Deciding on whether or not to pursue a career as a nurse practitioner can be a daunting task. One thing that can help make the decision easier is learning from the experiences of professionals in the field, who have already obtained degrees in nursing. To that end, we were fortunate to have the opportunity to interview David A. Boley II, MS, ANP-BC. David is currently pursuing a Ph.D at Johns Hopkins University, while also working as an adult nurse practitioner. His educational experience, coupled with his personal knowledge of the field, offers excellent insight into the career of a nurse practitioner.
- When you were evaluating schools for your MSN degree, what factors did you value as most important?
- What courses did you have to take to obtain your MSN, and how did they prepare you for your career as a nurse practitioner?
- What type of nursing did you decide to focus on, and why?
- What are some of the challenges you face day-to-day as a nurse practitioner?
- Technology has changed many things in health care; how do you utilize technology as a nurse practitioner?
- Most NPs have obtained a master’s level of education; what advantages are there to obtaining a PhD?
- What organizations typically employ nurse practitioners, and how should new graduates go about finding them?
- What do you think are the career advantages to being a nurse practitioner as opposed to a different kind of medical professional?
- What skills do you consider to be essential for success as a nurse practitioner?
- What is one piece of advice you’d give to someone deciding to start a career as a nurse practitioner?
1. When you were evaluating schools for your MSN degree, what factors did you value as most important?
When I was evaluating schools for my MSN degree there were three main factors that I was looking for:
- An accelerated, graduate-entry degree program
- A large university setting
- A respected nursing program with a reputation of excellence
First, the school had to offer an accelerated program. I had a liberal arts bachelor’s degree, which I knew was good enough to get me into graduate school, and I knew that I wanted a degree in a true profession. Since I had some school loans and had already completed a bachelor’s degree I really didn’t want to enter into a BSN program. So, it was really important for me to find a school that would “convert” my bachelor’s degree into an advanced professional degree.
The second factor was the size of the school. I was a nontraditional student during undergrad, which meant that I was a little bit older than most other students and, since I had a career, I also took a lot of night classes. I always felt as though I missed out on the undergraduate experience. So, when I started comparing nursing programs, it was extremely important that the school had a large student body, and was dedicated to student involvement and leadership.
Finally, I wanted a school with a reputation for excellence, tradition, and success. I wanted to be sure that graduates from the program passed the certification exams a a high-rate. You know, deciding to become an NP is a big, life-changing commitment to the future. It takes a lot of money, intellectually challenging work, sometimes grueling clinical schedules, and personal sacrifice. I fully believe that my future is shaped by my present choices, so I wanted to be educated in an inspiring environment, with vast resources and renowned success.
2. What courses did you have to take to obtain your MSN, and how did they prepare you for your career as a nurse practitioner?
The curriculum, all the courses that make up the educational plan for NP programs, is designed to meet standards set by professional organizations that create and maintain the licensing, accreditation, certification and education (L.A.C.E) processes for advanced practice nurses. So, if the school is accredited, every class you take prepares you to think critically, provide direct individual and population-based care, and fulfill administrative role functions. I took classes in research, policy and finance, ethics, professional development, nursing theory, diversity, and health promotion. Of course there were also plenty of classes focused on advanced assessment, objective measurement and therapeutic treatment planning, including pharmacology.
More importantly though, incoming students have to be aware that the requirements for obtaining license as a nurse practitioner can , and do, change. Right now, this a hot topic. By the year 2015, professional boards will require the Doctor of Nursing Practice (DNP) as the entry-level degree for nurse practitioners. The Masters degrees will be awarded to nurses who practice in non-patient care related roles. More information about this and other nursing eductaion topics can be found at the website for the American Association of Colleges of Nursing (AACN)
I’m an Adult Nurse Practitioner and my focus is on health maintenance, illness prevention, and care or rehabilitation after illness or injury in community care clinics. I will see patients as young as 16-17 and as old as old can be (It helps that I have a close relationship with an adult-gerontology NP)! Of the various career paths that NPs have to choose from, Pediatrics and Women’s Health, just didn’t appeal to me, which also meant that the family nurse practitioner option wasn’t right for me either. As a former Field Medical-Service trained Hospital Corpsman in the US Navy and Emergency Medical Technician with a Level II Trauma Center, I felt I had had enough experience with the more “edgy”, intense options like acute care or anesthesia. I found the perfect niche in the slower pace of a community clinic. I enjoy the extra time I have to get to know my patients, teach them, and work with them to develop a care plan that fits into their lifestyle.
