Ep #90: Starting Nurse Practitioner School: What We Wish We’d Known with Anna

Welcome to Becoming a Stress-Free Nurse Practitioner, a show for new NPs and students that want to pass their board exam the first time and make that transition from RN to NP as seamless as possible. I’m your host Sarah Michelle. Now, let’s dive into today’s episode.

Sarah: Hey friends. It is me and Anna here again today and we’re going to finish up this little series we’ve been doing over the last few weeks where we talk about some things we wish we had known at different points of our NP journey.

And so we’ve talked about things we wish we had known before graduating. And we’ve talked about things we wish we had known before clinicals. And now we’re going to take it even a step before that and talk about things we wish we had known before we ever started nurse practitioner school.

And so the very first thing out of the top of my mind to talk about are just all the different paths to becoming a nurse practitioner because it gets very confusing to try to talk to students and be like, “Oh, you could be a DNP, but you could also be a master’s degree prepared nurse practitioner.” And so there are all these different ways you can go and I think the easiest place to start was my own path because it was very unique.

And so I got my bachelor’s degree in nursing. And then I decided, hey, I want to teach someday, I love to educate, let me get this master’s degree in nursing education. So this had nothing to do with being a nurse practitioner at all at the time. But when I finished up that degree, my employer was paying for school and they announced that they were about to stop paying for school.

And so I was like, okay, I want to go to nurse practitioner school. What’s going to be the fastest way for me to do that? And the fastest way was actually for me to get something called a post-master’s certificate. So I am a post-master’s FNP, which means that I got to skip some of the classes in this master’s degree program because I already had a master’s degree in nursing education.

And so what I actually got to skip was the three Ps. But because of that, it saved me a lot of time and I got to jump right into clinicals. Now, Anna, what about your path? How did you get here?

Anna: So I would say I took the more traditional path.

Sarah: Yeah, I took a weird path.

Anna: Yeah, I graduated nursing school, I worked as an RN. And then I did kind of decide on a whim. I always knew I wanted to go back to school, I thought maybe teaching, maybe being an NP. I didn’t really know. And then it was like, well, why not go to nurse practitioner school? And my husband was about to deploy, he was in the military at the time and I was like, well, I need something to do while he’s gone to not drive myself crazy.

And so I applied to nurse practitioner school. And I applied directly to an MSN program for my FNP. And I think I started my application the week before it was due. I think I had six days or something to get everything in, my letters of rec and everything. But it worked out very well for me. So yeah, I just started out as a nurse and applied for my MSN FNP program.

And I did it all online because, again, my husband was in the military at the time and so I didn’t know where we were going to be living, or kind of what our next couple of years looked like. And so I specifically looked for an all-online program.

And what I really like about the path I took, and there’s no wrong path for you, by the way. So anything that you are thinking of is totally the right choice for you. But I wasn’t 100% sure what I wanted to do. I knew I liked being a nurse. I could see myself working in a clinic. I could see myself teaching. And going the nurse practitioner route really opened up a lot of doors because I could really do any of those things.

Sarah: So how long did it take you time-wise?

Anna: So I did it full-time. It was a little crazy, I did full-time work and full-time school for quite a while and it took me two years. And I did through the summer programs as well. So I had a summer semester, a fall semester, and a spring semester full-time.

Sarah: Yeah, where I cut out the three P’s, I only had to do a year and a half, because I’d already done the three P’s as part of my master’s program. Which is why those post-masters certificates can be enticing because they really do speed up your process if you, of course, already have that degree.

And then the path that neither of us took was going the doctorate route, which traditionally takes at least three to five years.

Anna: Yeah, and my sister-in-law actually has her DNP and she went from RN to MSN, and then she actually went back to school later to get her DNP which is something I haven’t quite decided if I want that for myself.

Sarah: Yeah, I’ve always been like one foot in, one foot out on that.

Anna: Yeah.

Sarah: I’m like I want the title, I want the extra education, but do I have the time to commit? That’s always the hard part. And I do think there will be a wave of the future where we’re trying to push away right now from associate’s degrees into bachelor’s degrees, but that’s been a long time and that still has not been successful. So I think that will come in the future for having your doctorate as a nurse practitioner, but I don’t think we’re there yet. And so maybe I’m just biding my time on that one.

Anna: Yeah, I feel like if I go back for my doctorate, it’ll be very similar to my master’s program where I just decide on a whim and I just start it.

Sarah: Just go.

Anna: Yeah.

Sarah: I’m looking for a WGU style DNP.

Anna: Yeah.

Sarah: Have you heard of Western Governors University? Know much about it?

Anna: Yeah, I have heard a little bit about it. But for anyone listening who doesn’t know, do you want to explain?

