From CNA to Family Nurse Practitioner

A Family Nurse Practitioner Talks About Her Career Path and Education

Shannon R. is a Family Nurse Practitioner living and practicing in the state of Nevada. She attended Vanderbilt University School of Nursing and graduated with her Master of Science in Nursing Family Nurse Practitioner Specialty and a 4.0 GPA. She is a Licensed Advanced Practice Nurse: Certified Nurse Practitioner in Nevada, a licensed Registered Nurse in Nevada, APRN Board Certified by American Nurses Credentialing Center and is a Certified Legal Nurse Consultant (CLNC).

In the Beginning

I had a previous college degree, a bachelor's in Psychology. I had also knocked out a bunch of Medical School and Physical Therapy School pre-requisite requirements. I really didn't know, at that point, what I wanted to do. I had thought about Medical School, PT school, Physician Assistant school and nursing school.

"As far as being in family practice forever, maybe, I like the variety of patients."

My Mom was a nurse. She always told me that I should go into nursing, but after college I had narrowed it down to becoming a Physician Assistant (P.A.). Though I did not know the difference between a PA and a Nurse Practitioner. I met with an advisor at a Nursing School in the city where I was living. She explained to me the difference and really emphasized the fact that as a nurse practitioner you can always fall back on nursing. She pointed out that there will always be a demand for nurses if mid-level practitioner (NP or PA) demand falls. The advisor was very convincing and I chose the nursing path.

Back to School

I went to the local community college and completed a Certified Nursing Assistant (CNA) program. I began working in a medical center as a CNA where I assisted patients with activities of daily living, ambulation and primary care nursing. I then took a position as an Apprentice Nurse Providing direct patient care to patients pre-operatively, post-operatively, and in a skilled nursing environment. During this time I completed my BSN. I was one of those second degree BSNs.

I completed my BSN and got licensed as a registered nurse. I worked in the intensive care unit (ICU) of a local medical center for a very short period. I knew I wanted to go straight into a master's in nursing program. Working in the hospital was not the right fit for me. Long hours and shift work was not for me and a major reason why many other nurses choose to go back to school and get their MSN.

I worked as a registered nurse at Vanderbilt Medical Center while completing my Master of Science in Nursing Family Nurse Practitioner Specialization program. I was working in the Neurology, Pulmonary, Orthopedic, and Stallworth Rehabilitation Hospital Pediatric Units. I provided direct patient care to patients of various ages in a rehabilitation environment. I also supervised LPN’s and technical staff. This was all great work experience which has carried over to my current position.

Family Nurse Practitioner Specialization

I chose the Family Nurse Practitioner specialization since it was the most broad. My rotations covered pediatrics, women's health, family practice and internal medicine. I wasn't really in the hospital at all. I figured if I wanted to specialize in cardiology, urology or different area I could get on the job training at another time. Some nurses in my BSN class knew then that they wanted to work in cardiology when they were done with their BSN or specialize as a nurse practitioner, so they would work in telemetry to gain the experience. I did not see myself in family practice forever, but the broad training in family practice allows for such a large scope of practice that I could work in pediatrics if I wanted to. A Nurse Practitioner specialized in Adult Nurse Practitioner can't work in family practice because they can't see kids. I figured there would be more jobs as a Family Nurse Practitioner.

Looking Toward the Future

As far as being in family practice forever, maybe, I like the variety of patients. There are many career advancement opportunities for a Family Nurse Practitioner and things are looking like they could be even better in the next few years. For one, there is legislation in Nevada for Nurse Practitioners that if passed would allow for independent practice. There are only a few states that allow Nurse Practitioners and Nurse Midwives to practice independently. In the state of Nevada a Nurse Practitioner can practice almost independently. An NP still needs a collaborating licensed physician, but that physician need not be on site just reachable by phone. This is an exciting career option for many nurse practitioners.A friend of mine is originally from Alaska whereshe says it is mostly Nurse Practitioners and Midwives running the clinics. It works.

The Doctor of Nursing Practice has also become quite popular. The growth in popularity of DNP programs can only help the Nurse Practitioner profession by lending a greater credibility. Some Nurse Practitioner programs have implemented residency programs that take one or two years to complete. Residency programs, I believe, again offer greater merit to the profession.

Nurse practitioner residency programs were brought to the table in lieu of the medical residency cap on hours laws that were passed around six years ago. Now Nursing schools are creating these residencies for advanced practice nurses to follow their education and provide them with the initial practice focused training under supervision of a current nurse practitioner. Residents are salaried and placed in an environment where they are exposed to intense and continually more autonomous situations that prepare them for what is expected of them following residency.

The Doctor of Nursing Practice has also become quite popular. The growth in popularity of DNP programs can only help the Nurse Practitioner profession by lending a greater credibility.

Medical residency caps on hours have created many NP jobs. When I finished my MSN program I worked at the Children's Hospital in Chicago doing inpatient. The position I had was created by the caps set on medical residency hours. I filed in by doing rounds on their patients before or after surgery, which allowed the medical residents could spend more time, for example, in the operating room and not exceed their hours. As a result there are more opportunities in the hospital for those NPs that want that type of work. Other hospital opportunities exist as well. An example is a local group of hospitalists that have been hiring NPs. For me, I chose not to work in the hospital due to the long hours, weekend and night shifts.

For now, I am happy working in a family medicine group practice where I provide comprehensive health care to patients of all ages. It is a fast paced environment and I am able to see a variety of patients, which keeps it interesting.

Professional Advice

Get the best grades possible whether you are presently in high school, college or nursing school. Nursing schools have wait lists and entrance is very competitive for pre-licensure. While in school, join the student nurses association. Join your local and national professional nursing organizations. Being a Family Nurse Practitioner may be for you and it may not be. Do your research. There were many nurses in my BSN program that had no idea what nurses actually did. Make sure you know what you are getting yourself into. It is a lot of hard work, but extremely rewarding work.

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