There are many considerations that went into my decision to become a nurse practitioner. And to be honest, it wasn’t an easy decision at all. It’s not like picking your outfit for the day. This is, after all, what I will be doing the rest of my life. It’s also a huge investment ($110,000 to be exact) so I didn’t make the decision lightly. I also fluctuated between pursuing medical school, PA, or NP.
Here are some elements of the nursing role that contributed to my decision to become a NP (and some explanation as to why NP over PA). . .
The Holistic Approach
If you’ve done any research at all on nursing then you’ve read that we take a “holistic approach” to care. But what does this mean? And more importantly, what does this mean for NPs? In hindsight, I was still a bit unsure what this meant until I was fully submersed in nursing school and was able to live it and breathe it.
It means that nurses and NP’s take the whole patient into consideration, not just the current illness, disease process, or affected organ.
We consider all determinants of health when diagnosing and determining a plan of care. Where does the person live? How is their stress level? Do they have resources like a car, family support, insurance, and a job? How is their diet? Do they live in a food desert? What is their home environment like? Are there possible toxins, pollutants, or allergens that may contribute to their disease state? Do they have spiritual needs that need to be met? Are they struggling with anxiety or depression that may have led to their current state?
We strive to heal the person as a whole, not just the body part or organ.
It makes then sense that NPs specialize by population (pediatrics, women’s health, family, etc.) and not by body part or organ (dermatology, orthopedics, neurology, etc.).
The first step to becoming a NP is becoming a RN first. I’m in a program at Vanderbilt that fast-tracks to the NP role, but I am still becoming a nurse. The first year of the program is strictly RN material. We complete 700 hours of clinical experience as bedside nurses in the hospital and we sit to take the NCLEX to obtain our RN license. This is such an advantage in the clinical setting. I cannot imagine progressing to a provider level without gaining the bedside manner, experience, and skills that accompany nursing.
There are many things that NPs learn that many PAs do not, such as start IVs, draw blood, insert Foley catheters. . . Some PA’s may learn this depending on what setting they are in, but ALL NPs learn this no matter what. While this may sound like a small detail, it is huge for traveling abroad to help with disaster relief, working in global health, and all are useful trades for broadening our scope of practice.
NPs have more autonomy than our PA counterparts. In some states, NPs do not even need an MD to work under – meaning NPs can start their own practice. PAs are required by every state to be supervised by a licensed physician. They are, essentially, what their title suggests. . . The assistant to the physician. I’m not sure if this is something I will ever do. But it sure is useful for NPs who have years of experience and are fit to work independently. Plus, it’s nice to have this option if I one day do decide to start my own clinic.
Serving the Underserved
One fabulous thing about being a NP is that our care is more affordable for patients. As someone who wants to work with underserved populations locally and abroad, this was essential for me. NPs have the ability to provide stellar healthcare at an affordable price. . . Which to me is just straight up ethical and good for humanity.
Who are we kidding. . . the pay has something to do with me choosing this career. I have friends who started at $90k/year after graduating. And they work a 9-5 schedule, four or five days a week. Doesn’t sound half bad to me:)
If you’re even slightly considering the NP role, get out and shadow, make phone calls, ask around. . . Get more and more exposure to what the career entails. Do research on the salary, required schedule, job opportunities and outlook. Take a holistic approach to choosing your career and take all of your circumstances into consideration.
And please do not be scared off by this not being the career you wanted since you were five. Not all of us had the luxury of knowing our calling by preschool! I went back and forth between MD, NP, PA for about six months – a year. NP just happened to be the best choice for me.
As a nurse, we have the opportunity to heal the heart, mind, soul and body of our patients, their families and ourselves. ~ Maya Angelou