mingus_lost

I've been accepted to the only MEPN program in my area, and I'm schedule to start in 2 months. I am having major cold feet though. I don't know exactly what I want to do in nursing, and this school only has a small handful of specialty tracks to choose from. I'm worried that I'll want to do something they don't offer after I do the pre-licensure year. Also, there is no BSN awarded after the first year like there is in some programs. So, I worry that it if it isn't a good fit, I would end up totally stuck and unable to step out after getting through the RN portion. I am confident that I could be very successful in this program, but I just don't feel very excited about starting. I already have two graduate degrees. This would be my last, and I want it to be the right one. For those of you who are in MEPN type programs, do you think my hestitation and lack of clarity about my goals are likely to be big problems? In other words, do you think one needs to be totally enthusiastic about and commited to the effort to get through it? Did anyone else have such doubts and end up glad they went for it anyway? Sorry if I sound whiny; I've been debating this for months and I'm worn out from it.

Deb, would you be willing to say more about the therapy you do? I know I've talked to a lot of people who think the split whereby patients get meds from the psychiatrist and therapy from the psychologist or counselor is frustrating. It seems like psych NPs could help address this by increasing the number of providers who can provide both meds and therapy, but often the impression I get is that most psych NPs spend almost all their time prescribing. So, I'm enouraged to hear that you do some therapy. How big a part of your work is it, and does it seem to be common or uncommon for other psych NPs you know to do therapy?

Wow. This adds a whole extra layer of complication for those of us considering masters entry APRN programs. I've seen it advised on this board that MEPN students plan to work as RNs for a few years in their specialty area before seeking, or at least expecting, their first APRN job. However, if my employer and I would have to assume additional liability due to my advanced training and/or there is likely to be a reluctance or ethical dilemma with hiring me as an RN in my specialty area, the MEPN route begins to look like it will create a catch-22 for me. I really think universities would be wise to open more accelerated BSN programs instead of so many MEPNs. At least in my case, the MEPN is on the table because it is the only logical way into nursing around here, but I think an accelerated BSN would be a better choice for me if it were available. Then I could get some experience and take it from there.

oops, double post.

caldje- no, I'm not already an RN. If I do a masters entry NP program, I'll be an RN after the first year of training and then could do the rest of the program more slowly so that I could work part-time as an RN to gain experience before graduation. I'm looking at that as a way to balance the relatively small number of clinical hours required to graduate.

Hi Brown Rice. Actually, the female MDs (the ones who've voiced an opinion anyway) and med students I know are saying don't go to med school and that medical training is inhumane. They're encouraging me to go the NP or Pa route instead, particularly because I have a child. I agree that is very likely a better choice for me and am leaning toward becoming an FNP. I'm glad to hear that you are enjoying your training so much. :)

Yes, those are some very good points. I do have quite a bit of concern about the liability one takes on when delivering babies. It's a little awkward for me to even say it, but my father is a medical malpractice lawyer who has prosecuted plenty of OB/GYNs and midwives. He held his tounge for the most part about my using a midwife and having a birth center birth, but I know it bothered him. I think my becoming a midwife would be a big issue. My sister is on her way to becoming an OB/GYN, so we've been talking about the malpractice insurance costs, but I suppose neither one of us can really imagine what the personal and professional costs of defending a lawsuit would be. It is a complicating factor and adds to my feeling that it is probably best that I get a good broad base of training and experience before I decide if delivering babies in any capacity is something I want to pursue. As for the PA vs. NP part, it seems that both have generous practice laws in the states I'd like to live in. NPs do have more options for independent practice, but I can't predict with any certainty if I'd ever want to excercise that option. I think that I will likely choose to do the FNP program at my local university because it fits in very well with other aspects of my life. My reservations have been/are about whether the coursework and # of clinical hours will be sufficient to prepare me to practice competently soon after finishing school. I'm realizing though that I've been wanting to rely on a degree or program to make me a good clinician. I can't do that. I have to use whatever education I am getting to my full advantage but also recognize that it will be my effort, dedication, and gathering of experience that will develop me into a good clinician. I am confident that I'll get there - I've been a very good clinician in my current field - and I could take it slow and stretch out the time I'm in my NP program so that I can work more hours as an RN if that will help me be ready for work after school. Also, it occurred to me that if after my pre-licensure year rotations, I feel certain that there is a specialty that I want to concentrate my schooling in, I could stop, work as an RN in that area for a couple years, and then move to a specialty NP program. Thanks for the input on my situation; it is helping me think through all the implications of my different options. Life has certainly gotten more complicated. I don't think this decision would have been easy when I was fresh out of college either, but as my husband said, at that point, everything we owned fit in a small truck, we had no pets (not to mention no child), we had no mortgage, we were still on our parents' health insurance plans, and we were ready for adventure. I still want adventure, but now there's more to lose if things don't go as planned.

Thanks for the encouraging replies. They're just what I needed; I'm feeling more excited than anxious about my career change again now. Cladje - thanks for those links. I'm going to look into what the PA role in OB looks like more I think. I like that PAs have access to formalized residency training. Does anyone know if there are programs like that for new NPs? I talked to a public health nurse I work with yesterday, and she knows some of the professors in the nursing school here and will put me in touch with them so I can find out more detail about the masters entry program. This will help a lot. I guess I'll be weighing my options for awhile still, but it is true that they're all good options. :)

Hi meagain. I just thought I'd say I feel the same way. This thread makes me so sad. Everywhere online that I've gone trying to hear about people's experiences as I figure out what route into being a health care provider have so much negativity. The female doctors (and the ones I know IRL) all say don't do it, it's horrible; the PAs are smart but defensive and tend to slam NPs; and the RNs and NPs seem so nice but some give the impression they'd rather be caught dead than working with a person like me (a person for whom it makes way more sense - in terms of schooling - to do a masters entry NP program than wait around for a spot in an ADN program and then eventually probably go back for the MSN anyway). My background is in mental health (and research) too, btw. Good luck to you.

