pro-student

NYS, in an effort to push back on diploma mills, requires any higher education institution that offers any part of its program within the state (including clinicals) to be approved by the state department of education. All schools with a campus in the state have to go through this process anyway. But schools outside of NY are seldom willing to jump through all the hoops. The only school I know of that has is Frontier which has both FNP and WHNP programs and allows you to complete your clinical in NYS. You can also use this link to look up all NYS approved programs, located inside or outside the state. Choose the option “search for programs leading to a professional license” and choose the NP specialty you’re interested in. Then it will give you a list.

A 3.0 is the bare minimum GPA for any reputable program. Your best option is to take any college classes (for credit) to increase your GPA. It would be wonderful if you can take something healthcare related or even psych but honestly, any classes that you can get As in. A 3.0 is also the bare minimum (read- not a competitive applicant) so in the meantime, work on building your overall application. When you’re eligible, get certified in your specialty. See if you can get involved in committees or projects at your workplace. Even doing volunteer work can help you stand out. Since you know your grades are not going to be you strength, do everything else you can to make your application stand out.

There are MSN programs that will accept students who are RNs + have a bachelor's degree in any field but they are not the majority. Since you didn't mention any specialty or type of program you are interested it, it's hard to recommend a specific program. Take a look at schools you might be interested and their admissions requirements. If not listed, you can contact the school and ask specifically. This is a common question so many schools post it on their website or in FAQs. One word of caution: depending on the geographic area, some places are very difficult to find jobs for nurses without a BSN. They don't consider an ADN + another bachelor's equivalent to a BSN. And if, for any reason, you don't finish you MSN, employers will still not consider you having the equivalent of a BSN. Since you could probably finish a BSN relatively inexpensively and within about a year, it might make more sense for you to do that and then be able to apply to any MSN program you want.

Many school have a minimum GPA of 3.0 but (officially or unofficially) expect a GPA of at least 3.5 if you have a master's degree or higher. Regardless of your other qualifications, your application might get rejected simply because your GPA is low. You also choose three quite competitive programs. Schools that have non-traditional academic models like WGU might be considered less rigorous and, combined with a low GPA, doesn't make you look like a strong applicant to these programs despite your other qualifications. You have basically 2 choices: you could try to improve you GPA or you could apply for less competitive programs. Since you probably have lots of credits, it won't be that easy to improve you GPA so your best bet would be to be a realistic about the schools you apply to. If you have your heart set on a particular program, you could try taking a few classes as a non-matriculated student which might show the admissions committee that you are up to the rigor of grad school.

In terms of job opportunities, it doesn’t matter. You will be considered a new grad/entry level nurse regardless of whether you get the BSN or MSN. Some healthcare organizations might pay you a slightly higher hourly rate if you have an MSN but it might cost more to complete an MSN program as well. I would go with whichever option is cheaper and seems like a more doable for you. No one in healthcare is going to think you are a more qualified entry level nurse just because you have an MSN on your resume.

I think you want to be a CNS. Part of CNS practice includes staff development and education which sounds like what interests you more. CNS are often encouraged to maintain involvement in clinical practice too which helps make one a better educator. Most nursing education programs are focused on preparing faculty at prelicensure programs which you’ve said you’re not interested in. As others have mentioned, if the school you attend also has education classes, you could probably pick up a few as electives or part of your CNS program.

I’ve never even heard of a school that offers additional pathophys classes. Some schools will allow you to take additional courses provided you pay the extra tuition however I think there would be less benefit than you might imagine. Instead, it would probably give you a better education and be much more cost effective if you do additional reading on topics you’re interested in. Look at course syllabi which often list recommended or additional resources such as books or journal articles. Ask professors in courses you are interested in for suggestions of additional articles on topics of interest. Check the references in your textbooks for additional depth on topics you want to learn more about. Consider picking up additional books such as those used in medical schools on topics you really want to go into depth on. All of these things will likely give you more quality information that additional course work, can be better tailored to topics of interest or areas of weakness you want to increase you knowledge in, and are more valuable lifelong learning skills to develop than continuing coursework.

I think a dual WHNP/CNM would be redundant. Maybe someone else can weigh in but, as far as I know, there aren’t any benefits to doing both (not to mention the extra schooling, boards, and maintains two overlapping certifications/licenses). The FNP could expand the scope of practice for a CNM particularly seeing men and children. I know a number of dual trained CNM/FNPs. Unfortunately, many struggle to find positions that allow them to use their full scope of practice but it would be akin to family medicine in which one could be a primary care provider for the whole family including through pregnancy and childbirth. It also provides a much stronger background in women’s health than most FNP programs provide. But if none of that interests you, or if your career goals can be accomplished through midwifery alone, I don’t see any benefit to adding extra credentials just to have them. As far as the DNP, it really is not necessary to be well-qualified and marketable as a provider. Most employers still don’t know what it is and it won’t add much to your employment prospects unless your aiming for a job in leadership or academics. As a new provider, I don’t see much advantage to the DNP. If, after you’ve gained some experience, you still have a desire to continue your education, there are plenty of post-MSN programs that would allow you to complete the DNP while working. That way your project could be more meaningful if based on what you see in your own practice and/or as a springboard to a leadership or academic position if that’s the direction you’d like to take your career. Ultimately, it’s a personal choice and, for most providers, won’t change your employment prospects much.

For the life of me, I don’t know why someone would do a dual CNM/WHNP. Literally the entire scope of practice for the WHNP is contained the CNM scope. I get that midwifery is often poorly understood even by many fellow healthcare providers who don’t understand that primary care and gynecology are within the midwife scope. Is there a reason you’re considering both?

