Q and A

Nursing as a Second Degree: A Friend’s Question

The other day, my cousin reached out, telling me she had a former classmate who was considering nursing and wanted to know more about the program I am in. I emailed her, and we had a good conversation about how to get into nursing as a second degree. I get a fair number of questions about second degree nursing, so I thought I’d share!

(Also, feels like a good time for an academic question as I am wrapping up the semester! Woot woot!)

Thanks for reaching out! I’m looking for something possibly accelerated. I’m really unsure of where to go at this point since so have a background in Psych. I hold a Batchelors degree and haven’t found fulfillment. I’ve been considering PA or NP, just trying to figure out the best route. My hospital provides reimbursement for my classes. I have one course left before I can apply for the RN program. What do you suggest? Did you have another degree and decide to go back or were you an RN first?

Great! Thanks for your background. Super helpful!

I was really fortunate in that I knew I wanted to be either an NP or PA at 17. I did not know what PAs did between undergrad and graduate school, so I chose nursing. Maybe not the best logic, but it’s worked out for me! I worked as a nurse for about 4.5 years before going back to school, and I’m glad I had all the time that I did. I was able to save up a bit of a nest egg before going back, and between that, other savings, and tuition reimbursement, I’m paying for graduate school out of pocket.

When it comes to PA v. NP, it’s a blurry line. Functionally, PAs and NPs do basically the same thing. The only differences lie in schooling and licensing. PAs always have to have medical doctor supervising them. They could not start their own free-standing clinic, which in theory NPs can. However, that varies by state. Wisconsin has a limited license for NPs compared to other states, so I too will have to have a supervising doctor. This can be pretty loose, though. For instance, the NP I have clinical with is independent and has an MD who looks over a couple cases a quarter and is available for questions via the system’s instant messaging system.

For schooling, PA school is very hard to get into. A bunch of the people I work with are trying to get it, and I know only 1 has succeeded this year so far. NP school is easier to get into, but you need to know your specialty area before going in. NPs can be midwives, nurse anesthetists, family practice, adult-gerontology, acute care, pediatrics, or psych. I am in a family program since with schooling I can work with patients from birth to death. However, we tend to focus on outpatient and family practice clinic information. I want at this point to work in an Emergency Department after graduating, so I will have the schooling to work with birth to death, but we are not taught as much critical care information as an acute care program does. Acute care NPs (ACNPs) work in hospital settings, ICU to wards. FNPs can work in a hospital, but cannot work in the ICU unless they have a bajillion certifications.

PAs, however, can work anywhere within the health care system with any kind of patient. I know I want to get out of a hospital. I know kiddos are fine but not all the time. I like people awake, I don’t want to birth babies, and psych is not my forte, so I’m not mourning the loss of not being able to do anything else. FNP is a great fit for me. PAs are also Masters programs whereas NP programs are moving to DNPs (Doctorate of Nursing Practice). Many Masters programs still exist, but they are phasing out. And Mayo (for example) as already said that DNPs are preferred candidates for jobs, so as a 29-year-old with a least 30 years of work ahead of me, I’m getting the DNP.

That’s awesome that you have tuition reimbursement! Many hospitals will do so. Mine offers $7500 a year, regardless of full-time status, so I am working part-time (but enough for full-time benefits) and going to school full time. Wherever you end up going, looking for a hospital for tuition reimbursement is great.

A program my friend is in is the Bachelors to MSN program at Marquette University. There are also new MN (Masters of Nursing) programs. From my understanding, a girl I know who is is graduating from an MN program is having difficulty with NP school admission because the MN is a newer degree. If you’re going to get a Masters from a non-nursing bachelors, I would go the MSN route. Marquette also offers a direct entry MSN NP program for Associate Degree Nurses.

I like my program, but I would not describe it as accelerated. My program started in the spring and I’ve been taking full-time classes. It will end up being 3.5 years until I graduate. I am eligible to take my boards before graduating though since clinical ends a semester before I graduate and my last semester is implementing a project. What I like about it is that it is made so you can work and get your degree. It’s blended, so half is online and half in person. I’m more at the in-person part of the program, and all our classes are stacked on Wednesdays so I’m able to work 20-30 hours a week. It’s a bit hard with clinical now, but I’m making it work and somehow still sleeping with a bit of a social life.

There’s also a ton of online programs that my co-workers are using like Walden and Remington College of Nursing. Those tend to be more accelerated.

Whew. That was a lot and likely a little confusing. The thing with health care is that there’s a million ways to do it, and it’s really up to you. I have personally enjoyed being a nurse before an NP because I have gotten a ton of experience and knowledge. I also love my colleagues, many of whom know I am in school and let me learn on patients. There’s not one perfect way to become an NP. There’s not a perfect way to become a PA, if that’s what you want to do either!

Hope it made sense and was helpful! Let me know what else I can help you with!

There is an ADN program I can apply to here. Im going to try that and also apply for the accelerated batchelors. Either way I want to work while I’m school since I don’t really have the means not too. If I get the ADN I would likey get hired on..(fingers crossed) and try to put away money to bridge. Ultimately I want to have a doctorate if I go the nursing route. Thanks again for emailing me! Hope everything is going well for you and your program!

I think you have lots of time to figure it out, and sometimes you don’t until later on. I know I have no idea what I want to do as an NP, but I knew enough to pick my program, and that’s good enough. Getting experience and trying out different things is sometimes the best option because then when you’re in a particular program, you know what you’re getting into.

Let me know if you have questions about anything else! Best of luck to you!

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