Too early to start planning for becoming NP?

chempansy · Oct 25, 2020

It depends on what type of patient demographic you want to work with and where your experience ends up being. It might be easier for you to transition to NP as time and experience allows. For instance: If you love working with kids/adolescents, you might work in a pediatric setting and then pursue PNP. Or if you like working with smaller babies, you get a job like the NICU and then pursue NNP. It really all depends on the patient population you want to work with.

However, PA does have an advantage of lateral mobility as they are more generalists and have cross-training in many different specialties. This allows them to be in just about any speciality with a lot of their training being on-the-job training. They have a lot more clinical hours and clinical rotations. You might end up having to go back to school to obtain more credits in the hard sciences or retake courses to be more competitive and then take GRE or whatever standardized test they’re taking at that time.

I would think about what patient population you feel like you’re drawn to, where you end up working and then maybe make a decision. I wouldn’t put too much pressure on yourself during this time and just enjoy the experience you end up getting. It’ll reveal a lot about yourself and what you’re actually interested in.

MDBoy · Oct 26, 2020

Great response. Thanks for taking the time.

MDBoy · Nov 1, 2020

My mom is an NP, I am not sure yet though which branch I want to follow, PA or NP. I have been hearing about nurse lawyering and am interested as I love law. Also I have very good science and math grades and think I could easily do the "harder" sciences that would be needed to go for the PA route, plus that is only 2 years of school right? Any advice on which of these path has its benefits to what I am looking for.

DrCOVID, DNP · Nov 1, 2020

All routes have their pros and cons. I believe PA education follows the medical model (that of MD) and you always have to have a collaborating MD. NPs have to have a collaborating only in some states. I also think PA is more focused on medicine, A&P and "hard" science. Nursing is "softer" and the doctoral program has a lot of leadership/research courses as well as a clinical capstone focused on QI or practice change. It's probably best to talk to people in each field or shadow.

Of course you have you also have MD/DO options, which are more comprehensive, time consuming & depth, not to mention costly. But at the end you are theoretically at the "top" of the totem pole.

If I knew what I knew now, I would have just done MD. But as a soon to be PMHNP that will be independent + with telehealth, I couldn't be happier. You can do really well for yourself as an NP. Practically speaking, there is little difference between the PMHNP role and that of a Psychiatrist. I have worked with/for and shadowed both before getting into mental health.

My only encouragement is to not do FNP, or at least choose a specialty like dermatology or aesthetics, or if you do FNP, to start a concierge service. You will most likely not feel ready unless you work hard, spend 4 years in school and do more clinical time.

MDBoy · Nov 1, 2020

1 hour ago, adammRN said:

If I knew what I knew now, I would have just done MD.

Why is this? I am 32 and although I think MD or DO is more in line with my personality I think its a bit late no?

DrCOVID, DNP · Nov 1, 2020

12 minutes ago, MDBoy said:

Why is this? I am 32 and although I think MD or DO is more in line with my personality I think its a bit late no?

Just timing. I got out of the AF after kinda being stuck as an RN for 8 years. I feel too old & jaded to do medical school. I like learning about the brain, but I feel like going back to undergrad to learn Chemistry would be a bit excessive. It's just not practical at this point to do the job of psychiatrist. A BSN doesn't prepare you for medical school. I would need a handful of undergrad credits. To become a psychiatrist would be 1 year of undergrad, 4 year med school + 4 year residency. I would be 40 by the time I was done and on my own again.

Meanwhile, there is the NP route, 2 years and you can go back to work. NPs are independent in many states. The a PMHNP role is essentially the same as a psychiatrist. In clinic I learned we can gross over 250k...

So, I felt weighing all angles med school didn't make sense... but you are mostly correct. I think I would have enjoyed the in depth science. It's more of a practical thing now. It's just not worth a decade when you realize it's just a job... and life balance is so much more important.

chempansy · Nov 1, 2020

1 hour ago, adammRN said:

Just timing. I got out of the AF after kinda being stuck as an RN for 8 years. I feel too old & jaded to do medical school. I like learning about the brain, but I feel like going back to undergrad to learn Chemistry would be a bit excessive. It's just not practical at this point to do the job of psychiatrist. A BSN doesn't prepare you for medical school. I would need a handful of undergrad credits. To become a psychiatrist would be 1 year of undergrad, 4 year med school + 4 year residency. I would be 40 by the time I was done and on my own again.

Meanwhile, there is the NP route, 2 years and you can go back to work. NPs are independent in many states. The a PMHNP role is essentially the same as a psychiatrist. In clinic I learned we can gross over 250k...

