from RN to Palliative Care NP?

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Hello, all!

I'm a second-career nurse who graduated from the first segment of a BSN-to-MSN program in NYC last May. I attended the first summer semester of coursework for the Adult-Gerontology Primary Care NP program and then decided to take a leave of absence to get RN experience and "figure things out."

I worked in home care for several months before securing a position in a busy, understaffed and urban ER last November. I'm learning a lot, but with a consistent 12+ pt-to-RN ratio, the shifts are obviously stressful (especially considering my relative lack of experience and RN spidey sense).

I went into nursing because I was drawn to geriatrics, palliative care, and end-of-life nursing. My temperament, which was a great match for the Hospice rotation I did in nursing school, can be a little too soft for Emergency. I get my job done, and I take care to do it well, but the physical, emotional, and mental exhaustion bleed into my days off. I don't have time to provide the kind of care that makes me feel good (and would presumably benefit my patients!). At the same time, I recognize a need for palliative care and palliative-minded advocates in the ED setting.

As far as the future of my career goes, I waffle a bit – some days I think I'd like to work in the ED as an NP, and at other times the harried nature of my department sends me (mentally) screaming towards a career in Primary Care. At the end of the day, though, I still feel most inspired by the Palliative Care NPs that I've met, who inspired me to become a nurse in the first place.

Now I need to decide if I will return to school this fall, and I'm considering several options:

1) Continue to work as RN for a few more years, and pay down my debt (did I mention I already owe $100,000?). I'll stay in this job to see if promised unit changes improve work conditions, and perhaps look for a less-stressful position elsewhere. At some point down the line, I could pursue an advanced degree at a less expensive institution.

2) Go back to school while working 2 shifts per week, accruing approximately $50K more in debt before earning my MSN. I would have approximately 2 years of acute care RN experience when I graduate.

SUB QUESTIONS:

- But then, is the Adult-Gerontology Acute Care track or Primary Care track better suited to a career in Palliative Care? I can see both sides, especially since Palliative Care will be expanding outside of the inpatient environment in years to come. That said, almost all of the NPs working in Palliative Care that I know have Acute Care background and certification.

- Do I need to get DNP certification? My school would have ya think so.

Delaying the graduate education seems like the smarter financial choice, but my dissatisfaction at work and my wanting to start a family (I'm over 30) push me towards getting the inevitable masters degree "out of the way," esp. considering the fact that I already started it.

If you have any advice, please chime in! I'm driving myself crazy by thinking in circles.

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Specializes in Nephrology, Cardiology, ER, ICU.

Moved to Student NP forum for more answers

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I really don't see the use in getting a ACNP for palliative care.I think broad FNP or ANP would suffice. Our palliative NPs are all FNP in inpatient. Most of our ACNP did not go into that track with the idea of doing palliative.

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Specializes in Psychiatry.

I am staring the adult/older adult track for a DNP program this fall. I am currently a hospice nurse and plan (so far) to continue in either palliative care or primary care. SOME schools offer a palliative care post-grad certificate program, but I'm sure you could get into palliative care without it. Good luck!

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Specializes in ICU.

I think either the AG-ACNP or FNP would be good options to pursue. They both can generally be used for palliative care or the ED.

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Hmm…so I would definitely advise you to try to pay that debt. I would not give up the opportunity of your acceptance in NP school because u may never ever get it back…of course they may let you take up to 2 years "off" and then u can restart….instead…why not go part time….maybe one class or two classes a semester AND continue to work? ask your dean and tell them your situation. because this way at least u will have some classes done …instead of completely taking a break :)

hope this helps

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Specializes in Assistant Professor, Nephrology, Internal Medicine.

I agree with the posters that said AG-PCNP or FNP. I know of several palliative NPs that are FNP or AG-PCNP. Most (but sometimes not all) patients in this setting are 65+, but occasionally you will find the terminal 10-20 year old. I think either of these would be right for the setting. ACNP is definitely not a route you would want to go if you intend to become a palliative/hospice NP. This track is all about inpatient and focuses on acute care. Since hospice and palliative care a different mentality entirely, it would not benefit you to take this path.

Good luck

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Hello everyone,

I am a FNP but have been working with an inpatient consult palliative care team for the past year and plan to take my advance practice palliative certification next month. Has anyone taken the advance practice exam for palliative and hospice care?

Any tips or guidance on studying would be greatly appreciated!

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Hello,

Can you tell me your experience working as inpatient NP for palliative care and what the duties/day consist of?

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