I applaud your goals of providing holistic healthcare and trying to screen for IPV. Unfortunately, however, without resources and a plan in place for what you would do in the event someone says they are unsafe, you're not actual providing holistic care, you're fishing for information. Real holistic care means you're not just screening and asking questions but you're ready to provide the necessary step to address any problems you identify. As others have pointed out, the setting you are currently working is different from a primary care office visit for many reasons. Also, without a plan in place, you could just as likely be putting many people, including those you're looking to help, in greater danger since there is a good chance an abusive partner is in the facility with the patient and will not respond well to any delay. To make an effective plan, you would need to know not only who you could contact and refer this person to in order to get help (which has already been made more difficult with the pandemic and many shelters closing or being limited in space), a way to keep them safe in the facility while waiting for help to arrive, and a way to keep the rest of the staff and patrons safe from a potentially violent person who is becoming suspicious when getting a vaccine takes more than a few minutes. A better approach might be to see if your employer would allow you to post resources for local IPV resources such as a poster in the space where you do the vaccinations. You could also consider checking with your local community resources. Some of them provide "shoe cards" - cards with emergency numbers a victim can hide in their shoe to avoid detection by a partner.

I wouldn’t worry too much about going into psych right away as a new grad if that’s what interests you. The advice that every nurse needs a couple years of med-surg is very outdated. Certainly it can be a great place to start but so can many other areas. That being said, you’ll definitely want to wait until you do your psych clinical before deciding that’s where you want to take your career. In terms of NP preparation, there are programs that will accept students who are RNs will a bachelors in a different field so it wouldn’t be essential to get your BSN. However, if you wanted to broaden your options, it wouldn’t be a bad idea to get a BSN. Many programs are available designed for working nurses and accessible for new ADN grads. You might even find an employer who will help with the cost. How much experience you need it a hotly debated topic but I think it is, ultimately, a personal decision. Some programs open to new grads without any experience. Others will prefer 1-2 years. The NP role is quite different from the RN role and there is no evidence that experience as an RN translates into better preparation as an NP. Just like the med-surg advice, you will probably hear a lot of opinions about how much experience you need as an RN before going for your NP but there’s just no simple answer. Some people finish their RN program ready to continue on with their education. Some people need a few years to solidify their knowledge and skills and/or to determine what area they want to specialize in. All NP programs will begin with the 3Ps: advanced Pathophysiology, advanced pharmacology, and advanced (physical) assessment. If you really struggled with these (in an ADN program, you may not even have had full courses in the basics of these 3), then gaining some experience might be helpful. However, just working shifts as an RN isn’t going to improve your knowledge in pharacology or Pathophysiology or your assessment skills. You have to be very intentional about using your experience as a learning opportunity: asking questions of more experienced nurses and providers, looking things up, participating in continuing education. Ultimately, you have to do what is best for yourself and your career. Take all the advice with a grain of salt. If you feel like psych is your niche, then go for it. If you feel confident with your options without a BSN, then skip it. And when you feel you’re ready to advance your knowledge and skills to become an NP, then go for it.

I think part of the idea of the DNP is for you to be translating the current research/evidence into practice guidelines not simply finding existing guidelines. In terms of a PICOT question, you probably want to just think through the letters with a eye on what you’re professional interests are and what the current literature is. Is there a population you want to focus on more so than obese people (e.g. - patients with obesity and a co-occurring condition such as diabetes or heart disease). Is there a type of intervention you’re interested in looking into such as lifestyle interventions, motivational interviewing, medications, etc...

I would cut the first 3 paragraphs entirely. While they tell some nice anecdotes about you, they do nothing to answer any of the prompts, and honestly sound like they were copied and pasted from a BSN application. They are specifically asking why your want to be an DNP-prepared FNP, not why you wanted to be a nurse. As much as it shows dedication to the profession, it doesn’t do anything to show you shouldn’t just stay in the role you’re in now. Importantly, no where in the prompt does it ask you to reflect on your past life/nursing experience yet this is what you spent most of the essay doing. The prompts, however, are clearly asking you to think about your future goals/role and are trying to assess your understanding of them. Talking about what your do as an RN or even before your were a nurse is not what they are asking you to do and should be avoided and kept to a minimum. You have some decent points scattered throughout but never concisely and directly address the 3 prompts. I would suggest formatting one paragraph for each prompt (about FNP role, what a DNP adds, and about integrative health in the NP role). After writing each paragraph, re-read it and make sure you have shown you clearly know what each aspect is on it’s own rather than conflating each of these distinct prompts. Essentially, could someone who reads your essay match each paragraph with a single prompt and say you answered it completely.

Most DNP programs that require around 1,000 hours are post-BSN programs training advanced practice nurses. Since typical NP programs include 500-650 clinical hours, another 400 would put the total at around 1,000. Since the DNP in Education would not be for an advanced practice role and would not broaden your scope of practice, there would like be far fewer hours required. Most would be related to your project and a smaller amount will probably involve some mentored experience in an educator role. It would be best to ask the school directly what their requirements for preceptors are. Most MSN-level education programs would require an experienced nurse educator with at least a masters degree in nursing. Since it is a DNP program, it’s possible they may want you to be precepted by a doctorally-prepared nurse.

Whether or not your midwifery training was completed as part of your MSN, post-masters, or DNP wouldn’t matter to most employers. You shouldn’t have a problem enrolling in a post-masters after an MSN from. WGU but since you wouldn’t have a grade for them and they aren’t taught with advanced practice nurses in mind, you will likely have to repeat the 3-Ps: advanced pharmacology, advanced pathophysiology, and advanced physical/health assessment. But it would be a good idea to contact a few programs you might be interested in directly to find out how they would handle the situation.