the case with CRNA programs). Furthermore, consider the fact that physician assistant programs don't require nursing experience, heck they don't even have standardized healthcare experience requirement. Since I'm taking 203 credits over three years, year-round, you can imagine I have my reasons for not having RN experience.

These credentials could be something very, very different - a rare combination to say the least. I'm in my fourth month at pharmacy school and I can't even begin to tell you how much my BSN has helped me! I firmly believe that FNP + PharmD are credentials that could have remarkable synergy. Not to mention I'd serve as the peacekeeper each time a nurse calls down to pharmacy complaining their Maalox hasn't been sent up yet, while the pharmacist is at the laminar hood preparing a chemo drip.

BSNtoPharmD · Dec 11, 2009

I'm curious too, why a BSN then PharmD then NCP? Are you working as an RN now? How much experience do you have in healthcare working as a nurse and where are you working? What state is this PharmD program or is it an online? I've heard of Pharmacists or nurses/practioners getting an MBA or similar if they want to do healthcare management. Your story is very interesting. I'm a RN but think about going back to school and have considered both options but believe NCP is the better option because from what I've read about pharmacy is that it is boring, stressful and almost like a robo-pharmacist if you work for the chains like Walgreens. I've read they monitor how quickly you answer calls, process scripts and you basically run the whole shift just like nursing unless you are fortunate enough to be in a suburban slow store.
Are you in PharmD and now having second thoughts, and that's why you want to change to NCP. How much money is all this costing and what loans are you using to pay for it? Do you plan to work as a pharmacist while going back for NCP. My impression of pharmacy school is that it would be similar to medical school in time and money and you wouldn't have time to work due to the intensity of the program. While many NCP work part or full time while pursing their degree.

This PharmD program is in person - I've never heard of an online program and if there is such a thing, I'd say it's a horrible idea haha. At this point I am only considering the FNP option IF and only IF these two credentials can work in tandem. Working at CVS or Wags makes disappointing use of the fabulous skills taught in pharmacy school and it can get frustrating if you don't have time for counselling. It can also be boring, but I believe that's highly dependent on what you put into the job. Wags is also moving to centralized dispensing for refills, which supposedly will give pharmacists more time to counsel.

I'm having zero second thoughts about the PharmD program. I just want to explore ALL post-grad education opportunities cuz when I talked about pharmacy school during nursing school, people thought I was nuts but now I know I made the right choice When I was in nursing school, you can imagine I explored PA, FNP, PharmD and MD - so again, I will explore all opportunities. With all these minute clinics popping up I can only wonder how attractive it would be for them to hire someone capable of running the pharmacy and their clinic. If I was CEO I'd have a medical assistant or RN working the clinic and I'd have the pharmacist/FNP called over when his/her scope of practice was insufficient for something or additional assistance was needed.

Regarding debt: I graduated nursing school with $0 debt but when I finish my PharmD I will owe about $25k (no interest accrues until six months after graduation).

BSNtoPharmD · Dec 11, 2009

Aren't they adorable when they're young?
First of all, the doc-in-the-box type clinics are usually placed in the higher volume pharmacies. I think its unlikely to impossible to manage both the pharmacist role for a 10K script a week pharmacy, AND try to carry a decent patient load that would make such a split feasible. I've been a tech in a pharmacy that was doing half that volume and the PharmD in charge had no slack time. None. Seeing patients as part of the day would have been impossible.
I'm also willing to wager strongly that you would not be compensated adequately for taking on multiple roles. You'd reasonably be expected to pro-rate salaries. Due to legal liability issues alone, I'd expect that you'd be expected to block your time so that you only did one job or the other. And anyway, most of these clinics are separate corporate entities anyway, so you'd be on two payrolls.
Of course, one would be remiss in not mentioning the loss of safety coming from one person fulfilling both roles. I don't need to tell you how vital the pharmacist is to the protection of patient safety. If you write an order for a patient then fill that order, you don't bring fresh eyes to the patient's profile and health history.
Some might raise ethical questions, but I don't think that they would be any different for a separate NP and PharmD. The AMA is unhappy with the idea of in-store clinics funneling prescriptions to the parent pharmacy.
Where I would see a person with your willingness to keep up in two very different professions at the same time would be in rural health. Even there, the loss of objectivity is an issue. But in a town with one pharmacy and maybe a handful of practitioners, your skill-set combination might be a strongly positive difference in an area where the economics of adequate care are not working. After all, they may only be able to afford half a NP and you can earn your keep at the pharmacy.
Obviously in disasters, all bets are off and you'd be welcome to wear both hats, and push a broom while you're at it.
Another, big-city solution is the obvious one. In-hospital clinical pharmacy. Pharmacists that work the floor are amazingly helpful and how hospitals did without them is a mystery to me. Nice side benefit: no FNP necessary.
By the way, if you're looking at doubling up as a way to make the economics of being a pharmacist work for you, I might humbly submit that you need to look at someplace other than the chain that owns the doc-in-the-box you mention. Costco, for example, pays well enough that you shouldn't need two jobs, and definitely a lot more than most chains.
Best wishes to you.

