Congratulations, if you’re reading this you are probably considering applying for grad school! You are also probably as confused as I was about which program you want to apply to. There are a huge variety of grad programs to choose from with endless possibilities for your future career. It is confusing, overwhelming, but also extremely exciting. Nursing is a dynamic profession and you can truly create your dream job. Are NP and APRN the same thing? Pretty much…there are 4 APRN (advanced practice registered nurse) roles: certified registered nurse anesthetist (CRNA), certified nurse-midwife (CNM), clinical nurse specialist (CNS), and certified nurse practitioner (CNP). I can only speak to the CNP (NP) role but can always provide resources for the others. After deciding you want to be a nurse practitioner, you then choose which population you want to work with e.g. adults, children, neonates, families, psych, etc. This graphic is a good overview:
Then, decide if you want to work in acute or primary care. Acute care ~ think hospital setting and sick kids. Your work hours will probably include nights, weekends, and holidays. Primary care ~ think doctor’s office or clinic and relatively healthy kids. Typically the hours are your normal office hours with few (if any) nights, weekends, and holidays. Primary care also includes Family NP, Women’s Health NP, Psych NP etc.
As a registered nurse (RN), you can work with any population in any setting. This includes inpatient, outpatient, infants, children, adults, labor and delivery, psych, critical care, OR, ED, PACU, etc. However, once you pick your APRN role, you can only work with your specific population in your designated acuity. I am in a pediatric acute care program, meaning I can only take care of children less than 21 years old in an acute care setting (inpatient/hospitalist services, ICU, ED, specialty clinics etc.). I used to think as an acute care NP I could also work in any primary care setting too. Wrong, I can’t. Most hospitals across the US are now strictly following the regulatory model and only hiring based on acute vs primary certification. This does vary by state but will only get stricter as more acute care programs become available. I know in some states you can still get hired into an acute care setting with a primary care degree since there are so few acute care peds programs. However, in Michigan, hospitals now won’t hire any primary care NPs into the hospital and vice versa (this doesn’t mean you still won’t find primary care NPs working inpatient, they were just grandfathered in before the regulatory model). The scope of practice for each setting is extremely individualized. This makes it especially challenging to choose a program if you are not completely sure about what age and area you enjoy the most. You can also dual enroll if you want to do both acute + primary care or pediatrics + midwifery for example. Here are some of the programs offered: + Leadership (MSN).
Once you decide your APRN role, population, and acute or primary care, think about going part-time or full-time. MSN or DNP route? Do you want your program online, on-campus, or a hybrid? All the programs listed above can typically be done part or full-time and as either MSN (Master of Science in Nursing) or DNP (Doctor of Nursing Practice). I go part-time because I also work part-time. Going part-time obviously takes longer but allows you to make money while going to school. I am also in the DNP program, which too takes longer but is considered a terminal degree in nursing, meaning there is nothing higher to achieve. MSN is 2-3 years while DNP is 3-4 years. In addition, my program is pretty much all on-campus. I don’t live in the same city as my school anymore but don’t mind the commute since it’s only a few days each week. My time in grad school is four years post my five years in undergrad.
Should I work while in grad school?
Yes, if you’re like me and didn’t have extensive nursing experience prior to starting. The experience I get from working is invaluable and complements almost everything I learn. Working as a nurse gives you a strong foundation in pharmacology, pathophysiology, and patient health assessments (the 3 core-advanced-Ps required for an APRN program). It is also recommended to work with your desired population, so I only applied to pediatric jobs (ICU and general care). I think working with adults would have had some benefit but a peds job gives me hands-on learning and better supports my curriculum. I also need to pay for school at the same time. However, what differs for each person is how much you want to work…I started grad school at 28 hrs/week and went down to 24 hrs/week once I started clinicals last fall. Some of my friends still work full time (>30 hrs/week) and others are contingent picking up shifts when available. A lot of employers have tuition reimbursement which is an added incentive. It all depends on your financial situation and how much time you need to devote to school alone. Even if you only work for your first year or so, I recommend it. That way, if you didn’t work as an RN at all before applying, you will still have some nursing experience before graduating.
Should I choose DNP over MSN?
It depends on what your end goal is. Whichever you choose, you will be applying for the same jobs at first. Most NP job descriptions require at least an MSN. A lot of times they are looking for either an advanced practice provider (APP) ~ NP or PA (Physician Assistant) but are usually never looking for a DNP alone. This may change in the future, but it hasn’t quite yet. I chose DNP because I didn’t want to go back to school later on. If you are considering teaching at all, choose the doctorate. However, they are now offering more Post-Master’s DNP programs which are shorter and allow you to work as an NP before applying. I was also offered a scholarship for choosing the BSN to DNP option so that was a huge factor. Despite the added year, it is worth it to me to just finish all my schooling now. Either way, at this time you will get the same starting job with either degree.
Should I choose online or on-campus?
My pre-covid answer: I think it depends on if you want to relocate and have the means to do so. I am a loyal supporter of my university and just started a new job in the same city. I wasn’t super interested in moving out of state at the time and I learn better sitting in class. These two factors alone made it an easy choice to go on-campus. Other factors include the relationships you can make with your professors, getting close to your cohort, and the school coordinating your clinical placements. Not having to find my own clinical placements was a huge plus. I didn’t have the time or energy to search for my own, and I heard a lot of my friends having trouble finding good sites. Some universities offer online-only programs with several on-campus sessions per semester. Online is great if you love where you live and work. They are also best if you have a busy schedule and want to do schoolwork on your own time without having to drive anywhere. More and more programs are offering hybrid-programs, which could be the best of both worlds. My post-covid answer: You’ll probably mostly have virtual classes for at least the next year, so think ahead of what your options may look like when universities transition back to on-campus class.
I hope this helps! You can’t go wrong with advancing your career in nursing 🙂