Sarah: Yeah, so I went to WGU to get my master’s in nursing education, actually. And the way it works there is super unique, it’s called competency-based. And so you can actually open up a class and if you can pass the test on the first day, I mean, it’s proctored, of course. So you actually have to know your information. But if you can pass that exam on the first day, you don’t have to take the class because you literally just have to show your competency.

And I would love, love, love that kind of option for my doctorate. So if anyone out there knows something like WGU where you can get your doctorate, please let me know because I would be all about it. I love school if you can’t tell.

Anna: Always learning. I feel like that’s one thing about nursing, is we are always learning and there are always so many different opportunities. That’s kind of another thing before starting NP school that kind of overwhelmed me, was all the different specialties that you can go into.

Sarah: So many.

Anna: Because when you look at med school or you look at PA school, they go in and they start school first and then after school is kind of when they can decide what specialty they want to work in. Whereas with NP it’s a little bit different. You go to school for a specific specialty.

So you can go the Family Nurse Practitioner route. Or the other one I was really heavily considering was the women’s health nurse practitioner, a WHNP, which there are not as many programs for. But that was another route. I know, one of my past preceptors was a neonatal nurse practitioner. There’s primary care, acute care, there are so many different areas that you can go to.

Sarah: Yeah, and I really like, you know, when I was thinking about going to nurse practitioner school and trying to decide because I was really torn between FNP and psych for me personally. I liked the flexibility of the FNP degree because I feel like with FNP if I wanted to do a little bit of women’s health, in Kentucky I could do that. Not everywhere do you have that capability to kind of bend a little bit and kind of ebb and flow in that way. But I felt like psych was going to limit me down a lot more.

However, on the flip side, because there’s so much less psych nurse practitioners out there, there’s a really high demand for them. So you kind of pay for it in the trade.

Anna: Yeah, absolutely. And that is ultimately why I ended up going the family nurse practitioner route instead of women’s health. My women’s health preceptor throughout school was a family nurse practitioner. I had a preceptor who used to work in pediatrics and she was working asthma/allergy, and she was a family nurse practitioner.

And so I just saw these people and I was like, okay, there are so many different routes I can go. And if I ever don’t want to work in women’s health or I ever don’t want to work in a specialty, I can go to primary care or I can switch and do this. So I did like that flexibility that was kind of in front of me in the state that I lived in at the time.

But you’re right, a lot of – When I was in clinicals I fell in love with pediatrics. I never thought I would because I did not like it as a bedside nurse. But I loved being in a pediatric clinic. However, a lot of them are looking for pediatric nurse practitioners.

So yes, a family nurse practitioner can. My peds preceptor was a family nurse practitioner, but I think it would be a lot easier if I knew that’s where I wanted to stay.

Sarah: Yeah, and for perspective, the last time I was looking at the stats, and it’s been a hot second, I believe it’s like 75% of the nurse practitioners licensed today are licensed in primary care. So that’s either FNP or AGPCNP. And kind of like you, Anna, I had no idea until I actually got into the clinical rotations how much I liked the AGNP side of things and how much I like geriatrics, ironically. The kids, I was always a little bit stressed out about, to be honest. But I really enjoyed geriatrics.

So I think if I had known ahead of time how much I would have liked it, I probably would have gone the AGNP route and kind of narrowed it down a little bit. But I’ll always like the flexibility of FNP.

Anna: Yeah, I think now looking back at it, I chose the right one for me because although I didn’t love just my primary care clinics, I loved all the different specialties. I love peds. And I love women’s health. And I love the asthma/allergy rotation I did. I found myself really liking those little niches you can get into. But I like all of them. And so that’s kind of ultimately what made me stick with that family nurse practitioner route.

Sarah: Yeah. Now, I think the next thing that I wish I had known before I had gotten into nurse practitioner school, I didn’t start thinking about board prep until the end. And by the end, I mean like my very final semester I’m like, okay, I’m going to get a book, I’m going to do some practice questions.

I remember I was teaching clinicals at the time and on my lunch break I would sit and do practice questions every day because that was me as a person. But I never thought about actually utilizing board prep courses while I was in school. And now, running this company, I’m just like I don’t want to say I was dumb, but what a missed opportunity.

Anna: Yes. I started studying my last semester as well. And I literally started studying, like I didn’t do anything in depth at first, for the first half of the semester. All I did was I had some courses that I could listen to on my phone. I had an hour drive to clinical, or 45 minutes, something like that, and I just listened to them in the car as I drove. That is all I did.

And it made such a big difference for me in clinicals. It’s like I showed up to clinical and I felt so much more confident because I was like, oh, I do remember this. Or I was just reviewing this or just listening to this. And it showed me how much more I did know that maybe I just didn’t realize or I had forgotten. And even though it wasn’t like super in-depth board prep like I did those six weeks before my exam, it made such a big difference in that last clinical rotation.