Nice words of wisdom, thanks. I'll only consider the FNP if it can work in synergy with my PharmD. (1+1=3)

I'm thinking I'll drop this whole desire for continued education once I get worn out a little more. With that in mind, it's a Friday afternoon and I have an immunology test to study for right now

BluegrassRN · Dec 11, 2009

Look, you can do whatever you want. Might as well go for the MD after the PharmD and the NP, and then you can be medical director, pharmaceutical director, and nursing director all at the same time. While you're at it, an RT certification would be terribly helpful, particularly during flu et pneumonia season. I understand your desire to learn more...hell, I'd love to have the knowledge of a pharmacist, RT, PT/OT, and medical tech all rolled into my nursing degree. I'm just saying you might be overdoing it with your collection of degrees, and I think your idea of your options after you are *finally* finished with school might be a little fantastical.

You asked for opinions, you got opinions. I think, unless you have a limitless flow of cash (and I hear this exists for some people), you are wasting your money.

I also do not want a nurse practitioner who has never worked as a nurse. Most reputable schools I have looked into require 1-3 years full time RN experience prior to entry. I suppose some don't, but are those the ones you are interested in, really? I can't understand how someone would go to school to be an advanced practitioner without having had their own patients, knowing what lung sounds are significant of what, having had to treat the same patients over and over again for the same diagnosis, learning when to get excited and when you can sit on something and monitor it for a while. I agree with you about PAs, and that's why I personally don't go to one, nor do I allow my children to see them. Too many of their programs to not require enough real world experience, many of them are riding on their physician's coattails, hoping they don't screw anything up. It's unfortunate for the good ones, but I'd rather have an NP any day as opposed to a PA.

I have no doubt that your BSN has helped with your PharmD. I would further guess that EXPERIENCE would also help. How much patient teaching have you done, outside of nursing school? How often have you personally given vanco, hydromorphone, or labetelol to one of your patients? I'm not knocking your education; I'm just saying experience also counts, and most people in the position for director or head of clinics or pharmacies have a lot of experience as well as the education. By the time you are finished with school, you will have three degrees, with absolutely no out-of-school experience to accompany any of them, making you hyper-qualified in theory, and more lowly qualified in practice.

If you have a limitless flow of cash, go for it. Don't be shocked, though, if no one offers you a dual-director position making bank when you graduate. A new grad is a new grad. You'll just be a new grad x 3.

BluegrassRN · Dec 11, 2009

Okay, I'm just still totally intrigued by your desire to do a BSN to PharmD to ARNP journey.

If you were my kid, and I could throw as much money as I wished into your education, here is what advice I would give you: Finish up your PharmD and work as year (minimum, two would be better), either as a pharmacist or a nurse, preferably in an acute care setting. After you do that minimum 1-2 years, go prn in one, and then try getting a part time job in the other. So, if you worked as a nurse for 1-2 years, seek out a part time position as a pharmacist. Then do this for a couple of years. You would be gaining real time experience, in BOTH your areas, and would have a solid foundation of experience (again, in BOTH AREAS) to compliment your education.

THEN decide what you want to do. If you think a NP would better position you for a career you want, go for it. You'll have already put in so much time in school, what's another year for getting your DNP matter? You'll have real-world experience, which will only help you in NP school. You'll be able to better define your long-term goals, and since you will already be in the workforce, you'll have an insider feel of what sort of job possibilities might exist for someone of your relatively unique preparation.