7 Tips For Choosing The Perfect Nurse Practitioner Program

Choosing to go graduate school is NOT an easy decision. It is one that requires a ton of thought and internal processing. In this article, I will give you first hand advice and questions that I asked myself before I started my graduate program. In the end, fingers crossed, your mind will be put at ease and the decision to start the application process will move from a maybe to a YES! Students NP Students Article

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7 Tips For Choosing The Perfect Nurse Practitioner Program

Currently I am in graduate school to become a Family Nurse Practitioner. I am in my first of three clinical rotations, and in December of this year I will graduate. I never once have regretted the decision to go back to school to become a Nurse Practitioner. Below is a list of 7 tips that I know will help any nurse who is contemplating on whether or not to apply to a Nurse Practitioner program. It is my hope that this article will answer some questions that are holding you back and will lead to you starting that application process.

1) Ask yourself... Do you want to work in the Hospital or Office?

This will help you decide if you should apply for an Acute Care program or a Primary Care program. I will say, do not get a degree in primary care and expect to work in a hospital. I foresee the days of the Family Nurse Practitioner working in the ICU is a thing of the past.

2) What scenario do you see yourself resonating with more?

  • I want nothing to do with adults = Pediatric Nurse Practitioner
  • I want nothing to do with children, they scare me = Adult/Gerontology Nurse Practitioner
  • I like taking care of all ages = Family Nurse Practitioner
  • I don't like pediatrics or adults, I like the neonates = Neonatal Nurse Practitioner

These are just examples of the multiple options of specialties you will be able to choose from. There are many more degree options for Nurse Practitioners that are not listed here, but this will get your mind churning. Use your answer to question one to guide you in the right direction of choosing primary care or acute care for the specialty you have decided on. Remember, do not choose a primary care degree and plan on working in the hospital.

3) School Full Time or School Part Time?

My vote is for school full time. Any type of schooling you want to commit to and be able to submerge yourself in fully. Where there is a will there is a way, and you will be surprised with how resourceful you can be when placed in a challenging situation. As nurses, it is in our DNA to just "figure it out". Get the ball rolling and get the program completed.

4) Work Full Time or Work Part-Time?

Personally, was able to manage working full time while in school up until my clinical rotations started. Then, it was too much. Three twelve hour days at work and the requirement of all the clinical hours for the semester, plus your regular class work, on top of all the work that goes into clinicals and not to mention if you have real responsibilities of a house, kids or family members. There are just not enough hours in the day to do everything to your fullest.

5) Online Program or On Campus Program?

What appears to be the trend are hybrid classes, an online-ish program. There still are all on-campus programs and all online programs, so you will be able to choose. Don't let the technology scare you, but think about how technically challenging a program might be when you are selecting one. In my opinion, regardless of online, hybrid or on campus, what you put into the education is what you will get out.

6) If you don't work in the ER, transfer there!

I was fortunate enough to get a job in an Emergency Room directly after passing my NCLEX. I directly correlate all of the lessons that I have learned in the Emergency Room have helped me TREMENDOUSLY in the Family Nurse Practitioner program. First off, in the Emergency Room, you see and care for all sorts of patients, birth to death and everything in between. Also, you will see everything across the acuity spectrum as well, from primary care issues to acute care issues. Another reason to move to the Emergency Room is the ability to have a flexible schedule, with a large staff and many shifts to choose from.

7) DNP program or MSN program?

I will start this out by saying I am currently in an MSN program. It is my goal to complete my DNP, but there was some strategy involved with choosing the MSN program first. My thought process was, I am not required to complete the DNP at this time and once I complete my MSN I will be able to start working as an NP. Completing the MSN portion first, roughly in 2 ½ years, and start working as an NP, versus the 4 plus to complete the DNP and all this time would be spent working at a nurse's salary. Choosing this route, you are losing out on 2 ½ years of NP salary that you could be making if you chose to get your MSN first and complete your DNP after. The trend for all programs seems to be moving to the BSN to DNP structure, without the MSN, so this is even another reason to start the NP program sooner than later.

Still not sure what program, but you know you want to be an NP. Then just start! Start searching different programs, start critically thinking about what specialty you think you would enjoy the most, spend some time in conversation with both Nurse Practitioner students and practicing Nurse Practitioners and start the application process. Just put one foot in front of the other and everything else will fall into place. If you don't, then "life" will happen, time will go by and then you will no longer have the option to go back to school. Again, I have no regrets about entering Nurse Practitioner school and I am excited to start the next chapter in my nursing journey!

Michael M. Heuninckx RN-BSN

Nurse Practitioner / Author
11 Articles   43 Posts

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zmansc, ASN, RN

867 Posts

Specializes in Emergency.