Sarah: Yeah, well there’s a lot to be said about learning some mnemonics and some memory tools. And just the confidence that comes along with doing auxiliary courses in addition to just having a different perspective from how you’ve been taught in school. So then when you walk into those clinical rotations, just like you were talking about, you’re like I was already learning about this, I just listened about this, I know this mnemonic. And you can really start to piece it all together.

I think that’s really, at its core, what board prep should be. You’re piecing the things together you’ve already learned. You’re building up that confidence so when you go and take that exam, you’re ready. You don’t even have to think about it, you’re just ready.

Anna: Yeah, really that board prep course I was listening to, it helped me tie it all together. And then right alongside that my clinical rotations then helped solidify that information as well because I’m hearing this, I’m studying for boards, I’m listening to it. And then I go into the clinic and I see a patient who was diagnosed with diabetes and this is what we’re doing. And now I have something that I can relate it to.

And so it just helped really tie it all together. You got that whole big picture. And I wish I had started that my first semester of clinicals.

Sarah: Yeah, it makes me think about the one class in nurse practitioner school, ironically peds, that I got a B in because I’m like, if I’d had a good board prep course, I could have probably tied it all together. What a missed opportunity for me.

Anna: Yeah, it kind of reminds me of one of my very first preceptors who literally sat me down and was like, “You need to go back to med-surg.” And okay, granted, this was like my first day of clinical ever. So I’m like a deer in the headlights, I don’t know what to do, I’m petrified. But maybe if I had shown up and been a little more confident, she would have been like, “No, you’re fine.”

Sarah: Confidence is hard.

Anna: It is so hard, especially just that very first one you don’t know what to expect and you’re scared. And that preceptor was a little bit intimidating. And I can say from personal experience, like having that med-surg experience was not a necessity for me. It really wasn’t.

Sarah: Something I really like to establish when people come at me with that, because it’s like it’s a pet peeve of mine, to be honest, is that being a nurse practitioner and being an advanced practice provider and being a registered nurse are two totally different jobs with two totally different types of liability and two totally different types of responsibility.

And so is it helpful to have been a nurse first and know how to talk to patients and know how to manage your time and prioritize and delegate, all those things? Yes. But being a nurse practitioner is an elevated role that you’re going to have your own learning curve for and it doesn’t matter if you’ve been a nurse for one year or you’ve been a nurse for 25 years, you’re still going to have that same learning curve because you’re a provider now.

When you were working as a nurse, you were carrying out the orders of a provider. But now you are the person who is responsible for putting in the orders, setting the plan of care, all of the things. It’s just totally different.

Anna: Yeah, it is 100% different. It seems like, yes, a little bit of that nursing experience helps. Like I said, I have a full background in women’s health. I worked a variety of women’s health roles as a nurse. And so when I went into my women’s health NP clinicals, I at least did feel a tiny bit more confident going in there.

 I was like, okay, I know how to read this rhythm strip already. Or, okay, I know what all of these different methods of induction are so I can talk to this patient a little bit quicker or a little bit more comfortably. But that doesn’t mean that I wouldn’t have learned that in that clinical rotation and gotten that confidence throughout.

And so you don’t have to have experience in all these different areas because, like you said, it is a very different role. And no matter what, starting out as an NP even if I did women’s health, it was going to be a learning curve. And it was going to be a shock for me still.

Sarah: Yeah, absolutely. All of my clinical rotations in their own ways were learning curves. Like each individual place had its things that I had to figure out how to overcome. And every place works a little bit differently. And so you just have to kind of go in with that always learning mindset that we were just talking about, too.

Anna: Yeah, absolutely. And I know we talked about this on our last episode. But that’s part of why getting a variety of sources for your clinicals is so helpful because you learn so many different things along the way. And an area that you might not have thought was your thing, you might love.

Sarah: Absolutely. And I think the biggest thing I wish I had known before nurse practitioner school, which might surprise some people, is that I should have put more emphasis in the beginning on making friends or finding some sort of online support community. Because if you’re doing an online program, and most nurse practitioner programs are completely online right now, it gets very isolating very fast.

And you want people to bounce ideas off of. If you’re struggling in clinical, you want somebody to talk to about it who is going through the same things. There’s this big confidence hurdle that you’re going to go through as you go through your clinicals and as you become a provider, and you want somebody there kind of alongside you that is feeling those feelings with you. And you can kind of build off one another and talk to each other and support one another.

And at the beginning of my nurse practitioner program, I had made two friends, but they both went the psych route. So I was kind of deserted for a little while. And it was really hard to almost keep my motivation to keep going in school because I had no one to feed off of, like what do you think about this instructor or this?