So, I felt weighing all angles med school didn't make sense... but you are mostly correct. I think I would have enjoyed the in depth science. It's more of a practical thing now. It's just not worth a decade when you realize it's just a job... and life balance is so much more important.

Did you get any psych experience prior to pursuing PMHNP? How long did you wait to pursue it and what other units have you worked on?

DrCOVID, DNP · Nov 2, 2020

Little to no psych exp beforehand. I worked long term care for a while with some folks that were homeless/schizophrenic... but I just gave the meds they were prescribed, like most other RNs. I don't know how much RN exp helps in the provider role. I think the base skills like critical thinking/time management, maybe some very basic medical stuff... the NP role is a lot different than RN. I was a RN 8 years before entering grad school.

MDBoy · Nov 2, 2020

Good for you adamm. And you enjoy it so far and find it fulfilling working in that role? What are some of the aspects that are the things that you find most appealing about that job?

As for me, I am just beginning my assoc. degree RN program this January however when I think about it, even the process of applying to med school sounds pleasant to me. I am outgoing, and charismatic and articulate + possess a good command of language so I always do very well in any interview scenario. I love writing essays and I make great narratives in my essays so I could demolish that aspect (plus I have a great Rocky-like against the odds type story), my science and math stats are formidable, I would only need Ochem1 and 2, Physics 1 and 2, Biochem, and statistics maybe calculus, so like 2 more semesters or courses as prereqs to do. It just seems the grander goal... I am not sure though, part of me thinks, hey, 4 more years of school before a residency then maybe 3-5 more, I mean time is gonna go by anyway, I might as well pursue something really challenging and full of depth and rewarding while I am living, no? But the other part of me thinks that I should just stick with my current plan of getting ADN then starting work as nurse while I get my RN-BSN and get employer to pay for it and then do same for MSN NP or PA. Just not sure what will bring me more satisfaction in long run, What do you guys think?

chempansy · Nov 2, 2020

1 hour ago, MDBoy said:

Good for you adamm. And you enjoy it so far and find it fulfilling working in that role? What are some of the aspects that are the things that you find most appealing about that job?

As for me, I am just beginning my assoc. degree RN program this January however when I think about it, even the process of applying to med school sounds pleasant to me. I am outgoing, and charismatic and articulate + possess a good command of language so I always do very well in any interview scenario. I love writing essays and I make great narratives in my essays so I could demolish that aspect (plus I have a great Rocky-like against the odds type story), my science and math stats are formidable, I would only need Ochem1 and 2, Physics 1 and 2, Biochem, and statistics maybe calculus, so like 2 more semesters or courses as prereqs to do. It just seems the grander goal... I am not sure though, part of me thinks, hey, 4 more years of school before a residency then maybe 3-5 more, I mean time is gonna go by anyway, I might as well pursue something really challenging and full of depth and rewarding while I am living, no? But the other part of me thinks that I should just stick with my current plan of getting ADN then starting work as nurse while I get my RN-BSN and get employer to pay for it and then do same for MSN NP or PA. Just not sure what will bring me more satisfaction in long run, What do you guys think?

If I were in your position, and I had the time/energy to dedicate to becoming an MD/DO, I would just pursue it now. It would set you back to pursue something else. You still seem every much passionate about it. And you might regret it later if you realize that nursing isn’t what you think or isn’t “challenging” enough or whatever. You’re thinking about a lot of things: nursing vs MD/DO vs PA.

It’s definitely easier to transition from nurse to nurse practitioner. However, you would need to take extra courses/standardized tests for MD/DO/PA. Not to mention the extra training and education (especially for med schools paths). I know you said you wouldn’t have a problem having to take those classes or the tests. But it all just takes more time and more money. At the end of the day, it depends on what you’re comfortable doing and where you truly see yourself at. It’ll save you a ton of headache and stress if you can figure that out now before pursuing anything.

DrCOVID, DNP · Nov 3, 2020

22 hours ago, MDBoy said:

you enjoy it so far and find it fulfilling working in that role? What are some of the aspects that are the things that you find most appealing about that job?

Yes. I am very happy. NPs can be completely autonomous, have great mentors and own their own business. That was my main goal. More than money or work location, I just wanted to be on my own. Being a nurse was very difficult, as nurses can be really catty and divisive as you see on this forum often. The PMHNP role in the west is nearly identical to that of the psychiatrist. I have talked with and worked with several now. Yes, there are some caveats especially in IP states. But my mentor owns her own practice (NP) and talks to her collaborating once a month or when needed.

If I were in your shoes, didn't have a degree or BSN/RN yet - it sounds like you really like learning and aren't jaded to school or care much about the extra time or money - I would go to medical school and do the HPSP military scholarship. Nursing will be for a long time faster and less rigorous and more restricted overall.