Interesting article. It seems you have detailed many of the decisions that were right for you in choosing your program, but I have to say, they would not necessarily be the right decision for me, many (most) of my classmates, or many of the AN members who have PMed me for advice on this subject.

1 & 2. What type of NP do you want to be? While in your local area, you may not want to become an FNP if you want to work in a hospital setting, that is not the case nationwide. In fact I know of several hospitals in multiple states that staff there entire ER with FNPs, and many others that employ FNPs over ACNPs for the portion of their provider pool that is staffed by NPs. There have been many discussions on this point that are still relevant, so I don't see why we need to rehash it again.

3 & 4. Fulltime/parttime work & school. How each student decides to split their time is a very personal decision with many factors that need to be taken into consideration. I have classmates who have worked two jobs while going to school full time, and classmates that have quit their jobs completely to focus on school.

I have classmates that choose part time school for various reasons, and I think it is personally belittling their decision and efforts to say they should go full time and "as nurses it is in our DNA to figure it out". They have figured it out, and what is appropriate for them is the schedule they chose. That is part of the benefit of having options, everyone can choose the option that fits their needs the best.

5. I'm not sure how you determined that hybrid is the trend. If by that you mean more of the classroom programs are offering either part or full didactic online to their programs, that part is true. I don't believe the various online programs are offering classroom options, so if anything the trend is to go more and more online.

The fact of the matter is that there are students who prefer one option over the other, and each option has it's strengths and weaknesses. That is the great thing about there being multiple schools each with the freedom to do their own thing in this manner. If you prefer online, you can choose that, if not you can choose classroom based.

I think there are many points on this subject that were glossed over or completely ignored:

- Many traditional B&M universities are offering their courses either in part or completely online now, so for students that want the classroom experience, they should be careful to check that the program will be offering that.

- For students who want the online experience I would suggest that they investigate the university and the programs skills in delivering content online. It's non trivial, and can trip up a program quite easily if they don't have a good feel for the limits of the technology. This is best checked up on by contacting current students/recent graduates from that program and discussing with them how effective the school utilized technology.

- Another aspect that is tangentially related to this is the preceptor issue. Most programs require you to find some/all of your preceptors. Online and rural oriented programs more so than state universities and programs in major metropolitan areas. Aspects about finding preceptors and pitfalls to avoid might be important to include.

6. To insinuate that the ED is the only place for students entering or in NP programs is just wrong. Again it may have been good for you, but each individual needs to make that decision for themselves. There are many good nurses, who will make excellent NPs who are not suited for working in the ED, it's not what fits them best. Also, your assuming this is the best for PMHNPs, NNPs, etc., when clearly it is not in all specialties or for all personalities.

I have classmates in all kinds of roles as nurses. Some of the ED classmates are doing quite well, but so are some of the non-ED classmates. Some of the better students have many years of experience, and some of the students with many years of experience failed out immediately. Some of the better students have very little experience, you get my point. It is another individual item that cannot be generalized across the entirety of the field.

7. MSN vs DNP. Again there are a wide variety of factors that play into which degree you want to go for. Some inaccuracies, at least the assumption that a DNP takes 1.5 years longer than the MSN isn't always true, at my school it takes 3 quarters, less than one year to complete the DNP after the MSN in conferred. And yes, that is correct, both a MSN and a DNP are conferred in my program, so you don't have to choose one vs the other, at least not in every program.

In summary, while I believe this article may reflect what decisions were best for you, it doesn't give the perspective NP students a very complete picture of why these decisions were right for you and why they might make other decisions that will help them to pick the program that is right for them.

Trauma Columnist

traumaRUs, MSN, APRN

88 Articles; 21,249 Posts

Specializes in Nephrology, Cardiology, ER, ICU.

There are many determining factors when deciding on the NP route and much depends on the individual. We have two very solid plans now.

What other options are out there?

sauce

178 Posts

I work in the hospital as an fnp. But then again I'm very rural. Also in a decent sized hospital strangly enough. Er probably would be one of the better experiences. Esp since you see a little of everything. Your job experience will greatly outweigh what type of program you go through after a few years of practice. I feel a lot more comfortable in a hospital than a clinic. Your brain is always a lot more flexible than your degree makes it out to be

automotiveRN67

130 Posts

While this is an interesting article, it sounds like you need to do a little more research in the real world.

I have seen acute care NP's in offices, and I have seen family and adult NP's.....well, everywhere. I have a friend who recently went from an office cardiology practice to work as coordinator of a State University cardiology fellowship. She has privileges and sees patients in the hospital every day. She is FNP by training. As far as I am concerned, acute care NP was a failed experiment. It is not the physical location of the patient, but the illness that you treat. I don't think the real world cares what your degree is in, as long as you can do the job.