But I ended up finding a friend named Shelby halfway through and it totally changed the game for me. It made school so much more fun. Like everything was so much more enjoyable. We prepared for boards together, all the things.

Anna: Yeah, I was so fortunate in that aspect that if I hadn’t had a friend start it with me, I would have learned this along the way. But I never had to find that out on my own because I had a really good friend that I worked with who we both lived in Colorado, we worked at the same hospital. And she is actually who got me to apply to school.

And that’s kind of why I applied on a whim. She was like, “Oh, I applied to NP school, the application is due next week.” And I was like, “Oh, I’ll apply to NP school with you.” And so I kind of applied with her. And we worked on our application essays together, like literally days before the application was due. And we went through the whole program together.

And that was so nice because we had projects coming up, we could talk about them. Even I remember once we were in our peds rotations around the same time and she would message me like, “I have looked at 20 kids’ ears today and I still don’t know what I’m looking at. What am I doing? Why does my preceptor probably think I’m so dumb?” And it was just someone that you could relate to, like, yeah, I’ve looked at 20 ears and it took me weeks until I felt comfortable diagnosing an ear infection.

And so having that person who you could just relate to who was going through it at the same time you were, it was just huge. It was so nice. And then someone also that you could just celebrate with at the end when you get through it and you’re graduating. And then you’re applying for jobs at the same time. Just having that support is so nice.

Sarah: And while it would be really convenient to find someone in your program, I know it can be intimidating online to try to make friends. And so it doesn’t have to be someone in your program. We have a Facebook support community with literally 30,000 nurse practitioner students and nurse practitioners in there that just feed off of one another all the time.

They’re like, I have this assignment, what do you think about this question? Or what do you think about this over here? Or I’m preparing for boards, I’m making this plan. And so there are other ways to find that support too. So it doesn’t have to be someone in your program, but obviously I think that’s the most ideal.

Anna: Yeah, and I mean, if you’re having a hard time finding somebody in your program, I guarantee you there’s someone in that program on our Facebook page. I wish our Facebook page existed back when we were in school. Having something like that would have been so, so helpful.

But, like I said, luckily I got very lucky that I had just one friend that I did it with. And so we at least could text each other and hang out with each other while we were doing assignments or whatnot. But finding that online community or just some source of support and someone you can relate to, is so big.

Sarah: Yeah, I can’t imagine if I had had our Facebook community when I was a student, what a game changer that would have been. Because I felt like I was just aimlessly wandering around on the internet right before my boards. I’m like, what are other people doing? What are other people talking about? What is this review? Because in my school we didn’t talk about board review courses. That was something you did on your own. So it was just really, I felt like I was a little bit lost during that time. And if I had had that extra layer of support, it would have been really, really nice.

Anna: Yeah, I was very lost, very lost throughout that whole process. And the thing is, so were my classmates. So even though we had a little class Facebook page for whatever class we were in, nobody knew. Nobody had experience studying for boards. Everyone was doing something slightly different.

And so having a supportive, established community of people who maybe have been through your program, or are in the same shoes as you or maybe one semester ahead of you, just being able to relate to them and reach out and have that support. And the level of NPs who are in there, like you just have a content question, there is support there. It would have been a game changer for sure.

Sarah: And one little shameless plug for our Facebook community. One of my biggest pet peeves about Facebook groups is that you can’t get that reputable support. And so we have actual true nurse practitioners, full-time people in that Facebook group responding to those questions and all those things, so you always know. Okay, yes, are you getting other student answers? Of course, but you’re also getting a reputable answer from SMNP, too, which I think is a big deal. And there’s not really any other Facebook group out there that does that.

Anna: No, there’s not. And I would have just done so much for that during school, of finding that support and those reputable answers instead of just being like, well, what do you think? Well, I’m kind of guessing it’s this. Okay.

Sarah: A free nurse practitioner to answer my questions on Facebook? Yeah. Wild.

Well cool. I don’t think I have anything to add. Do you?

Anna: No, I think that about covers it.

Sarah: Well, thank you guys for listening along. I hope you’ve enjoyed this little mini-series. If any of you out there have any ideas for future mini-series or possible interviews, we are all ears. But we will be talking to you guys soon. And hopefully we see you in our Facebook group, or you can come join us on our Instagram and TikTok. We’re basically building communities there too. So we are everywhere all the time. Look for us at Sarah Michelle NP Reviews. Talk to you next week.

As an extra bonus, friends, if you’re looking for support no matter what phase of your nurse practitioner journey you’re currently in, I have communities available for both students and new nurse practitioners. In these communities, we work to uplift one another and grow this profession together every single day. Links to join will be included for you in the show notes.

Thanks for listening to Becoming a Stress-Free Nurse Practitioner. If you want more information about the different types of support we offer to students and new NPs, visit https://www.npreviews.com/resources. See you next week.