So you want to be a Nurse Practitioner?

np

First let me say that Nurse Practitioners (NPs) play a valuable role in our health care system.  As nurses with clinical expertise from years of experience working with patients and advanced educational training, NPs have a lot to offer patients, healthcare teams, and organizations.  NPs are awesome and job opportunities for nurses in this role are increasing, in part because they are a more cost-effective healthcare resource than general physicians.

However, in talking to nursing students, reviewing scholarship applications, and entering survey data from new graduate nurses, I have noticed that everyone and their dog seems to want to be an NP.  I have also fielded lots of questions from people about how to get into the NP program, mainly “what GPA do I need?” and “what’s the minimum amount of experience I need before I apply?”   Another thing that I have noticed is that many people who did not choose nursing as their first career choice wanted to be doctors which makes me wonder if some people see nursing only as a means to become an NP, under the misconception that NPs and doctors are pretty much the same thing.  Let’s unpack this a little bit.

1. We need more NPs but we need way more nurses.  I hate to bust your bubble but from a resource planning perspective we need way more RNs in the workforce than NPs.  It’s actually more competitive to get into nursing and Canadian NP programs than medical schools. To boot, in Ontario you are only allowed to apply to one program per year so if you don’t get in (which is highly probable), better luck next year.

2. If you don’t want to be a nurse, do something else.  This may seem ironic coming from someone who’s career goal is to becoming a nursing professor but I wholeheartedly love being a geriatric rehab nurse and if I didn’t care so much about the bigger picture I would be happy to work full-time as a staff nurse.  I believe that most nurses who become NPs really want to make a difference in that role and I admire that.  However, I think that one of the things that makes the NP role so valuable is the wealth of nursing experience that people bring with them.  You can’t skip that part and if you don’t like getting your hands dirty working in the trenches, perhaps you should reconsider your career choice.   After all, chances are pretty good that you will work as an RN rather than an NP for most of your career.  There are also tons of other people who would love to be a nurse and you are taking their spot.  I’d also like to point out that if you wanted to be a doctor and end up working as a staff nurse you might end up really hating your job and being resentful.  Maybe not the best life choice.

3. 2 years of experience is not enough for most people and who cares about your GPA, really.  Some of my research work is on new graduate nurses and we consider a new graduate nurse anyone with less than 2 years of nursing experience (and sometimes even 3 years or less).  Patricia Benner also outlines the stages of development from beginner to expert nurse, stating that it takes about 3 years to become competent and at least 5 to become an expert.  Given that we know that it takes several years to develop nursing expertise, it baffles me that nursing schools allow nurses with a minimum of 2 years of clinical practice to apply to their NP preparatory master’s programs.  Moreover, it concerns me that some people are in such a rush to become NPs without considering the amount of responsibility that comes with their new role and the benefits of having more experience (to their patients as well as themselves).  There are exceptions I’m sure but I really think we need to reconsider the minimum experience requirements, especially considering that there is high demand for NP education.

While I’m on the topic of NP education, I don’t think GPA is necessarily a good indicator of an excellent nurse or of someone who will make a fantastic NP.  That isn’t to say that you can’t have a high GPA and also be an awesome clinician.  My point is that there are amazing nurses who are highly knowledgeable and skilled, with high levels of emotional intelligence and leadership skills that may not have achieved a 4.0 in their undergraduate nursing program.  I don’t think we need to throw the baby out with the bathwater here because the NP program is demanding and rigorous but it would be nice to see other elements included in the application process.  In real life it doesn’t matter what your GPA was if you have limited social skills or can’t apply the knowledge that you learned in a meaningful way.

Before you jump on the “I want to be a Nurse Practitioner” bandwagon, I hope that you will take some time to engage in self-reflection about where you are in your career and what skills, knowledge, and experience you have to offer, as well as areas that you want to develop further.  Just because you have a perfect GPA and can apply to an NP masters program after 2 years of working  doesn’t mean you should. Not everyone is cut out to be an NP and being an RN can be as rich and rewarding a career as you want it to be.

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Why I Love Working with Older Adults

older ladies

During my undergraduate nursing degree, many of my colleagues were passionate about working with children or pursuing the excitement of the emergency department.  To be honest, I wasn’t really sure where I saw myself working when I graduated but luckily, I found the perfect spot.  I work in Specialized Geriatric Services on a rehabilitation unit. Like all nursing specialties, it can be challenging and hard work at times but it is also extremely rewarding to be part of the healing journey.  Going to work still makes me feel like I won the lottery!  I get to help people who are mostly amazing and I get paid for it?  How lucky can a girl get?

When I think about it now, it seems obvious that I work in geriatrics.  In my past life as a personal trainer I helped run a cardiac rehab program, taught fitness and aquafit classes for seniors, and worked with many older clients.  I grew up in Nova Scotia which is pretty traditional in a lot of ways and I think that has also had a profound influence on me.  I enjoy reading, gardening, and quilting (among other things), and I cringe at the thought of living in a fast-paced city like Toronto or having to drive more than 15 minute to work.

Seniors have perspective, life experience, and many also have wisdom.  Some are full of colourful stories.  Seniors tend to value people and experiences more than material wealth (to be fair, I also have a lot of young friends who share these values).  Many of them appreciate a good conversation or a listening ear;  they live in the real world, not the mind-bubble of their smart-phone.  To be sure, there are grumpy old people and some who are not doing so hot (just like any other age group), but generally I find older adults to be kind, sincere, and appreciative.

I think that all nursing programs should have a core course devoted to seniors.   Not only are they wonderful people to work with but their physiology is different (e.g. responses to medications are different than healthy young adults which drugs are tested on) and they face unique psycho-social challenges that younger people don’t think about like losing your independence and living on a fixed income.   I learned a lot about aging during my kinesiology degree but I am really keen to further my expertise in this area and recruit more nurses to this wonderful area of nursing practice!

Wishing you a Happy Canada Day!

-Emily