I am saddened by the growth of online programs. I think they churn out a mixture of good or bad without regard for standards. I would be very reluctant to hire a nurse practitioner who had an online degree. If that is all they have, I would really look for some substantial work history to before considering them. A nurse who has very little experience won't have much credibility with an online advanced practice degree.

I agree with the suggestion to take the last year off from work to concentrate on clinicals. I think it gives a person focus. But, if I interviewed a new nurse practitioner who told me they HAD to take the last year off because clinicals, schoowork, 3 12-hour shifts, and family was too much, I would look for another candidate to hire. If someone has trouble with that load, they won't make it in an office where they have to see 25-30 patients per day.

I completely disagree with your assessment of the ER. ER staff do see a lot of stuff in a hurry, but they see a lot of stuff in a hurry. When I worked in cardiology, I was glad they were awake to admit my patient at 3 am. But, checking off pre-printed order sets and handling emergencies is much different than correctly diagnosing and treating patients. If a student wanted to go into ER right out of school, this would be a good suggestion. If student plans to go into other fields, it has less validity.

MSN vs DNP. No comment.

Guttercat, ASN, RN

1,353 Posts

One of the reasons I am hesitant to commit to *any* NP program, is precisely because of the fluid academic and professional requisites for entry to practice.

The rules of the game seem to change with the tides, and it is very difficult to know between which waves to jump.

MWelch18

21 Posts

Great and informational post

subee, MSN, CRNA

1 Article; 5,416 Posts

Specializes in CRNA, Finally retired.

One symptoms of a bad program is requiring the student to find their own preceptor. The student is paying for INSTRUCTION but too many schools are too willing to provide only GRADUATION instead of education.

Ponting

11 Posts

Worth to read it. Really informative.

Dranger

1,871 Posts

I always find it hilarious when FNPs get so defensive after ACNP are mentioned as preferred providers in acute care. God forbid a hospital hire ACUTE care providers in ACUTE care. FNPs don't have lordship and expertise over everything.

Family med docs aren't on the floor as hospitalists internal med guys are but I don't hear family med docs complaining.

FWIW, my hospital only hires ACNP hospitalists.

allnurses Guide

BostonFNP, APRN

2 Articles; 5,581 Posts

Specializes in Adult Internal Medicine.
Dranger said:
I always find it hilarious when FNPs get so defensive after ACNP are mentioned as preferred providers in acute care. God forbid a hospital hire ACUTE care providers in ACUTE care. FNPs don't have lordship and expertise over everything.

Family med docs aren't on the floor as hospitalists internal med guys are but I don't hear family med docs complaining.

FWIW, my hospital only hires ACNP hospitalists.

Honestly it's because you don't understand the whole issue. Perhaps before you post about how "hilarious" it is, you should think about educating yourself on the issue you are posting about.

The crux of the issue is at the professional level. Nearly ever state defines the NP scope of practice to the full extent of the education and training, which is supported by the IOM.

As a profession, APNs need to tread a careful line. Some FNPs have appropriate education and training to function as an acute provider. Many don't. As a profession (APNs) we are walking a tight line of not limiting our practice while maintaining legal/ethical obligations for practice. A blanket statement is simply not the best way for the profession to handle the issue.

Dranger

1,871 Posts

BostonFNP said:
Honestly it's because you don't understand the whole issue. Perhaps before you post about how "hilarious" it is, you should think about educating yourself on the issue you are posting about.

The crux of the issue is at the professional level. Nearly ever state defines the NP scope of practice to the full extent of the education and training, which is supported by the IOM.

As a profession, APNs need to tread a careful line. Some FNPs have appropriate education and training to function as an acute provider. Many don't. As a profession (APNs) we are walking a tight line of not limiting our practice while maintaining legal/ethical obligations for practice. A blanket statement is simply not the best way for the profession to handle the issue.

I find it hilarious that poster, as seen above, go as far to say ACNPs are a failed experiment in order to justify their claim that FNPs can handle acute cases just as well or better. By that logic any ANP can work in any area. So why do we have specialties at all?

The nursing bodies limited NP practice when they created specialties but they also made ANPs more viable by differentiating skill sets for different areas of practice because no one can realistically treat kids and OB issues one day then manage a vented adult the next. Having specialties helps to clarify those grey lines just as physicians have for differing residencies.

Family/internal med docs with hospital privileges is getting rarer and rare in my area. I can think of 2 maybe and they usually sign out to the hospitalists after an intial visit.

I get there are FNPs who have solely worked in inpatient for years with a ton of experience but for the future I think ACNP should be pushed for those who want to work only inpatient or closely related specialty areas that round on patients.