Thanks for your reply. It is reassuring, and it makes sense for me to choose something that will allow me to decide after I've had more experience exactly which area to work in. I guess it's just hard because all of the options in front of me have pros and cons, but I won't know for sure until I'm in school and/or working if I definitely made the right choice.

If any of you isn't entirely sick of 'what should I do with my life?' posts, please help me try to figure some of this out. Some background: I'm a 27-year old mother of a toddler who has a Ph.D. in developmental psychology and has decided to pursue a career in health care. I love what I've studied and done so far, but I want to be a clinician (at least primarily, I might like to stay involved in research to some extent) and would like to work with more than mind/behavior. I don't have a lot of experience in non-mental health care (have worked in medical settings in mental health though), but some events in my personal like also make me certain that health care is for me (my child has some fairly minor but chronic medical conditions, I had the best imaginable experience with prenatal and delivery care with a group of midwives, spent a lot of time in the hospital with my mom before she passed away, and now have recently dealt with the diagnosis and treatment of Grave's disease in myself). I find that I spend a lot of time using the medical library at the university I work for to research and understand all the different aspects of the problems I and others are experiencing, and I love talking to health care providers just because I like learning whatever I can from them. The dilemma: I could go to medical school (have the family support and $ necessary), but I don't think it will give me the lifestyle I want and may not be fair to my child. So, I'm about 90% sure that I won't get an MD. Then, I'm left looking at PA and NP programs. [[i don't mean to drag up a whole debate about which is better; I'm just looking to fill in some gaps in my understanding of NP education and specialization.]] I think I understand the education and training process of PAs pretty well. The benefits I perceive of the PA route, for me, are that I'd rotate through everything before having to know what I want to specialize in, and I would get more clinical hours during training than I likely would in an NP program. For my situation, the downsides of the PA route are: I'd have to move my family (and my husband loves his job), I'd have to wait an extra year before starting and don't know how to spend that year, it seems fewer PAs than NPs work in peds like I'd probably like to, and I sort of like the idea of considering going into private practice some day far into the future and couldn't count on that option as a PA. Now for the pros and cons of NP training in my particular situation: Pros: There is a brand new MEPN with an FNP option in my area that I could probably start in one year, it is the least costly and burdensome option for my family, I like the idea of working as an RN during the second and third year of school and possibly after that for a bit too, and I like the overall flexibilty of being a nurse and that I could shape my career in any number of ways over time. Cons: I know that FNPs can do all sorts of things, but I don't want to be pushed out of peds primary care or especially peds specialties because I wouldn't be a PNP without moving for a different program; I keep hearing rumors that NPs can't find jobs, and I'll admit that it would really bug me to get this training and then not use it (I think being an RN for awhile would work for me, but I do worry about getting 'stuck'); and I don't know for sure yet that I don't want to work in midwifery/OB, and as an FNP that'd be out, whereas there are PAs who work in OB, so I'm putting pressure on myself to make the call about whether to try for midwifery programs (which brings along all the complications of moving, waiting an extra year to start, etc.). I know this will all get worked out in time, but I'm pretty antsy to decide what path I'm on. It will affect which prereqs I take this year (but too not much) and possibly what type of clinical experience I try to get this year. Mostly though, it's that I really loathe the idea of committing to one path, getting a third advanced degree and then realizing that I made the wrong choice. I'd love to hear from any of you about what you might do if you were in my situation and whether any of my concerns about becoming an FNP are unfounded. Many thanks.

Papadoc, thanks for your reply. Reading a couple of other threads that you pointed me to was helpful. I fully realize that being a mid-level practitioner is not the same as being a physician. I think I'm okay with that. I've been realizing many reasons why going for an NP or other advanced practice nursing degree will be best for me and my family overall. I'm excited about it. What are the prerequisites or recommended courses to have taken before applying to direct entry NP or MSN programs? I've been looking at the new program near me and they just recommend a background in A&P and nutrition. I will probably end up applying elsewhere also, so what other courses might I want to take. I currently have a few bio, many stats, and lots of social science classes under my belt. Thanks.

I am a psychologist who intends to go back to school to become a mid-level health care professional, probably a nurse practitioner. I would like to consider becoming a CRNA too, however. I think I would enjoy the challenge. I don't know how I would get there though. Are there any direct entry NA programs?

Hello. I'd like to first admit my total lack of experience and relative lack of knowledge about nursing. I hope you don't mind my naive questions. I have decided that I want to pursue a career in health care. This is after receiving a Ph.D in psychology. I would like to work in pediatrics. I have a spouse and a toddler, so I will continue to have a lot of outside obligations when I go back to school. I see a lot of possible advantages to going into nursing instead of medicine (e.g. as I read in another post - the more holistic view of health that NPs often have; there are also a number of ways in which it would be more practical), but I'm wondering how those of you who are NPs feel about your career choice. If you were beginning again and both MD and NP were available options, would you become and NP again? Thank you.