As far as work is concerned, I suppose I face the same challenges as other people on a day-to-day basis. I think that the most persistent challenge is keeping up with and maintaining my knowledge base and my credentials. It’s also challenging to fulfill the multiple roles of an advanced practice nurse. Not only do I practice in a clinic, but I also have an active research career, and am a Certified Nurse Educator. So, making sure that I always have an activity that is related directly to one of those roles is challenging. Keeping them balanced is another story! But, all other things aside, my greatest challenge when I’m in the clinic is staying on time.
5. Technology has changed many things in health care; how do you utilize technology as a nurse practitioner?
I have an affinity towards technology. In fact, any one of my colleagues would probably tell you the same. So for me technology has always been an important part of my nurse practitioner training and career. In clinical practice, my smart phone is my greatest resource. I keep an extensive library of reference books on it, which I use frequently. In the classroom, I use all of the traditional tools (e.4k, PowerPoint, blackboard, virtual classrooms, etc.) and look for ways/opportunities to integrate newer forms of technology into the learning experience. We have yet to fully realize the learning potential of social media and web 2.0 technology in the classroom. The technology I use in the lab is “other-worldly.”
6. Most NPs have obtained a master’s level of education; what advantages are there to obtaining a PhD?
With the introduction of the DNP, the advantages of obtaining a Ph.D. have never been clearer. The advanced practice nurse with a Ph.D. has a research focused career. One that is aimed at generating new knowledge through carefully designed, scientific studies. There is an intense amount of study involving the history and philosophy of science. Ph.D. students also study, in great detail, the theories that have guided discovery in nursing and the behavioral sciences for decades. Studying the philosophy and theories from various scientific disciplines gives Ph.D. prepared nurses breadth and depth of knowledge that informs their research designs and can ultimately lead to the creation of new theoretical frameworks that explain symptoms, disease states, and human responses to the same.
7. What organizations typically employ nurse practitioners, and how should new graduates go about finding them?
Nurse practitioners can be found working in a variety of job settings. A great place to start is USA jobs, which allows you to search for and monitor federal jobs across the country. Additional web-based job services such as Career Builder, Monster, or MedHunters also provide job listings. Although, I find many of them are duplicated across services. Another option is to check with the local nurse practitioners association in your state or the state you are interested in working in. Above all, it’s important to remember that many of the best jobs aren’t publicized. So, it’s important to network with other medical professionals and build strong relationships during your clinical rotations. Many of my colleagues were hired straight out of school by the hospital or service they precepted with.
8. What do you think are the career advantages to being a nurse practitioner as opposed to a different kind of medical professional?
Autonomy. Unlike many other medical professionals, nurse practitioners can practice independently. Having autonomy to practice independently of a physician is crucial to the further development of the nursing profession. NPs approach patient care in a manner that is distinctly different from any other profession and without full autonomy that approach is stifled. While it’s true that some states have more limitations on NPs than others, a great deal of progress has been made in this area.
The single greatest skill that a primary care health care provider can have is the ability to coordinate care across multiple organizations. Patients have the right and should be encouraged to visit or be seen by any provider they choose. Therefore, it becomes essential for the nurse practitioner to ensure that all of those health-care visits are documented and duly recorded in the patients’ medical records.
10. What is one piece of advice you’d give to someone deciding to start a career as a nurse practitioner?
Enroll in a school that offers the Doctor of Nursing Practice (DNP) degree and go for it!